100 INFLUENTIAL MINNESOTA HEALTH CARE LEADERS
Mark Steffen, MD, MPH Vice President and Chief Medical Officer | Blue Cross and Blue Shield of Minnesota
David Thorson, MD Entira Family Clinics Challenges: Conversations should be about delivering health, not
Challenges: Two of the greatest areas for opportunity are
collaboration and equity. Minnesota has fantastic health care providers, managed care organizations, and public health systems however these often operate in silos and aren’t always designed in ways that are easy to use or that support the most vulnerable populations. Strategies: We are focusing our efforts on reinventing the health care system through value based partnerships designed to more efficiently and effectively address the needs of all the populations we serve through intentional, data-driven, patient and community centered design.
health care. We need to encourage collaboration between medical providers and public agencies. Social determinants of health need to be addressed to decrease cost and improve health. The centralization of health care through merged vertically integrated systems has not delivered on its vision of decreased cost with increased quality. Strategies: Entira Family Clinics has a foundational goal of being high quality and low cost. We accomplish this by maintaining our independence and referring to likeminded subspecialists. Our physicians have a broad scope of practice (including OB) and we evaluate, identify and implement best practices. Entira Clinics are also certified Health Care Homes to address social determinants and bridge the gap between clinics and community resources.
Anne Stephen, MD
Paul Thurmes, MD
Chief Medical Officer–East Market | Essentia Health
Executive Vice President | Minnesota Oncology
Challenges: Providing preventive care amid the pandemic will be an ongoing challenge for months to come. To keep our patients and staff safe, we need to ensure social distancing. That means having fewer people in hallways, lobbies, and clinics. We are working on creative ways to keep people safe and still get all the
Challenges: Cost and complexity are challenges in cancer care.
care they need. Strategies: We deliver some patient care via telehealth, but we can’t screen for cancer
properly or administer immunizations virtually. We have set up special locations for immunizations to reduce the number of people who are in our clinics at the same time. We screen every patient who comes in for colonoscopy, mammogram, and cervical cancer tests for COVID 19 and practice safe prevention guidelines.
These include high drug costs driven higher by 340B pricing structure and a proliferation of high-cost services. Novel therapies provide opportunities to change the trajectory of a patient’s disease, but also add complexity and cost to care. Strategies: We collaborate with payers and providers to deliver the best care that is also cost-sensitive. We intervene early to help patients define their goals and expectations. We have implemented tools for real-time symptom identification, and have structured our workflow to address symptoms before they spiral out of control. Our oncology-specific EMR integrates patient characteristics, staging, and molecular/genetic information to guide our use of evidence-based and cost-effective therapies.
Paula M. Termuhlen, MD
Jakub Tolar, MD, PhD
Regional Campus Dean | University of Minnesota Medical School, Duluth Campus
Dean | University of Minnesota Medical School
and accessible care. The health disparities that many communities of color experience are ones that we are called upon to tackle. Disparities in quality of care and accessibility of care also vary by region. In Minnesota, this includes rural and urban settings.
Challenges: Health care faces the same challenges that our society does in recovering economically from COVID-19: jobs lost, many people uninsured. During the pandemic, many people stayed home and put off important preventative care. This puts our most vulnerable populations—the elderly, the underserved, those with chronic health issues—in a very difficult place.
Strategies: As a medical school, we are called to teach our students about the social determinants of health that impact the experience and accessibility of care. We have new curricula under development to help our learners gain deeper understanding of their patients in both rural and urban settings and understand the public health impact of structural racism.
Strategies: In academic medicine, we combine scientific research with clinical care to help identify and solve the problems we see in our medical practice, in our community, in our health care systems, and in the kinds of treatments needed to help people. This has allowed us to improve care and outcomes in COVID-19. Our role is to move medical care forward and train the next generation of caregivers.
Challenges: One of the biggest challenges is to provide equitable
John Thomas,
MD, MBA Otolaryngologist | M Health Fairview
Challenges: Meaningful payment reform. The current payment system is a straightjacket on any attempt at innovation. Several colleagues and I developed an alternative model for ENT delivery pre-COVID that would have been more convenient and safer for patients, less expensive and more satisfying to us. What killed it? According to our legal counsel, it was ahead of its time because it would be impossible to implement given the current payment system. Strategies: After running up against an ossified payment system, I decided to throw
in the towel on private practice and joined a large system for now. In my opinion, the business healthcare has become far too complex and requires professional managers to handle the regulatory burden. I am still looking for ways to innovate and disrupt.
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NOVEMBER 2020 MINNESOTA PHYSICIAN
Mark Traynor, JD, MA President and CEO | UCare Challenges: The biggest challenge is ensuring that individuals and
families living at or near poverty, particularly from communities of color, are able to access care and supportive services. COVID19 and economic disruption have exacerbated inequities and gaps while impacting the financial resources of providers, social service organizations, and government partners when they are most needed. Strategies: We invest in programs and collaborations with providers, social service organizations, and government partners to clear the path for our members to access needed care and supportive services. For our members on Medicare and our MNsure plans, we also have provided premium discounts and waived copays for primary care and mental health services.