Hope Plavin, MPA, MHCDS ‘16
Director of Planning, Office of Quality and Patient Safety, New York State Department of Health
As a child growing up in New York City, Hope Plavin regularly tagged along with her father, a pediatrician, as he visited homebound seniors on so-called “Medicare weekends.” She saw firsthand the numerous challenges his patients faced—in income, education, housing, and language—that made it difficult for them to follow through with their treatment. “He would prescribe a medication and know it was 50-50 whether they’d even fill it,” she remembers.
Fast forward a few decades, and Plavin is now into her 32nd year in a career helping to design a better medical system for New York State. In the 1980s, under then–governor Mario Cuomo, Plavin worked on an early attempt to implement universal health care that led to statewide Medicaid coverage for children 13 and under, a model for the national S-CHIP program. Now as a director of planning under Governor Andrew Cuomo, she oversees the New York State Health Innovation Plan, an ambitious plan to use government finance and policy levers to transform health care for New Yorkers—improving quality and access while also reducing cost.
“This is a huge time of change and experimentation, and I want to be part of the solution,” Plavin says of her decision to enroll in Dartmouth’s Master of Health Care Delivery Science. “I thought by going through this program, it would help me do my job better in New York.” Already she’s been inspired by the high level of discussion in the program about such issues as the role of Accountable Care Organizations (ACOs) and how best to implement value-based payment systems. “Those are all questions we are grappling with in real time as the system is evolving,” she says.
A recent case study on mergers and acquisitions, for example, gave her insight into current mergers in upstate New York. “Short of going to the Federal Trade Commission and raising anti-trust issues, we are asking what state insurance regulators can do in those hard discussions with providers about what care models we want to support.” Classroom discussions have made her more effective in those negotiations. “There are things said to me in class that would not be said across a formal negotiating table, so that’s been very helpful,” says Plavin. “No provider is going to tell me that if reimbursement rates are cut they will simply learn how to become more efficient. However, there are efficiencies to be found and my goal is to figure out how to work together with people who are normally competitors to create a more seamless and effective system overall.”