Bio
Chris Palmieri has deep expertise in publicly funded healthcare and a firm commitment to
providing high-quality care coordination and delivery and specialized services to individuals with
significant health needs, including seniors and people with disabilities that address the spectrum
of social determinants of health.
Since 2015 as President and Chief Executive Officer, Chris has transformed Commonwealth
Care Alliance with a scalable, validated care model that improves health and quality outcomes.
Commonwealth Care Alliance has rapidly achieved long-term sustainability while growing
revenue and its customer base. Chris is also the founder of Winter Street Ventures,
Commonwealth Care Alliance’s healthcare start-up accelerator and venture investment
subsidiary.
Prior to joining Commonwealth Care Alliance, Chris served as CEO of Remedy Partners, a
national bundled payment company in Darien, Connecticut. Chris also served as President and
CEO of Visiting Nurse Service of New York CHOICE Health Plans, successfully transforming
the organization into a $2 billion safety-net insurance company offering both Medicare
Advantage and Medicaid Managed Care products. Additionally, Chris held senior positions with
Amerigroup Corporation, Metropolitan Jewish Health System, and Faxton-St. Luke’s Health
Care/Mohawk Valley Network.
Chris is currently Chair of Association for Community Affiliated Plans (ACAP), a national trade
association representing 67 nonprofit health plans in 28 states; and Vice-Chair of the National
Managed Long-Term Services and Supports (MLTSS) Association, a consortium of leading
managed care organizations serving state Medicaid programs and beneficiaries. He is also
currently Chair of the Board of LifePod, a Winter Street Ventures portfolio company, and serves
as the independent director and Chair of the Board of Healthify.
The Interview
This interview has been edited for length and clarity.
Q1: Looking back on the last 90 days, what issues have you been focused on the most? Do you think your peers (leaders in other MCOs) have been focused on similar issues?
If you would have asked me this back in November or December, we would have been seven months into COVID. But it was before we really knew what to expect with vaccines. Now that we are talking in February, we have a very different outlook.
Our last 90 days have been focused on vaccinations, and thinking about how we emerge from the pandemic. And as we do emerge, how we bridge new HHS priorities from previous focus areas.
For vaccinations, our teams spent much of the last 90 days preparing for administering vaccines to our own patients and to the broader community. We were the first integrated plan vaccinating our own members in the state of Massachusetts, and one of only a few in nation.
We have been focused on supply chain (i.e., cold storage). We’ve been creating vaccination clinics for frontline staff and other workers in the healthcare community.
All our preparation efforts have paid off: 10% of our member population has had at least 1 dose (as of the time of this interview). 2% has had both doses. And 83% of ours members in nursing home have been vaccinated.
In addition to the vaccine rollout, our focus for the last 90 days mostly comes down to three areas:
1. How to keep our enrolled members safe? Especially our seniors over age 65.
2. How do we keep our workforce safe? How do we remain aware and proactive in keeping the mental health our staff positive? Keep them feeling engaged? How do we support them with new challenges during the pandemic, like the education their children?
3. What can we do to help our community at large? One of the things I have been focused on recently is how I transfer our internal knowledge so others can benefit from that.
We also focused on things I think most businesses dealt with these last several months. Things like the pivot to a virtual work model. We pivoted to 90% virtual, 10% out in the community and seeing patients at home.
Finally, the past 90 days had us focused on our core strategic growth strategy. Despite the pandemic, we still have to stay focused on where we are going. How do we as an organization thrive- not just survive? We plan on expanding to 5 or 6 states over the next 4 years, serving similar populations as we do in Massachusetts today. And in order to do that, we have to keep a foot in 2 worlds: current priorities and the growth strategy.
Q2: Looking ahead for the next 90 days, what do you think the most pressing issues will be?
One of the things that come to mind are the COVID isolation and recovery sites we have been operating for the state of MA. These are places for people who are COVID-positive sites (not just for our members). As we start to see less of a need for those, we are working to figure out what role that plays next. We served about 1,500 individuals, with an average stay of 12 days. Those were very important because they helped keep the pressure off of hospitals.
I think we are also starting to see fatigue in workforce. And we need to think about how we continue to support staff in the best way possible as the pandemic drags on. This is especially true for our staff with kids who are in remote learning models.
And maybe the biggest question from a staffing perspective is: What does our moving forward work model look like? We were named the best place to work by the Boston Globe in 2020, and we are very proud of that. We must remain a place people want to work for, and at same time we need to function with high performance. We – like a lot of other organizations- are figuring out our hybrid model. There are 1,700 people not coming into the office right now. Some of those people never want to come back and some want to get back as quickly as possible.
As we navigate this transition, we have tried to have the most effective approach we can while allowing room for flexibility. Our approach focuses on educating all team members about the plan, building peer to peer relationships in remote situations, and onboarding effectively in this new environment. We are not abandoning office sites. They will be based on occupancy standards in certain locations.
One third of our staff are in the field, and that work will continue. The pandemic has allowed us to gain insights into the different benefits of different care delivery models (virtual and face to face). For example, when we delivery care in the community, our staff can practice at top of their license; when doing work virtually, that allows more contacts with members and allows them to be more engaged in their care.
Finally, we are very much focused on growth moving forward. Related to that, I think all Medicaid plans have to stay laser-focused on the changes happening in Washington D.C. There are important things to watch for in terms of what direction CMS is going in the innovation center. We also are tracking trends in value based payment models, direct contracting models, as well as what will happen with duals integration.
Q3: What advice would you give to your peers about managing vendor partner relationships?
The way I think about it, I want to have my relationships with vendors (we like to call them partners) be about problems I am trying to solve instead of problems they want me to solve. We are very deliberate in how we manage solution partner relationships in our operational model. Our staff identify needs, and then they go out and explore the market to find something based on their need. Because of that process, we can set expectations early on and save a lot of time.
We have invested significant resources internally to understand what our needs are from a business and technology perspective. We are constantly assessing where we are headed with technology, commercial applications and additional support areas. We want to know where we can move from good to great, because this is closely tied to where I want to take our growth strategy and continuance of mission.
As far as general process and tips go, I also think it is very important to get precise definitions of value and success early on in the discussion. That helps us get to alignment from day 1 about what they want to solve and how.
A second thing that I think helps is making sure the solution is appropriately resourced. Is the proposed solution too big for a small problem? Too small for a big problem? We really need to see partners bringing the right (and right amount) of resources to the table.
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