“I sincerely believe that when health systems and health plans collaborate and partner in unique ways, that it makes a profound positive difference to clinical outcomes, to the patient experience, to the provider experience and ultimately the overall cost of healthcare,” said Thomas Lundquist, MD, MMM, FAAP, FACPE, Highmark’s new Chief Medical Officer.
Dr. Lundquist was hired in January 2022 as CMO of Highmark Health Plans and Senior Vice President of Integrated Care Delivery for Highmark Health. As Chief Medical Officer, Dr. Lundquist leads Medical Policy and Quality Management, and works closely with Care Management, Disease Management and Utilization Management leadership. He will also be collaborating with the analytics teams to further enhance provider reporting in support of evolving value-based agreements and anchor partnerships.
He said his entrepreneurial spirit combined with Highmark’s reputation of growth and innovation were what interested him in the position.
“Highmark has a strong reputation for developing deep, collaborative partnerships between health plan and health systems and that was certainly what was attractive to me joining Highmark,” he said.
Before coming to Highmark, Dr. Lundquist served for eight years as SVP and Chief Medical Officer for Sentara Health Plans where he led all clinical and pharmacy care services including care management, disease management, utilization management, medical policy, pharmacy utilization, as well as quality management, population health management, healthcare analytics and informatics and network contracting and management. He was also instrumental in driving value-based care agreements with key clinical integrated networks for Sentara Health Plans across Virginia.
After earning his MD from The Johns Hopkins School of Medicine and completing his residency at Johns Hopkins, Dr. Lundquist began his career as a physician with Bellevue Pediatrics in the North Hills of Pittsburgh, Pennsylvania. The practice was closely affiliated with Allegheny General Hospital when he joined the group.
“Our practice was one of the first primary care practices that was brought into Allegheny Health Network back in the mid-’90s, so it’s great to be coming home and reconnecting with so many great providers and leaders across the community as I get myself up to speed on the great progress that has been made towards building a truly great healthcare delivery system,” he said.
Dr. Lundquist said he’s built his career around creating value for patients as well as for practicing physicians. He believes working together as a team comprised of innovative-thinking providers, integrated health systems, and a collaborative health plan can significantly impact health for our members. That’s what Living Health is all about.
“Living Health is going to help us as a health plan really lean in and partner with physicians and patient care teams in new and very unique ways to help them care for our members,” he said. “My commitment, as part of the great team at Highmark, is to further create and build upon innovative ways to close healthcare gaps, provide members with a more seamless navigation of the healthcare environment to meet their healthcare needs, and to do all of that while supporting and encouraging our network providers.”
Dr. Lundquist said one of the big ways Highmark aims to support our providers and care teams is to focus on administrative simplification: reducing administrative burden related to how providers interact with Highmark, thereby helping them to spend more time on outreach and interaction with our members, and less time doing paperwork.
“This does take mutual commitment and accountability,” he said. “But isn’t that at the heart of true collaboration focused on the best interest of our members?”
The COVID-19 pandemic led to an increase in the utilization of telehealth technologies as well as home monitoring and home care. Dr. Lundquist said he believes truly partnering with providers will help us think about the best ways to leverage these new technologies and opportunities for the betterment of our members.
“Physicians should feel good about how we expand the use of telehealth and home-based healthcare tools,” he said. “They should be valued as the leaders of the care team for their patients in our communities. We want to hear from them about how to best apply new technologies and methods of patient engagement in a highly reliable, high quality and cost-efficient way. Thinking together about how to use innovation in healthcare to positively impact patients’ well-being and clinical outcomes is a great opportunity that should bring great satisfaction to all involved.”
Dr. Lundquist said he knows firsthand the many pain points that exist at the front lines of healthcare, but he also believes many of the great ideas for improvement exist there as well. He’s hoping to keep an open dialogue with providers and care teams so that they may share their ideas on what they believe needs to be improved.
Highmark Health, through its Living Health strategy, is committed to provider success.
When asked to define provider success, Dr. Lundquist said, “at the end of the day, at the end of every week and the end of every month – providers should feel that they have done their very best in caring for their patients and they should feel that they have valuable partners in doing that from Highmark Health. Provider success means there will be tangible clinical outcome measures and right care validation that demonstrates their best performance, all leading to their greater satisfaction as a provider of care. To get to that state of success and satisfaction will take further innovation. It’s stepping back together as providers to plan and think creatively and innovatively about how we provide care effectively and efficiently for the very best patient experience and outcomes.”