M-RCBG Senior Fellow-Led Study Group: Alexandra Schweitzer

Perspectives on Social Determinants of Health

Study Group Session One:  SDOH and Primary Care
September 25, 4:30-6:00, Taubman 301

Study Group Session 2:  Successful Housing and Health Integration:  The Right Care, Right Place, Right Time (R3) Model
February 5, 4:30-6:00, Taubman 401

Many studies suggest that more health care costs are driven by social factors --commonly referred to as Social Determinants of Health or SDOH -- than by medical care itself.  It’s both intuitively obvious and supported by evidence that inadequate nutrition, housing, and transportation make it difficult or impossible for some people to follow healthy diets, manage chronic conditions, engage with primary care, and avoid unnecessary emergency room and inpatient utilization.  

Despite years of pronouncements that health care spending is unsustainable, it continues to grow.  As the health care system adopts “value-based care,” health care organizations (HCOs) have a powerful incentive to improve the “upstream” social factors that affect “downstream” care – particularly when that care includes expensive avoidable emergency room and inpatient hospital utilization.  The industry has embraced the proposition that addressing SDOH might help control cost and utilization, as well as improve patients’ quality of life.  Health plans, health systems, hospitals, and other HCOs are actively creating and participating in initiatives to address SDOH.

While the link between inadequate nutrition, housing, or transportation and suboptimal health and use of the health care system is obvious, it is much less clear how to address the social barriers to health.  This series of study groups will explore foundational challenges, and how successful SDOH initiatives address them, from a variety of perspectives.  Future sessions will cover:

•    Housing and health integration
•    Hospital investments in SDOH
•    Human-centered design in SDOH

Session 1: SDOH and Primary Care (September 25)
This session will be a discussion with Julita Mir, MD, Chief Medical Officer, Community Care Cooperative (Medicaid ACO) and Rushika Fernandopulle, CEO and co-founder, Iora Health. 

Our topics will be:
•    Introduction to SDOH
•    Patient stories
•    The SDOH challenges that primary care providers encounter
•    Challenges and opportunities for primary care to address SDOH
•    Primary care’s role in addressing SDOH, vs. other sectors
•    How reimbursement helps or hinders primary care’s ability to improve SDOH, individually and globally.

Session 2:  Successful Housing and Health Integration:  The Right Care, Right Place, Right Time (R3) Model (February 5)
This study group will highlight an innovative local model to integrate senior care into affordable housing.  Hebrew SeniorLife's R3 initiative provides comprehensive services to promote health and reduce avoidable hospital and emergency room utilization.  It addresses social influencers of health, including safe housing and loneliness.  Exciting features of this three-year-old program include its effective collaboration across sectors, rigorous evaluation of results, and plan for sustainability.

The session will provide cross-sector perspectives on the following questions:
•    What motivated each organization to launch / participate in the R3 program?
•    How do they define and measure program success?
•    What are the results to date?
•    What factors have driven the program’s success?
•    What lessons can they share for other organizations investing in SDOH programs?

•    Alexandra Schweitzer, Senior Fellow, Mossavar-Rahmani Center for Business and Government, Harvard Kennedy School
•    Kim Brooks, Chief Operating Officer, Senior Living, Hebrew SeniorLife
•    Marc Cohen, PhD, Professor and Co-Director, LeadingAge LTSS Center@Umass Boston; Research Director, Center for Consumer Engagement in Health Innovation, Community Catalyst
•    Gregory Davis, Senior Vice President EMS Operations, Transformative Healthcare, Fallon Ambulance Service
•    Denise Kress, M.S, GNP, BC, CHIE, Vice President, Care Management for Senior Products, Tufts Health Plan

Alexandra Schweitzer headshot photoAlexandra Schweitzer is expert at leading complex new ventures and transformation initiatives from strategy through successful execution.  She combines entrepreneurial passion and drive with the ability to navigate through large organizations and alliances, balancing mission and business discipline.  Her systems perspective is grounded in deep senior leadership experience as a P&L owner, a product portfolio manager, a client services executive, and the head of departments and teams with multi-million-dollar budgets.  Her health care sector experience spans payers, providers, state government, and specialized analytics and managed care organizations. Population health strategist and builder:  Alexandra has built and led value-based integrated systems of care, including tools to address social determinants of health, in innovative accountable care and provider-payer organizations, including: i) A “partnership model” Medicaid ACO under the new Massachusetts delivery system reform program; ii) Iora Health, a venture capital-backed startup nationally known for its relationship-driven, technology-enabled care model, predominantly for Medicare Advantage members; and iii) The Tufts Health Plan Senior Care Options (SCO) program for dual eligible seniors, which she built and ran.  Practical strategic planner:  As a business leader, a consultant, and a hands-on not-for-profit board member, Alexandra has led the development of numerous mission-critical strategic plans.  She emphasizes broad input from stakeholders, alignment of mission and financial goals, and a strong focus on execution to achieve results. Innovative board leader:  Alexandra is the Board President of Goddard House, an assisted living residence in Brookline, MA, where she is driving a major organizational transformation to develop innovative programs serving isolated seniors in the Greater Boston community.  As a LeadingAge board member, she initiated and led a cross-sector workgroup to promote tightly-integrated programs using affordable senior housing as a platform for health.  She was the Board Vice Chair of the Visiting Nurse Association of Boston and led their strategic planning committee. Alexandra has a Master’s in Public Policy from the Harvard Kennedy School and a B.A. in English and American Literature from Brandeis University.  A lifelong learner, she has completed an executive MBA at Columbia University and certificates in strategic selling, large account management, and project management. Her research project as a senior fellow is entitled, Addressing Social Determinants of Health: Why Some Initiatives Thrive and Others Don’t. Her faculty sponsor is Dutch Leonard, George F. Baker, Jr. Professor of Public Management at Harvard Kennedy School, and Eliot I. Snider and Family Professor of Business Administration at Harvard Business School. Email: aschweitzer@hks.harvard.edu