an informative q&a with oc’s top healthcare professionals

HEALTHCARE ROUNDTABLEAn Informative Q&A with OC’s Top Healthcare Professionals

Barry Arbuckle, Ph.D.President & CEOMemorialCare

Sunny Bhatia, MD, MMM, FACC, FSCAICEO, Region I and Chief Medical Officer

Prime Healthcare

Robert T. BraithwaitePresident and CEO

Hoag

Mark E. CostaSenior Vice PresidentKaiser Permanente

Jeff Goad, PharmD., MPH.Professor and Chair, Department

of Pharmacy Practice Chapman University School of Pharmacy

John KaoChief Executive OfficerAlignment Healthcare

Chad T. LefterisCEO

UCI Health

Kevin P. ManemannChief Executive

Providence Southern California

Marshall MoncriefCEO

Be Well OC

Gene RapisardiMarket President,

Southern California and NevadaCigna

Catherine Sinardi, Ed.D. MFTDirector of Healthcare Programs,

Associate ProfessorConcordia University Irvine

School of Health & Human Sciences

Stephen E. Thorne, IVFounder and CEO

Pacific Dental Services

Kimberly Chavalas CripePresident and Chief Executive Officer

CHOC

Jennifer Mitzner, MPA, CPAChief Executive Officer

Hoag Orthopedic Institute

Annette M. WalkerPresident

City of Hope Orange County

CUSTOM CONTENT • April 19, 2021

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HEALTHCAREROUNDTABLE PARTICIPANTS

Alignment Healthcare Alignment Healthcare is a consumer-centric platform delivering customized health care in the United States toseniors and those who need it most, the chronically ill and frail, through its Medicare Advantage plans. AlignmentHealthcare provides partners and patients with customized care and service where they need it and when they needit, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers healthplan options through Alignment Health Plan, and also partners with select health plans to help deliver better benefitsat lower costs.

Be Well OCThe vision of Be Well OC is to lead the nation in optimal mental health and wellness for all residents of OrangeCounty. Be Well OC brings together a robust, community-based, cross-sector strategy – public, private, academic,faith-based and others – to create a community-wide coordinated ecosystem to support optimal mental health. Formore information visit bewelloc.org and follow @bewelloc on Facebook and Instagram.

Chapman UniversityFounded in 1861, Chapman University is a nationally-ranked private university with campuses in Orange and Irvine.Chapman is categorized by the Carnegie Classification as an R2 "high research activity" institution and offerspersonalized education to more than 9,000 undergraduate and graduate students. The university has produced aRhodes Scholar, been named a top producer of Fulbright Scholars and hosts a chapter of Phi Beta Kappa, thenation's oldest and most prestigious honor society. Along with its historic campus in the City of Orange, Chapmanalso includes the Harry and Diane Rinker Health Science Campus in Irvine. In 2019, the university opened its 11thcollege, Fowler School of Engineering, in its newest facility, Keck Center for Science and Engineering. Learn moreabout Chapman University: www.chapman.edu.

CHOCIllness or injury shouldn’t put childhood on pause. That’s why CHOC is committed to being a leading destination forchildren’s health by providing exceptional and innovative care. Our growing healthcare system includes two state-of-the-art hospitals in Orange and Mission Viejo and a regional network of primary and specialty care centers servingchildren and families in four counties. CHOC offers several clinical programs of excellence providing the highestlevels of care for the most serious pediatric illnesses and injuries, both physical and mental. Our research andinnovation institutes are focused on translating real patient needs into real-world treatments so every child can livethe heathiest and happiest life possible. To learn more, visit www.choc.org.

CignaCigna is a global health services company dedicated to improving the health, well-being, and peace of mind of thosewe serve. With more than 180 million customer and patient relationships in more than 30 countries and jurisdictions,we are able to harness actionable insights that address whole-person health and drive better health outcomes. Ourglobal workforce of more than 70,000 employees is dedicated to living our mission and being champions for ourcustomers and communities. We call this the “Power of We.” By working together in close partnership with ourcolleagues, customers, providers, clients, and communities, we are able to create personalized solutions andadvance whole-person health.

City of HopeCity of Hope, a world-renowned cancer research and treatment center, speeds tomorrow’s discoveries to the peoplewho need them today. Expanding our pioneering work to Orange County, we are developing a comprehensivecancer campus of the future in Irvine and an Orange County network of advanced cancer care that will bring highlyspecialized cancer care, pioneering research and breakthroughs directly to the community. Construction is underwayon the Lennar Foundation Cancer Center at City of Hope Orange County, which will open in 2022. Orange County’sonly hospital dedicated exclusively to treating and curing cancer will open in 2025. City of Hope Newport Beach, thefirst phase of the Orange County expansion, provides Orange County residents first-time local access to world-renowned physicians backed by the powerful City of Hope network.For more information, please visit www.cityofhope/OC.

Concordia University Irvine – School of Health & Human SciencesThe School of Health & Human Sciences at Concordia University Irvine brings together health science and serviceprograms for greater collaboration and interdisciplinary learning with a shared focus on serving our neighbors’ healthand welfare. The School comprises residential and online undergraduate degrees in Kinesiology and HealthcareManagement; an Accelerated Bachelor of Science in Nursing; fully online and face-to-face graduate degrees inHealthcare Administration and Public Health; and a nationally-renowned M.A./M.S. in Coaching & AthleticsAdministration / Exercise Sciences. A Lutheran liberal arts university serving over 4,000 students annually,Concordia University Irvine prepares students to become wise, honorable, and cultivated citizens dedicated to theirvocations and communities. To learn more, visit us at cui.edu/healthcare.

Hoag Memorial Hospital PresbyterianHoag is a nonprofit, regional health care delivery network in Orange County, California, that treats more than 30,000inpatients and 480,000 outpatients annually. Hoag consists of two acute-care hospitals – Hoag Hospital NewportBeach and Hoag Hospital Irvine – in addition to nine health centers and 14 urgent care centers. Hoag has invested$261 million in programs and services to support the underserved community within the past five years. Hoag is adesignated Magnet® hospital by the American Nurses Credentialing Center (ANCC). Hoag offers a comprehensiveblend of health care services that includes five institutes providing specialized services in the following areas:cancer, heart and vascular, neurosciences, women’s health, and orthopedics through Hoag’s affiliate, HoagOrthopedic Institute. In the 2020 - 2021 U.S. News & World Report Best Hospitals Rankings, Hoag is the highestranked hospital in Orange County and the only OC hospital ranked in the Top 10 in California.

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HEALTHCAREROUNDTABLE PARTICIPANTS

Hoag Orthopedic Institute Hoag Orthopedic Institute (HOI) is located in Orange County, California, consisting of a specialty hospital located in Irvineand four ambulatory surgery centers in Newport Beach, Mission Viejo, Orange and in Marina del Rey. HOI specializes intreatments of knee, hip and spine disorders, sports medicine, orthopedic trauma, and extremities care. HOI opened in2010 through a unique partnership between Hoag Memorial Hospital Presbyterian and a select group of Orange Countybased orthopedic physicians with many years of experience providing excellent care to orthopedic patients. Our mission isto be the premier musculoskeletal system of care in Orange County, sought for our superior outcomes and value. HoagOrthopedic Institute is nationally ranked in the Top 2% and 50 best orthopedic hospitals of U.S. News & World Report's"2020-2021 Best Hospitals" list. Visit hoagorthopedicinstitute.com for more information.

Kaiser PermanenteKaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’sleading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission toprovide high-quality, affordable health care services and to improve the health of our members and the communities weserve. We currently serve 12.4 million members in 8 states and the District of Columbia. Care for members and patients isfocused on their total health and guided by their personal Permanente Medical Group physicians, specialists, and team ofcaregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advancesand tools for health promotion, disease prevention, state-of-the-art care delivery, and world-class chronic diseasemanagement. Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support ofcommunity health.

Memorial CareMemorialCare’s 225 locations include top hospitals - Long Beach Medical Center, Miller Children’s & Women’s HospitalLong Beach, Orange Coast Medical Center and Saddleback Medical Center; MemorialCare Medical Group, GreaterNewport Physicians, MemorialCare Research, MemorialCare Select Health Plan and numerous outpatient ambulatorysurgery, medical imaging, urgent care, breast health, physical therapy, dialysis and primary care and specialty carecenters. Accolades include Best Health System, Best Workplaces, Top Performing Medical Groups, Magnet NursingExcellence for all MemorialCare hospitals, 10 Largest Children’s Hospitals, Top 50 U.S. Hospitals, Top 50 CardiovascularHospitals, Best Orthopedic Hospitals, 100 Best Hospitals-Spine and Prostate Surgeries, Best of Orange County and LongBeach Hospitals and Medical Groups honors from seven regional newspapers, U.S. News & World Report Best Hospitalsand "high performing" in 31 clinical categories, Newsweek Top 100 Hospitals, Best Maternity Hospitals, Best Hospitals inthe World and more. Visit memorialcare.org.

Pacific Dental ServicesFounded in 1994, Pacific Dental Services® (PDS) is one of the country’s leading dental support organizations, providingsupported autonomy that enables dentists to concentrate on clinical excellence and the highest levels of cost-effectivecomprehensive patient care. PDS originated the Private Practice+® model to enable dentists to focus on their passion:serving patients. PDS also pioneered the concept of Modern Dentistry so that dentists are equipped to combine advancesin the latest technology with the best operational practices and procedures, highly skilled support staff and a commitmentto ongoing training and education. PDS continues to grow, with more than 800 supported dental offices across the UnitedStates. PDS has been on the Inc. 5000 list of the fastest growing private companies in America 14 times. PDS supporteddentists aim to be the provider of choice in all the markets they serve and to develop Patients for Life™.

Prime HealthcarePrime Healthcare is an award-winning national hospital system with 46 hospitals and more than 300 outpatient locationsproviding nearly 40,000 jobs in 14 states. Fifteen of the hospitals are not-for-profit and members of the Prime HealthcareFoundation, a 501(c)3 public charity. Based in Ontario, California and one of the largest hospital systems in the country,Prime Healthcare and its hospitals have been recognized among the “100 Top Hospitals” in the nation 53 times andamong the nation’s top health systems several times according to IBM Watson Health. Prime Healthcare continues to growand fulfill its mission of “saving hospitals, saving jobs and saving lives” and remains committed to delivering exceptionalquality care and creating a legacy that will improve community healthcare. Visit www.primehealthcare.com.

Providence Southern CaliforniaProvidence Southern California is a not-for-profit Catholic health network with 11 hospitals, approximately 90 clinics,TrinityCare Hospice and its TrinityKids Care pediatric hospice, Providence High School, home health care services, eightwellness centers and numerous physician groups in its Southern California Region. Together these ministries, includingsecular affiliates and some representing other faiths, generate $7.5 billion in net revenue and have approximately 35,000employees – called caregivers – and nearly 5,200 physicians on staff. Providence Southern California is part ofProvidence, a health system of 111,000 caregivers serving in 52 hospitals, 829 clinics and a comprehensive range ofservices across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Providence strives to increaseaccess to health care and bring quality, compassionate care to those we serve, with a focus on those most in need.

UCI HealthUCI Health comprises the clinical enterprises of the University of California, Irvine. As Orange County’s only academichealth system and tertiary/quaternary care center, UCI Health plays a unique role in serving the health and wellness needsof our community. Patients can access UCI Health at physician offices throughout Orange County and at its main campus,UCI Medical Center in Orange. U.S. News & World Report has listed the 418-bed acute care hospital among America’sBest Hospitals for 20 consecutive years. UCI Medical Center features specialty ambulatory care clinics, Orange County’sonly National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program, combinedLevel I trauma center and Level II pediatric trauma center and is the primary teaching hospital for UCI School of Medicine. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast LosAngeles County.

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HEALTHCARE ROUNDTABLE

Patient-centered, virtual careaccelerated as essential for patientsneeding access to safe, convenienthealthcare during the pandemic.Remote, seamless, best-in-classvirtual healthcare complementing in-person care is here to stay.

Barry ArbucklePresident & CEO

MemorialCare

The COVID-19 pandemic has sparked new waysof thinking and approaching long-standingproblems. How has the pandemic acceleratedsome of your initiatives?

Kimberly Chavalas Cripe, CHOC:Our response to the pandemic has highlighted ourculture of innovation and collaboration. United bycommon, clear goals and - quite frankly - necessity,we accomplished a lot: we established daycare,featuring robust programming, within 72 hours; welaunched a 24/7 nurse helpline in two days; wequickly enabled a remote workforce, for which weprovided ergonomic support and technology assis-tance; we implemented new safety measures, in-cluding an online screening tool and a vaccinedashboard; we delivered medications to medicallyfragile patients; we created outdoor evaluation cen-ters to accelerate COVID testing; we provided anon-site market to make grocery shopping stress-free; and we enhanced spiritual care programs thatsupport mental and emotional well-being. These arejust a few examples. We did all of this while still ad-vancing care and research because our children’shealth and the hope for their futures require us topush the boundaries of what is possible.

Catherine Sinardi, Concordia University Irvine –School of Health & Human Sciences:Securing a wide variety of internships, capstoneprojects, and clinical sites has long been a focus forthe healthcare programs at Concordia UniversityIrvine. The pandemic restricted access to hospitalsand other healthcare settings, and a limited numberof students secured remote internships. Reimagin-ing fieldwork afforded greater flexibility to explorenew and different avenues for students to gain valu-able experience. Our nursing students continuedtheir educational hours through virtual simulationand virtual patient care. We discovered a myriad ofremote options for professional development activi-ties, including hosting virtual workshops for our stu-dents with industry experts from all over the country.A shifted focus to addressing community healthneeds during this crisis led to invaluable real-worldexperiences for our students. Examples includeconducting contract tracing, participating in commu-nity health education, and helping with COVID-19testing, vaccine distribution, operations, and admin-istrative tasks at our university’s Wellness Centerand large-scale vaccination sites.

Stephen E. Thorne, IV, Pacific Dental Services: The COVID-19 pandemic has spotlighted the impor-tance of the connection between oral health andoverall health, accelerating our initiative of pushingfor the integration of dental and medical services tobetter support the whole-body health of patients.Studies have shown a link between poor oral hy-giene and an increased risk of COVID-19 complica-tions, as well as a relationship between certaincomorbidities and COVID-19, in particular, peri-odontal disease and cardiovascular disease. Forthis reason, healthcare professionals promoting thepractice of proper oral hygiene as a way of main-taining optimal whole-body health has never beenmore important. At PDS, we have historically led thecharge in calling for medical and dental profession-als to better collaborate to ensure better systemichealth outcomes for patients.

Jeff Goad, PharmD., MPH., Chapman UniversitySchool of Pharmacy: Pre-pandemic, medical clinics had just started test-ing the use of remote audio-video connections toallow their medical specialists and pharmacists tosee patients virtually at different locations. Thesesystems were often expensive and required the pa-

tient to come to their clinic and sit in a room to seetheir physician or pharmacist on a computer screen.With the availability of online platforms, pharmacistsquickly converted their practices to virtual formats.Patients could remain home and still get their med-ication therapy management by their pharmacist.Some services, like immunizations, still need to bedone in person, but we learned that many other pa-tient visits could effectively be done virtually, whichwill likely continue long after this pandemic ends.

Marshall Moncrief, Be Well OC:When the Be Well OC movement began severalyears ago, it was our mission to create optimalhealth and wellness for all OC residents by trulytransforming the system of mental healthcare. Itwas an audacious goal. Depression, anxiety andsuicide were already epidemics, and the pandemichas added fuel to the already existing fire. The workwe were undertaking - already desperatelyneeded—was even more urgent than ever before. With more than 40% of U.S adults are strugglingwith mental health or substance abuse as a result ofthe pandemic, it was imperative to bring servicesonline that could provide care to those in need tonot only improve the community’s well-being, butalso help alleviate pressures on community re-sources (e.g., EDs, jails). We opened the first Be Well Campus, which pro-vides best-in-class mental health and substanceuse treatment services to OC residents, in January.Building and opening a healthcare facility that willtransform the way that mental health care is pro-vided in Orange County is a significant undertakingat any time. Doing so in the middle of the pandemicadded a unique layer of complexity, but the pan-demic was a blessing in disguise because it helpedto accelerate the coalition building process and en-couraged us to work even more collaboratively.

Barry Arbuckle, MemorialCare: Patient-centered, virtual care accelerated as essen-tial for patients needing access to safe, convenienthealthcare during the pandemic. Remote, seam-less, best-in-class virtual healthcare complementingin-person care is here to stay. In the past year,MemorialCare NOW digital technologies—offeringquality care when, where and how you want it—re-sulted in 225,000 primary, specialty, urgent care andbehavioral health video visits. Here are some exam-ples: E-visits allow patients with less urgent needsto submit healthcare questionnaires. MemorialCarephysicians provide diagnoses within one businesshour. A virtual triage bot using artificial intelligencechecks symptoms and guides consumers to appro-priate levels of care. E-consult capability allows pri-mary care physicians to send patient historieselectronically to specialists for consults, reducing of-fice visits and increasing timely access. Babyscriptsallows OB-GYNs to remotely monitor expectantmothers between in-person appointments. Its appeducates, engages and inspires expecting mothers.SilverCloud’s online educational and therapeuticprogram helps manage anxiety, depression, stress,and trouble sleeping. SpotRX Pharmacy deliversmedications to your door. Expect more virtual video,audio and online advances in the future.

Robert T. Braithwaite, Hoag: The pandemic forcefully underscored the critical im-portance of research and clinical trials that con-tribute to the development of new and effectivetreatments for existing and emerging diseases.Even before successfully treating California’s firstknown COVID-19 patient back in January 2020,Hoag was conducting more than 150 clinical trialsannually that are helping to determine the safety





The challenge for Hoag – and theentire health care industry – is makingsure that whatever new technologieswe adopt not only make our jobsmore efficient but are designed toensure better long-term outcomesand quality of life for our patients.

Robert T. BraithwaitePresident and CEO

Hoag

and efficacy of new drug regimens, therapies, med-ical devices, and clinical and surgical methods.Early in the pandemic, Hoag quickly became part ofthe national effort to develop effective treatments forthe novel coronavirus. Over the past year, Hoaghas conducted more than 20 COVID-19 clinical tri-als to expand patient access to cutting-edge thera-pies and innovative treatment options. Some ofthese trials markedly improved outcomes, includingdecreased mortality and decreased length of stayfor hospitalized COVID-19 patients. In October,Hoag became the first in the nation to offer a phase1 trial for a novel COVID-19 vaccine candidatebeing developed here in Southern California.

What new techniques and strategies are youusing to address employees’ mental health?

Sunny Bhatia, Prime Healthcare: Everyone has been affected differently by the pan-demic–whether as a frontline worker or those ad-justing to a new work-life situation. A new survey bythe Kaiser Family Foundation reported that 45 per-cent of Americans felt that the COVID-19 crisis isharming their mental health, while 19 percent feltthat it is having a “major impact.” Our employeeslook to us for resources to help them cope. In addi-tion to the Employee Assistance Program, Primelaunched a “You’re Not Alone” series focused onself-care, mindfulness and compassion fatigue. Thefoundation of the series stems from the fact that wecannot take care of others unless we’re also takingcare of ourselves. Prime Healthcare also offers aweekly mental health and wellness support group.The “In Prime Health” app provides helpful wellnessresources such as podcasts on mindfulness andself-compassion featuring Dr. Sarabjit Singh, Corpo-rate Medical Director of Psychiatric Services andPrograms, along with a multitude of wellness andmental health resources that can help us throughchallenging times.

What are the top three challenges faced by thehealth care industry today?

John Kao, Alignment Healthcare: A significant challenge, accelerated by COVID-19,is health equity in access to health care services,as well as in the availability of resources to meetdaily needs such as food and transportation. AtAlignment, we provide benefits that address thesesocial determinants of health—such as grocery al-lowances, non-emergency transportation, and com-panion care—in addition to traditional health planbenefits so that our members’ quality of life is notcompromised, which in return helps them stayhealthy. Secondly, the pandemic led to a dramatic rise inmental health issues. The industry needs to priori-tize these issues, which, if left untreated, amplifyover time, leading to other health problems. Lastly, lack of care coordination continues to be acritical issue—especially as the industry defines thepost-pandemic normal. The overwhelming and ac-celerated move toward virtual care during COVID-19 will further intensify gaps in patient carecoordination.

Robert T. Braithwaite, Hoag: 1. Across the nation there is a significant ongoingshift in how and where people access medical care.Locally, in response to a reduction in hospital-basedcare and lower emergency department visits, Hoagis continuing to increase access to telehealth andoutpatient offerings by bringing health centers andurgent cares into the community to serve individualsand families where they work and live. 2. The patients and families we serve lead ex-

tremely busy lives. One of Hoag’s greatest chal-lenges – and, I believe, opportunities – is develop-ing and delivering health care and wellness servicesthat are tailored to a wide array of lifestyles, includ-ing innovative offerings like Hoag for Her and theHealthy Lifestyles Program. Providing world-class,quality care is our number one priority, as reflectedby being the highest ranked hospital in OrangeCounty by U.S. News & World Report. But providingit in a way that accommodates people’s daily livesand needs is also paramount.3. Technology continues to revolutionize the healthcare industry, from the way clinical trials are con-ducted to lifesaving surgeries aided by robotic ad-vancements. The challenge for Hoag – and theentire health care industry – is making sure thatwhatever new technologies we adopt not only makeour jobs more efficient but are designed to ensurebetter long-term outcomes and quality of life for ourpatients. In other words, technology for technology’ssake won’t cut it. Technology’s litmus test must beits proven ability to enhance patient care.

What areas of care are going to be critical thisyear?

John Kao, Alignment Healthcare: The need for virtual health care has exploded in thepast year and it will see no signs of slowing downthis year—especially as payers and providers beginto offer more seamless virtual experiences for pa-tients and practitioners. Because of COVID-19safety concerns, more patients are now interestedin virtual services and have already begun to appre-ciate the convenience and flexibility that virtual careprovides. Another critical area of care is mentalhealth. Loneliness, depression, and anxiety are onlya few of the “side effects” of the pandemic, as thefull impact of COVID-19—from loss of life and jobinsecurity to social isolation and civil unrest—hasyet to be determined.

Jeff Goad, PharmD., MPH., Chapman UniversitySchool of Pharmacy: Preventative healthcare, such as immunizationsand disease screenings, have hit historic lows dur-ing the pandemic. Virtual visits and mail-order med-ications helped keep people safe during thepandemic, but you can’t get your shingles vaccina-tion or lab work done at home. Diabetes and hyper-tension didn’t disappear, they just aren’t beingscreened for as often as pre-pandemic. We arelikely to see people later in disease progressionrather than earlier when preventable. Ignorance isnot bliss. While there wasn’t much influenza aroundthis season, shingles was not affected by peoplestaying away from other people. If we cannot restartour routine adult and pediatric immunizations, we’relikely to see a resurgence of diseases such asmeasles and mumps.

Barry Arbuckle, MemorialCare: MemorialCare—renowned for cancer and heart disease treatment—is advancing these efforts even more.MemorialCare Heart & Vascular Institute’s globallyrecognized specialists perform thousands of com-plex, less invasive heart procedures available at fewhospitals. Through the years our innovators helpedrevolutionize stress tests, vascular surgery, pace-makers, angioplasty, minimally invasive tran-scatheter aortic valve replacement (TAVR) andmore. Today, aortic and mitral valve heart surgerywith two-to-three-inch chest incisions, instead of tra-ditional open-heart surgery six-to-eight-inch breast-bone incisions, promote faster recoveries andgreater comfort. MemorialCare Cancer Institute’sglobally ranked specialists participate in research





and breakthroughs for many types of cancer.MemorialCare Breast Centers—our region’s largestbreast cancer network—provides the most sophisti-cated screening and diagnostic technologies. In ra-diation oncology, we’ve educated colleaguesworldwide in specialty procedures and offer the re-gion’s most highly advanced treatment technolo-gies. These precisely target tumors withsub-millimeter accuracy, minimizing exposure tohealthy tissue and reducing treatment time. The re-gion’s only health system with adult and children’shospitals, we ensure patients a lifetime of seamless,coordinated care.

Annette Walker, City of Hope:Orange County must focus on the serious illnessesthat have been with us too long. Cancer, for exam-ple, continues to be a pressing issue – 1 in 3 Ameri-cans will be diagnosed with cancer in their lifetimeand the disease also affects family and friends.Cancer care is a complex and rapidly evolving field.Yet, despite remarkable advances in cancer sciencecreating more effective treatments and cures, toomany cancer patients do not have access to highlyspecialized care and lifesaving research. That’s oneof the gaps City of Hope is solving for with our fu-ture cancer campus in Irvine and the OrangeCounty network of cancer care we are building. Wewant everyone in the community to benefit from theexpertise of our physicians and researchers whoare singularly focused on finding better treatmentsand cures.

As we continue to evolve from the traditionalfee for service to value-based care, how do weensure we maintain quality and accessibility?

Kevin P. Manemann, Providence Southern Cali-fornia: Providence is focused on keeping our communityhealthy by providing comprehensive, coordinatedand highly-effective team-based care in the primarycare setting. This patient-centric model meets theimportant health and wellness needs of our pa-tients. When specialized care is needed, we providehigh-quality, evidence-based medicine at every ac-cess point in our network. Our focus on quality continues with our Clinical In-stitute model, which enables our providers to dis-cuss new studies and technologies, their potentialbenefits to patients and best-practice implementa-tion. The institute model also ensures a streamlinedreferral process that provides patients with easy ac-cess to an impressive list of specialists across ournetwork. Under this care model, if a patient requiresa highly specialized procedure, a specialist withinthe network comes to the patient. This means thepatient has access to high-quality care close tohome. The Clinical Institute model also reduces clinicalvariation, which translates into high-value, high-quality care.

Gene Rapisardi, Cigna: It comes down to two words: collaboration and ac-countability; which is why Cigna named our earlyvalue-based care program with physician groupsCollaborative Accountable Care. Cigna collaborateswith providers to ensure we’re all focused on thesame goal – getting people connected to the rightcare that delivers the best quality at the best price,which is the very definition of value. It’s a matter ofCigna sharing useful information that the providermight not have about their patients (such as ER vis-its, hospitalizations, prescription fills) and providingaccess to resources that can serve as extensions ofthe practice (health coaching, chronic conditionmanagement), while compensating providers for

delivering evidence-based care that improves out-comes. And it’s a matter of providers being account-able for how they practice medicine.

Jennifer Mitzner, Hoag Orthopedic Institute: The community deserves more value out of theirhealth care expenditures. HOI was founded by ourentrepreneurial orthopedic physicians to be a pio-neer (and a Harvard Business School’s case study)of a value-based model of care, meaning we copi-ously measure our quality and cost of care, to en-sure the best outcomes at a reasonable cost. HOIcontinually evaluates established processes, proto-cols and practices to ensure value is added. As anorthopedic specialty hospital, HOI is able to focuson reducing variation and achieving a high level ofstandardization in clinical practice, leading to excel-lent outcomes. Research and evidence-based prac-tice is standard at HOI. Importantly, there is a highlevel of peer accountability among the surgeons toensure that practices and protocols are adhered to.Operationally, we have a lean, flat organization andall stakeholders are incentivized to effectively man-age costs while ensuring the highest quality careand patient outcomes.

Many patients have postponed health care serv-ices due to fears of COVID. How does your or-ganization plan to ensure patient safety aspatients resume seeking medical services?

Chad T. Lefteris, UCI Health: The postponement of health care services may beone of the deepest and longest-lasting effects ofthe COVID pandemic. UCI Health has encouragedits patients and the community at large seek pre-ventative and critical care and was a proud mem-ber of a coalition of Orange County hospitals thatcome together to promote this important message.While the early pandemic was marked by concernabout patient safety in healthcare settings, UCIHealth has consistently provided safe inpatientand outpatient care and even expanded access tolifesaving care such as launching the county’s firstventricular access device and ECMO programs forpatients suffering heart failure and or severe, life-threatening illnesses that damage proper heart orlung function. This month, we launched thecounty’s first COVID Recovery Program to man-age the long-term health effects seen in those whowere hospitalized for COVID. It is estimated thatup to 30% of people after their initial illness aresuffering with prolonged COVID-19 symptoms andcomplications. These “long haulers” continue toexperience complications for months after their in-fection and are best treated by an academic healthsystem like UCI Health.

Kimberly Chavalas Cripe, CHOC: Before COVID-19 spread to Southern California,CHOC convened a command center to ensure thebest response against the virus. We immediatelyimplemented new safety measures to protect ourpatients and their families, as well as our providersand staff. We launched a 24/7 nurse helpline, 1-844-Get-CHOC, and expanded our telehealth pro-gram to provide alternatives to in-office visits andensure continuity of care. During the initial lock-down, we implemented a medication delivery serv-ice for our medically fragile patients. We continue toprovide helpful tips and information to families. Ourleaders are closely monitoring the hospital environ-ment, our community, and the world to adapt our re-sponse as needed. Our commitment to patientsafety is reflected in our culture and our strategicplan, with leaders’ compensation tied to patientsafety goals. We consider it a privilege to have fami-


Cigna collaborates with providers toensure we’re all focused on the samegoal – getting people connected to theright care that delivers the best qualityat the best price, which is the verydefinition of value.

Gene RapisardiMarket President, Southern

California and NevadaCigna

The postponement of health careservices may be one of the deepestand longest-lasting effects of theCOVID pandemic.

Chad T. LefterisCEO

UCI Health




For most Americans, the impact ofthe COVID-19 pandemic has causedsignificant levels of stress, triggeringnew or worsening current mentalhealth challenges.

Catherine Sinardi, Ed.D. MFTDirector of Healthcare Programs,

Associate ProfessorConcordia University Irvine –

School of Health & Human Sciences

lies entrust us with the care of their children; that’s aresponsibility we don’t take lightly.

Stephen E. Thorne, IV, Pacific Dental Services: Healthcare experts have cautioned that the conse-quences of delaying needed care can be a great riskto overall health. Patient safety in dental practiceshas remained prioritized and consistent throughoutthe pandemic. Our supported practices are membersof the Organization for Safety, Asepsis and Preven-tion (OSAP) and consistently follows its guidelines,as well as the Centers for Disease Control’s InfectionControl Guidelines for Dental Practices. To help buildpublic confidence about the safety of dental practicesthroughout the pandemic, dental professionalsacross the country took part in a grassroots cam-paign, #DentalSAFETY. Using #DentalSAFETY intheir social media posts, the campaign highlightedthe essential role dental clinicians have played in theoverall healthcare system and within their communi-ties by keeping patients with emergency dental con-ditions out of the hospitals.

Sunny Bhatia, Prime Healthcare: Patient safety has always been a top priority forPrime Healthcare. In addition to new policies andprotocols such as enhanced sanitation procedures,providing face masks and ensuring safe distancesin waiting areas, we utilize our infection control ex-pertise in accordance with guidelines from the Cen-ters for Disease Control and Prevention (CDC) andOccupational Safety and Health Administration(OSHA). We have redesigned hospital units, less-ening the risk for infection among staff and patients.We are also enforcing infection control protocols inhallways, waiting rooms, and entries into units,which are just as important as patient rooms. Wehave robust testing protocols in place to promptlydiagnose all patients at risk for COVID and thosepresenting for elective procedures. Furthermore,Prime Healthcare has successfully vaccinated itsemployees and physicians and has implementedmany large-scale community vaccination programswhich will ultimately be the key driver to recoveringfrom the COVID pandemic.

Annette Walker, City of Hope:In cancer care, the situation is serious because, asa nation, we saw steep declines in cancer screen-ing throughout 2020. This is a cause of great con-cern for all of us because we know delays inscreening can lead to “missed” cancers that mightbe more advanced when they are finally detected.Cancer didn’t stop because of COVID-19 and it wasvital that patients continued their care with teamswho took rigorous precautions to safeguard againstinfection. Because of our expertise in caring for im-munocompromised patients, City of Hope was oneof the most prepared places in the country to helppatients through the pandemic. We put in placestrict safety protocols to keep our patients and staffsafe and expanded our used of telemedicine; thiscommitment to safety will be in place long after thepandemic is over. Our patients can be assured thatCity of Hope is a safe place for world-class care.

Jennifer Mitzner, Hoag Orthopedic Institute: When the CDC recommended, and the State ofCalifornia mandated, suspending elective surgicalprocedures due to COVID, HOI’s team developed aplan to resume elective surgery in a safe and re-sponsible manner. While continuing to care for ur-gent/emergent patients, HOI created a risk-based,phased approach to patient selection for electivesurgery and shared it with the Orange CountyHealth Agency who agreed our model was safe. Asan orthopedic specialty hospital, we already had thebest infection prevention protocols: HVAC systems

with HEPA filters and UV radiation, UV radiation inour water filtration system sterile processing, UVlight “robot” for disinfecting rooms, strict operatingroom protocols, etc. We created strict employeeand visitor screening procedures, and followed rec-ommended use of PPE. We test all patients pre-op-eratively for COVID-19 and continue to operateunder strict guidelines to ensure the health andsafety of all involved while maintaining the samehigh-quality orthopedic care and outcomes.

In the past 20 years, we have seen a decrease inthe stigma associated with mental health treat-ment. What do you think the next 5-10 years willbring in terms of changes in the perception ofmental health stigma? How will the workforcebe impacted by these changes?

Catherine Sinardi, Concordia University Irvine –School of Health & Human Sciences: For most Americans, the impact of the COVID-19pandemic has caused significant levels of stress,triggering new or worsening current mental healthchallenges. Factors including social distancing re-strictions, changes in family dynamics, job loss, fi-nancial insecurity, safety concerns, confusing healthmessages, illness, and death of loved ones, haveled many to experience feelings of grief, loss, isola-tion, uncertainty, loneliness, anger, fear, and psy-chological distress. Reports of suicidal ideation,self-harming behaviors, domestic violence, andsubstance abuse have risen during the pandemic,along with documented increases in symptoms ofanxiety and depressive disorders. These shared ex-periences with mental health struggles will continueto bolster awareness and help reduce the stigma.Healthcare professionals are experiencing burnoutat alarming rates, contributing to workforce short-ages and adverse physical and mental health out-comes. Employers must make the mental health oftheir employees a priority by creating better re-sources for support, nurturing self-care, and imple-menting changes that promote well-being andreduce workplace stress.

Marshall Moncrief, Be Well OC:While progress has been made, there is still muchwork to do. In the next 5-10 years, it is my hope thatwe will have made significant progress against thestigma associated with mental health treatment. Weneed to get to a point where mental health is lookedat the same way that you view physical health. Mostpeople wouldn’t think twice about seeking treatmentfor hypertension or diabetes and we must viewmental health in the same way. While the social impact of this change of perceptionwill be large, it will also have a significant economicimpact. Each year, it is estimated that nearly $1 tril-lion in productivity is lost per year due to depressionand anxiety. Employers have the opportunity to playa major role in reducing stigma, normalizing conver-sations on mental health and providing their em-ployees and their families, with educationalresources and access to mental health services.One of the key areas of focus for the Be Well OCmovement is the reduction of stigma, one of our sixresult areas that coalition and community membersactively work on all throughout the year. 0

Kevin P. Manemann, Providence Southern Cali-fornia: In 2016, Providence implemented a $30 millionmental health initiative in California to identify, ad-dress and treat mental illness, including depressiveand psychotic disorders; addictive behavior; home-lessness; and other root causes of mental illness.We also recognized the need to openly talk about


Most people wouldn’t think twiceabout seeking treatment forhypertension or diabetes and we mustview mental health in the same way.

Marshall MoncriefCEO

Be Well OC




mental health and how physiological changes likecancer or hormonal imbalances can impact mentalwell-being. This led to specialized mental healthservices, such as post-partum depression screen-ings for new moms and group therapy for cancerpatients. This focus helped Providence recognize the signsand symptoms of stress, anxiety and depression inour own caregivers during COVID-19. We created aTelebehavioral Health Concierge, which providesvirtual appointments for confidential, convenientmental health care when and where it is needed,and TeleSpiritual Health, which offers prayers forstrength.We must continue to talk openly about mentalhealth, be vigilant for signs and symptoms and con-tinually advocate for accessible resources.

Gene Rapisardi, Cigna: Stigma continues to be a barrier to mental healthtreatment, which presents a continuing challengefor those of us who promote the concept of wholeperson health. Nevertheless, we may have reacheda significant turning point. During the COVID-19pandemic, people experienced more stress, anxi-ety, depression and other behavioral health issues,and became more open about discussing them.Mental health was no longer just for “other people;”it was something that resonated with nearly every-one as we coped collectively with fear of a deadlydisease, disruption of our daily lives, job insecurity,financial pressures, social isolation, etc. At thesame time, mental health care became more acces-sible through virtual visits, and people were willingto try it. This growing realization that we are all frag-ile, combined with easy access to virtual care, willlead to more people getting the mental health carethey need. And that will result in a more resilientworkforce in the long run.

Mark E. Costa, Kaiser Permanente: Thankfully we have seen a reduction in the stigmaof Mental Illness, yet more progress must be made.The Pandemic made more visible the challenges ofmental health within both the workplace, as well aswithin our communities overall. As we move for-ward, we must address the fragmentation of ourcurrent mental health system. We must give greaterfocus to prevention and mental wellness and betterconnect those in need to available community re-sources that best address the challenge any individ-ual is facing. Through both digital tools andresources, as well as through face to face support,all individuals will be better able to optimize theirmental wellness, just as we now focus on our physi-cal health through diet and exercise. Employersmust give greater focus to the mental wellness oftheir workforce with the outcome of more engagedemployees and improved productivity and atten-dance. Creating work environments and associatedHuman Relations policies that support mental well-ness will become a greater priority. And finally, em-ployers and their managers will enhance theirabilities to identify staff who may be at risk for someaspect of mental illness leading to quicker and coor-dinated referrals to needed mental health care. Weknow that our mental health is as equally as impor-tant as our physical health in relation to our overallquality of life, including that part spent within ourplace of employment.

What are the strengths of being part of a largehealth system?

Stephen E. Thorne, IV, Pacific Dental Services: Pacific Dental Services is one of the country’s lead-ing dental support organizations, providing sup-ported autonomy that enables dentists to

concentrate on clinical excellence and the highestlevels of cost-effective comprehensive patient care.The essence of our business model is simple – weenable clinicians to focus more on the patient andworry less about the business operations. This hasnever been more important than during the pan-demic as we were able to focus on the many criticalinfrastructure items our supported dentists neededto serve their patients and their local communities ina time of need; such as securing PPE, setting upteledentistry within a week to allow patients criticalaccess, and continuing with our deployment of anew electronic medical record system, Epic®, whichfurther gives us the ability to advocate for dental-medical integration on behalf of better patient out-comes.

Sunny Bhatia, Prime Healthcare: Prime Healthcare is one of the largest health sys-tems in the United States, with 46 hospitals in 14states. A large health system can provide robustsupport for its hospitals while “keeping health carelocal.” We can share expertise and best practicesacross our hospitals. This allows us to better imple-ment processes that promote delivery of high-qual-ity, affordable care while realizing our economies ofscale. 2020 really redefined “normal” and shifted theground beneath our feet. As a large health system, Iam proud of the way we were able to addressCOVID-19 with regard to supplies, drugs, equip-ment, staffing, and more. Our hospitals supportedone another, along with city, county and state healthsystems, in the care of our patients. We are over-coming this together, and we will be stronger for it.

Barry Arbuckle, MemorialCare: As the largest health system headquartered in Or-ange County and the only one in the region to in-clude teaching, community-based, and children’sand women’s hospitals, MemorialCare is uniquelypositioned to address the needs of all ages and allfamilies—offering a lifetime of seamless, continuouscare within one health system. In addition to our tophospitals, MemorialCare’s 225 community-basedcare locations encompass the region’s most expan-sive network of outpatient surgery, imaging, urgentcare, breast health, physical therapy, dialysis, pri-mary care and specialty health centers. Our size,geographic coverage and diversity of services pro-vide our community members with many conven-ient options for accessing the care they need closeto where they live and work. Larger health systemslike MemorialCare also have the opportunity toshare resources between their entities. This was ex-tremely valuable during the pandemic as the num-ber of COVID-19 patients among our four hospitalsfluctuated by the hour.

What challenges lie ahead for healthcareproviders and systems? And what will theCOVID-19 pandemic’s impact be on patientcare? How will virtual visits, which surged dur-ing the pandemic, affect the practice of medi-cine? What other trends do you foresee in thenext five years?

Kimberly Chavalas Cripe, CHOC: The COVID-19 pandemic led to a significant reduc-tion in well child visits (including vital developmentalassessments and immunizations) and acute carebeing sought by our most vulnerable children. As anindustry, we were forced to adapt quickly to imple-ment comprehensive telehealth programs. As ofMarch 25, 2021, CHOC has performed over109,000 telehealth visits in primary and specialtycare, autism, speech and language, mental health,and care coordination.


A large health system can providerobust support for its hospitals while“keeping health care local.”

Sunny Bhatia, MD, MMM, FACC, FSCAICEO

Prime Healthcare Region I


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Employers should strongly encouragetheir employees to get vaccinated andprovide as many incentives aspossible.

Jeff Goad, PharmD., MPH.Professor and Chair, Department

of Pharmacy Practice Chapman University School

of Pharmacy

Consumers and care providers have become com-fortable with the ease and convenience associatedwith telehealth, and they will expect this mode ofcare to remain. What happens, however, post-pan-demic? Many issues will need to be addressed atlocal, state, and federal levels via legislation and ad-vocacy:• Which types of visits are, and are not, appropriatefor telehealth?• How can employers, as purchasers of healthcare,advocate for continued telehealth support?• What happens if/when payers decide not to covertelehealth?• How do we measure quality telehealth care?• How do we continue to innovate and expand thebenefits of telehealth?

Jeff Goad, PharmD., MPH., Chapman UniversitySchool of Pharmacy: Early in the pandemic, elective procedures and rou-tine visits were stopped while hospitals filled withpatients. While the public may have interpreted thatas a financial boon for hospitals, the health systemsthat own the hospitals rely on elective proceduresand clinic visits for revenue. Ironically, while hospi-tals filled with patients, their budgets were strainedto maintain or even grow their workforce. During fu-ture pandemics, health systems must implement fa-cility safety protocols rapidly and switch to billing forvirtual visits to allow continuity of care in a fiscallyresponsible manner. The switch to virtual visits willforce health insurers to adequately compensate arange of online visits. Technology will need to ad-vance quickly to allow seamless at-home monitor-ing of everything from blood pressure to asthma.

Should employers require their employees to bevaccinated before returning to the workplace?

Jeff Goad, PharmD., MPH., Chapman UniversitySchool of Pharmacy: In California, we require vaccinations for K-12 stu-dents, and adults in higher education. For students,this requirement may bar them from attendingschool. Employers of healthcare providers, such ashospitals, require influenza vaccination. Adults, un-like students, can sign an active declination of vac-cination. So, it’s more complicated to required avaccination as a condition of employment. Duringthe pandemic, many employers require COVID test-ing as a condition to return to the workplace. Usingthe same logic, employers could require vaccinationfor someone to be in person at the workplace. If,however, that creates a condition of employment, itgets complicated again. At a minimum, employersshould strongly encourage their employees to getvaccinated and provide as many incentives as pos-sible.

As we continue to face down the COVID pan-demic and its effect on healthcare, what do yousee as trends and major issues facing us in2021?

Catherine Sinardi, Concordia University Irvine –School of Health & Human Sciences: With the acceleration of digital technologies such astelehealth and the use of artificial intelligence, aca-demic institutions will need to prepare healthcarestudents for a new workforce. Adapting coursework,funding research, and increasing experiential-basedlearning opportunities that focus on the science,use, development, implementation, and evaluationof digital health technologies is a priority. Futurehealthcare leaders will need to be skilled at leverag-ing digital solutions that address disparities, createmore efficient workflow processes, enhance patientcare, and drive better health outcomes for our com-

munities. The pandemic initiated unprecedentedcollaboration across sectors, communities, organi-zations, and industries. Competitors and unlikely al-lies joined forces to combat the COVID-19 crisis,resulting in rapid and extraordinary innovation. Col-laborative learning approaches are now essential inhealthcare education to cultivate the skills neces-sary to thrive in robust ecosystems that reducehealth disparities, advance health equity, promotehealthy communities, and transform the future ofhealthcare.

Sunny Bhatia, Prime Healthcare: In addition to the unprecedented transition to tele-health and focusing on the safety and well-being ofour staff and patients, ensuring health equity is topof mind. Evidence shows that Black, Latinx, PacificIslanders, and indigenous and immigrant popula-tions have endured disproportionate harm fromCOVID-19. This year, clearly addressinginequities is essential for meaningful and sustain-able quality improvement in healthcare. The rea-sons for the disparities are complex, with healthcareaccess and underlying health conditions (e.g., hy-pertension, diabetes) acting as contributing factors.Prime Healthcare remains focused on serving allmembers of the community. Our mission of savinghospitals in rural, inner city, and underserved com-munities has never been more important. Movingforward, social determinants of health must be ad-dressed and will likely require significant govern-ment support. We are unlikely to succeed innarrowing health inequities if we don’t commit to ad-ditional funding and policy changes.

Robert T. Braithwaite, Hoag: COVID-19 poses an obvious health risk to millionsof Americans, but there’s a subtler risk, as well –many people have delayed seeing their doctors forroutine screenings and chronic disease manage-ment. Primary care physicians at Hoag reported agradual return of their patients in recent months, butnoticed that many of the screening results weremore advanced – and harder to treat – than theywould have been had people come in for their rou-tine screenings. It’s imperative that we encourage patients not to putoff these vital screenings any longer. Mammograms, pelvic exams, prostate cancerscreening and blood tests, colonoscopy, oral examsby a dentist for head and neck cancer, low dose CTscans for smokers at risk of lung cancer and skincancer screenings with a dermatologist all are rou-tine but can uncover life-threatening illness. All ofthem should all be scheduled regularly, to not onlydetect cancer, but catch it as early as possible,when treatment is most effective.

Marshall Moncrief, Be Well OC:One thing has become clearer than ever during thispast year—we crave connection as human beings.We are social creatures. Depression, anxiety, sub-stance abuse, were all epidemics before COVID en-tered our lives. The isolation and stress of thepandemic—whether financial, health-related, per-haps the loss of a loved one, missed milestones,missed family time—has exacerbated those issuesfor people of all ages. Leaders across Orange County, through the work ofthe Be Well OC movement, are rallying around uni-fied systems change to meet the growing needs ofthe mental health crisis worsened by COVID-19.The work of Be Well OC is more important thanever before since the mental health impacts ofCOVID-19 are projected to persist far beyond thephysical health problems of the pandemic.





To successfully roll out virtual care toeverybody equitably, providers andpayers will have to consider access totechnology as a social determinant ofhealth since it’ll play a big role in apatient’s health care journey.

John KaoChief Executive OfficerAlignment Healthcare

John Kao, Alignment Healthcare: Virtual care offers many opportunities to make healthcare more accessible, unbound by geographicalconfines and leveraging technology through multiplechannels. This year, Alignment launched a virtual-first health plan that helps members convenientlyand safely access care anywhere by phone or video.Other payers and providers have begun offeringsome form of telehealth service, and there is a hugeopportunity to enhance these offerings further tomake virtual and in-person care more seamless forpatients. On the flip side, there is a digital divide thatthe industry will have to address. To successfully rollout virtual care to everybody equitably, providers andpayers will have to consider access to technology asa social determinant of health since it’ll play a bigrole in a patient’s health care journey.

Telehealth can extend access to those living inrural areas, seniors, low-income and high-risk in-dividuals. Health systems need to be morestrategic in how they develop their virtual/tele-health offerings. What is your organization doingin this area?

Kevin P. Manemann, Providence Southern Cali-fornia: Providence has transformed care delivery throughthe use of digital innovation and technology by offer-ing a safe and easy way for patients to speak withtheir primary or specialty health care provider viasmart phone, tablet or computer. Between 20-30%of our office visits are virtual. When COVID-19 hit,Providence quickly transitioned to telehealth to pro-vide continued care from the safety of patients’homes. Outside of the pandemic, telehealth contin-ues to eliminate barriers to care such as transporta-tion or the inability to take time off of work for adoctor’s visit. And, for the same cost as a standardoffice visit co-pay, many patients enjoy the conven-ience telehealth provides.

Gene Rapisardi, Cigna:Cigna was an early leader in telehealth, starting withcoverage for “virtual house calls” in 2007. Since thenwe have developed, refined and expanded that earlymodel. For many years we have offered telehealthcoverage through large national players (likeMDLIVE, which Cigna's Evernorth division is acquir-ing), as well as through independent providers.Cigna covers telehealth for both medical, behavioraland even dental care. In 2020, we added Talkspaceto our behavioral provider network, which enablescustomers to use private messaging (text, voice, andvideo) to connect with licensed therapists. And inCalifornia we launched a 12-week app-based virtualcare program focused on anxiety, depression andburnout with Meru Health. The COVID-19 pandemicwas a turning point and customers are now embrac-ing telehealth. Virtual services, for medical and be-havioral combined, increased over 4,000% in 2020,compared to 2019, and 60% of Cigna's behavioralhealth customers are now using telehealth.

Sunny Bhatia, Prime Healthcare: Prime Healthcare was an early adopter of telemedi-cine and has implemented various programs acrossthe system to better serve the needs of communi-ties, both near and far. We have successfully utilizedtelehealth in areas such as psychiatry, crisis stabi-lization units, neurology, and even intensive careunits. We have been able to scale these programs toserve rural communities across California and thecountry while focusing on high-risk individuals, suchas the elderly and low-income patients, who havechallenges accessing high-quality health care. Thebreadth, depth and impact of these programs grewconsiderably in response to the COVID pandemic.

We needed to expand our telemedicine program tosupport ambulatory clinics, urgent care clinics, firstresponders, acute care hospitals and our employeesthrough a novel telehealth platform. We believethere will be an ongoing role for telemedicine in theyears to come and look forward to expanding our of-ferings to better support the delivery of high-qualityhealthcare.

John Kao, Alignment Healthcare: Alignment offers its “Care Anywhere” program, whichleverages AVA™, Alignment’s proprietary data andtechnology platform, to provide a dedicated clinicalteam with the necessary insights to deliver timely, ef-fective and coordinated care to those who need itmost – shifting from almost all in-person visits priorto COVID-19 to almost all virtual visits in only a fewweeks. Remote care has always been a core part ofAlignment’s care model so that our members canget the care they need, when and where they needit. We took that a step further this year by introducingthe AVA™ HMO plan, a virtual-first plan that givesmembers a dedicated virtual primary care provider—accessible by phone or video on the AVA™ platform– as well as providers available in-person to see thepatient at home or in the doctor’s office as needed.For our members who don’t have access to a smart-phone or computer, we also provide access totablets and data plans as well as old-fashioned per-sonal outreach through our concierge teams to helpthem easily connect with their providers.

Mark E. Costa, Kaiser Permanente: Kaiser Permanente is a strong proponent of tele-health and has implemented telehealth as an optionto our members for numerous years now. Prior tothe pandemic, approximately a third of our clinicalappointments were conducted via telehealth. Anddue to the pandemic, we saw this surge to approxi-mately 90 percent of all clinical appointments beingconducted virtually. We anticipate the use of our in-teractive telehealth capabilities, will remain a popularand necessary tool for our members. We recognizethat our members are individuals with busy lives andthat they wish to receive care in the most convenientway for them and their families. As such, we areproud to offer our members various ways to maintaintheir health, be it through in-person visits, telehealthvisits, mail order pharmacy, and 24-hour nurse hot-lines.

Outpatient, community-based care that takesplace outside the hospital is increasingly em-braced by patients, employers and health plansdue to advantages of convenience and cost sav-ings. What is your experience in this arena andhow has its growth advanced value-based care?

Barry Arbuckle, MemorialCare: In addition to renowned hospitals, MemorialCarecontinues to expand our 225 community-based out-patient locations near where patients live and work.MemorialCare’s high quality outpatient surgery, im-aging, urgent care, physical therapy, dialysis, breasthealth, primary and specialty care centers offer sub-stantial savings for employers, health plans and pa-tients. For example, MemorialCare Breast Centersattract world-class specialists dedicated solely tobreast cancer. Additionally, technological advancesmean many surgical patients who spent days in ahospital now receive care in outpatient centers with-out overnight hospital stays. Unlike most health sys-tems, our ambulatory centers aren’t operating ashospital-based outpatient departments with higherprices. Instead, procedures can be a fraction of whatthey cost in hospitals with the same surgeons andadvanced equipment. For an arthroscopic knee pro-





Patients want convenient care, andProvidence is committed to deliveringhigh-quality, affordable care close towhere people work and live. In fact, weare growing our network with the goalof being 15 minutes from 15 millionpeople in the communities we serve.

Kevin P. ManemannChief Executive

Providence Southern California

cedure, for example, in one of our high quality,lower cost surgery centers, you can access thesame surgeon and same equipment at a more con-venient location. When this procedure is done in ahospital-based center, the price can be twice ashigh. For a brain MRI, the hospital-based imagingcenter can be 800% higher than in one of our 33community-based imaging centers. The results:tremendous savings for patients with high de-ductibles and self-insured employers.

John Kao, Alignment Healthcare: Alignment recognized early on the importance ofcustomized, coordinated care delivery for our mem-bers. Four years ago, we launched our “Care Any-where” program, an advanced clinician-drivenmodel of care staffed by Alignment-employed physi-cians, advanced practice clinicians, case managers,social workers and behavioral health coaches to as-sure execution of cross-functional care plans. Theprogram creates several benefits for our high-riskmembers: improved quality of life, high patient satis-faction, lower re-admission rates and reductions inunnecessary emergency room visits and inpatientcare. Along with the positive impact it has on ourmost vulnerable members, it has also allowed us toestablish a more direct relationship with seniors,building trust and engagement more broadly. Theserelationships enabled Alignment to effectively en-gage our members with critical education and re-sources.

Kevin P. Manemann, Providence Southern Cali-fornia: Patients want convenient care, and Providence iscommitted to delivering high-quality, affordable careclose to where people work and live. In fact, we aregrowing our network with the goal of being 15 min-utes from 15 million people in the communities weserve. We understand that many people can’t take time offfrom work to focus on their health. This is when aurinary tract infection can progress to a painful kid-ney infection and an ER visit. Through our ExpressCare neighborhood clinics, urgent care centers, andvirtually through telehealth, we can meet consumerhealth needs wherever, however and whenever it’sconvenient for them. And, for continuity of care, weprovide referrals to primary care providers and spe-cialists who seamlessly continue the patient’s carejourney.

Chad T. Lefteris, UCI Health: UCI Health has long recognized the trend towardoutpatient, community-based care. We continue toexpand our commitment to meeting these needswith the opening last fall of the UCI Health – New-port Beach office, with a special commitment to in-tegrative health, and the expansion of specialties atUCI Health – Yorba Linda and UCI Health—YorbaLinda Infusion Center. Balancing this is our continu-ing commitment as the region’s largest tertiary-qua-ternary care provider to improving access to criticalcare at UCI Medical Center in Orange and the re-cently announced plans for UCI Medical Center –Irvine at the UCI campus. This commitment is com-plemented by plans to open more outpatient cen-ters across Orange County.

Jennifer Mitzner, Hoag Orthopedic Institute: Hoag Orthopedic Institute has been a leader in re-ducing the length of stay for our patients whilemaintaining an unrivalled patient experience since2010. HOI’s surgeons are pioneers in outpatientjoint replacements, charting a course that is now ex-panding across the nation, as consumers seekquicker recovery, less pain, and reduced costs,while maintaining the utmost quality care. HOI was

founded in 2010 on a model that anticipated theshift to more outpatient care. A year ago, 15% of ourhip and knee replacement patients were goinghome the same day. Today, this number has in-creased to 40% and the trend will continue to growcommensurately as more and more proceduresevolve to outpatient care status. Our strategic plancalls for the building of more ambulatory surgerycenters throughout Orange County and greaterSouthern California, which will increase access tooutpatient orthopedic care in more communities.

Orange County employers are seeking highquality and value-based care for their employ-ees. How does your organization engage withbusinesses and what have been the results ofyour efforts on patient care, cost and access?

Gene Rapisardi, Cigna: Cigna's approach to high quality and value-basedcare involves a strong collaboration between em-ployers, consultants and local healthcare providers.We work closely with delivery system alliance part-ners Providence St. Joseph Health and Hoag in Or-ange County. Together we developed the SelectNetwork HMO plan for employers with 100+ em-ployees. This unique plan includes reporting fortransparency; analytics and intervention manage-ment to reduce overall health risks; closing gaps incare to improve outcomes; and educating employ-ers about programs and services that can help im-prove health through employee engagement. Ourapproach has led to 24.7% lower pharmacy spend-ing, 5.7% fewer hospital admissions, 6.5% highercancer screenings, increased wellness visits, andtotal healthcare spend per customer per year that’snearly 20% lower for the Select HMO Plan com-pared to our full HMO plan.

Barry Arbuckle, MemorialCare: MemorialCare’s high-value healthcare offers rigor-ous quality, exceptional patient experience, en-hanced care coordination and chronic diseasemanagement at a reduced cost—critical to today’seconomic challenges. Our diversified network of225 care locations offers unique advantages withSouthern California’s largest number of value-basedemployer and health plan contracts—includingbeing selected for the Blue Shield Trio network inOrange and Southern Los Angeles counties. We’reassuming financial risk for defined populations, andensuring quality, service and cost targets are met.With hospitals and outpatient care locations stretch-ing over a wide area, we’re uniquely positioned toprovide consumers, employers and health plansquality, convenient care at a lower cost in the mostappropriate settings. The MemorialCare Health Al-liance customized direct-to-employer contract be-tween MemorialCare and The Boeing Company,significantly reduces healthcare costs for employ-ees enrolled in the plan and for Boeing. This suc-cess has led to additional similar partnerships withF&M Bank and Novartis. As healthcare’s landscapecontinues to transform, MemorialCare will continueleading the way in revolutionizing value.

Mark E. Costa, Kaiser Permanente: With our integrated medical record system, we canprovide businesses with medical statistics specificto their members, reviewed by a KP physician, ac-count manager and wellness consultant. This dataincludes the statistics on rates of chronic illness intheir employees, the trends in frequency of their ill-nesses over time, utilization of our services, phar-macy utilization and screening rates. This allowsbusinesses to predict medical costs over time andascertain the results of any wellness programs con-





Understanding the needs andchallenges of our members hasprompted innovation to provide ourmembers’ medical care in the mediumthat is most convenient to themember while maintaining our highstandards of quality medical care.

Mark E. CostaSenior Vice President

Kaiser Permanente

ducted by companies. The data also provides aclear pathway of where resources can be usedmost efficiently within a company to improve thehealth of employees and their families, and whathabits need to be adopted by our members to im-prove overall outcomes. The use of our expertise asmedical consultants with thorough knowledge of ourmembers, combined with the diverse integratedmedical delivery model, has evolved into a businessstrategy for the companies that we serve which re-duces their overall business costs and increasesemployee production.Kaiser Permanente has also benefitted from thispartnership. The physicians and account managershave a direct line of communication with our leader-ship, and we have used the feedback from our busi-ness partners to optimize our delivery of care.Understanding the needs and challenges of ourmembers has prompted innovation to provide ourmembers’ medical care in the medium that is mostconvenient to the member while maintaining ourhigh standards of quality medical care.

Jennifer Mitzner, Hoag Orthopedic Institute: Orange County employers have a growing stake inthe decisions they make on behalf of their employ-ees’ health care. Hoag Orthopedic Institute was anearly innovator in the development and participationof commercial bundled payments, which providebusinesses with one fixed cost for an episode ofcare, such as a knee or hip replacement, with awarranty pledge, which accommodates the busi-ness’ desire to reduce health care costs while re-ceiving the highest quality care. Patients withemployer-based direct contracting programs cometo HOI from all over the U.S., undergo surgery andrecover here before returning home, all at a pre-fixed fee. Because of the high value provided underthis program at HOI, our direct business agree-ments continue to grow.

We all underwent crisis mode in 2020, but nonein our organizations were under more pressurethan our frontline workers. Our industry is see-ing many cases of PTSD and other crisis-relatedemployee concerns. How do we help our peopleheal mentally, physically, and financially?

Kimberly Chavalas Cripe, CHOC: As employers of choice, we need to support ourstaff in having the time and energy to restore theirhealth. From a physical and mental standpoint, thisincludes things like normalizing breaks, discourag-ing work after hours, and encouraging paid time off.Additionally, consider spaces for meditation, guidedimagery, and spiritual care, for example, to help em-ployees rejuvenate. Approach workers through thelens of trauma-informed care to better understandthe traumatic impact the pandemic has had onthem, and to promote an environment of healingand recovery.To address financial health, examine what fiscallosses employees and their family members haveexperienced. Even if jobs have been restored, it cantake time to recover. Offer classes on managing fi-nances, and provide on-site services, such as apantry for groceries or physical fitness activities,that help workers save time and money, and con-tribute to their health and well-being.

Mark E. Costa, Kaiser Permanente: Kaiser Permanente takes the total well-being of ouremployees and physicians very seriously. As an or-ganization, we recognized early on that the pan-demic impacted all our employees and physicians,not just those on the frontlines. It impacted theirtotal well-being as they continued their commitment

to our patients while facing the disruption of homeand family life. As such, we implemented a new pro-gram, #oneOCstrong, focused on the overall well-being of our team members. The program includes dedicated discussions tosupport the opportunity to process individual pan-demic experiences to address the stress, sorrow,and grief that has impacted the total well-being ofour providers and teams. For example, we have setup Respite Rooms where employees and physi-cians, can find support services, share their experi-ences, or simply to sit quietly in reflection. Weimplemented weekly Open Support Calls for individ-uals to share personal impact stories and gainmuch needed support. We also know the power ofthe term, “strength in numbers,” and as such, weimplemented facilitated conversations within individ-ual departments, particularly at high risk, to discussthe pandemic and its effect on them or members oftheir families. Kaiser Permanente knows that we must take careof our own, so that we in turn can give the best tothose that need us.

Chad T. Lefteris, UCI Health: UCI Health recognized even before the pandemichit the US that supporting its frontline caregiversand co-workers would be a key to managing thisunprecedented public health crisis. We created afood pantry and free childcare program to assistemployees who were spending long hours at thehospital. Caregivers from UCI Susan Samueli IntegrativeHealth Institute provided regular programs designedto reduce mental and physical stress in individualsand care teams. As the demand for inpatient spacegrew at the height of the pandemic, so too did ourcommitment to creating places of rest for providers.Our longstanding relationship with the SchwartzCenter for Compassionate Care, in which health-care workers address the stress of their jobs, hasfocused on helping providers cope with theirCOVID-related experiences. In addition, the UCIHuman resources teams have greatly offerings tosupport mental and physical health and wellness,as well as financial support opportunities. Our com-mitment to our co-workers remains our focus as weslowly transition out of the pandemic.

Orange County has long been noted for healthyliving. Yet, despite this image, our incidence fordiseases such as breast cancer exceeds the na-tional average. Layer this with an aging popula-tion and we have another health care crisisahead. How do we put more energy into well-ness and disease prevention to ensure a health-ier future?

Catherine Sinardi, Concordia University Irvine –School of Health & Human Sciences: The COVID-19 crisis illustrates how crucial collabo-ration is in advancing innovation and improving thehealth of our communities. Stakeholders from multi-ple sectors, industries, disciplines, communities,and systems with differing viewpoints and expertisejoined forces to solve unimaginable challenges,driving sustainable improvements in health. Com-munities united by assisting neighbors, creating re-sources to help essential workers, raising funds forthose in need, and finding creative ways to connectwith one another. However, the pandemic has alsohighlighted deep social disparities and health in-equities. A concerted effort to address and betterunderstand the social determinants of health in ourcommunity is vital to improve overall wellness anddisease prevention. Comprehensive epidemiologi-


Orange County employers have agrowing stake in the decisions theymake on behalf of their employees’health care.

Jennifer Mitzner, MPA, CPAChief Executive Officer

Hoag Orthopedic Institute




cal research examining the underlying causes ofhealth disparities will lead to targeted interventionsand improved health promotion strategies, providingpathways to optimal health for all. The current mo-mentum of unwavering commitment and synergisticcollaboration must continue to create innovative so-lutions that harness a culture of health and promotehealth equity in our community.

Kevin P. Manemann, Providence Southern California: Providence’s vision is health for a better world. Toachieve this, we are acutely focused on preventionand wellness through community education, healthscreenings and proactive management of chronicdisease to prevent future complications. Our inte-grated care teams ensure care plans address diet,exercise, lifestyle, mental and physical health goals.In addition, our Clinical Institutes conduct ongoingresearch that ensures our patients have access toleading-edge, best-practice medicine at every ac-cess point throughout our expanded network. Providence also extends care deep into our neigh-borhoods. In 2020, Providence provided $164 mil-lion in total benefit to our local communities,including $121 million in unpaid costs of Medicaidand $20 million in free and discounted care for theuninsured. We work closely with our communitypartners to address the needs of the poor and vul-nerable, including access to health and dental care,mental health and substance use services, housingand education.

Annette Walker, City of Hope:We know that wellness and prevention are signifi-cant components to cancer care's new frontiers. AtCity of Hope, we believe the best way to treat can-cer is to prevent it in the first place. It’s vital to notonly educate people about how to find the best careif they have cancer but to help them reduce theircancer risks – and that is an area of focus at ourNewport Beach practice and at City of Hope. Whenwe open our Irvine campus, you’ll see us launchnew programs for preventing cancer and treating itin its early stages, including highly targeted ge-nomics and precision medicine breakthroughs. As anational health care leader, City of Hope has a re-sponsibility to fulfill our promise of improving Or-ange County lives by applying our advancedcapabilities and teams of experts to preventing andcuring cancer.

If OC health care could do 2020 all over again,what should we have done differently? Whatlessons did we learn and are you hopeful for2021 and beyond?

Annette Walker, City of Hope:As leaders, we must take stock of the lessons of2020. I can enumerate several of the most impor-tant takeaways. First, no one is immune from ahealth care crisis, whether it’s COVID-19 or any se-rious illness. We need to ensure there is equity inaccessible health services for everyone in need. Welearned how we can come together as an industryand as individuals to solve problems and care forone another. I’ve never been prouder to serve in thehealth care industry. It goes without saying that welearned more deeply about the heroism of our front-line workers and the sacrifices they make to keepus all safe. We recognized the power of investing inmedical research so that breakthroughs – like avaccine developed in months, not years –are possi-ble. And finally, we learned about the power of com-munity. We saw that we must focus not on ourdifferences but on our shared desire to defeat seri-ous illness and live healthier lives. I’m very opti-mistic about the future. City of Hope was founded

on hope. We want to share this powerful sentimentsourced by lifesaving cancer treatments and scien-tific breakthroughs with our community – in 2021and beyond.

How is your organization involved in the localOC community?

Catherine Sinardi, Concordia University Irvine –School of Health & Human Sciences: Service is embedded in the mission of CUI and fos-tered throughout all levels and activities of the uni-versity. Many classes integrate service-learning andstudent clubs and athletic teams regularly performcommunity service projects. ConcordiaCares, a stu-dent-run program, offers opportunities to serve thelocal community by partnering with organizations tobuild sustainable volunteer programs and educateour campus about current social justice issues. CUIalso hosts ConcordiaServes, an annual day of serv-ice for students, faculty, staff, alumni, parents, anddonors to dedicate their time to serve others in anyway they choose. Last year, on one day, over 1,000members of the CUI family stepped into the com-munity to serve in a variety of capacities. Through-out the year, healthcare students come together toraise funds for organizations that improve the livesof those in our community. Additionally, healthcarestudents are required to volunteer in organizationsthat improve our community’s health.

Gene Rapisardi, Cigna: Cigna actively supports Orange County organiza-tions making a significant impact to help bridgegaps in care and promote health equity across allpopulations. In 2020/2021, Cigna supported: WHWEmployment Success Program, American Heart As-sociation women’s stroke and heart education,Leukemia and Lymphoma Society fight againstblood cancer, FIT mental health program for middleschool children and families, The Trevor Projectserving behavioral health needs of LGBTQ youth,MOMS Orange County healthy babies and familiesprogram, and Children’s Hospital Orange Countysupport for financially challenged families of babiesneeding care.

Jeff Goad, PharmD., MPH., Chapman UniversitySchool of Pharmacy: Chapman University’s health science programshave been actively involved COVID vaccination out-reach efforts throughout Orange County. As soon asvaccination became available, our faculty and stu-dents began volunteering at hospitals and with thepharmacies vaccinating nursing homes. As vaccineeligibility expanded, we starting volunteering at theCounty’s mass vaccination sites at Disneyland andthe Anaheim Convention Center. We have had over100 faculty, and students volunteer in the commu-nity to give COVID vaccines.

Marshall Moncrief, Be Well OC:Be Well OC is a movement made up of people andorganizations from our community and we are work-ing to ensure that Orange County will lead the na-tion in optimal mental health and wellness for allresidents. Be Well OC is a community of action,which has brought together public, private, aca-demic, and faith-based partnerships to create a ro-bust, best-in-class system of care for those sufferingfrom mental health and substance use disorders.Families across Orange County are suffering in theface of increasing mental health and substance usedisorders. For many families, these challengeshave led to devastating and often catastrophic out-comes. The January opening of the first Be Well OC Cam-


No one is immune from a health carecrisis, whether it’s COVID-19 or anyserious illness. We need to ensurethere is equity in accessible healthservices for everyone in need.

Annette WalkerPresident

City of Hope Orange County




pus in the City of Orange is the first visible sign ofsystems change spearheaded by the Be Well Coali-tion. However, there is so much work that happensevery day, as community and coalition membersgather to collaborate, bring in diverse voices and findsolutions to make our system of care more inte-grated to better serve our loved ones.

Annette Walker, City of Hope:We came to Orange County in response to apressing community need and we are here as agood neighbor. For us, community involvement isingrained in all of our work. For example, duringthe design of our cancer campus, we invited morethan 500 people to provide feedback, ensuring thatthe campus being built for the community is alsobuilt with the community. We are also ensuring thatall areas of Orange County have access to the re-sources of a world-class cancer institution as webuild a network of care throughout the region. And,because we understand that socioeconomic fac-tors influence good health, we contribute to a thriv-ing community not only as a growing localemployer but also through our involvement withchambers of commerce, business partnerships,educational institutions, community non-profits,and the area’s incredible entrepreneurial sector. Allthese practices honor our commitment to helpingOrange County become healthier with each newgeneration.

Robert T. Braithwaite, Hoag: Hoag’s dedication to the community began at itsinception 70 years ago. Hoag’s Community BenefitProgram focuses on meeting the unique needs ofOrange County residents, with particular emphasison the disadvantaged and underserved.Hoag annually contributes millions of dollars andin-kind services to a wide spectrum of communitynon-profit organizations. From free health clinics,food banks and mobile dental visits, to family sup-port services, mental health wellness and legalsupport, Hoag partners with organizations thatfocus on Orange County’s vulnerable, underservedindividuals and families. Hoag’s Community Bene-fit program has given approximately $261 million tomore than 100 local programs and services thatare changing lives every single day. At the MelindaHoag Smith Center for Healthy Living at our New-port Beach campus, underserved individuals andfamilies have access to a wide range of free orlow-cost services, staffed by community non-profitsand conveniently located under one roof.Moreover, during the past year, Hoag has affirmedits reputation as a trusted partner in the health andwellness of our community by providing thousandsof COVID-19 vaccines to the underserved andsenior populations through community clinics, aswell as by donating personal protective equipment(PPE) to local agencies in need.

What are hospitals doing to provide access toquality health care for the underserved commu-nity?

Chad T. Lefteris, UCI Health: Providing access to quality healthcare for all in ourcommunity goes to the heart of UCI Health’s mis-sion as an academic health system. UCI Healthwas the first system in Orange County to open fed-erally qualified healthcare centers in the early1980s, in Santa Ana and Anaheim, to provide ac-cess to care in underserved communities. TheseUCI Health Family Health Centers have been atthe forefront of educating their community aboutthe COVID-19 pandemic, providing access to test-ing and now to vaccinations. This effort includesforging partnerships with school districts and other

local organizations to provide vaccinations andother COVID-related services, ensuring thesecommunities are not overlooked. In addition, anddespite the pandemic, the Family Health Center inAnaheim moved to a larger location that expandsservices for family, children and women and allowsfurther growth in a central location.

Costs of health care remain top of mind amongboth consumers and providers of care. Onearea that is being showcased in Orange Countyis the drive to move more surgical care out ofthe inpatient setting and into shorter stays orambulatory surgery centers, especially duringCOVID-19 pandemic. How have you adapted toor managed the growth of outpatient care dur-ing this time?

Jennifer Mitzner, Hoag Orthopedic Institute: HOI was perfectly positioned for the shift to outpa-tient surgery. Over the past several years, HOI de-veloped a model of care focused on enhancedrecovery for low risk patients resulting in many ofour patients receiving a hip replacement in themorning and going home to recover that same af-ternoon or evening. A year ago, 15% of our hip andknee replacement patients returned home thesame day and the COVID pandemic further fueledthis tectonic shift to outpatient surgery as patientsdesired to recover at home rather than in the hos-pital. Today, nearly 40% of these patients are leav-ing the same day to recover in the comfort of theirown homes. Patients who undergo outpatient hipor knee replacements report a high degree of sat-isfaction and they are happy to be able to get backto their now-mobile lives with the same high qualityresults that HOI inpatients report.

The availability of quality mental health serv-ices has lagged in Orange County for manyyears. What are the obstacles to improving ac-cess to this care and how is your institutiontrying to address the need?

Kimberly Chavalas Cripe, CHOC: Orange County’s mental health system of care isfragmented, making it challenging to navigate.Services are not consistently or sufficiently cov-ered by insurance, which often leads to individualsdelaying or avoiding treatment, and the low reim-bursement rate has resulted in a shortage of quali-fied providers. All of this adds up to serious gaps indiagnosis and care.CHOC believes mental health is just as importantas physical health. We have engaged broad sup-port from individuals, organizations, leaders, andhealthcare partners to identify and address thecommunity’s greatest needs. At CHOC, we be-came the first in the county to offer inpatient men-tal health treatment for children 12 and younger;we have increased specialized services for chil-dren who have medical disorders and mentalhealth conditions; we are developing hospital-widetrauma-informed care principles; and we are col-laborating with the Orange County Department ofEducation to identify school-based needs. We willcontinue to advocate for mental health.

Marshall Moncrief, Be Well OC:Orange County system issues historically havebeen that people cannot connect to the right carein the right place when they need it. Gaps in serv-ices, access, and funding plagued the mentalhealth system, especially in terms of services foryoung children and adolescents, crisis interventionand addiction treatment. Additionally, silos in caremean services aren’t integrated, compounding


Orange County’s mental healthsystem of care is fragmented, makingit challenging to navigate. Servicesare not consistently or sufficientlycovered by insurance, which oftenleads to individuals delaying oravoiding treatment, and the lowreimbursement rate has resulted in ashortage of qualified providers. All ofthis adds up to serious gaps indiagnosis and care.

Kimberly Chavalas CripePresident and Chief Executive Officer

CHOC




service gaps and access challenges, maintainingcompetition between organizations and dilutingcollective impact potential. There have also beendisparities and inequities in geographic serviceavailability throughout the county. Success in addressing these challenges startswith acceptance that the mental health sectoralone cannot solve all of the challenges of thiscomplex and pervasive health challenge. The BeWell OC movement brings together a robust, com-munity-based, cross-sector strategy—public-pri-vate, academic, faith, and others – to positivelyimpact those challenges that diminish mentalhealth and well-being. Orange County will be acommunity of action, leveraging collective powerto transform mental health service delivery into aworld class system of care. In creating a community-wide ecosystem of opti-mal mental health care and support, the coalitionis creating a new reality for OC, where we boldlyimpact individual and societal conditions so thatall residents can Be Well.

Robert T. Braithwaite, Hoag: In response to the growing concern around mentalhealth, which has been exacerbated by theCOVID-19 pandemic, Hoag is working to improveaccess and expand resources for those strugglingin our community. As one example, we recently opened, the HoagYoung Adults Mental Health Program. Theoutpatient program helps individuals ages 18 to26 that are struggling with depression, anxiety,trauma and other symptoms, navigate thechallenges of the transition into adulthood.Hoag also continues to offer the ASPIRE Program(After School Program: Intervention and Re-siliency Education), an intensive outpatient pro-gram for 13- to 17-year-olds in both NewportBeach and Irvine. Our own health care workers need mental healthsupport as well. To help ease the emotional toll ofcaring for critically ill patients during the COVID-19 pandemic, Hoag has piloted a new programcalled CenteredVR, a virtual reality-based mindful-ness and stress management program to helphealth care workers reduce chronic stress, buildresilience and enhance coping skills.Hoag is also proud to support Be Well and helpestablish a best-in-class mental health system tocare for all of Orange County.

Mark E. Costa, Kaiser Permanente: The current mental health system within OrangeCounty is fragmented making access to neededservices difficult. The multiple public and privatemental health providers work as separate entitiesleading to challenges for those in need. As an ex-ample, Orange County residents who may needcrisis related services have over 15 differentsources for care, but with 15 different contactnumbers. Such fragmentation is costly and ineffi-cient. As an integrated health system, Kaiser Per-manente has focused on expanding access to allmental health related resources to our 585,000health plan members. Through a single coordi-nated call center, and as well as through ourKaiser Permanente App. members can gain ac-cess to all available services. This includes ac-cess to telemedicine mental health visits andother digitally enabled tools and resources. KaiserPermanente is also a major supporter of Be WellOC, a collective of more than 200 entities repre-senting both Public and Private, whose focus is oncreating a system of Mental Health Services for all

residents of Orange County, including our ownKaiser Permanente members.

What is the oral-systemic link and how is thedental industry integrating oral health with tra-ditional medicine?

Stephen E. Thorne, IV, Pacific Dental Services: The oral-systemic link refers to the connection be-tween oral health and overall health, what we atPDS call The Mouth-Body Connection®. Re-search shows that bacteria and inflammation inthe mouth can indicate and even cause systemicconditions throughout the body. That is why webelieve it is essential for the entire healthcarecommunity to join forces and push for dental-med-ical integration to help provide patients with an all-inclusive continuity of care. PDS has been activelyengaged in joining forces with partners who sup-port these initiatives, and has implemented mod-ern, proven technology that helps improveoral-systemic health. PDS is one of the only den-tal organizations nationwide that has implementedthe Epic® EMR system to facilitate better collabo-ration between medical and dental professionalson behalf of patients.

There is concern across the U.S. that access toquality healthcare is limited. What is your or-ganization doing to improve healthcare equity?

Stephen E. Thorne, IV, Pacific Dental Services: The Pacific Dental Services® Foundation aims toimprove overall health by improving access to oralhealthcare. We recognized the need to increaseaccess to oral healthcare for the special needscommunity and responded by opening the firstPDS Foundation Dentists for Special Needs officein Phoenix, Arizona. This unique office providescomprehensive dental care for people with specialneeds and is helping make oral health achievablefor patients between visits. In response to thewidespread need for oral healthcare, the PDSFoundation’s Mobile Dental Clinic traveled acrossthe country (pre-pandemic) to provide donateddental care and oral health education to those inneed. Looking beyond our borders, we also pro-vide donated dentistry through annual interna-tional service trips to Guatemala, Fiji and Ethiopia.

Chad T. Lefteris, UCI Health:As part of an academic health system dedicatedto serving its entire community, UCI Health isdeeply involved in ensuring healthcare equity in itsclinical practices and its role in preparing healthcare leaders for tomorrow. The Healthcare Equal-ity Index has recognized UCI Health’s commit-ment to the equity and inclusion of LGBTQpatients, visitors and employees and the UCISchool of Medicine’s unique Program in MedicalEducation for the Latino Community (Prime-LC)and Leadership Education to Advance Diversity–African, Black, and Caribbean (LEAD-ABC) pro-grams recognize that healthcare equity oftenstarts with ensuring opportunities for underservedcommunities. These efforts continue to train care-givers to be sensitive to the unique needs of pa-tients from all socio-economic, ethnic and racialbackgrounds. UCI Health was the first system inOrange County to open federally qualified health-care centers in the early 1980s, in Santa Ana andAnaheim, to provide access to world class care inunderserved communities. For decades, thesecenters have set the standard for whole-familyhealthcare.

It is essential for the entire healthcarecommunity to join forces and pushfor dental-medical integration to helpprovide patients with an all-inclusivecontinuity of care.

Stephen E. Thorne, IVFounder and CEO

Pacific Dental Services


an informative q&a with oc’s top healthcare professionals

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