Latest / Becker’s Healthcare Podcast / Leading Medicaid Through Change and Uncertainty with Crissy Turino

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Leading Medicaid Through Change and Uncertainty with Crissy Turino · Becker’s Healthcare Podcast

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  - The strategic agenda facing hospital and health system
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  - So join us November second through the fifth
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  - upper right.
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  - Hi, everyone. This is Elizabeth Cassello with the
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  - Becker's Women's Leadership podcast.
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  - I'm thrilled today to be joined by Chrissy
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  - Torino, COO of CountyCare. Chrissy, thank you so
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  - much for chatting with us today. Thank you
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  - so much for having me. I'm thrilled to
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  - be here. Of course. So before we jump
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  - in, can you fill us in about your
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  - health care background,
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  - a little bit more about yourself, and your
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  - current job at CountyCare?
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  - Absolutely.
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  - So
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  - I had a little bit of a circuitous
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  - journey to into health care.
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  - I,
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  - began at a for profit rural surgeon's office
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  - in a small town in Illinois, and folks
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  - would call in daily from the community
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  - experiencing challenges with being able to access dental
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  - care.
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  - And there was actually a phone number posted
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  - at each of our desks.
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  - I answered phones, and so we would refer
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  - folks that, were patients that they didn't have
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  - insurance or they couldn't pay for,
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  - some of the procedures at that oral surgeon's
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  - office. And it was actually for a health
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  - hotline,
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  - a nonprofit organization that helps people
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  - access health care, navigate the health care system.
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  - And I began volunteering there, and then shortly
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  - after,
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  - about three months after I was hired on
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  - to oversee that hotline, a small group of
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  - community health workers that provided advocacy and case
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  - management support,
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  - and helped people apply for Medicaid, hospital financial
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  - assistance, prescription programs, and this was before the
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  - Affordable Care Act. So it was a lot
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  - of piecing different programs together for folks when
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  - they needed it.
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  - And I really witnessed the negative impacts of
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  - disinvestment
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  - and the lack of access to food, to
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  - health care,
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  - housing, and other health care,
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  - needs and and health related social needs.
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  - So
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  - I
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  - after about three years working with that within
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  - that position, I moved to Chicago to pursue
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  - my master of public health, my MBA,
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  - and it was really with this goal of
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  - taking a systems approach
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  - and improving our health care system and implementing
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  - policies that would improve the lives of our
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  - members, our patients, and, community members.
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  - So now I serve as the chief operating
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  - officer at CountyCare Health Plan. We're a Medicaid
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  - health plan owned by Cook County Health serving
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  - about 375,000
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  - Cook County residents, and really privileged to carry
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  - out a lot of that systems work
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  - with the aim of improving health outcomes and
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  - equity.
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  - And CountyCare is owned by
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  - Cook County Health,
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  - which is,
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  - a large health system
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  - in the Cook County area,
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  - including two hospitals,
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  - a group of ambulatory clinics, the Cook County
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  - Department of Public Health,
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  - and then also
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  - CountyCare Health Plan, which is where which is
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  - where I work. And,
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  - we're the only
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  - government owned and only provider led Medicaid managed
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  - care organization in Illinois. So I have direct
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  - leadership,
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  - over the plan wide strategic planning cycle, our
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  - member and provider operations and experience and growth.
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  - And I've had, you know, the opportunity across
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  - my career to be able to work in
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  - a variety of settings within an outpatient clinic
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  - and a nonprofit organization and
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  - an academic research center,
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  - and,
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  - now in a cover county government sponsored Medicaid
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  - plan. So all of those positions have really
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  - been focused on improving health care equity and
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  - access.
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  - So I was told as we were lining
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  - up this interview that when you were in
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  - grad school, you got your health coverage through
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  - CountyCare. So what do you remember about your
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  - coverage experience at the time, and how has
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  - that shaped your leadership?
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  - Yeah. So I moved to Chicago in 2014,
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  - as I mentioned, to pursue my Miles per
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  - hour and my MBA.
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  - And I was attempting to complete both of
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  - those degrees within two years. So I was
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  - working part time as a research assistant, and
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  - I had been, you know, previously helping people
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  - apply for Medicaid, so I knew I qualified.
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  - And I actually signed up for CountyCare and
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  - for Medicaid
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  - about two years after the plan started. So
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  - the plan started in 2012
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  - under an 11/15 waiver. We had this opportunity,
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  - and this is before, of course, before I
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  - worked at the health plan.
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  - But the health plan had the opportunity to,
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  - sign folks up through the Medicaid expansion,
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  - and brought on about a 100,000
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  - folks really rapidly,
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  - at that time in 2012.
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  - We've come a really long time and a
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  - long way since then,
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  - but I was so fortunate to have coverage
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  - at that time. I went through
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  - a really
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  - challenging
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  - health scare
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  - that made it, you know, so important that
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  - I had coverage, that I could go and
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  - get support from quality providers that just, at
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  - that time, wrapped wrapped around me.
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  - And,
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  - so it's so important that that coverage is
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  - there for folks. And as,
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  - we're now anticipating
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  - large changes to the Medicaid program, I actually
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  - would have been one of the individuals that
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  - would have had to go through,
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  - and, you know, work requirements and more frequent
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  - redeterminations,
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  - due to those changes.
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  - Yeah. I would love to just ask as
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  - a follow-up, what's front of mind for you
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  - as you navigate these upcoming changes,
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  - when it comes to the expansion population?
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  - Yeah. Absolutely. I'm really happy to answer that
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  - question.
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  - We know that the majority of people who
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  - are going to have to go through the,
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  - process of showing that they meet work requirements
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  - are actually either working or would otherwise qualify
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  - for an exemption. So the majority of them,
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  - about 77%,
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  - would already qualify for,
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  - some kind of exemption.
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  - But just due to, you know, the bureaucratic
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  - nature and the additional administrative requirements that will
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  - be required of them.
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  - Many of them will not get through that
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  - process.
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  - Our team is working to,
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  - really pull together
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  - in different areas to ensure that we have
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  - a broad communications
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  - plan.
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  - We're,
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  - lucky to be part of this larger health
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  - system that has been bringing together,
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  - different community based organizations,
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  - providers,
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  - payers,
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  - to
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  - come together and really unify and support folks
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  - through these changes.
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  - So,
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  - that group has,
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  - it's called the Medicaid Impact Work Group. Cook
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  - County Health has been the convener
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  - and, have already created, the getmedicaidfax.com
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  - website. We're creating a lot of communications in
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  - support of our members,
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  - and our providers and really anyone that are
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  - help, that are helping organizations,
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  - that are supporting the same members,
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  - and patients that that we are. We also
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  - have events,
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  - about five days a week in the community.
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  - So over the last year, we've hosted about
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  - 250 events,
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  - and we'll be there for the community for
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  - those that need support in person.
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  - We are partnering with different community based organizations
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  - that, we maybe didn't partner with previously,
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  - but are doing a lot of work around
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  - workforce development, making sure that they are aware
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  - of our events, we're able to collaborate with
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  - them, and then training our staff and bringing
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  - together a group of ambassadors,
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  - who will be able to get the word
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  - out.
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  - And so, really, we're we're looking to build
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  - upon our experience after the public health emergency
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  - when we had to kind of have all
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  - hands on deck,
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  - and,
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  - and ensure that folks are are getting the
• 8:32
  - coverage that, they qualify for.
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  - So in your experience as a leader at
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  - CountyCare, what do you think makes a really
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  - strong Medicaid plan leader, especially in today's day
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  - and age as so much is changing so
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  - fast?
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  - I think what makes a really strong Medicaid
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  - leader is someone who can
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  - fully balance mission
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  - with operations
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  - and public policy and changes that are coming
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  - from a regulatory standpoint.
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  - There's such a need for adaptability. We're constantly
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  - getting
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  - new requirements that come out,
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  - either from the federal government or through,
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  - the states.
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  - And,
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  - you know, we, of course, need to be
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  - there in support of our members when there
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  - are things like the public health emergency and
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  - during COVID nineteen,
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  - different regulations and funding challenges.
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  - So remaining agile,
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  - really resilient,
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  - and being open to kind of working through
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  - those changes with a cross functional team is
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  - really important.
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  - Of course, being really mission driven
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  - and being able to kind of inspire teams
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  - to work from their strengths.
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  - And lastly, kind of leading through that ambiguity,
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  - which I was kind of mentioning,
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  - wherever possible, supporting the team to kind of
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  - bring clarity when there's uncertainty
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  - until you can get to a point where
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  - you really understand the requirements
• 9:58
  - and,
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  - being able to develop, you know, new programs,
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  - and new changes.
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  - So I know a lot of health system
• 10:06
  - leaders listen to this podcast as well. So
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  - I feel like in that environment, we've been
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  - seeing some shifts in terms of what the
• 10:13
  - COO role looks like. In your experience, how
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  - has your role evolved over time?
• 10:20
  - Yeah. As you mentioned,
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  - there are a lot of different kind of
• 10:24
  - rising pressures. So
• 10:26
  - increased scrutiny and federal and regulatory concerns around
• 10:30
  - program integrity.
• 10:32
  - There's been
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  - increased utilization
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  - and fiscal challenges and as I as we
• 10:37
  - had talked about kind of these forthcoming challenges
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  - to the Medicaid program.
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  - So I think,
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  - with all of those challenges,
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  - they also lead to opportunities. So there's this
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  - opportunity for us to
• 10:51
  - look at all of our operations under a
• 10:53
  - bit of a microscope and and make some
• 10:55
  - decisions about, am I doing this the most
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  - efficiently, the most cost effectively,
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  - and find improvements,
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  - in ways that that,
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  - you know, still
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  - are are working towards improving the quality of
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  - the services that we provide.
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  - There's also kind of this opportunity, I think,
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  - in,
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  - in these times of,
• 11:17
  - these really challenging times to to build more
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  - connections, like I mentioned, through the Medicaid impact
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  - work group.
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  - There are sometimes these moments where,
• 11:26
  - there's a challenge, but it's really unifying and
• 11:29
  - bringing together lots of folks across sectors
• 11:32
  - to come towards,
• 11:34
  - really fulfilling a need and a common goal.
• 11:38
  - So for our audience of women's leaders, I
• 11:40
  - would love to just hear what advice you
• 11:42
  - have for others in health care.
• 11:45
  - So my advice is that we
• 11:49
  - are stronger together. So
• 11:51
  - wherever possible to kind of look to mentor
• 11:54
  - and build teams
• 11:56
  - that are really mission driven and with individuals
• 12:00
  - that care deeply about
• 12:02
  - your population
• 12:03
  - and that can bring their unique talents,
• 12:06
  - really looking to building upon their strengths and
• 12:09
  - ways that you can motivate them and support
• 12:11
  - them.
• 12:12
  - And then, also, I think
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  - something I've really been working working on and
• 12:17
  - working towards is
• 12:19
  - finding deep relationships with different mentors and finding
• 12:22
  - mentors that are,
• 12:24
  - able to to bring kind of their gifts
• 12:27
  - and their perspectives and experiences,
• 12:30
  - and I've been very lucky to have mentors
• 12:33
  - that have been willing to, you know, kind
• 12:34
  - of share their their time and wisdom with
• 12:36
  - me. And,
• 12:38
  - that's been
• 12:39
  - really, really helpful, especially as we're, you know,
• 12:42
  - kind of in in these challenging times in
• 12:43
  - in health care and finding ways that,
• 12:46
  - we can look towards solutions together.
• 12:49
  - Well, Christy, thank you so much for taking
• 12:51
  - the time to chat with me today. Thank
• 12:53
  - you so much. I really appreciate it. It
• 12:55
  - was such a pleasure. It was great having
• 12:57
  - you. And to our listeners, if you'd like
• 12:59
  - to hear more podcasts from Becker's Healthcare, you
• 13:01
  - can visit beckershospitalreview.com.
• 13:04
  - Thank you.