Ep 33 – How Black Lives Matter in Value-Based Care, with Dr. Lerla Joseph

In this episode, reflect on the importance of Black History Month, an important time to recognize and honor the contributions and achievements of the millions of African Americans who have helped build our nation and enrich our culture. We also address racial disparities in care, which have become increasingly evident during the pandemic and vaccine distribution response. And we consider how value-based care can work to ensure true population health and parity in health outcomes for all.

This week we are honored to speak with Dr. Lerla Joseph, an African American physician, businesswoman, humanitarian, role model, mentor, and philanthropist. In 2012, she founded the Central Virginia Coalition of Healthcare Providers (CV-CHIP) one of the nation’s few minority-owned Accountable Care Organizations. Dr. Joseph not only leads a successful ACO, she has also led medical missionary trips to Haiti for the last 16 years. As a community leader, she has also served on boards for Richmond Community Hospital and the Bon Secours health system and was the 1st woman elected President to the Richmond Medical Society. This year she was a “Strong Men & Women in Virginia History” Honoree, a program that honors prominent African Americans past and present who have made noteworthy and admirable contributions to the commonwealth, the nation, and their profession. Dr. Joseph is a shining example that black history is around all of us.

Episode Bookmarks:

01:45 Black History Month is a time to contemplate the faith and sacrifice of every black ancestor.

03:00 “As leaders in value-based care, we endeavor to create the opportunity for health equity.”

03:30 Intro to Dr. Lerla Joseph, Founder and CEO of CVCHIP ACO (one of the few African American-led ACOs in the country)

05:30 “Of all the forms of inequality, injustice in health is the most shocking and inhumane” – Martin Luther King, Jr.

06:30 Outcomes research on racial disparities of care showing that inequities are built into the healthcare system.

07:45 A medical career devoted to bring about health equity to African Americans

08:20 “Having a health insurance card is not enough in terms of getting the proper care that African American need. Our populations needs physicians like them that understand their cultural background.”

09:20 The Accountable Care model as a vehicle for both access to care and health equity

10:50 How do we begin to have an open conversation as a society when it comes to recognizing systemic racism exists?

12:15 “Your health should not be determined by your zip code.”

14:15 Dr. Joseph speaks about her experience growing up with segregation and benefiting from affirmative action

16:05 An opportunity for America to overcome supremacy

16:55 Creating a movement for African Americans and White Americans to come together to have a conversation on race

18:20 Unwillingness of African Americans to take the COVID-19 vaccine due to past experiences that created distrust of health system

20:55 “As long as there are disparities in health care, the costs will remain high.”

21:20 Creating CVCHIP ACO with the recognition that African Americans were getting left behind in the value-based care movement

24:20 A recent study showing that life expectancy dropped sharply to its lowest level in 15 years, and even lower for Black Americans, during the first half of the coronavirus pandemic

25:35 The mission of CVCHIP to sustain the viability of the independent practice and how Dr. Joseph’s ACO helped practices during COVID-19

27:30 Implementing telehealth and ensuring patient access during the pandemic

29:00 The impact of COVID-19 on African American patients

30:00 Dr. Joseph’s medical missionary work in Haiti and her commitment to help others in the world

31:40 The most rewarding experience in her life and how she inspired others to serve

33:50 “Living in America, even with all of the disparities and inequities, is still the best place in the world to live.”

36:35 Convincing doctors that Fee-For-Service was going to end and how Dr. Joseph engaged physicians at the beginning of CVCHIP starting as an ACO

39:00 A personal patient story of how the ACO engaged community resources to help someone in their home (“looking beyond the diagnosis”)

42:00 Our nation’s long-standing mental health crisis that has been exacerbated by major societal stressors: the covid-19 pandemic, racial inequality, and a heated election season

43:55 Forming partnerships within the ACO to provide access to Behavioral Health services and treatment for Substance Use Disorder

48:00 A coalition led by the Larry Green Center to reform Primary Care Financing

49:30 Establishing an advocacy effort within the ACO to speak on behalf of Primary Care

51:50 “The lack of African American ACOs in the country is regrettable – all communities must be represented.”

53:00 “My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style”.  – Maya Angelou.

53:50 Dr. Joseph shares her perspective on leadership and how others can lead in the value-based care movement.