Managing the Health of the Most Complex Patients and Plan Members

An interview with David Rosales, who recently became Executive Vice President and Chief of Provider Services. He previously was EVP and Chief Strategy Officer.

What would you say is our greatest strength as an organization?

I think it’s our ability to build trust with our patients and their families and change the entire direction of their lives. That’s why so many providers in the community trust us to take over and manage a patient’s care after that person has left their hospital, or after someone has experienced a wrong turn in their health. It’s something we do tens of thousands of times a day—and when we do, that’s where the magic happens.

What are your key priorities as Chief of Provider Services?

One of our key priorities is enhancing the experience of our team members who provide direct care to our patients and clients in our provider businesses—which include Home Care, Hospice, Personal Care, Behavioral Health and Care Management. We are very well-positioned to care for the most vulnerable members of our communities, especially those with medically complex needs, and we have over a century of expertise with this population. Our vision is to increase the number of people whose lives we’re impacting and do it within the context of today’s workforce dynamics. The competition for clinical health workers has increased dramatically in the post-COVID world — so for us to expand our reach, we first have to make sure the experience of our team members each day is engaging, frictionless, and attractive.

What are you doing to ensure this?

For our team members in the field, what makes their jobs attractive is the ability to engage one-on-one with patients and their families in a home or community setting. At the same time, these are challenging jobs, so we’ve been working to strengthen the systems of support we surround them with. We’ve been holding regular round tables with our field staff and managers, and we’re using those insights to make meaningful changes. For example, we recently established a dedicated preceptor role—team members whose only job is to guide, support and mentor our new clinical hires—and we’re expanding our Nurse Residency program for nurses who are new to home care. We’re also streamlining the workflow of our clinical field managers so they can focus more on their field clinicians. In addition, of course, we’re very focused on ensuring that VNS Health is competitive when it comes to compensation and benefits.

What other strategies are you employing to expand our impact?

We’re very focused on partnering with external health plans, which we see as one of our best opportunities to expand our reach. The challenge those plans struggle with most is how to change the health trajectory of individuals with very complex needs. That’s something we’ve become quite good at, so a key part of our strategy is to offer intensive care management solutions to health insurers. A good example is our Behavioral Health team’s substance use care management program, which launched in 2023. By engaging individuals with substance use disorder at the time they’re being discharged from inpatient stays, we can connect them to the services they need to continue on the path to recovery. Health plans have limited tools available to help these plan members—but through our care model, we’re able to fill that gap and link their members to essential services that support their recovery.