Nicolette (Nikki) Highsmith Vernick accepted the positions of president and CEO with The Horizon Foundation in February. She brings Horizon almost 20 years of health policy and philanthropic experience, which dovetails with her passion for improving health and health care for vulnerable Americans.
Before joining the foundation, Highsmith Vernick served as senior vice president for programs at the Center for Health Care Strategies (CHCS), a nationally-recognized center for improving care for beneficiaries of this country’s publicly-financed health care programs in Princeton, N.J.
Highsmith Vernick has led quality and equity work in state capitals nationwide in her efforts to unite disparate stakeholders, including Medicaid agencies, private payers, providers, community organizations, state departments of health and social service agencies to improve health outcomes and achieve common health care reform objectives.
She also has led many national philanthropic programs for such organizations as the Robert Wood Johnson Foundation’s Medicaid Managed Care Program, which has given more than $15 million in grants to states. Highsmith Vernick also sits on several national committees and advisory groups related to health care redesign and quality.
A one-time senior Medicaid analyst during the Clinton Administration at the Executive Office of the President, U.S. Office of Management and Budget, Highsmith Vernick was also a professional staff member for U.S. Congressman Michael Andrews of Texas. She holds a master’s degree in public administration from American University, in Washington, D.C., and a bachelor’s in history from the University of Texas.
What is your opinion of the Healthy Howard program? Do you think this model will be replicated more often in other jurisdictions?
It’s very innovative. It combines a patient-centered medical home with a personal health coach. This is really about helping people live with, and manage, chronic conditions with a one-door approach that streamlines applications to multiple public programs.
Through its accreditation programs for child care agencies, schools, restaurants, and workplaces, Healthy Howard is working to improve institutional policies that improve access to healthy and affordable food, as well as increased recreational opportunities, which is in line with our work concerning obesity prevention in the county.
Howard County is once again the healthiest county in Maryland, according to a report released by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. What is Horizon’s stance as you move forward on that positive news?
I think we should applaud our successes, as well as the many, many partnerships across the county that have resulted from the achieved vision of leading long, healthy lives and creating a healthy community.
That said, we can’t rest on our laurels. There are two things that we have to do to preserve our forerunner’s status: One is address obesity, which the report highlighted as an area where we can, and must, do better; and we also need to find ways to address disparities that still exist, even in Howard County, based on race and ethnicity, as well as socioeconomic status.
Doctors in Maryland have been given greater impetus to pay for and use Electronic Health Records (or EHRs). What do you see happening on that front in Howard County?
EHRs and Health Information Exchange (HIE) among doctors and in institutions hold great promise concerning improved patient safety, higher quality of care and lower health care costs.
I think we’re lucky to be in a progressive state that is encouraging EHR adoption and HIE. However, it’s going to take a collective effort to show those doctors who are late adopters the value of EHRs in their practices, and how it will improve patient workflow and make their lives easier. Incentives from Medicare and Medicaid to become meaningful users will help; but our local efforts, especially those of the Chesapeake Regional Information System for our Patients (or CRISP), are vitally important.
What is your take on Obamacare?
I’m one of the few people that you might meet who have actually read all 2,400 pages of the Affordable Care Act (ACA) report. I feel very strongly that we have to take advantage of this national opportunity to provide health care for all Americans.
The numbers on this front are stark: We have 50 million Americans who are not insured. In Howard County, about 20,000 of our residents do not have health insurance. We spend more per capita on health care than any other country, but we do not have better health outcomes. And health care costs represent a staggering 17% of our national Gross Domestic Product.
By those metrics, I would say that the current system is broken and that the ACA is an attempt to improve the lives of individuals by expanding health care coverage, reforming the health insurance system and providing better care at lower cost. It also includes increased coverage for preventive services, small business tax credits, providing insurance coverage for people with preexisting conditions, and filling in the “donut hole” that will help seniors on Medicare pay for their prescriptions. Howard County has been a leader in covering the uninsured and our state has been a leader in developing the state health insurance exchange, so we have a great foundation from which to build.
I look forward to Horizon and other organizations partnering to help Howard County understand and implement health care reform if it is upheld by the Supreme Court or ways we can move forward on our own.
What do you think you’ll do differently than your predecessor, Rich Kreig?
Rich left a legacy of tremendous impact in Howard County, and I’m proud that I was chosen to be his successor. This foundation is a huge resource for the community and, moving forward, we can help tackle the major problems. I want to continue the tradition of “tackling the hard stuff,” and I have a tremendously committed and engaged board of trustees that will help the foundation in that mission.
The issues I’ll tackle will be different than those he did, however. The first is tackling obesity, and reducing consumption of sugary and sweetened beverages is part of that effort. We are taking into account that one of every four children in Howard County is obese or overweight. For children aged 2 to 18 years old, sugary drinks are not only the largest source of added sugar, but the largest single source of calories.
The second issue is helping people access health care services and insurance. On that front, language access is big issue in the county, so we have a service called MARTTI (My Accessible Real Time Trusted Interpreter) that is designed to provide video language interpretation services at the point of care. It is currently being used at three sites, including Howard County General Hospital, Chase Brexton Health Services in Columbia, and the Healthy Howard Health Plan. It’s proving to be a phenomenal tool for the health care community, and we want to do more on that front.
Third, we need to better understand health disparities in our community and the different challenges that our diverse communities face in accessing health care, particularly primary and preventive care services.
Also, I have a particular philosophy about private philanthropy and how it can create social change; in the spirit of Howard County, I’d like to tackle the tough problems, create innovative solutions and use seed money as an investment to do.
What is the state of The Horizon Foundation’s budget? What are your goals in that regard?
We have a $75 million endowment that was created from the sale of Howard County General Hospital to John Hopkins Medicine. We provide grants to the community and run sentinel initiatives, such as our work on obesity prevention.
Our endowment is strong and the budget reflects the strategic priorities of the organization. Our annual distribution ranges from $2 million to $2.5 million in annual grants and strategic initiatives. I look forward to embarking on an outreach effort to talk directly with community leaders in all quarters of the county as we move forward with our priorities.