By: Mary Jane Osmick MD and Jaan Sidorov MD
March 26, 2020
As the unprecedented coronavirus pandemic continues to evolve, the Population Health Alliance has been closely following the growing reports of and debate about the reopening the US economy. Choosing the right timing to take this action requires a medical, public health and scientific understanding of how to equitably and ethically care for, prevent, or slow the spread of the virus for all our citizens while protecting our front-line workers on whom we depend. Yet, at the same time, we also need to find a way to navigate the choppy waters of US economic stability. This navigation requires a well-defined and clearly stated data-driven strategy that provides all Americans the required knowledge and hope to overcome the pandemic and return to economic prosperity.
There is ample research evidence to suggest strong links between overall health, chronic illness, mortality and economic instability. Based on PHA’s national leadership role on health equity and social determinants of health, we find the latter a critical consideration. Nearly half of the US population can ill-afford job and wage loss, having little or no ability to absorb even a small catastrophe. Now, families are being pushed into precarious economic situations, asked to social distance, school children at home, work remotely or not at all – at no fault of their own. The anticipated financial blows from the pandemic can and will lead to significant housing instability, food insecurity, loss of personal safety and access to necessary health care and other social determinants, all of which are amplified by the anxiety and stress of an unpredictable collective future.
For your consideration, we offer a timely and nuanced discussion of this topic in a paper by McKinsey & Company entitled “Safeguarding our lives and our livelihoods: The imperative of our time”. Find the article and exhibits at this link.
Above Chart is Exhibit 2 from “Safeguarding our Lives and our Livelihoods: The Imperative of our Time” ©1996-2020McKinsey&Company
In the paper, authors Sven Smit, Martin Hirt, Kevin Buehler, Susan Lund, Ezra Greenberg, and Arvind Govindarajan note the significant trade-offs that must be made if we choose an “either-or” approach – that is, addressing the viral pandemic OR opening the economy. Instead, the authors suggest a data-driven and historically-supported middle-of-the-road way forward that allows for mitigation of the lingering health effects of the pandemic, while at the same time, avoiding lasting damage to the US economy. In other words, a strategy that works in parallel to successfully achieve both goals – caring equitably for the population while protecting our economic futures.
We recognize and applaud the U.S. House of Representatives, Senate and White House and Senate for their bipartisanship in issuing $2 trillion to support those in need. We also applaud the courageous State Governors and their teams for their cool-headedness, tenacity and unrelenting courage in doing what is necessary at a local level to increase healthcare resources and do what it takes to limit spread of the virus. Countless small and large employers across the U.S. deserve credit for also finding creative ways to keep working, retooling to produce what is needed and continuing to keep their employees working. Finally, the American people should be recognized for our willingness to hear and respond to the efforts of our leaders to respond collectively and protect one another.
We do not know precisely when and how well this will work in the weeks and months ahead, however, we trust that we will overcome this deadly public menace.
Our colleagues at McKinsey & Company suggest the we need to save lives without destroying livelihoods. As members of the Population Health Alliance community, we look forward to working with our political leaders to advance a solution that truly uses an informed and practical approach to the challenges ahead – one that addresses a win-win for the country and our people. We know that the member companies of the PHA stand ready to support continued public health and economic efforts that will lead to a successful outcome to the pandemic.
For Further Reading on The Interconnectedness of Health and the Economy:
- Health and Economic Growth: Reconciling the Micro and Macro Evidence by Bloom DE, et al. NBER Working Paper No. 26003, June 2019.
- How the Economy Affects Health by Frakt AB. JAMA, March 2018
- 3 Examples of How Economics Affects Health and Health Care by The Dartmouth Institute for Health Policy and Clinical Practice, April 2017
- Impact of the Economy on Health Care by Health Care Financing & Organization, August 2009
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Mary Jane Osmick MD, Principal at Mary Jane Osmick MD Consulting, LLC is a member of PHA’s Board of Directors, a lead author on PHA’s digital textbook: Social Determinants of Health and Health Disparities: Taking Action and presenter of several webinars on the subject of SDOH in Population Health Management Strategies
Jaan Sidorov MD, CEO & President at PA Clinical Network is PHA’s President and Chair of PHA’s Provider Engagement Initiative.
Rose Maljanian, Chairman Emeritus at PHA and Chairman & CEO at HealthCAWS invites thought leadership on pressing topics to our PHA community to join in on our Leadership Circle.
Ms. Polak is a senior director based in Washington, D.C. In her role, she provides policy counsel and analysis to clients with matters involving regu-lations, legislation, and business implications. Anne Marie’s experience includes developing strategic messages and policy positions for Capitol Hill, administration, trade associations, and corporate audiences. Prior to joining Leavitt Partners, Anne Marie was a vice president for Faegre BD Consulting in the firm’s health and biosciences group. She also spent five years with the Podesta Group in Washington, D.C., while completing her law degree in the evenings at the George Mason University School of Law, graduating cum laude in 2010. Anne Marie also worked in the government and legal affairs office of Novo Nordisk in Washington, D.C., and as a congressional aide to Rep. Michael Ferguson of New Jersey.
Dr. Fabius has recently returned to his start up. HealthNEXT, a company dedicated to the development of organizational cultures of health — after serving as Chief Medical Officer of Truven Health Analytics (formerly the healthcare business of Thomson Reuters), the world’s leading source of intelligent information for business and professionals. In this capacity he is charged with developing and deepening relationships with customers, advising on product development, and providing counsel to the leadership on business strategy and medical issues. Formerly, Dr. Fabius served as strategic advisor to the President of Walgreens Health & Wellness Division. This organization will coordinate over 1,000 workplace health centers and 10,000 pharmacies, many with retail clinics, into a seamless primary care network across the country within the next five years. In the not too distant future, it will be possible to offer large employers medical and fitness services on-site as well as episodic illness care, health coaching and disease management monitoring at the employee’s nearest Walgreens pharmacy.
Mr. Buettner is an explorer, National Geographic Fellow, award-winning journalist and producer, and a New York Timesbestselling author. He discovered the five places in the world—dubbed Blue Zones—where people live the longest, healthiest lives. His articles about these places in The New York Times Magazine and National Geographic are two of the most popular for both publications.
Ms. Cooney provides strategic direction for the Centers three Pillars of Population Health – Clinical to Community Connections, Health Equity and the Social Determinants of Health, and Public Health Data Analytics and Informatics. Mary Ann previously worked for 14 years at the New Hampshire Department of Health and Human Services where she was Deputy Commissioner for the Department and Director of Public Health.
Mr. Scully is a General Partner in the Healthcare Group, having joined WCAS in 2004. Before joining WCAS, he was the Administrator of the Centers for Medicare and Medicaid Services (CMS) for three years and the President and CEO of the Federation of American Hospitals for six years. He also served as the Deputy Assistant to the President and as the Associate Director of OMB under President GHW Bush from 1989 to 1993, and has practiced law at Alston and Bird; Patton Boggs; and Akin, Gump, Strauss Hauer and Feld. He is a Principal at the Lincoln Policy Group.
Dr. Don Wright has served as the Deputy Assistant Secretary for Health and Director of the Office of Disease Prevention and Health Promotion (ODPHP) since January 2012. In this capacity, he leads coordination and policy development for public health and prevention activities within the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. He is also currently the acting Executive Director of the President’s Council on Fitness, Sports & Nutrition.
Dr. Sidorov is a board-certified in general internal medicine physician with more than 25 years of experience in primary care, inpatient care, medical education and evidence-based practice. Jaan believes physician leadership throughout the continuum of care is the bedrock of value-based care delivery. He received his medical degree from Pennsylvania State University College of Medicine, and completed his internship and residency at the Dartmouth Hitchcock Medical Center in Hanover, New Hampshire. Jaan also served as a Chief Resident at Reading Hospital in Reading, Pennsylvania.
Dr. Ostrovsky is a practicing physician, social entrepreneur, and health policy expert who specializes in human-centered design, lean manage-ment, quality improvement, population health, and digital health. Dr. Ostrovsky was most recently the Chief Medical Officer for the Center for Medicaid and CHIP Services (CMCS), the nation’s largest insurer covering over 74 million people, annually.
Dr. Choice is vice president and medical director for physical medicine services at American Specialty Health (ASH). Dr. Choice oversees the Rehabilitation Services Clinical Quality Evaluation program and leads the content development, training and clinical quality processes for ASH’s musculoskeletal health and pain management products.
Ms. Forte is responsible for leading Tufts Health Public Plans expansion efforts. Prior to her current position, she was vice president of care management for all Public Plans members.
As Director of Strategic Initiatives, Ms. Bowman oversees new social needs intervention initiatives among our clinical partners — including program design, resource database build-outs, and integration of Health Leads’ signature technology, Reach. Elise brings 10 years of direct service experience to her role, having previously served as a Health Leads program manager, a case manager for adults struggling with mental illness and homelessness, and in developing parent engagement initiatives in public education settings.
Mr. Johnson leads the Sage Consulting’s work for a number of public sector, corporate, non-profit and multi-employer clients. David brings particular expertise in evidence-based workplace wellness programs and leveraging Behavioral Economics principles in Human Resources Management. He is also an Adjunct Professor in the Department of Psychology at Towson University.
Dr. Wadhwa is a leader in building population health programs for vulnerable populations. He serves as the senior vice president of market innovation and is the chief health officer for Solera Health where he is focused on scaling the Diabetes Prevention Program as well as health-related, social support interventions. Previously, Sandeep held population health leadership positions with 3M and McKesson. He also served as the State Medicaid Director for Colorado under its former Governor. While there, he oversaw a $4 billion program and led the effort to implement an accountable care collaborative. Sandeep also serves on the board of Reinvestment Fund, a $1 billion non-profit, financial institute devoted to revitalizing low-income neighborhoods. Sandeep continues to see patients at the Seniors Clinic at the University of Colorado Hospital where he serves as associate clinical professor in the division of Geriatric Medicine.
Focused on the intersection of information technology, informatics, clinical medicine and innovation, Dr. Jain is VP and Chief Health Informatics Officer at IBM Watson Health. He was Co-Founder, Senior VP and Chief Medical Officer of Explorys, Inc. formed in 2009 based on innovations that he developed while at the Cleveland Clinic. In April 2015, Explorys was acquired by IBM as an integral component of the newly formed Watson Health business unit. In 2017, he was appointed by Congress to the Federal Health IT Advisory Committee established by the 21st Century Cures Act.
Ms. Maljanian is an accomplished senior executive with more than 25 years of experience in the health care industry. Rose’s leadership experience
John Haughton MD, MS