At the center of healthcare leadership is Lisa Wright , a veteran professional guided by a mission of compassion and a career that has been devoted to enhancing the lives of the individuals who are struggling through the intricacies of health insurance. Lisa's career path in the field of health insurance was significantly influenced by early experiences in the National Marrow Donor Program, where her spirit of compassion was given purpose.
Her commitment to healthcare increased as she devoted considerable time on behalf of patients requiring a bone marrow or stem cell transplant. This advocacy increased her health care skill set, as a result of the immense coordination with insurance organizations. For twenty-plus years, Lisa Wright has gained considerable professional experience in the health care sector, with an interest in government programs and underserved populations.
As an executive at WellCare in Tampa, Florida, and a regional leader for UnitedHealthcare's Texas region, Lisa Wright developed expertise in health insurance. In May 2020, inspired by her passion for creating a positive difference, she became President and CEO of Community Health Choice (Community). There, she oversees a passionate team united by a vision of improving the well-being of the underserved population, a mission dear to her.
Community Health Choice is a local, non-profit health plan that provides a variety of health insurance programs and services to our Members. As a Managed Care Organization (MCO), it provides coverage under the Children's Medicaid (STAR) and CHIP programs, and an HMO Dual Special Needs Plan (D-SNP), as well as providing plans made available through the Health Insurance Marketplace.
In this special feature, we go in-depth with Lisa's remarkable path, delving into her experiences, reflections, and the impactful role she fills at Community Health Choice.
A Leader's Journey at Community Health Choice
Lisa's entry into Community Health Choice was during a revolutionary time in the healthcare sector. Among a group of hardworking people, she shared a common mission with Community to provide healthcare services to under-served residents in Southeast Texas. Highlighting the non-medical determinants that affect health, Lisa Wright reports, "In addition to medical care, Community has a strong focus on addressing the non-medical drivers of health, understanding their role in enhancing health outcomes and reducing health disparities."
Starting her career in the midst of the COVID-19 pandemic, the initial priority was to cushion its effects for employees, patients, and health professionals. Looking back on almost four years at Community, Lisa Wright is optimistic, saying, "I am optimistic that we will find more effective ways to address the health challenges and make a positive impact on the communities we serve."
At Community, Lisa Wright led strategic growth and diversification, achieving an impressive 42 percent growth, setting a record of more than 550,000 Members, 25,000 providers, and 100 community collaborations. Lisa's staff was instrumental in addressing mental health issues through creative partnerships, like collaboration with the Harris Center for developing an inpatient center for the homeless. This facility offers an enabling environment to rehabilitate and reintegrate into society successfully, demonstrating the dedication to well-being and responding to social needs in vulnerable communities.
In her own words, "As part of my dedication to leadership development, I have initiated new leadership initiatives with an emphasis on alignment across the organization to make certain we not just excel together but also become better at the services we provide to those we serve." She invites leaders to adopt the mantra 'Run it like you own it!'
Personalized Healthcare Solutions for Every Stage of Life
Understanding the individuality of each person's healthcare needs, Community is dedicated to offering customized solutions empowering individuals and families to succeed and live healthier lives. The variety of health insurance plans is created to support every phase of life so that complete coverage and assistance is provided:
CHIP Unborn: Pregnant women are provided prenatal care for their unborn child.
CHIP: Insurance through age 19 for those whose families don't qualify for Medicaid and cannot pay for private coverage.
STAR: Medicaid coverage through age 21 for U.S. citizens who cannot afford health coverage.
Health Insurance Marketplace: Designed for those and their families without employer-sponsored coverage.
Medicare Advantage HMO Dual Special Needs Plan (D-SNP): Only for those low-income individuals eligible for both Medicare and Medicaid, providing additional benefits without cost.
STAR+PLUS: Global coverage for adults with disabilities or seniors aged 65 years and older, integrating acute care with long-term services and support (LTSS) to foster community living.
Third-Party Administrator (TPA) – Harris Health Indigent Program: Community participation in contracting, claims administration, and provider relations for this program.
Outside of insurance plans, Community Health Choice's CareerReady initiative is instrumental in furthering the Medicaid mission, seeking to offer a way out of poverty and upward on the economic ladder. Focusing on young adults aged 17 to 30 years old, pregnant women, high school seniors, and eligible Marketplace Members, the CareerReady scholarship subsidizes tuition, fees, and books necessary for job certification.
Adapting and Thriving
Overcoming the challenges of the COVID-19 pandemic became one of the biggest challenges for Community Health Choice. Looking back at this difficult time, Lisa Wright adds, "We adapted by utilizing Telehealth to effectively continue serving our Members throughout this crisis. We shifted the majority of our 800-member workforce to working remotely while maintaining productivity and personal obligations."
During the pandemic, the commitment to Members did not falter. Emergency healthcare requirements were met immediately, using out-of-the-box thinking such as organizing transportation for office appointments and conducting in-home physician visits. Partnerships with Federally Qualified Health Centers helped organize immunization drives among people in communities, and an alliance with Mom's Meals made sure children had food available. Immunizations for kids and visits to elderly people were given high priority. In the midst of the challenges, the commitment to delivering uninterrupted service to more than 550,000 Members continued.
Lisa Wright points out, "The pandemic presented challenges but also made us reconsider our work approach. We pursued a hybrid office setup, offering our employees options for working remotely and in the office." This approach not only provided flexibility but also put the onus on employee engagement. As it evolves, Community Health Choice is poised to move to a new office located in the center of Houston. Designed to foster collaboration, communication, hoteling space, and employee well-being, the office is reflective of the organization's focus on resilience and flexibility.
Embracing Innovation for Improved Member Experience
In its commitment to providing excellent service to its Members, Community Health Choice continually seeks technological alternatives that make plan administration more efficient, save time, and are more convenient for Members.
Lisa Wright points out, "This year, we introduced our Member mobile app. This app gives access to benefits from a user's smartphone or tablet any place, any time." The app enables Members to see coverage plan information, find a doctor, review claims and authorizations, get notices, and more.
Community Health Choice continues its virtual care promise by offering several services such as Telehealth and a virtual-only product. Telehealth allows Members to speak with a physician for their everyday health issues 24/7, accessible anywhere using phone, web, or mobile app. Members may order or refill prescriptions and obtain guidance from healthcare professionals prior to visiting an ER or urgent care center.
In the future, Community is set to adopt cutting-edge technologies, especially with artificial intelligence (AI). Lisa Wright observes an emerging trend across the healthcare industry where AI is being used to review the need for prior authorizations, a radical change in relationships among health plans and healthcare providers.
AI integration automates the evaluation of incoming authorization requests. AI makes a detailed evaluation, establishing the sufficiency of clinical documentation against the specifications of mandatory authorization. Lisa Wright points out that AI-based recommendations simplify the authorization process, with improved overall efficiency.
Lisa Wright's vision is, "The adoption of this technology will free our staff from routine tasks, giving them the ability to improve their skills and concentrate on mission-critical activities."
Pioneering Progress
In its steadfast dedication to providing superior services, Community Health Choice aggressively undertakes ongoing research and development (R&D) activities in a bid to comprehend changing health needs in the community. Lisa Wright emphasizes, "Our goal is to better understand the changing health needs of our Members," highlighting the importance of these assessments in informing Member benefits in a better alignment with distinctive needs.
Strategically utilizing Member information, Community positions itself to anticipate and respond to changing needs and behaviors. Lisa Wright highlights continued R&D efforts, such as the assessment of children's mental health, nutrition's effect on pregnancy, and research aimed at non-medical determinants of health (NMDOH).
To tackle children's mental health, Community has teamed up with futuresTHRIVE and integrated TweenScreen mental health screening software. This easy-to-use application, based on sound research sources, actively identifies potential mental health threats in children, providing helpful information for healthcare professionals and parents.
In reaction to sobering data on black maternal health disparities, Community partners with Harris Health in the ACCESS Black Maternal Health program, which seeks to mitigate the risk to black women at birth and infant mortality. Lisa Wright clarifies, "This disparity is partly due to poor care before, during, and after pregnancy."
Community's commitment to advancing services is extended to a collaboration with ProgenyHealth, offering maternity care management services in their entirety. The co-branded Community/ProgenyHealth app offers Members persistent, connected support throughout their parenting experience, advancing optimal maternal and infant health.
To address the widespread mental health issue, Community works in conjunction with the Harris Center to provide a specialized inpatient center for the homeless. This center transcends traditional measures, promoting rehabilitation and successful integration into society.
In a major milestone, Community Health Choice achieves interim NCQA accreditation, reflecting its dedication to improving Member health outcomes. As the state's lone dually accredited health insurance plan, in addition to current URAC accreditation, Community establishes a high standard of quality healthcare in Texas, reaffirming its commitment to excellence.
Building a Bright Future
In providing advice to future healthcare professionals, Lisa Wright stresses the need to be ready for challenging, dynamic issues that require creative and cooperative answers. She emphasizes the necessity for a strong passion for enhancing the health and well-being of varied populations and meeting the social and environmental determinants impacting them.
To be successful in the healthcare industry, Lisa Wright recommends developing a strong leadership, vision, and sense of responsibility, combined with lifelong learning and professional growth. Upcoming professionals are urged to take active steps towards increasing their knowledge and expertise in healthcare economics, policy, management, and delivery. Establishing networks with like professionals and stakeholders who have the same goals and values is also important
She also relates, "My advice to potential leaders is to channel your energy into what you can manage; the rest is gravity." Emphasizing the need to develop good relationships for sustainability in the long run, Lisa Wright highlights the usefulness of investing in people and developing a team of skilled professionals. Knowing that each day is a learning day, Lisa tips future leaders not to feel obligated to have all the answers, stressing the importance of employing the best and brightest workforce.
When dealing with challenges, Lisa Wright encourages adopting the mindset that there is always an alternative and a "no" can even be considered as delay instead of rejection.
Next Chapter in Healthcare
In an important move toward increasing the health and well-being of underserved Texans, Community Health Choice is pleased to add the Texas STAR+PLUS program to its 2024 plan offerings. Designed specifically to offer life-saving Medicaid managed-care services to those with disabilities and individuals 65 and older, generally among the most vulnerable in our communities, Lisa Wright points out, "The STAR+PLUS program will enable Community to reach an additional segment of the population."
The roll-out of the STAR+PLUS plan is a landmark expansion, symbolizing Community's dedication to creating healthier lives for everyone. More than just insurance coverage, the overall goal is to provide extensive long-term services and support that are tailored to the specific needs of participants in the program.
Lisa Wright underscores, "We will adopt a more intensive service-coordination model to maximize care and delivery, in alignment with the individualized needs of each Member." Redesigning Member benefits to optimize alignment with individual needs; Community uses Member information to proactively anticipate needs and behaviors in order to maximize tailoring and effectiveness of care.
Placing emphasis on prevention strategies, such as vaccine encouragement, environmental health issues resolution, and resolution of non-medical determinants of health (NMDOH), Community Health Choice seeks to raise its proactive role. Through advanced Member data, the organization effectively identifies Members needing preventive interventions or support in resolving NMDOH, avoiding sickness and health decline.
Lisa Wright sees Community's future with greater focus on meeting NMDOH through digitalized operation and incentive models. Data is critical in determining required benefit increases to meet certain NMDOH factors, further testifying to Community Health Choice's dedication to global, personalized, and effective healthcare for its Members.
