I’ve always had fundraising responsibilities; however, balancing an organizational growth strategy with an integrated scenario driving budget has been a new experience. To aid with this, we contracted with a retired, very experienced CFO to help us with a sophisticated budget metrics approach based on scenarios — level set, above targets, below targets.
As part of my series about “individuals and organizations making an important social impact”, I had the pleasure of interviewing Mike Cheek.
Mike Cheek is the President & CEO of SNP Alliance, a national force for improving the health and well-being of individuals living with significant, complex needs through specialized managed care. Mike comes to the SNP Alliance from his role as the Senior Vice President for Reimbursement and Market Strategy for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL). Prior to this role he was the Director of Medicaid Long Term Care for the District of Columbia’s Medicaid agency, the Department of Health Care Finance.
Thank you so much for joining us in this interview series! Can you tell us a story about what brought you to this specific career path?
I’ve had a life-long interest in healthcare, and eventually I found my way into healthcare policy. From there, I discovered my true passion, which is advocating for persons with complex care needs.
Can you share the most interesting story that happened to you since you began leading your company or organization?
Congress, CMS, and other federal agencies are scrutinizing the Medicare Advantage program broadly as well as Medicare and Medicaid integration — this is a key focus for the SNP Alliance. On my second day leading the organization, draft legislation was dropped laying our sweeping integration reform proposals. Since then, we have been scrambling to keep up with the effort, which we applaud, and provide meaningful, constructive input.
It has been said that our mistakes can be our greatest teachers. Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
In my previous role, we had expansive one year work plans. This organization was larger and the Board expected broad, detailed plans. When I presented my proposed 2024 work plan to the SNP Alliance Board, they asked me how I planned to spread out the work I proposed for 2024 over three years. Challenges with differing organizational cultures!
Can you describe how you or your organization is making a significant social impact?
We are a heavily mission-driven organization focused on improving care and services for people with chronic complex healthcare needs. Over the years, the SNP Alliance, which began as the National Coalition for Complex Care, led the charge that resulted in the development of the Special Needs Plan authority in the Medicare Modernization Act of 2003 as well as making permanent the SNP authority in the Balanced Budget Act of 2018. All of this policy has had a profound impact on access to services for persons with complex care needs.
Can you tell us a story about a particular individual who was impacted or helped by your cause?
Chronic Condition SNPs (C-SNPs) are tailored to people with specific complex, permanent health care needs such as diabetes, congestive heart failure, and HIV/AIDs. Positive Healthcare Partners (PHP) is a C-SNP targeted to persons with HIV/AIDS. PHP enrollees are assigned a consistent Registered Nurse Case Manager (RN-CM). RN-CMs are responsible for health risk assessments (HRA) and the development of an individualized plan of care (POC) in collaboration with the member, the member’s HIV Primary Care Provider (PCP), and other care team members.
A very recent PHP enrollee was hospitalized for failure to thrive and UTI. While at the hospital, his RN-CM learned that the patient had not been taking the HIV medication and was highly susceptible to catastrophic opportunistic infections, opportunistic cancers, and death. After inpatient stabilization, the RN-CM worked to ensure a smooth transition to an appropriate skilled nursing facility and then home. While at the skilled nursing facility, the POC was updated. As part of this process, the RN-CM learned the patient was frustrated with the array of pills, multiple physicians’ offices, and poor physician office communication.
With RN-CM support, the patient began taking his medication and streamlined his PCP and other physician visits. During a routine visit, his PCP detected a second UTI and contacted the RN-CM to request assistance with an ED (emergency department) visit. The RN-CM met with the patient and the ED to coordinate a telehealth meeting between the PCP and ED. With this clear communication, the patient was successfully treated with an appropriate IV antibiotic to target the infection and avoided an inpatient admission. Since this challenge, the patient continues to engage with the RN-CM and participates in the POC.
Are there three things the community/society/politicians can do to help you address the root of the problem you are trying to solve?
First, policies that ensure flexibility to innovate in care delivery and service design are key as well as the ability to keep up with America’s evolving complex care population. For example, the proportions of persons with complex care needs who also require behavioral health assistance and substance abuse support, as well as those with intellectual disabilities, are rapidly increasing. SNP capacity to address these growing sub-populations is critical. Second, states and communities should develop plans, with dedicated funding, to support our nation’s growing over-age 85 population. By 2025, the over age population will have grown by 11%, and by 2030, the percentage will jump another 30% (Source: ATI Advisory). Third, as a society, an effort is needed to change how we view elders and persons of all abilities. In other nations, elders are valued and considered important resources on lived experience. In out society, unfortunately, we have a long history of moving our elders to the sidelines and losing an important opportunity to avoid past errors through their knowledge.
How do you define “Leadership”? Can you explain what you mean or give an example?
In terms of the Alliance, we lead by developing and proactively socializing forward-thinking policy ideas and promoting best practices among its members. For me as a CEO, leadership means leading by example in addition to servant leadership. More specifically, I focus on thinking of my team as people first, and staff second. This may sound a bit obvious, but for senior leadership, one can easily slip into a “just get it done” mindset and losing sight of the importance of others’ views as well as not understanding their broader life pressures.
What are your “5 things I wish someone told me when I first started” and why. Please share a story or example for each.
- My experience with association work has been with state government and provider organizations where there is a single point of contact or member. Plan associations typically have association liaisons, but there are many staff who engage. Since I joined the SNP Alliance, I’ve learned we need to do a better job of liaising with this array of people, so we are developing new work groups to give them a voice.
- I understood a bit of this coming into the job, but the scale has changed over time — that is the scrutiny of the Medicare Advantage (MA) program. The past year, and upcoming years, will likely push many plan associations into unfamiliar territory with playing more defense. The SNP Alliance is developing an array of proactive approaches to feed into MA reform.
- This is my first experience as a CEO. While I have years of experience in policy and Washington, running a small business is a whole different skill set. While my predecessor did her best to prepare me, I wish I had spent more time studying business practices.
- Similar to the above, leading a Board with the Chair is new for me. I have supported Boards and Board subcommittees for years, but driving the entire agenda for an organization is new — particularly a smaller organization — requires a long-game approach to planning. I am an aggressive type A personality, so slowing down and spending more time reflecting before charging ahead has been a learning experience in terms of the long-game approach.
- I’ve always had fundraising responsibilities; however, balancing an organizational growth strategy with an integrated scenario driving budget has been a new experience. To aid with this, we contracted with a retired, very experienced CFO to help us with a sophisticated budget metrics approach based on scenarios — level set, above targets, below targets.
You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
The needs of complex care populations are changing, as are treatments and therapies. For example, three new Alzheimer’s medications have been introduced, and little is known about how these medications will impact caregiving. Establishing a research/think tank organization that holistically focuses on these trends and develops with translation into care delivery best practice would be a lot of fun.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Never be afraid to hire people smarter than you.”
Some managers are intimidated by staff who are faster learners or have more expertise than they do. I view hiring such people as a real strength. You’re only as good as the people around you, and helping younger staff grow is both rewarding and often helps your organization continue to thrive as they move into bigger, better roles.
Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them. 🙂
An English historian and archaeologist named Mary Beard studies Roman and classical history. Her ability to assemble lines of sight into a 2,000-year-old society based on hundreds or thousands of puzzle pieces is mind-boggling. I would love the opportunity to learn about how she developed her visionary skill set and, if possible, learn how to think like her.
How can our readers further follow your work online?
You can find me on LinkedIn.
This was very meaningful, thank you so much. We wish you only continued success in your great work!
Social Impact Heroes: Why & How Mike Cheek Is Helping To Change Our World was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.