1 00:00:00,080 --> 00:00:02,080 Hello, everyone. This is Jacob Emerson with the 2 00:00:02,080 --> 00:00:03,859 Becker's Payer Issues podcast. 3 00:00:04,319 --> 00:00:06,980 Thrilled today to be joined by Dorothy Zaleski, 4 00:00:07,040 --> 00:00:09,039 who is the president of Medi Cal at 5 00:00:09,039 --> 00:00:11,439 Health Net. Dorothy, thank you so much for 6 00:00:11,439 --> 00:00:12,960 taking the time to be with us on 7 00:00:12,960 --> 00:00:14,019 the podcast today. 8 00:00:14,320 --> 00:00:15,779 Thank you for having us. 9 00:00:16,184 --> 00:00:18,024 Yeah. Absolutely. And and before we dive into 10 00:00:18,024 --> 00:00:19,785 everything we wanna talk with you about, Dorothy, 11 00:00:19,785 --> 00:00:21,785 and and some really special things happening at 12 00:00:21,785 --> 00:00:23,385 Health Net, can you tell us a little 13 00:00:23,385 --> 00:00:25,864 bit more about yourself, your background in health 14 00:00:25,864 --> 00:00:27,384 care, and what it is that you do 15 00:00:27,384 --> 00:00:28,684 today at Health Net? 16 00:00:29,359 --> 00:00:29,859 Sure. 17 00:00:30,160 --> 00:00:32,000 So I have worked in health care my 18 00:00:32,000 --> 00:00:32,979 entire career. 19 00:00:33,440 --> 00:00:35,299 It's been more than thirty five years. 20 00:00:35,920 --> 00:00:38,979 I have worked at hospitals with physician groups, 21 00:00:39,679 --> 00:00:42,565 health plans, mostly with health plans. But I 22 00:00:42,565 --> 00:00:44,905 started my career at a federal agency, 23 00:00:45,524 --> 00:00:48,344 working in legislation and public information. 24 00:00:49,524 --> 00:00:52,325 About eight years ago, I had been with 25 00:00:52,325 --> 00:00:53,465 Health Net in the, 26 00:00:54,005 --> 00:00:56,585 nineties, and about eight years ago, I returned, 27 00:00:57,120 --> 00:00:59,200 to work on specifically on the Medi Cal 28 00:00:59,200 --> 00:00:59,700 team. 29 00:01:00,079 --> 00:01:02,979 Our focus was on enhancing our local relationships, 30 00:01:04,000 --> 00:01:05,620 with community organizations, 31 00:01:06,560 --> 00:01:09,540 doctors, hospitals, and and the government agencies, 32 00:01:10,405 --> 00:01:13,465 public health, mental health, all of the agencies 33 00:01:13,525 --> 00:01:15,605 who serve the same families that we do, 34 00:01:15,844 --> 00:01:17,865 at Health Net in the Medi Cal program. 35 00:01:18,484 --> 00:01:21,225 So earlier this year, I was, promoted 36 00:01:21,605 --> 00:01:23,784 to the president of the Medi Cal program, 37 00:01:24,325 --> 00:01:25,784 and I lead the teams 38 00:01:26,219 --> 00:01:26,719 who, 39 00:01:27,900 --> 00:01:30,400 deliver the benefits to our Medi Cal members, 40 00:01:30,620 --> 00:01:32,159 who work with those community 41 00:01:32,780 --> 00:01:34,319 partners that I just described, 42 00:01:34,859 --> 00:01:37,659 and who work on implementing new services and 43 00:01:37,659 --> 00:01:38,159 programs 44 00:01:38,700 --> 00:01:39,680 to help families 45 00:01:39,980 --> 00:01:42,159 and, the members that we serve. 46 00:01:43,155 --> 00:01:45,635 Fantastic. So a long career in health care, 47 00:01:45,635 --> 00:01:47,954 Dorothy, and now you're you're overseeing one of 48 00:01:47,954 --> 00:01:48,614 the largest, 49 00:01:48,995 --> 00:01:51,174 Medi Cal plans in the state of California. 50 00:01:51,635 --> 00:01:53,234 In that vein, we're here today to talk 51 00:01:53,234 --> 00:01:55,814 about Health Net and the Centene Foundation 52 00:01:56,480 --> 00:01:58,480 awarding more than $9,000,000 53 00:01:58,480 --> 00:02:01,120 in grants to help bolster the future of 54 00:02:01,120 --> 00:02:01,620 California's 55 00:02:01,920 --> 00:02:03,060 physician workforce. 56 00:02:03,600 --> 00:02:06,000 As you know, the the physician workforce in 57 00:02:06,000 --> 00:02:08,800 the state is facing a significant shortage. It's 58 00:02:08,800 --> 00:02:11,735 certainly not a new problem, but current predictions 59 00:02:11,955 --> 00:02:14,115 is that there will be a physician gap 60 00:02:14,115 --> 00:02:15,335 of 86,000 61 00:02:15,395 --> 00:02:16,915 by the year 2036, 62 00:02:16,915 --> 00:02:19,254 which really is not that far away. So 63 00:02:19,555 --> 00:02:21,875 talk to us about the impact that Health 64 00:02:21,875 --> 00:02:23,495 Net and Centene's investment 65 00:02:24,030 --> 00:02:26,289 in things like early childhood education, 66 00:02:26,909 --> 00:02:28,209 medical school support, 67 00:02:28,829 --> 00:02:30,449 professional development initiatives. 68 00:02:30,750 --> 00:02:32,989 How is that all gonna help address this 69 00:02:32,989 --> 00:02:35,469 this growing gap, particularly when it comes to 70 00:02:35,469 --> 00:02:36,689 underserved communities? 71 00:02:37,504 --> 00:02:39,584 Great question. 2036 72 00:02:39,584 --> 00:02:41,685 is not that far away, and 73 00:02:42,705 --> 00:02:45,985 we've focused our effort across the continuum. We 74 00:02:45,985 --> 00:02:46,485 believe 75 00:02:46,944 --> 00:02:49,504 real solutions are gonna take place 76 00:02:49,905 --> 00:02:52,004 take root long before residency. 77 00:02:52,979 --> 00:02:56,520 You know, we by sparking curiosity in preschool 78 00:02:56,580 --> 00:02:59,060 classrooms, it's 2025 79 00:02:59,060 --> 00:02:59,560 now, 80 00:02:59,939 --> 00:03:02,599 eleven years mid preschool classrooms, 81 00:03:03,539 --> 00:03:04,520 elementary school, 82 00:03:04,819 --> 00:03:07,479 nurturing students who are going through college 83 00:03:07,855 --> 00:03:10,435 and guiding them during medical training and beyond, 84 00:03:11,135 --> 00:03:13,295 that's how we're planting the seeds for a 85 00:03:13,295 --> 00:03:15,314 stronger and more resilient pipeline. 86 00:03:15,694 --> 00:03:17,235 It's got to start early. 87 00:03:18,094 --> 00:03:19,795 When we think about the neighborhoods, 88 00:03:20,575 --> 00:03:22,995 where families struggle to find care, 89 00:03:23,460 --> 00:03:24,680 We know it's important, 90 00:03:25,219 --> 00:03:26,919 for students from underrepresented 91 00:03:27,379 --> 00:03:28,759 backgrounds in those communities 92 00:03:29,540 --> 00:03:32,040 see themselves reflected in future physicians. 93 00:03:33,060 --> 00:03:35,400 That way they feel empowered to pursue, 94 00:03:36,180 --> 00:03:38,655 a path they thought was once unreachable. So 95 00:03:38,735 --> 00:03:40,354 when you think about that support 96 00:03:41,294 --> 00:03:42,594 across, their education, 97 00:03:43,055 --> 00:03:45,235 they now have an opportunity, 98 00:03:45,694 --> 00:03:47,875 a real belief that they can pursue 99 00:03:48,334 --> 00:03:48,735 this, 100 00:03:49,134 --> 00:03:49,634 career. 101 00:03:50,094 --> 00:03:52,594 And by doing so, we're expanding our workforce 102 00:03:52,814 --> 00:03:53,555 and honoring, 103 00:03:54,490 --> 00:03:54,990 California's 104 00:03:55,290 --> 00:03:56,990 rich tapestry of cultures, 105 00:03:57,449 --> 00:03:59,469 again, by focusing on those underrepresented, 106 00:04:00,810 --> 00:04:01,310 communities. 107 00:04:02,009 --> 00:04:04,250 And finally, it takes more than just this 108 00:04:04,250 --> 00:04:07,689 investment. You know? By weaving together health care 109 00:04:07,689 --> 00:04:08,189 providers, 110 00:04:08,810 --> 00:04:09,310 educators, 111 00:04:10,375 --> 00:04:10,875 policymakers, 112 00:04:11,895 --> 00:04:14,855 and even those community organizations and champions I 113 00:04:14,855 --> 00:04:17,514 talked about earlier, we're building a collaborative 114 00:04:17,975 --> 00:04:18,475 safety 115 00:04:19,254 --> 00:04:20,555 net that really lifts, 116 00:04:21,095 --> 00:04:21,595 these, 117 00:04:22,214 --> 00:04:22,714 students 118 00:04:23,254 --> 00:04:25,595 and lifts tomorrow's doctors 119 00:04:26,430 --> 00:04:29,310 in those communities and and ultimately brings a 120 00:04:29,310 --> 00:04:31,730 fair access to care for every Californian. 121 00:04:33,150 --> 00:04:35,230 Certainly. And and let's let's talk about that, 122 00:04:35,230 --> 00:04:36,990 Dorothy, in terms of all the different groups 123 00:04:36,990 --> 00:04:39,230 and the sectors that are coming together on 124 00:04:39,230 --> 00:04:41,895 this on this problem. Can you elaborate on 125 00:04:41,895 --> 00:04:43,835 on some of the challenges, but also opportunities 126 00:04:44,055 --> 00:04:44,555 that, 127 00:04:45,014 --> 00:04:47,995 your organization has encountered in forging these partnerships 128 00:04:48,134 --> 00:04:50,074 across health care, education, 129 00:04:50,615 --> 00:04:53,460 advocacy sectors, and and how all of these 130 00:04:53,460 --> 00:04:55,860 groups collaborating is going to contribute to a 131 00:04:55,860 --> 00:04:57,000 long term solution. 132 00:04:57,540 --> 00:04:58,040 Jacob, 133 00:04:58,740 --> 00:05:00,839 the all of those groups, it's like that 134 00:05:01,060 --> 00:05:02,199 tackling that challenge 135 00:05:02,740 --> 00:05:05,720 is is a lot like, conducting a symphony. 136 00:05:06,134 --> 00:05:06,634 Right? 137 00:05:07,095 --> 00:05:08,854 Symphony. Each sector, you know, the health care 138 00:05:08,854 --> 00:05:10,714 sector that I represent, academia, 139 00:05:11,735 --> 00:05:12,235 advocacy, 140 00:05:12,935 --> 00:05:15,974 for the communities we're focused on, each one 141 00:05:15,974 --> 00:05:17,354 plays its own melody. 142 00:05:18,229 --> 00:05:20,009 But we're aligning priorities 143 00:05:20,310 --> 00:05:22,329 and timelines and resources 144 00:05:23,029 --> 00:05:23,930 across those 145 00:05:24,310 --> 00:05:24,810 melodies, 146 00:05:25,269 --> 00:05:26,649 and that takes patience 147 00:05:27,189 --> 00:05:27,930 and trust 148 00:05:28,310 --> 00:05:31,110 and compassionate leadership. It takes a lot of 149 00:05:31,110 --> 00:05:31,610 listening 150 00:05:32,444 --> 00:05:33,264 and finding 151 00:05:33,805 --> 00:05:34,785 finding commonalities 152 00:05:35,245 --> 00:05:38,044 of outcome that you're shooting for. So when 153 00:05:38,044 --> 00:05:41,404 we harmonize our efforts, you know, inspiration really 154 00:05:41,404 --> 00:05:44,785 blossoms. That that list that that listening 155 00:05:45,245 --> 00:05:46,064 and empathy 156 00:05:46,524 --> 00:05:48,269 really leads to inspiration. 157 00:05:48,889 --> 00:05:49,389 Educators 158 00:05:50,250 --> 00:05:52,410 are are are a part of our of 159 00:05:52,410 --> 00:05:54,990 this collaborative to ignite early dreams. 160 00:05:55,610 --> 00:05:58,490 The advocates we we we are engaging with, 161 00:05:58,490 --> 00:06:01,470 you know, they're working to dismantle systemic barriers 162 00:06:02,725 --> 00:06:03,305 to students, 163 00:06:03,685 --> 00:06:04,985 to the amount of, 164 00:06:06,165 --> 00:06:06,665 placements 165 00:06:07,204 --> 00:06:11,204 here in California for for, students graduating from 166 00:06:11,204 --> 00:06:13,925 medical school. And the health care leaders who've 167 00:06:14,084 --> 00:06:15,464 who have joined the collaborative 168 00:06:15,764 --> 00:06:16,904 are opening doors 169 00:06:17,439 --> 00:06:20,100 in real world situations in real, 170 00:06:20,720 --> 00:06:21,939 in real settings 171 00:06:22,319 --> 00:06:24,959 to provide extended training to to the students 172 00:06:24,959 --> 00:06:26,019 we're talking about. 173 00:06:26,639 --> 00:06:27,139 Together, 174 00:06:27,600 --> 00:06:30,319 we're crafting initiatives that are more holistic and 175 00:06:30,319 --> 00:06:30,819 inclusive, 176 00:06:31,435 --> 00:06:33,055 far reaching, and cover 177 00:06:33,754 --> 00:06:34,254 education, 178 00:06:35,354 --> 00:06:36,735 access to training, 179 00:06:37,115 --> 00:06:37,615 and 180 00:06:38,074 --> 00:06:40,334 access to the academics they need. 181 00:06:41,115 --> 00:06:43,595 Absolutely. And and I'm glad you called out, 182 00:06:43,834 --> 00:06:46,175 that this is really looking to tackle systemic 183 00:06:46,699 --> 00:06:49,580 barriers in this physician workforce as well, Dorothy, 184 00:06:49,580 --> 00:06:52,300 because as you know, a significant portion of 185 00:06:52,300 --> 00:06:54,080 this investment is focused on increasing 186 00:06:54,459 --> 00:06:55,120 the representation 187 00:06:55,420 --> 00:06:58,779 of Latino physicians in the state given their 188 00:06:58,779 --> 00:06:59,279 underrepresentation 189 00:06:59,819 --> 00:07:01,199 in the medical field despite 190 00:07:01,574 --> 00:07:05,175 California's large Latino population. So how do you 191 00:07:05,334 --> 00:07:08,394 how does Health Net envision this investment improving 192 00:07:08,454 --> 00:07:11,574 health care access and patient outcomes, from from 193 00:07:11,574 --> 00:07:12,235 that lens? 194 00:07:12,935 --> 00:07:14,154 You know, we've seen 195 00:07:14,729 --> 00:07:17,610 trust blossom between patients in the health care 196 00:07:17,610 --> 00:07:20,269 system when patients meet doctors 197 00:07:20,970 --> 00:07:22,189 and other practitioners 198 00:07:22,649 --> 00:07:23,949 who speak their language. 199 00:07:24,410 --> 00:07:25,389 That trust, 200 00:07:26,490 --> 00:07:29,550 between patient and doctor leads to clearer communication 201 00:07:30,345 --> 00:07:31,645 and healthier outcomes. 202 00:07:32,504 --> 00:07:35,004 You noted that there's some, discrepancies. 203 00:07:35,305 --> 00:07:38,685 Nearly forty percent of Californians identify as Latino, 204 00:07:39,145 --> 00:07:41,964 but just 6% of the physicians are Latino. 205 00:07:43,000 --> 00:07:45,879 This isn't just a statistic when you it 206 00:07:45,879 --> 00:07:49,019 really does create a barrier to culturally centered 207 00:07:49,399 --> 00:07:51,979 care and, therefore, to better health outcomes. 208 00:07:52,839 --> 00:07:54,540 So that's why, you know, 209 00:07:54,919 --> 00:07:56,199 as part of this, 210 00:07:57,194 --> 00:07:59,194 part of the focus of this investment is 211 00:07:59,194 --> 00:08:00,014 we're committed 212 00:08:01,034 --> 00:08:03,834 to every step from full tuition scholarships for 213 00:08:03,834 --> 00:08:05,854 first generation students to culturally, 214 00:08:07,274 --> 00:08:09,914 attune training programs that I mentioned, and even 215 00:08:09,914 --> 00:08:11,935 leadership development for mid career 216 00:08:12,629 --> 00:08:16,569 clinicians, especially Latino physicians, to advocate on behalf 217 00:08:17,189 --> 00:08:18,410 of growing this pipeline. 218 00:08:19,270 --> 00:08:22,009 Over time, you know, we expect these efforts 219 00:08:22,069 --> 00:08:23,210 to to dissolve, 220 00:08:24,389 --> 00:08:27,770 both cultural and linguistic barriers to care, 221 00:08:28,365 --> 00:08:31,404 to boost patient engagement through that trust between 222 00:08:31,404 --> 00:08:32,544 patient and doctor, 223 00:08:33,165 --> 00:08:36,684 and, ultimately, to derive measurable improvements in health 224 00:08:36,684 --> 00:08:40,225 care because of that trust and willingness 225 00:08:41,559 --> 00:08:42,040 to, 226 00:08:42,519 --> 00:08:45,019 heed the advice of their doctor and ultimately, 227 00:08:46,279 --> 00:08:48,839 lifting the the well-being and the wellness of 228 00:08:48,839 --> 00:08:51,179 of Latino communities across the state. 229 00:08:51,720 --> 00:08:52,700 You know, our vision 230 00:08:53,475 --> 00:08:56,514 is a state where everybody sees can see 231 00:08:56,514 --> 00:08:57,815 a doctor or a nurse 232 00:08:58,355 --> 00:09:01,955 or a physician for assistant, dentist, or other 233 00:09:01,955 --> 00:09:04,455 provider who understand their their 234 00:09:05,330 --> 00:09:08,309 world, understands their world, and really honors 235 00:09:08,929 --> 00:09:10,870 their personal journey to wellness. 236 00:09:12,210 --> 00:09:13,970 Certainly. And that is such a such a 237 00:09:13,970 --> 00:09:16,610 large gap that you mentioned, Shworty, but but 238 00:09:16,610 --> 00:09:17,889 so great to know that this is a 239 00:09:17,889 --> 00:09:20,565 top priority for Health Net in terms of 240 00:09:20,565 --> 00:09:22,024 bridging that divide. 241 00:09:22,644 --> 00:09:23,625 Before we go, 242 00:09:24,004 --> 00:09:26,085 anything else you'd like to share with our 243 00:09:26,085 --> 00:09:27,845 listeners? We've got a lot of other health 244 00:09:27,845 --> 00:09:29,925 plan leaders listening in from all over the 245 00:09:29,925 --> 00:09:32,805 country. Any final bits of advice you wanna 246 00:09:32,805 --> 00:09:34,679 share with them? I don't know if it's 247 00:09:34,679 --> 00:09:36,939 advice so much as a challenge, Jacob. 248 00:09:37,319 --> 00:09:39,559 I would say to to my colleagues in 249 00:09:39,559 --> 00:09:42,439 in health care, don't wait for change to 250 00:09:42,439 --> 00:09:42,939 happen. 251 00:09:43,399 --> 00:09:44,379 Be the spark. 252 00:09:44,839 --> 00:09:48,195 This physician shortage, as you mentioned, is it's 253 00:09:48,355 --> 00:09:49,654 huge and it's daunting, 254 00:09:50,195 --> 00:09:52,674 but it's also a chance for every one 255 00:09:52,674 --> 00:09:54,294 of us and our organizations 256 00:09:55,154 --> 00:09:57,654 to make a lasting impact in the future. 257 00:09:58,035 --> 00:10:00,754 I would also challenge my colleagues to invest 258 00:10:00,754 --> 00:10:02,134 early and boldly. 259 00:10:02,490 --> 00:10:02,990 You 260 00:10:03,370 --> 00:10:06,649 know, inspire students in classrooms, whether that's through 261 00:10:06,649 --> 00:10:09,850 investments or whether that's through your personal sharing 262 00:10:09,850 --> 00:10:10,909 your personal experience. 263 00:10:11,690 --> 00:10:12,830 Remove financial 264 00:10:13,209 --> 00:10:14,589 and systemic barriers, 265 00:10:15,384 --> 00:10:16,924 mentor emerging talent, 266 00:10:17,704 --> 00:10:19,644 and ultimately support the caregivers 267 00:10:20,105 --> 00:10:22,904 we're talking about who are already serving our 268 00:10:22,904 --> 00:10:23,404 communities. 269 00:10:24,504 --> 00:10:27,000 And finally, my final challenge is 270 00:10:27,399 --> 00:10:30,299 embrace cultural empathy and closing gaps in care, 271 00:10:31,080 --> 00:10:32,059 as your compass. 272 00:10:33,159 --> 00:10:35,580 You know, those two things together 273 00:10:36,519 --> 00:10:39,480 are necessary. You have to understand the journey 274 00:10:39,480 --> 00:10:41,100 in order to help the patient 275 00:10:41,735 --> 00:10:44,235 understand and seek the care they're they need. 276 00:10:44,534 --> 00:10:46,394 And so by partnering across 277 00:10:46,774 --> 00:10:47,595 health plans, 278 00:10:48,214 --> 00:10:51,495 schools, advocacy groups, and community organizations as we've 279 00:10:51,495 --> 00:10:52,954 been talking about this morning, 280 00:10:53,414 --> 00:10:55,654 we can build a future where everybody has 281 00:10:55,654 --> 00:10:57,970 a seat at the table of care and 282 00:10:57,970 --> 00:11:00,549 every Californian thrives. Those are my challenges. 283 00:11:01,089 --> 00:11:03,029 Last thoughts for my colleagues. 284 00:11:04,209 --> 00:11:06,370 Wonderful. Well, I think that's a great place 285 00:11:06,370 --> 00:11:09,089 to leave things, Dorothy. I wanna thank you 286 00:11:09,089 --> 00:11:10,690 for taking the time to sit down with 287 00:11:10,690 --> 00:11:13,524 us and for sharing with us and our 288 00:11:13,524 --> 00:11:16,485 listeners about all the impactful work going on, 289 00:11:16,804 --> 00:11:19,205 under your leadership at Health Net. So so 290 00:11:19,205 --> 00:11:19,865 thank you. 291 00:11:20,245 --> 00:11:22,164 Oh, thank you for having me again. I 292 00:11:22,164 --> 00:11:24,644 I really appreciate the opportunity to talk about 293 00:11:24,644 --> 00:11:25,940 this this wonderful, 294 00:11:26,800 --> 00:11:28,019 investment in our future. 295 00:11:28,480 --> 00:11:30,639 Absolutely. And to our listeners, if you'd like 296 00:11:30,639 --> 00:11:33,139 to listen to more podcasts from Becker's Healthcare, 297 00:11:33,279 --> 00:11:36,179 you can visit beckershospitalreview.com.