Tangerine Brigham, Chief Administrative Officer of Population Health, feels at home with the full steam ahead approach she sees from AHS staff. It’s the way she likes to get the job done.
She has been tasked with helping AHS improve quality of care system-wide, lower costs and improve health outcomes among the patients AHS serves. This is also known as population health. Prior to working at AHS, Brigham worked on the implementation of Healthy San Francisco (SF), an initiative that still exists to this day.
Healthy SF was launched before the Affordable Care Act. It makes health care services available and affordable to uninsured SF residents. After 10 years, it’s estimated that 96.7 percent of SF residents have health care coverage which is higher than the State average.
“It was one of the most grueling projects I ever worked on, but it was also the most rewarding project I’ve worked on.”
When asked how she accomplished this she replied, “I had help. With any major project I work on, there are people with specific skill sets that match the project needs and outcomes. I don’t do any of these huge undertakings alone, there is always a team of qualified individuals I work with.”
Brigham believes her background in policy and operations helps her successfully navigate organizations through change and is using that experience to help AHS transition to capitation under Medi-Cal managed care.
“Transitioning to population health solidifies our effort to strengthen our delivery system and be a part of the broader community. We no longer want to be seen as a system for episodic care, we want to push out the notion of prevention and use population health tools like S•A•P•P•H•I•R•E to understand who our population is and what their health needs are.”
The first major phase of the population health journey is switching to capitation for each of the wellness centers which has already commenced for patients under Alameda Alliance. To date, three out of four wellness centers have moved to a value-based model and the last center will transition in March 2019 bringing the total number of capitated managed care lives assigned to AHS to 48,000. The next step will be to approach Anthem Blue Cross to see if we can migrate to capitation for primary care services – AHS serves almost 12,000 Anthem members. AHS will also explore if it should assume risk for specialty care services.
Brigham, who admits that she doesn’t shy away from tough projects, believes her tenacity is just part of her constitution. At one point, she recalls going to live with her father and her three siblings in university student housing while he was working on his PhD and not giving up.
“I believe much of my success is due to hard work, not some innate talent. Just keep going until the job is completed. No excuses.”
As with many of us she could work anywhere, but she has chosen to work with vulnerable populations throughout her career, from housing to health.
“I think there’s a perception that companies that have bigger budgets or offer more perks are better or easier to work for, but for me it is about gratification. And I believe in serving all.”