Linda Hines, Virginia Premier Health Plan

Linda Hines, the Medicaid Plan President for Virginia Premier Health Plan, joins Meg on the podcast to talk about her start in health care as a nurse, why she chose Safety Net Health Plans, and how she has adapted her leadership to meet the challenges of both the COVID-19 crisis and the sale of Virginia Premier Health Plan. Find Linda's book recommendations here: https://bit.ly/2I1ktVb

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Speaker 1

0:00

  Welcome back to the ACAP Coffee Break with Meg Murray, a podcast from the Association for community affiliated plans. Thanks for listening. Our guest today is Linda Hines the Medicaid plan president for Virginia premier health plan. Linda has been with Virginia premier for 26 years, including serving as its CEO up until the sale of the plan to sentara healthcare earlier this year. Here's Meg

MM

Meg Murray

0:24

Linda, thank you for joining us today on the ACAP Coffee Break. We wanted to know, just tell us a little bit about yourself, how did you get to be the CEO of Virginia premier.

LH

Linda Hines

0:34

So first, thank you for having me today. Meg. This is an incredible opportunity. So I became the CEO of Virginia premier from... a pretty long journey. And so I really want to start back with you know, really, I really started in all of this. And I am a nurse, I don't know if many people know that by trade. And so I started in the healthcare world as a registered nurse on working in a safety net hospital, and did that for about 16 years. Before joining. We were known at that time, Virginia charter health plan. And then subsequently Virginia premier health plan, very small startup plan. At that time, we had about 3000 members, and I joined them really at the ground level, I did not have Managed care experience. So I started out as a utilization review nurse. But because we were very small, many of our services were outsourced to our sister plan in DC, I actually had the opportunity to do a myriad of different things within the organization. And so quickly, of course, I was in management before I came to the health plan. And so it's hard to stay out of  management and leadership, once you've done that really helped to start transitioning some of those services back to the local level at the plan, we saw such a need to be more local, more hands on to be able to service our members and our providers. And so then I became the director, actually for medical management, then the Vice President for medical management, and I did that for the health plan, probably for about 15- 16 years. And then with the with the death of our CEO, unfortunately, about six years ago, I became a

MM

Meg Murray

2:16

the wonderful Jim Parrot

LH

Linda Hines

2:17

Jim Parrot, yeah, that's correct. Jim and I have worked very closely together. For all of that time that I was at, in the medical management role. There really I was pretty much his right hand person from an operations perspective, as well as the medical management. So I moved into a chief operating role, because we did not have a chief operating officer. And so I stayed in that role about a year as they did a search for a CEO. I was fortunate to be promoted to CEO in 2015. And stayed in that role until the recent transition to sentara.

MM

Meg Murray

2:53

That's a good segue into talking about the purchase. So what what does it look like I my understanding is there's going to be two health plans. But why don't you tell us a little bit about that.

LH

Linda Hines

3:04

So previously, we were owned one hundred percent by Virginia Commonwealth University, which is an academic medical center, which is also a safety net hospital. with the new ownership structure we were purchased in April of 2020 yes to have 80% ownership by sentara Health System in 20% by Virginia Commonwealth University. So they still have their hands in a little bit. I'm really feeling this a natural fit for the health plan in the hospital. And so with that, you may know that senta ra Health System also owns Optima health, which is another health plan that serves Medicaid recipients in Virginia. And so instead of a full merger, we will still operate as two separate health plans. We both went through the Medicaid procurement process. And so we will continue to operate in that vein. 

MM

Meg Murray

4:01

And so why did you get into health care? You were a  nurse initially Why did you want? And are you from Virginia Originally?

LH

Linda Hines

4:07

I actually am from Virginia, and for a very small rural  community in Virginia, Nottoway  County. And so I grew up there went to college at Virginia Commonwealth University, to get my undergrad but really, always wanted to do something where I could feel like I can make a difference to community. I was torn to be honest with you, between being a social worker and a nurse and that was back in the 80s but really settled on wanting to be a nurse feeling that that's where I could really do the most good for what I wanted to do. But I also know knew that I really didn't want to work with this large mostly commercial insurers. I really wanted to work with people who were mostly underserved. I came from a very rural community where health care was a challenge. It still is a challenge unfortunately Access to Care in the community is so I saw that firsthand and felt that this is something that I really wanted to make an impact.

MM

Meg Murray

5:09

And there must have been people who influenced you along the way I can imagine who are some of those people that maybe encouraged you to get into health care and inspired you to reach the level you reached?

LH

Linda Hines

5:20

You know, it's funny, when I said I wanted to do social work, and or either nursing, I will tell you, I'm kind of a math science type person. And I started out thinking, oh, maybe I'll do like accounting. Personality didn't really fit then. So I had, you know, one of my teachers in school, they said, you know, while you're great in math, I just don't see that as your personality, but you know, of course, we'll encourage you. And so that really started to plant the seed of, well, you know, what, what else could you do? I think there's a lot in the healthcare arena that you have to combine those skills. And then, of course, my mother, my father died when I was 13, of cancer. And so, um, you know, she never remarried, but that's still stuck with me as well, with the health care. And then once I started my career, there were a host of individuals along in the hospital side. But when I went back to get my Masters of Science in Nursing, and I did it in nursing administration, I started to get that bug of you know bedside nursing is great, but it would be wonderful to help a larger population. And at the time, VCU did not own a managed care plan. And so they were looking to partner with a plan and decided to do DC chartered. And I happened to be in a management role at that time, and really was on the ground to see some of the previews of as they were thinking about partnering with that plan. And I really got hooked, I have to say, thinking, this is really wonderful. It's a different type of health care, then what I'm doing, I felt like, I could reach a much larger population than what I was doing. Plus, it really pulled at my, again, the vulnerable population, the more community partnership. And so that got me going. And I decided, you know, I think I want to go to the managed care world. And I will say, I remember saying, Well, I don't have any experience. And when I interviewed for that position, I met the current COO of the health plan at the time, I didn't know she was COO. And I was sitting in the lobby waiting to go into the interview, but she spoke with such passion about what they do. And she never really introduced her to tell me she was the COO, and then said, Well, good luck with your interview. And of course, once I got hired, I found out who she was. And she, she continues to be one of my mentors today. Her name is Sheryl Roberts, and she actually  works for the Medicaid office.

MM

Meg Murray

7:52

She's one of the Medicaid divas (laughter)

LH

Linda Hines

7:55

That's correct. But really, you know, I, I really felt I learned a great deal from her. It just really furthered my thirst and my passion for this population. It was a very much a startup playing around when again, we only had about 3000 members, didn't have all the infrastructure in place. So it gave me the opportunity to help to mold the culture, some of the services that we provided, they helped me to really grow it into what it is today.

MM

Meg Murray

8:24

So when you're hiring now, when you're the person who's on the other side of the table, how do you look for people to have--who have that same passion, and compassion and technical skills?

LH

Linda Hines

8:34

So you know,  of course, they have to have some qualifications, but I look really for why do you want to work with this population? It is it you know, some days, it's extremely rewarding, you're not always going to get a thanks. But your thanks is, when you see that mother have a healthy baby. When you see that elderly person, you know, be able to come back, stay in their home and become a little more independent. And so I'm looking for people to be able to talk passionately about what they've done in the community, how they have, you know, a passion for helping other individuals really to become independent. And then we're talking about what are your technical skills, even to down to, let's say, some of our analysts who may not be forward facing to our members, we want them to understand the mission of the organization. We do these during our staff, meetings, mission moments. And, of course, it's a natural fit for your caregivers or outreach workers, that sort of thing to have those. But we also look for those individuals who may not be as forward facing our transportation drivers, as i said our analysts our financial individuals where they've been able to see some abnormality sometimes down to the member level and be able to point that out to those individuals who are forward facing, so we share those at our staff meeting, just so that people understand and we connect them to what we do for our members and providers. And so sometimes also for our community, we have many of our staff, who serve on community boards, who do a lot of charity and volunteer work, because we cannot do this all just from a health perspective. So we do need to partner very closely with the community. And so we also want to salute those individuals as well.

MM

Meg Murray

10:29

This must be a very, very challenging time to lead a plan like yours through the merger and through COVID. Through the changes in the lines of business, what are the the main challenges you're facing right now? And how are you dealing with them? What do you what are your top three challenges?

LH

Linda Hines

10:43

I will say, um, well, there are a couple things. I mean, one for us  COVID Yes. But then you compound that with this new transition that happened right at the beginning of COVID. And we had to send all of our workforce home to work remotely. And now we're expecting them to work together. So what is their awesome shared services? We are under new ownership. So some of the challenges, of course, would be you know, how do you keep people connected? The How do you maintain the organization culture, that culture that I spoke of, of really having people to have a passion for the membership? And what we do? How do we make sure that members are staying and getting the care that they need, when they really don't want you in your home's Virginia premiers model. And I think one of the things that has made us so successful is truly that grass roots approach that we have very hands on with our members. And we have a whole team of community outreach workers and our care managers who are not just telephonic, but they're really going into the home, they are well respected in the community. And COVID really caused a lot of challenges. Well, I mean, they are resilient. And because they have that connection with the members, they're doing a lot of front porch type of calls or visits, where people are actually able to come and sit on their front porch by their stick a lawn chair, it sit out in the lawn, and talk to them, we're doing a lot of virtual connection to those members that are able to do that. We rely heavily on some of the personal care workers that are going in, it has fostered a much closer bond with many of them, because they are truly now our eyes and ears for those individuals that are in the community. But for the workforce, covid   is an issue. But again, the transition, we're doing things a little differently, people who were in traditional roles have moved into different roles, because we're now remote really trying to understand where are people now? How do they transition from their previous role into their new because the work does not go away, getting anybody who's new in the role up to speed. And then really working with a new partner, the model is a little different, because we are trying to get some synergies and we're two separate health plans, those things that need to touch a member, provider are separate. But there are some foundational services that will be shared. And what does that mean? So for the Virginia premier staff who've never worked in that type of model, and even in I will say, even for the optima staff, it is a little different, because we still have to keep some things firewalled we still have to represent the plans as two separate plans. And there are some challenges with people being able to get their arms wrapped around. 

MM

Meg Murray

13:40

what are some of the things that you're doing to to maintain your culture and keep people connected with your staff?

LH

Linda Hines

13:47

We're still trying to have the weekly email updates that go out to our staff we have we use SharePoint, we're doing a lot of WebEx in all staff meetings and small staff meetings. And we do cascading kits to our managers or leaders so that they are able to disseminate the message as well. We've done cultural surveys to kind of give us a checkpoint of where are we now where the staff would like to see us go as an organization, we have developed some focus groups to help to guide that culture, as well as in their small groups when they go back to their departments. They're able to talk about what's happening in those focus groups, and what's happening at the company as a whole. Also, keeping that mission, we are still very mission driven. But keeping that first and foremost, and really trying to remind people that you know, if you erre on the side of the member, maybe next time we can talk about we could have done that a little differently, but you're still doing the right thing. And we're trying to reward and acknowledge people for that.

MM

Meg Murray

14:58

 So what have you had to change Your leadership style, given the fact that you're not face to face with people, as well as with the other changes in terms of the merger, have you What have you done to change your style?

LH

Linda Hines

15:11

 I think it's two things. It's not only the merger, but it's also COVID. I mean, a lot of my leadership style was, you know, my staff were very used to seeing me as a walk around leader  being able to go and talk to different individuals, whether that's a conversation in the hallway in the break room, and, you know, you gain so much of being able to talk directly to your frontline staff, you know, what are the things that they're grappling with everyday? What are their suggestions, they have great suggestions. So you know, I do miss that. And that chain has had to change my leadership style a little bit. Because I did rely a lot on the very personal upfront in touch, I still trying to have those type of staff meetings, we do have staff across the entire state. So they're not all located in one place, even before we went remotely. And so it's having to do more of that (???) touch. But now it's done digitally, really trying to also help people understand where we're trying to go. Now, as an organization. For me also leadership. I mean, it's, it's a lot of the decision making, I think, that I had personally, is now disseminated more among the team. And so and having to work with a new team, many of the senior leaders in the sentara health plan system are pretty new in their roles as well, they've been there for a year or less. And so we're all trying to also bond as a team, which, you know, I've been at virginia premier for 26 years. And so you know, you you knew the organization, you knew the people, you knew all the systems. And so now, it's almost like starting somewhat over again. And so because of that you do have to change on how you communicate how often making sure that, you know, you're in some of those important meetings, that sometimes I think you can be an afterthought, because we are the new plan that's being acquired, so to speak. And so it's really being that advocate for Virginia Premier, and its brand, which I really didn't have to do that before, because we were such a brand in the community. And so one of the things that I really have to do now is to make sure that we don't lose our brand, we're very strong in the community, we hear that from our providers and our members, and we don't want to lose that identity. However, we also want to take advantage of those best practices. You know, there are many things that we do extremely well, there are things that senatara do well. And so we want to bring the best approach of both of those worlds.

MM

Meg Murray

17:52

You mentioned the sentara, we'll be doing some of the you may have said backroom services what what will sentara be doing and what will Virginia premier be doing

LH

Linda Hines

18:00

with sentara and then a lot of staff moved into those Shared Services role. So they they still are virginia  premier employees, but they're supporting sentara health plans as a whole. So some of the claims operations, some of our Member Services, unlike the call center operations, however, there are still numbers that go directly in with with agents that will say, you know, hello, you've reached Virginia Premier, we're looking at some of our platforms are there synergies there. So it's very new, we are truly in the point of really trying to blueprint, all of those services, and understand where can we do any... I won't say combining because we're still these two healthplans, we're really not combining services. But how can we support both health plans versus having each of the health plans having individual service? We're looking at some of our vendors, can we utilize some of the same vendors. So just really trying to see where are the synergies and where those things need to be separate? The things that need to be feel continued to be separate. Any enhanced benefits that we have, the care coordination definitely needs to be separate. quality. It's a little bit some things we're looking at a hybrid model, but also they're things that we keep very separate. Because we both hold contracts with the state. We're still competitors. And we're expected to do everything that we agreed to do in our RFPs and we are committed to doing so. In no way will we jeopardize any of that, or our providers as well.

MM

Meg Murray

19:40

well. It is quite a challenge and a unique structure. So we'll be interested to talk to you over time about how it works and the lessons learned. With all of the challenges that you're facing at work I'm curious in your free time, What do you do to relax and I know for myself, I'm a bookworm. I'm always reading something, and that's kind of my relaxation. So I'm curious, if you're reading something of interest that I can add to the acap book list, or,

LH

Linda Hines

20:07

well, I like to sew as well, and so hadn't done that in a while, but I find that now that I'm at home and you don't have a commute to deal with, actually, you find a couple of extra hours in the day and that you didn't have. And so I've started to get back into that somewhat, um, but from a read, I love to read as well. But one of the things I think that I'm reading right now that I find fascinating, because it's a very different perspective, it's, it's, um, it's a book called Extreme Ownership. And it's really based off of the US Navy SEALs, how they lead to win. And I thought it really has a lot of parallels. of course, you know, you've got to kind of get through all the different missions that they have. But the theme really is how do you pull a team together to see that even though they may not be responsible for certain function, they are responsible for the mission? And so how do you get the team to see that and organize them in a fashion where they can either do something that furthers the mission, or they make sure that they're getting their ideas moved up, to further the mission. And I thought that, you know, Wow, this is so applicable to where I am today, in my career and in in our organization. So really, great book. I'm about halfway through, and already really picking up some great tips.

MM

Meg Murray

21:37

Well, I will definitely look for that. And we will add that to the acap book list. So Linda, thank you so much for sharing your thoughts and experiences, especially someone who's been seen one plan, change so much over time in terms of the ownership and the leadership and the mission, maybe not the mission, but the lines of business in any event. So we appreciate your taking the time.

LH

Linda Hines

22:01

Thank you so much for having me and I look forward to hearing the other podcast.

1

Speaker 1

22:07

Thanks again for joining us today. You can find Linda's book recommendation and others on the ACAP coffee break Goodreads bookshelf, just head to Goodreads and search a cap. Our next episode features John Grgurina, the CEO of San Francisco health plan. Here's a preview. Don't miss that and more on the next episode of the ACAP coffee break. You can find it subscribe to the ACAP Coffee Break wherever you get your podcasts. And when you do give us a shout on Twitter using the hashtag acap coffee break. We'll put you in a drawing for a Starbucks gift card. So the next time you tune in your copies on us. Thanks for listening. We'll see you next time.