New Jefferson Health CEO Joseph Cacchione plans to tackle health equity

In the second part of a conversation with Chief Healthcare Executive, Cacchione says Jefferson is going to measure where disparities exist and work to improve the diversity of the staff.

As Joseph Cacchione prepares to take over Jefferson Health in Philadelphia, he says improving heatlh equity is going to be the highest priority.

“I think that’s going to be a big part of what we’re going to be thinking about at is health disparities,” Cacchione told Chief Healthcare Executive in a recent interview.

Cacchione has been named the new president and chief executive officer of Jefferson Health and Thomas Jefferson University. He starts in his new role Sept. 6.

In an interview earlier this month, he told Chief Healthcare Executive he hopes to take Jefferson Health to “a new level.” Cacchione talked about creating a better working environment to recruit and keep doctors, nurses and other healthcare professionals. He also hopes to more fully integrate some of Jefferson’s more recently acquired hospitals into the system.

But Cacchione said he’s looking very closely at closing disparities in health outcomes among minority groups and those with lower incomes. It’s going to involve research and developing a more diverse workforce, he said. (See excerpts of our conversation in this video. The story continues below the video.)

The COVID-19 pandemic has driven more urgent discussions among healthcare leaders about the need to improve health equity. It’s one of the top health priorities of President Biden’s administration. Increasingly, hospital leaders have named health equity as one of their top priorities.

‘Just start measuring’

Jefferson Health operates 18 hospitals in the Philadelphia area and in New Jersey. In selecting Cacchione as the new chief executive, Patricia D. Wellenbach, the chairwoman of Jefferson’s board of trustees, pointed to health equity as a key factor in his hiring.

“The Board was laser-focused on finding a leader who would be committed to our mission of ‘improving lives’ by prioritizing innovation, partnerships, and reducing racial, ethnic, health and socioeconomic disparities,” Wellenbach said in a statement earlier this month.

Cacchione, a cardiologist who comes to Jefferson after years in leadership posts in the Ascension system, said Jefferson will gather data to get a better handle of what healthcare needs must be addressed.

“You can’t fix what you don’t measure,” Cacchione said. “We’re going to have to do a better job of measuring things. You can’t wait for the perfect measure set. You have to just start measuring things. Do we have the best access for care for people in high vulnerability index zip codes? Are we treating diverse populations?”

To improve health equity, Cacchione said it’s critical for healthcare systems to employ a diverse workforce.

“One of the things we do know, when you have a diverse physician workforce, they do better for patients,” he said.

“Diversity in the workforce will help us deliver more equitable care,” Cacchione said.

Cacchione said it’s important to understand that health equity doesn’t mean giving everyone the same exact care.

“When you define what equity of care is, it’s really meeting people where they are, not just trying to treat everybody equally,” Cacchione said. “We have to do better for those patients that often times get left behind.”

The COVID-19 pandemic has pushed the industry to improve healthcare for all. The pandemic has also spurred the use of telehealth and hospital-at-home programs.

“The pandemic did show the vast disparity in care and access, although there were times when we were encouraged by the fact that in virtual care, virtual care was accessed as much by people from different walks of life, different payer mixes,” Cacchione said.

“Virtual care is a perfect example of access that allows people over age 80 or access to care virtually from people from high vulnerability index zip codes who were accessing us virtually. We have to parlay that in better outcomes for those folks.

“I’m encouraged by some of the things we’ve learned from the pandemic, but again we have to step on the gas.”

Collaborating with others

Jefferson will also be taking a closer look at the social determinants of health affecting communities, Cacchione said. He’s done similar research in his career.

“In my prior life, we collected data on over a million patients in social determinants. We started to act on those,” Cacchione said.

“The most prevalent social determinant of health in our database of a million patients was social isolation,” he said. “We put community programs in place to help combat that social isolation. Another one was access to affordable medication. We put together an affordable prescription drug plan.”

Jefferson aims to help improve health outcomes for all groups, but will need to collaborate with others in the Philadelphia region to make progress.

“This is not a Jefferson-centric thing,” he said. “Jefferson has to play a role, and often time has to be the convenor of the community assets that exist to solve these problems.”

In addition, Jefferson will be working with other health plans, including the organization’s own Jefferson Health Plan, to help manage patient populations, particularly Medicaid patients.

“Their care, up until now, has been often times fragmented and episodic,” Cacchione said of Medicaid patients. “How do we engage them in our practices better? How do we get them before they have to show up in an emergency room and have more advanced illness?”

“The way that turns out economically is feasible for a health system is we manage that premium dollar in a way that is more efficient,” he said. “It’s a better economic model for us. Most importantly, it’s a better care model for the patients that it serves.”

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