After Robert Eick, M.D., M.P.H., ’13, graduated from the Boonshoft School of Medicine, he matched into a family medicine residency program at the University of North Carolina at Chapel Hill. He truly enjoyed caring for patients and found fulfillment in directly helping to improve their wellbeing. But he realized he might be able to have a greater impact in a different role.
“The decision to leave clinical training and pursue a career in health system administration and leadership was difficult. However, I found I was most energized by the ability to participate at an administrative level in the health care payment and practice reform opportunities that were being realized with the passage of the Affordable Care Act,” Eick said. “It has been a rewarding path thus far.”
Part of his decision to leave primary care hearkens back to before he ever began studying medicine. It’s the reason that he chose to pursue a dual degree.
Eick realized that so much of health care and improving health is social. He saw the opportunity to study both medicine and public health as an ideal way to embrace that reality and to potentially create solutions to issues on a grand scale. His work after graduation has given him opportunities to do that. Currently, Eick serves as a policy fellow at the Duke University Margolis Center for Health Policy.
“I saw the opportunity to address the health needs of both the individual and the population as an extremely motivating proposition. The community-focused, whole-person, team-based approach embraced by the Boonshoft School of Medicine has prepared me well in this regard and enabled my success as a leader,” Eick said. “In addition, the public health and leadership training of the Physician Leadership Development Program has opened many doors for me professionally, providing skills that have made me a better leader.”
Eick previously has served as deputy chief medical officer at Community Care of North Carolina (CCNC), a not-for-profit organization that manages care for more than 1.7 million Medicaid recipients in the state. In this role, he got the opportunity to co-lead the organization’s Practice Transformation Network (PTN) cooperative agreement with the Centers for Medicare and Medicaid Services Innovation Center.
The work meant that Eick was able to spread the successes realized by CCNC in Medicaid across all payer types. The bulk of the initiative relied on using data to improve the cost, quality of care, and patient experience.
Prior to that role, he worked as executive director of Carolina Medical Home Network, where he directed a Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO) led by Federally Qualified Health Centers. He also led a health information technology and practice transformation network consisting of about 200 clinical sites and more than 400,000 patients.
As a consultant, Eick has had the opportunity to lead teams focused on tackling the challenges facing health care, including rising costs, poor outcomes, and sub-par patient and provider satisfaction. He has explored many different models of care, and how best they can be utilized.
“Over the last year, since leaving my role at CCNC, I have been an independent consultant focused on Medicaid transformation in North Carolina,” Eick said. “North Carolina is currently transitioning from a non-managed care Medicaid program to Medicaid managed care. This experience has provided a new perspective for me, as it has been my first opportunity to work with a managed care organization.”
Eick has gained experience in a number of care models. They include the Transforming Clinical Practice Initiative PTN, the MSSP, the ACO Investment Model, and the Health Center Controlled Network program.
“A common thread for each of these programs has been building on-the-ground capacity for health care providers to better utilize actionable data to drive more informed care, with the end goal of providing a higher quality of care at a lower cost,” Eick said. “In order to achieve such quality and cost goals, a realignment of health care reimbursement models has been taking place across health care payer types — commercial, Medicare, Medicaid, and so on — over the last decade.”
The changes have ushered in value-based models of care, including ACOs with shared savings, bundled payments, and population-based payments aimed at shifting financial accountability for clinical outcomes and costs toward providers of care and away from commercial or government-funded payers. He is already seeing some areas where improvements can be made.
Eick believes that health care transformation requires a slow and steady approach. More information is being gathered each day on the effectiveness of the new care and reimbursement models. The evidence base is growing.
“I do think that, regardless of the health care reimbursement model, there is a profound need for health care providers, especially primary care providers, to have a renewed focus on population health,” Eick said. “Primary care providers should strive to understand the patient population, current health outcomes, the social and economic barriers that patients face, and targeted interventions that could improve outcomes.”
He has hope for the future of the health care system, and the work he has done since graduation has underscored a lot of significant lessons he learned while a student at the Boonshoft School of Medicine. Eick has observed the importance of the social determinants of health. Things like housing, education, transportation, income, social support, and stress can have a great bearing on a person’s health. Eick sensed the importance of these elements in improving health before going to medical school. He has since witnessed the power of medicine’s social side in making a difference.
He is very grateful for the many leaders, teachers, and mentors he had while a student at the Boonshoft School of Medicine. One mentor who has continued to influence Eick is Janet Velasco, M.D., assistant professor of pediatrics. She has always treated Eick as a colleague, beginning during his time on the inpatient pediatrics service at Dayton Children’s Hospital and extending to volunteer work completed with her in Paraguay and the Dominican Republic.
Velasco and many others have shared valuable lessons with Eick that have helped him to flourish in health care administration.
“I have learned, and am still learning, to be present for the current moment. As each of us alumni have experienced, we spend what seems to be an endless number of years in school and training, leading us to so often be looking ahead to what is next and how to best position ourselves for success in the next phase of our career,” Eick said. “My advice is to embrace the diversity of experience that the current opportunity — medical school, residency, your post-training career — presents to you. I have found that experiences that remind me of why I got into medicine to begin with have been vital in helping guide and drive me despite the rigors of a career in health care.”
— Daniel Kelly