Nationwide, 100 million people are impacted by medical debt. Los Angeles County (LAC) has adopted a public health approach to reducing financial harm in healthcare systems. As a first step, the Department of Public Health is developing a consortium to monitor and measure the problem and identify opportunities to improve outcomes and reduce harm locally. The FUSE Executive Fellow will guide the development and direction of the consortium.
ABOUT THE FUSE EXECUTIVE FELLOWSHIP
FUSE Corps is a national nonprofit working to expand social and economic opportunities, particularly for communities that have been limited by a history of systemic and institutionalized racism. FUSE partners with local governments and communities to more effectively address pressing challenges by placing experienced professionals within city and county agencies. These FUSE Executive Fellows lead strategic projects designed to advance racial equity and accelerate systems change. Since 2012, FUSE has led over 250 projects in 40 governments across 20 states, impacting the lives of 25 million people.
When designing each fellowship project, FUSE works closely with government partners and local stakeholders to define a scope of work that will achieve substantive progress toward regional priorities. FUSE then conducts an individualized search for each project to ensure that the selected candidate has at least 15 years of professional experience, the required competencies for the role, and deep connections to the communities being served. They are data-driven and results-oriented and able to effectively manage complex projects by developing actionable roadmaps and monitoring progress to completion.
Executive Fellows are hired as FUSE employees and embedded in government agencies for at least one year of full-time work. Throughout their fellowships, they receive training, coaching, and professional support from FUSE to help achieve their project goals. FUSE Executive Fellows bring diverse perspectives and new approaches to their projects. They build strong relationships with diverse arrays of stakeholders, foster alignment within and across various layers of government, and build partnerships between governments and communities.
According to Kaiser Health News, 100M Americans are impacted by medical debt linked not only to personal financial strain, but also to widespread community hardship, endemic poor health outcomes and other social determinants of health such as housing and food insecurity. Another harm of the healthcare system is its inherent overuse of medical services. According to Segal et al in the Journal of the American Medical Association, “Overuse of health care, or the provision of low-value or no-value care, is consistently identified as contributing to high costs in the US health care system. This wasteful care is physically, psychologically, and financially harmful to patients.” Finally, community benefits spending can better target upstream issues that drive population health and prevent debt and overuse in the first place.
LAC’s Department of Public Health has adopted a public health approach to the threefold financial harms of medical debt, healthcare overuse, and improving hospital community benefit within its jurisdiction. To launch this approach, it is building a surveillance and analysis system to measure and monitor the landscape, and engage with community, industry, and government partners to develop policies and programs.
Los Angeles County will partner with FUSE Corps to create a consortium of researchers and healthcare experts to understand the environment of healthcare financial harms in Los Angeles County. The FUSE Executive Fellow will map out the data and stakeholder landscape and cultivate the partnerships necessary to collect and analyze the data. This work will equip LAC Department of Public Health with essential, current, and local information necessary to make effective, equitable interventions to reduce financial harm.
PROJECT SUMMARY & POTENTIAL DELIVERABLES
The following provides a general overview of the proposed fellowship project. This project summary and the potential deliverables will be collaboratively revisited by the host agency, the fellow, and FUSE staff during the first few months of the fellowship.
Starting in April 2023, the FUSE Executive Fellow will develop deep relationships with a range of critical stakeholders, including Department of Public Health leadership and experts; other LAC government entities (e.g., the Anti-Racism Diversity and Inclusion Initiative); state government; healthcare system researchers (i.e., Lown Institute, Los Angeles-area universities); for- and non-profit hospitals; and health justice advocacy groups. The Executive Fellow will gain an understanding of the status quo in the local healthcare system (both for- and non-profit); the regulatory environment in which it operates; and its strengths, weaknesses, opportunities, and challenges. At the same time, the Executive Fellow will conduct extensive research on how other similarly large and diverse communities have pursued a public health approach to eliminating financial harms.
Next, the Executive Fellow will conduct a landscape analysis, mapping the stakeholders in the healthcare system and their priorities; the data necessary to measure financial harm in the system (with emphasis on medical debt, medical overuse, and community benefits); the current and potential sources of data; and the possible levers (both incentives and disincentives) to correcting these trends and promoting more equitable healthcare access in Los Angeles County.
In addition, the Executive Fellow will develop a consortium of partners to adopt a public health approach to measuring and monitoring financial harm in the LAC healthcare system. This consortium should include community partners, academic researchers, and state and local government public health officials. In addition to facilitating relationships and meetings within the consortium, the Executive Fellow will coordinate the development of any contracts or grants needed to finance consortium partners’ participation in this effort.
Finally, the Executive Fellow will be the primary point of contact for consortium work, advancing their priorities and recommendations on a day-to-day basis on behalf of the County.
- Conduct a Stakeholder Listening Tour – Develop relationships with stakeholders in the County and State government, healthcare system, academic and research communities, and advocacy groups. Review literature, evidence, and models for measuring financial harm in healthcare systems
- Landscape Analysis – Map out LAC’s healthcare system, including stakeholders, their motivations, current and potential sources of data, and current and potential opportunities for intervention to reduce or prevent financial harm
- Consortium Development – Initiate and nurture relationships with County and State-level government officials as well as non-profit, academic, and public researchers to collectively advance the elimination of financial harm in Los Angeles County’s healthcare system. Coordinate grant and/or contract development to finance consortium participation as necessary
- Advance Consortium Work – Serve as day-to-day coordinator of the consortium’s work. Advance consortium mandate and recommendations within Los Angeles County government
- Executive Sponsor – Dr. Naman Shah, Director – Division of Medical and Dental Affairs; Department of Public Health
- Project Supervisor – Melina Boudov, Manger – Health Care Consumer Protection; Department of Public Health
In addition to the qualifications listed below, a background in hospital administration and healthcare finance is strongly preferred for this project.
- Synthesizes complex information into clear and concise recommendations and action-oriented implementation plans.
- Develops and effectively implements both strategic and operational project management plans.
- Generates innovative, data-driven, and result-oriented solutions to difficult challenges.
- Responds quickly to changing ideas, responsibilities, expectations, trends, strategies, and other processes.
- Communicates effectively both verbally and in writing and excels in both active listening and conversing.
- Fosters collaboration across multiple constituencies to support more effective decision making.
- Establishes and maintains strong relationships with a diverse array of stakeholders, both inside and outside of government, and particularly including community-based relationships.
- Embraces differing viewpoints and implements strategies to find common ground.
- Demonstrates confidence and professional diplomacy, while effectively interacting with individuals at all levels of various organizations.
FUSE Corps is an equal-opportunity employer with core values of diversity, equity, and inclusion. We encourage candidates from all backgrounds to apply for this position.