The Future of Healthcare: “We need to put a stake in the ground around parity” With Jill Wiedemann-West, CEO of People Incorporated
We need to put a stake in the ground around parity. Not only service, coverage and reimbursement parity, but the kind of parity that answers the question, “should entitlement insurance expectations be par with private insurance expectations?” The example here is simple: Do we believe that even though an individual’s healthcare insurance is paid for by our government, that they should enjoy the same access, coverages, services and cost models as everyone else? Parity levels the playing field, and we have been working on it for a really long time.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Jill Wiedemann-West. Jill joined People Incorporated as its first chief operating officer in 2010. She was promoted to CEO in 2014. Her professional background and experience includes 20 years in healthcare operations, management and service development, having previously served as the COO at Hazelden Foundation for 11 years. She earned a master’s degree in psychology and human behavior at National University in San Diego, and a bachelor’s degree in sociology and social work from the University of Wisconsin — Madison.
Thank you so much for doing this with us Jill! Can you tell us a story about what brought you to this specific career path?
The story starts way back when I was young. I always was very drawn to people, particularly vulnerable people and individuals who needed help, which is ultimately why I went to school for psychology and social work. My life has always been about discovering what talents and skills I needed to cultivate so I could be the most useful to others. As my story progressed, I learned as a young professional that, while I still really enjoy the direct service aspect of helping people, I became enamored with trying to make systems and conventions work better for people who are in such deep need. I’ve since cultivated a drive and interest in trying to identify and solve the systemic problems in the way vulnerable people are treated, access care and enter a recovery process, which includes improving policy and systems.
Can you share the most interesting story that happened to you since you began leading your company?
We run a program called Artability, which is a workshop program that promotes mental health through artistic self-expression. The only requirement for participation is that you need to be someone who lives with mental illness. Once a year, we offer a call for art from Artability artists and put on a three-day art show for them to show and sell their work. I have always loved this program for a number of reasons — one of them is because art is the great equalizer. All these artists suffer daily with so much; sometimes getting out of bed is a major challenge. Because I know the challenges and barriers these folks face, it’s the most amazing experience on opening night of the Artability Art Show to see their pride and excitement when they realize people are interested in their work — and pay money for it! That patrons revel in meeting these artists and learning about their particular abilities. Every time I think about it, I am just so filled with pride. Every day, these artists wake up with depression, anxiety, schizophrenia or bipolar disorder, but on opening night, their art — rather than their diagnosis — defines them. Even if it’s just for that sliver in time, they are not just someone living with mental illness; rather, they’re an artist. Extraordinary!
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
When I initially started at People Incorporated as COO, I was desperately trying to reach out to one of my specialty programs, which was for individuals with mental illness and deafness. I looked at the phone listing that I had strategically hung by my phone at my new desk, and proceeded to call several times, but never got a response. After several attempts, I went to another staff member and wondered aloud why I couldn’t reach the department. The person I was talking to said, “Well, Jill, it’s not only the clients in that program who are deaf; the program’s staff are deaf as well. If they’re not looking at the phone to see it light up, they won’t answer because they cannot hear it.” The eye-opening mistake I made continues to serve as a potent reminder for me to always remember to first “seek to understand” and never to jump to conclusions. And I made sure that all future phone listings had a note next to that program to email the staff instead of call.
What do you think makes your company stand out? Can you share a story?
I think the main reason People Incorporated stands out is because of the people who work here. They care deeply about the people we serve and are committed to serving them in all the right ways. They are skilled and professional, compassionate and invested. I always say we have the best chemistry at People Incorporated, and I absolutely believe that at my core. It’s not always perfect, but it stands out every day.
I also see our organization as a bit different because we commit to reinvestment in the organization in thoughtful and innovative ways that directly support our clients, who are the most vulnerable members of our community. For 50 years now, we have been focused on providing and expanding on our integrated care model at People Incorporated. Our clients do not come to us with one issue or concern to solve for. As a result, we need to be better than good at integrating all of the healthcare needs these folks present with every day. It’s not uncommon for us to see someone who — because of their mental illness — has major housing challenges, a history with law enforcement, an absent support system and is suffering with multiple medical issues, and they just don’t know where to begin. At People Incorporated, we believe no one thing is more important than the other. We wrap our arms around the whole person, recognize and practice an integrated approach, and seek better outcomes for our clients as a result. We coordinate their care with all of those needs in mind. And even if we don’t provide the services, we connect them. Our philosophy is to always find a way to make it work. Sounds simple, but in action, it is quite extraordinary.
What advice would you give to other healthcare leaders to help their team to thrive?
A few things come to mind. First, if you talk about or strive to be a team, know what you mean by that and truly make it evident in all the ways you lead. Too often, we stretch or contract the concept to adjust not to how we as leaders want to maintain our team approach; rather, we adjust it for the way in which we are actually implementing it. If you are not really deploying as a team, consistent with the manner in which you define it in your leadership and organizational culture, you will get sloppy and lazy — and it will have a horrible effect on all aspects of what you are aiming to accomplish.
Second is altitude. Altitude is a funny thing. On one level, leaders need to find the right altitude at which they manage and lead, and be cautious to really operate in the range 90% of the time. It’s hard, but I have personally come to learn that it’s really necessary. On the other hand, a good leader needs to make sure they never drift too far away from where the work happens and what that looks like. No good leader wants to just be a “suit of clothes.” We all want to inspire, so that others can aspire to do more. In order to do that well, we need to never completely remove ourselves from “the floor” where the work happens. I am not suggesting micromanagement or permanent altitude adjustments, rather staying close enough that one continues to feel kinship with the larger team and have a congruent awareness of the work. Not an obvious or easy balance, but I think worthy of the effort.
Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
- The primary reason is that the cost-benefit appears unaligned. The U.S. spends such a significant portion of its resources on healthcare, but we see a staggering level of homelessness, people who are uninsured or underinsured, people living at or around the poverty level with inhibited insurance because of high deductibles, copays and the like — not to mention, generally poor health status and of chronic illness related to lifestyle. If you look at the U.S. gross national product, it’s astonishing that healthcare is right there at the top of the list, yet we see an alarming amount of unmet need in all our communities. To the eye of the observer, it stands out as very misaligned.
- Additionally, our healthcare system is not set up to be a truly functioning system — the way we fund healthcare is set up in a very cohorted way. Of course, we need vehicles for proper payment or funding, but because we are cohorted as a country, our funding actually impairs our ability to provide a true system of care. We provide many discreet solutions or opportunities, but without an integrated system that treats the whole person, we’re never going to completely meet the needs that exist. Imagine you’re a person who is not safely and securely housed. If that is your experience, then no matter what I do to intervene and treat your mental health issues, strong and sustainable outcomes are unlikely. Because your housing status or lack thereof will not support your stability, adherence to treatment and proper symptom management will be virtually impossible. If we truly believe in a functioning healthcare system, it has to be for everyone, not just the people who have the money and insurance to pay for it. The system needs to treat the whole person, and it needs to be manageable. The system also needs to function like a system, understanding that attending to one aspect of health without an eye to the other aspects of health will leave us with an incomplete intervention. We are complex animals!
- I also believe the way we approach the most vulnerable people in society is too hierarchal — we seem to collectively think that individuals with significant disability, like mental illness or chemical dependency, somehow don’t have the same right to a level of care that is comprehensive, integrated and thoughtful. As a society, we have talked ourselves into entitlement insurance structures that provide less than what most of us need. That’s a dangerous mindset. If we’re to actually work and think like a functional system — expecting and anticipating high values and outcomes, even for our community’s most complex individuals — then we should be giving those individuals the highest, most appropriate level of care to get improved high value outcomes. Why we take ourselves off the hook is a mystery to me.
- Another staggering problem to me is what is left out of the public health crisis conversation. In the U.S., more than 100 people take their own lives each day, and those are just the ones that the medical examiner can conclude without a doubt. What about someone who jumped in front of a car, but we identify it as a vehicular accident? How many take their own lives and we don’t know that it was suicide? If we would look at the suicide rate against things like communicable diseases and other major illnesses in our society, how can we tell ourselves that it is less of a severe public health crisis? Somehow, we stop short. When you think about our history with public health, it seems like an obvious miss to me that we’re seeing all of what we’re seeing right now with mental health but we’re not actually acknowledging it as the significant — and devastating — crisis that it is.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- We need to put a stake in the ground around parity. Not only service, coverage and reimbursement parity, but the kind of parity that answers the question, “should entitlement insurance expectations be par with private insurance expectations?” The example here is simple: Do we believe that even though an individual’s healthcare insurance is paid for by our government, that they should enjoy the same access, coverages, services and cost models as everyone else? Parity levels the playing field, and we have been working on it for a really long time.
- We need to finish what we start. When we make sweeping changes in the way we treat certain members of our community, like those with serious and persistent mental illness, we need to close the loop. When we closed most of the asylums and moved our disabled into community settings, including our mentally ill, we did a great and important thing that honored the dignity of every individual. However, we need to complete this work. These folks need new and different community supports, housing and many other things that allow them to live fulfilled in community settings. Doing great and informed things is a long-game, which requires vision and commitment.
- Focus on integration. We are complex beings, all of us, and particularly those with a disabling disease or condition. We need to discipline ourselves to look at the whole person in our interactions, so that we are really creating sustainable and quality resolutions and interventions. We need to teach integrated thinking in all aspects of healthcare education, and we need to adjust our system to support this thinking and model of care. A great example of this is where we have a client presenting continually with a variety of physical complaints and conditions, which never seem to improve, and where the client does not follow through with recommendations and actually continues to acquire more issues. At some point, without assessing for mental health, we do not know if a mental health condition is vital to this client’s health complaints, a barrier to improvement, or both.
- We need to build and support focused mental health programming and interventions in our young. We need to put energy and resources into prevention and primary interventions around mental and behavioral health with our youth. Building coping mechanisms and resilience as “cost of admission” programming at every level, and strong interventions for those in need. The most poignant example of the challenges in this area reside in the growing rate of suicide among our youth and young adult populations. We just have to do better on a number of fronts.
- Keep our eyes on healthcare system reform. We have much to be proud of in the United States regarding our healthcare system, discoveries and improvements. We need a system for all that delivers this asset in a manner that is complete, fair and sustainable for everyone. I do not have all the answers, but I know they exist. When we can “stand-up” the return or outcomes on this important and significant investment and see the value and sustainability for our whole population, we can be proud!
Ok, its very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
- Individuals need to see disabilities differently. We all have to see the need for a functioning, integrated system and remove the stigma that’s very much still present.
- Corporations need to take a bigger role in supporting and investing in their communities. Many are doing good work, but we need to find sustainable funding sources that come from the private sector to support and sustain those dependent on the public sector systems.
- Communities need to step up to the plate to create sustainable, integrated, systemic change so that we are truly thinking about building our communities for everyone, and acknowledging the terrific needs that are going unmet currently. It is not a “one and done” solution. We have to create the whole solution.
- Leaders must be bold. We all have to be less afraid of telling our truths. Leaders are supposed to be in leadership roles because they are the lightning rods for potential change and reform. In everything from investments to technology, we’ve seen brilliant leaders put their own reputations at risk to make change for the greater good. We can’t be partisan politically. We can’t be afraid individually or professionally. If we know, think or see something that needs to change, we simply have to be bold enough to say it, and then seek the solutions to change it.
As a mental health professional myself, im particularly interested in the interplay between the general healthcare system and the mental health system. Right now we have two parallel tracks mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
That is right on; the systems do act parallel. Most healthcare professionals in the physical health area have some apprehension about getting outside of their lane. General practitioners or emergency room doctors who see telltale signs of addiction or mental illness struggle with addressing what they see, or even feeling competent to do so. There is a lot of fear about drifting out of an established comfort zone and addressing behavioral or chemical health issues with clients and helping them in identifying next steps. I get it, it’s awkward, like me discussing blood sugar or hypertension. Nonetheless, those at the top of our healthcare pyramid need to be prepared to go there with their patients. We know the comorbidity of cardiac disease and diabetes, for instance, as related to depression. In order to provide care in the best possible manner, we need to be integrated in our thinking. That integration requires us to get comfortable with the whole person, and to form our delivery system to ensure there are proper vehicles to address that whole person.
How would you define an “excellent healthcare provider”?
An excellent healthcare provider is an individual who first and foremost is really in touch with the human condition. I think it is essential that someone in the business of care in general should understand and appreciate all the complexity that is the individual before them. Additionally, a provider that is an active listener and learner will always produce a better relationship and a better result. Learning requires both listening and observation, and for the healthcare professional, all the data and diagnostics available cannot replace understanding and awareness.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Gratitude and attitude are not challenges, they are choices.” — Robert Braathe
I’m a person who tries to start from a place of gratitude in all things. If I start from and hold steady to my sense of gratitude, I am better, stronger and more resilient for anyone else who is counting on me. It helps me weather disappointments and frustrations because I can redirect myself to a better place. I wish I could tell you I do this well every day, but regrettably I do not. That said, I really am grateful to lead my organization and work with such amazing people, clients and potential. I believe we have choices; find a way to make something happen, or find a way not to. Be frustrated and angry about what did not occur, versus being grateful for what we did manage to achieve. Seek perfection only, instead of accepting and celebrating smaller victories. My attitude is that there is always a way, we just need to discover it. I am truly grateful to be a part of this field and the untapped potential that exists at every level.
Are you working on any exciting new projects now? How do you think that will help people?
Yes, I’m continuing to build out our integrated system to add an ability to provide physical healthcare for our clients. We have so many clients who have physical health issues as well as mental health issues. Having that integrated care option, in a place the client already feels safe, could really assist our clients with achieving better overall health and treatment adherence. Additionally, we are doing more to build out integrated wellness services through alternative resources like art, movement, music and nutrition. We have also made a significant turn toward supporting our clients in becoming tobacco free. Research shows that individuals who live with mental illness and also smoke die earlier than someone that does not smoke, and their death is more frequently tied to tobacco use. For this reason, we took all our properties and programs tobacco free in 2017.
We are also looking at data that helps us to better understand how we are engaging our clients and how they are engaging with us, in a hope to continually identify better treatment course and services.
We’re also working on creating data-driven stories that help us understand the efficacy of certain interventions and of the integrated model overall, so we can start to speak to what we see and the data that reports with confidence in our learning. We hope it will also help us inform some level of reform as we work with vulnerable populations.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I’m such a geek! I watch, read and listen to everything. I’m addicted to TED Talks and read a wide variety of books, articles, and newspapers. Everything I read and consume gives me ideas and urges me to challenge myself and my ideas. I am known for my affinity to connect random concepts to the manner in which we experience them or anticipate them in our work. Apart from watching TED Talks, I listen to a variety of podcasts and right now I enjoy reading business books about innovative business solutions in other industries and about culture and its power in our organizations. I like reading about holistic solutions in care and the mind-body connection. For me as a CEO, it’s about seeking out information and media that feed my intellectual curiosity and then finding the pearls of wisdom that hopefully contribute to me being a better leader and a more informed individual.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
I’m really passionate about inclusion. I feel like we’ve become a very diverse and dynamic world — whether you’re looking at it from a healthcare lens or just as a community member. But we really struggle with a sense of inclusiveness at a human level. I recently saw a bumper sticker that said, “peace to everyone, no exceptions.” I thought it was a great bumper sticker, and the sentiment is so true. There’s too much hate, anger and fear, which I think comes from a place of feeling excluded or different. If I had a wish, it would be for us to become more inclusive; certainly as the United States, but even broader as a world. Setting aside our differences and finding pleasure and potential in what we all bring to the whole. That whole Miss America “World Peace” sentiment gets a bad rap, but I truly wish we all looked at people in a positive light first, honoring their uniqueness rather than how they might be different than we are. I’ve had friends with special needs children tell me their kids come home from school crying every day because they feel excluded, bullied and taunted. I really wish we could become more inclusive and tolerant, so we could actually learn and grow from our diversity and differences rather than fear and avoid them.
How can our readers follow you on social media?
Jill Wiedemann-West LinkedIn: https://www.linkedin.com/in/jill-wiedemann-west-078547a/
People Incorporated Facebook: https://www.facebook.com/PeopleIncorporated/
People Incorporated Twitter: https://twitter.com/peopleincorp
People Incorporated LinkedIn: https://www.linkedin.com/company/people-incorporated/
Thank you so much for these insights! This was so inspiring!