Julie Miller-Phipps is the President of Kaiser Foundation Hospitals and Health Plan in Southern California, where in partnership with leaders of Southern California Permanente Medical Group she directs operations for the region’s 14 hospitals and 222 medical offices. Julie previously served as President of Kaiser Foundation Health Plan of Georgia where she was responsible for the delivery of health care needs to nearly 300,000 Kaiser Permanente members who are served through a network of 26 medical offices and specialty centers, as well as four contracted hospitals.
- Population health requires a long view of care to understand what contributes to patients being in the hospital and what can be done to avoid return to the hospital.
- We are broadening our thinking to pay more attention to social determinants of health like educational attainment, food stability, job creation and mental health.
- No one organization nor individual can solve the issues of improving health independently.
- The personal involvement of the leader in the work of improving health is important. It builds authenticity that helps to connect with others, fuels creativity, and helps to connect the dots.
From your perspective, how do you define your health ecosystem?
Kaiser Permanente (KP) has a 70+ year tradition of providing services to respond to the health needs in the communities we serve, namely our nearly 4.3 million members in Southern California and about 11.6 million people nationally. Interestingly though, some of our current top areas of focus are non-traditional aspects of healthcare, such as educational attainment, food stability, job creation, or mental health. We are now broadening our thinking around how to cultivate relationships in the community and pay more attention to the social determinants of care. The ecosystem includes the integration we have within our organization and the communities that we serve.
What is KP’s process for collaborating across the continuum of care?
At KP, we institute an “Inpatient Quality Management” approach, which is about treating patients with a “long view” of care. The long view is about understanding what contributes to the patient ending up in a hospital and how, with this knowledge, we can help them regain their health in a meaningful way and keep them from returning to the hospital in the future. We have intensified our work with community resources to ensure that we’re not just referring patients out, but that we’re doing a “warm hand-off” to community resources to make sure that long view of care is in place.
We also have a group that spends a lot of time on the phone with patients who are considered high risk to understand their social determinants and their needs that are contributing to the frequent health issues they’re experiencing. One interesting example is a new pilot we’re working on with Uber and Lift to provide transportation for pre-approved individuals at a reasonable cost. This might include assistance from the house to the car, or from the car to their destination. Essentially, we are helping to find opportunities and create resources to convene groups of people that can provide meaningful services.
How have you convened groups to participate in these conversations?
I spend about 20% of my time working to engage others in a very intentional way. We are often the conveners of like-minded groups who come together in public/private partnerships to solve important issues. No one organization can solve issues independently – it’s too complex and requires too much money, time, resources, and individuals to be able to move the dial.
For example, in Orange County, I worked with community health services on food scarcity issues, such as the lack of support for food pantries and the paucity of areas where people could access hot meals. We partnered on a food recovery and re-distribution program that started with my two hospitals whereby we recaptured our excess food for re-distribution. It has become a very robust, well-orchestrated program that is now operating on a wide-scale basis.
In Atlanta, I actively participated on the board for a unique partnership in which KP provided a substantial seed grant to the Atlanta Beltline Project. The purpose of the project was to restore the dilapidated railways to create a walkable space for the development of restaurants and affordable housing units, in turn bringing jobs to the communities and creating a village environment for people to enjoy recreationally. While we had a lot of political supporters, we also had detractors such as school systems who felt that the tax dollars were being steered away from education. We had to work through the politics to keep the project moving forward.
How do you overcome obstacles and resistance points to keep collaborative projects on track?
We are constantly building strong relationships with decision-makers in local and state governments. We offer our support and look to cultivate others who may not be as familiar with our work. Also, when we support a project, we have to be really careful about what it is, how it’s run, and how transparent and ethical the decision-making is as well as the sources of funding.
How do you, as a leader, stay engaged when you are faced with obstacles to collaboration?
I’m a very experiential learner, so I always start by spending time at ground zero with the organization that I’m working with, because it gives me the ability to support from my heart. During my work with the Atlanta Beltline Project, I walked up and down the segments of the Beltline that we had supported and got to really experience it. Getting to see the local art exhibits, new housing developments, restaurants, and families from all walks of life and ethnic backgrounds enjoying the community space –became the tipping point for me as a strong advocate for this work. I truly believe that it serves you well as a leader to get personally involved. It’s one thing to write checks and it’s another to actually witness what you’re supporting. I advise that leaders choose projects they have the passion to create an authentic ability to connect the dots when you interact with others to support the project.
How do you get others engaged in collaboration?
I align the “ask” to my personal story, to the extent possible. For example, in Orange County, I worked on a project dedicated to helping disenfranchised young adults get on a better track in their lives. We were charged with engaging companies in the community to offer mentorship programs for the most vulnerable population. I brought the issue back to my department managers and met with them on a routine basis to educate them about the community need and the support required by KP. I shared my own personal story about being one of the first to graduate in my family, and engaged them in a conversation by asking how many were first-time graduates in their family, and asking them to talk about what it took for them to overcome the barriers to achieving that. At the end of the conversation, I asked for volunteers who would be willing to mentor an individual over a 6-month period. I had 40 people raise their hands, and brought that list of people back to the project board and talk to the CEO’s around the room about the process I had gone through to engage these people. It was a tremendous source of pride for me that I could engage with our people and have them volunteer for such a worthwhile endeavor.