Founder’s Circle

The holidays are upon us!

Dear Friends and Colleagues,

This holiday season is upon us and there is no shortage of end of year activity on the Hill potentially impacting the healthcare industry from tax reform including release of the individual mandate to Medicare Advantage proposed rules including redefining open enrollment windows and new programs to address the opioid crisis.

In addition, mega mergers of delivery systems, and health plan and retail giants spell new ways of addressing individuals whether referenced as consumers, patients, members or employees, the end game is the same, deliver great quality, affordably, and a great experience or risk losing their loyalty.

We are embracing this challenge. While necessary to keep an ear to the ground for additional changes and the resultant adjustments required adjustments to programs and services, we wish our clients, partners and all of you a season full of joy celebrating with family and friends.

Happy Holidays,


Welcome to the future of health!

Dear Friends and Colleagues,

Now past the  halfway mark for 2017, uncertainty remains on the policy front but no uncertainty exists in terms of the need to prevent and combat disease, equip consumers with the means to self manage where possible and address the growing senior population in ways and in environments they prefer.  The innovators committed to value and preference based individual and population health solutions will succeed in making a difference. ​

The backdrop of policy change  requires a constant  ear to the ground and much energy and application of resources to navigate.  Given this environment expertise and experience are top of the list to handle the uncertainly versus being paralyzed by it. Seasoned leaders  guiding responsive teams and systems through clearing barriers, crisp decision making and disciplined execution will be the difference between organizations that falter and those that thrive; consumers and providers who feel well supported and those that feel the strain of uncertainty around them.

From planning and design to delivery, emphasize the right guiding principles. Align strategies and tactics with the principles of the HealthCAWS Call to Action:

  • Meet the new consumer where they are on their terms, with the least costly and invasive service and environment possible to achieve their best possible outcome


  • Limit unnecessary burden for providers and offer supports to advance value-based care 

  • Reduce system complexity and thus volatility for all stakeholders by simplifying requirements and processes; freeing up critical resources and mind space for innovation

The HealthCAWS principles culminate in  Combining Accountability With Support-“the CAWS™” to get the job done. We invite you to be part of the HealthCAWS solution!

Best for Success,


Rose Maljanian

Chairman & CEO


Glassball  at Mediterranean  Sea

HealthCAWS Welcome 2022!

Welcome 2022!

While we start the year in what feels like a setback, we are armed with vaccinations, rapid testing, advanced digital health technology, promising therapies and even greater resolve.

Our collective stronger resolve must be channeled to address the ongoing pandemic and the collateral damage thereof. 

  • Consumers are suffering in many facets of their life from health and financial to disrupted careers and relationships.  Previously marginalized persons have yet to recover or gain hope that there exists a path to break the cycle of poor health and poverty and many seniors are not experiencing the golden years they had anticipated.  All requiring inviting, comprehensive support.
  • Healthcare and frontline workers have barely had a reprieve from the demands the overwhelming need imparts to them.  They deserve support in the form of tools and a safe environment to do what they do best as well as understanding and recognition for what they are facing day to day.
  • Innovative organizations need the paths cleared to improve quality and access and mitigate compromising social factors and health disparities. In addition, a fair business model that rewards their value contributed and affords investment in tomorrow’s innovation today.

In short, the total health of individuals, the healthcare workforce and organizations must be advanced to overcome the current pandemic, dramatically rising rates of behavioral health issues, poverty, social isolation and the much needed catch-up in chronic condition prevention and treatment.

With gratefulness, humility and spirit of partnership, looking forward to doing my small part to advance the cause in 2022!

Rose Maljanian

Chairman & CEO HealthCAWS

Welcome 2021- Consumer Experience and Outcomes including Cost and Quality Go Hand in Hand

Consumers have been through enough. Make 2021 easier by accelerating companies that hit the mark and sun setting outdated practices.


  • Well integrated virtual care options, medical & behavioral
  • Primary cares that take full accountability
  • Timely home care and hospital at home
  • Community-based one stop shops visits, diagnostics, meds
  • Use of navigators and well-trained proactive care extenders
  • Consumer-caregiver adoption of intuitive PHRs
  • Use of early indicators from voice of the consumer & caregiver


  • PCP offices that run 9-5, break at 12, busy phone lines
  • ER as default path to get attention and action
  • Outdated medical necessity criteria ignoring early indicators
  • Delays in care due to convoluted processes
  • Staffing warm bodies versus proactive empathetic persons
  • Disrespect for consumer and caregiver time and resources

Unrelenting focus on consumer needs -right by consumers, smart business. It will show up through positive outcomes or consumers will vote with their feet by moving to a service that does hit the mark.

If you are in the business of accomplishing the above and believe you are not already on my radar, would like to hear about your great work!


#consumer experience #population health #valuebased care #outcomes

Growing and Promising Investments in the Healthcare Services Industry

October 13, 2020 HealthCAWS CEO Rose Maljanian to host Investor’s panel “Growing and Promising Investments in the Healthcare Services Industry in Tumultuous Times” at the annual Population Health Alliance Innovation Summit and Capital Caucus October 27th, 2020. Read more.

Innovations in Senior Care and Supports-Holding the Gains and Accelerating Progress

As we enter a new era of care delivery and coordination of care for the growing population of seniors, there are key principles informed by our past, gains we must hold, and new demands to meet as a result of the pandemic.  Gratefully to all, the spirit of rapid problem solving and innovation has never been stronger to deliver the desired quality, safety, convenience and affordability for seniors to live life to their fullest potential, said Rose Maljanian Chairman & CEO HealthCAWS and Chairman Emeritus Population Health Alliance.

Read the article at: https://www.bettermedicarealliance.org/blog-posts/innovations-in-senior-care-and-supports-holding-gains-and-accelerating-progress/

#populationhealth #seniors #medicareadvantage #innovation

Consumer Empowerment – the engage-able moment too precious to waste.

Under the current pandemic situation, the absolute first line of defense is to contain the crisis and protect consumers, especially the vulnerable and acutely ill at high risk for morbidity and death. As we move to the next phase of the containment effort, the population health management model instructs consumer empowerment as the mainstay.  

Today, consumers, old and young are certainly more conscious of first line defense against illness – limiting exposure (distancing, good handwashing, limited sharing of personal items) and bolstering individual resistance through good nutrition, physical fitness, sleep and reduced stress.  For those with underlying health issues such as diabetes, obesity, HTN, and hx respiratory illness, studies are increasing putting the spotlight on their risk and the need to vigilantly prevent or manage these conditions as real risks today, rather than something that may or may be seriously limiting later in life.

A successful Population Health Management strategy begins with leveraging all available data, including data gleaned from the consumer real-time, to understand individual risk factors and needs. Based on the insights, offer the best programs and tools to empower active consumer participation in care and ongoing self- management of their health, their risks, their conditions and where possible getting assistance to address their social factors.  Early and regular measurement of individual and population success against goals and performance metrics affords organizations and individual consumers with the insight to try an alternative when one tool or combination of tools is not resulting in the best possible health and cost outcomes. Adapt, Measure, Repeat. Adapt, Measure, Repeat.

In all the chaos of COVID-19 what emerges is an opportunity for us to step up our population health management efforts –as the engage able health and life changing moment for consumers before us now is simply just too precious to waste.

#consumer engagement #population health #pha #COVID-19

Thank you to the Population Health Alliance (PHA) for recognizing accomplishments as Chairman of the Board


Thank you to the Population Health Alliance (PHA) for recognizing my accomplishments as Chairman of the Board at the annual Innovation Summit and Capital Caucus in Washington, DC earlier this week. Great event with much discussion on the PHA Population Health Management Framework with VBC as an accountability/financial lever and addressing SDoH as the key lives lever for success all around. PHA represents a group of talented and dedicated leaders from across the healthcare ecosystem keeping the focus on what matters most-PEOPLE. Join the collective mission-together we can improve lives affordably and sustainably. 

Please COVID responsibly …and if you see something say something

In this time of COVID 19 crisis, many consumers are confused and afraid for their health and futures. It is no wonder.  The airwaves have been flooded with information, sometimes with inconsistent messaging.  For the heroic providers caring for the populations on the front lines, stress could not be higher. Guidelines are evolving as our experience with this virus in a global pandemic scenario is in its infancy; we don’t know how much worse it will get in various locations; if or when there will be another wave or waves; or if this is one of many pandemics we will face in the coming years.   To effectively empower consumers to take positive actions, they need the best up to date information.

As some well-meaning organizations have tried to quickly develop solutions or just contribute something, there have been some great support solutions as well as those that are less than helpful, including potentially harmful messaging or omissions.  Two occurrences last week resulted in my coining the term “please COVID responsibly”.  One was an okay start on a COVID APP but one that before release needs more testing, more clinical content review and a rigorous process for updates. The second was a headline of an email blast directed to individual decision making with a subject header that discouraged COVID 19 testing, albeit with some caveats for the consumer to read on and discern.

Clearly, the potential for missing information, misinformation or misinterpreted information leading to the continued spread or a life-threatening delay in treatment is real.  Everything must be read and re-read through the eyes of a consumer and what action they may take or not take as a result of receiving the information. Collectively healthcare leaders can help. Look, listen and take the time to provide feedback for course correction if you believe such a risk exists. Your thoughtful feedback will go a long way in helping to protect and empower consumers while researchers continue to advance progress on vaccines, treatments and antibody testing, the CDC aggressively disseminates updated guidance, and the heroes battle the big fight on the front lines.  

#COVID-19 #population health management #healthcare quality #CDC

LinkedIn: https://www.linkedin.com/posts/rosemaljanian_covid-population-healthcare-activity-6655825315161522176-Jm0I

Feel free to post the full image below.

Population Health Management in 2020: Kicking it into High Gear

On March 30th at the PHA Annual Forum I will  present Closing Remarks: PHAForum.

I expect to bring clarity to what Population Health Management is and is not, highlight innovative PHM strategies to succeed in VBC and set the stage for the PHA Innovation Summit (Save the date Oct 27th).

No doubt my remarks will include:

Population Health Management is not an EHR, a Value-based contract, or an epidemiological study.

Population Health Management is understanding the needs of each individual in a defined population through smart analytics and bringing those insights to the point of care or point of daily decision making so that consumers working with their care and life teams can address barriers to achieve their personal best while avoiding unnecessary costs, inconvenience, pain and discomfort.

If you are reading between the lines correctly you guessed it: consumers own their data, what we do must be fully integrated in care and life- high tech to high touch and the levers involve addressing comprehensive needs- traditional medical, behavioral health and SDoH.

Bottom line-PHM is all about delivering consumer focused results-quality, affordability and best possible experience.



Achieve Value Targets by Addressing Social Determinants of Health

“Population Health Management, including a comprehensive and integrated strategy to address behavioral and Social Determinants of Health, is the single most important strategy to drive improvement in quality, consumer experience and cost. Addressing consumers most basic needs as part of this holistic approach must be the first step of engagement rather than an afterthought if we are to make meaningful headway in delivering value to individuals and across populations”, says Rose Maljanian, Chairman and CEO HealthCAWS and Chairman of the Board for the Population Health Alliance. Read more.

Deploying Value Based Care Contracts Under the Umbrella of Population Health Management: A Must for Success


August 14, 2019

Rose Maljanian, Chairman & CEO HealthCAWS

Chairman Population Health Alliance


The evolution of our nation’s healthcare system and ecosystem from fee for service to value based care has only just begun, and while the goal is to rapidly accelerate the membership under value based care payments, it will be a long journey to refine the model.  Legislation, market driven mergers and disruptive innovation from industry veterans inside and outside of healthcare focused on the consumer are contributing to what at times feels like a roller coaster ride.  At the center of all of this is the growing population of seniors who largely receive their health benefits from the government, either directly or indirectly, through managed Medicare, Medicaid or Dual-eligible programs.  Seniors as customers want and demand choice, convenience and value as consumers do in other markets and industries.  The focus on these three elements is fundamental to any business strategy. However, necessary but distracting details, including type of legal entity, payment rates, payment flow, shared savings methodology and disbursements can completely envelop the airtime in leadership meetings. Alternatively,  framing value-based care under the umbrella of population health management supports a focus on seniors’ needs and wants and the strategies that result in affordably achieving optimal health for these populations.

Understanding payment models as financial lever of alignment

Value-based care payment models have been aggressively advanced by CMS and commercial payers over the last several years.  CMS’s stated purpose is to transform the health care system through innovation by paying providers for quality versus quantity of services delivered. Whether the program is a CMS program such as Advanced Payment Models (APMs), Merit-based-Incentive Payment System (MIPS) or a value-based contract as part of a commercial payer network, the payment method is simply put, the financial lever to align the care provided with outcomes-quality, experience and cost of care savings.

Virtually all value-based care models promoted or reporting positive results deployed the key elements of the population health management model to achieve success. Under current CMS value-based payment models 1 and those proposed for 2020 and beyond2, quality improvement strategies and population health metrics such a readmission rates are prescribed with advancing flexibility to reduce burden and achieve desired value.

In terms of results, Humana reported significant improvements in numerous quality metrics and 23.4% fewer inpatient hospitalizations and 15.6% fewer emergency room visits under value-based care arrangements in Medicare Advantage members.  In their report 3, they attribute the improvements to population health management infrastructure and strategies such as proactive outreach and whole person management.  Aetna similarly cited tools, infrastructure and approaches common to population health management as important to the success of their accountable care organizations. With Banner Health for example their Aetna Whole HealthSM program achieved 24 percent decrease in avoidable surgery admissions, a 4 percent increase in generic prescribing, and a 11.5 percent overall reduction in medical costs.4

In order for the end result to be a value-based contract that produces a positive net income versus one that adversely effects the organization financially, a solid population health management strategy must be deployed, tightly managed and iterated as populations and market conditions evolve.  Furthermore, without a positive consumer experience and health outcomes, retention of patients/members in a practice or plan is likely to suffer, further eroding the chance of success.

Staying true to the principles of population health management (PHM)

There are three enduring components of the population health management model:1) defining and understanding the population for which the organization holds accountability; 2) a portfolio of evidence based solutions that can be tailored to individual need at any given point in time and 3) measurable outcome results. The Population Health Alliance outlined a value focused framework for Population Health Management more than ten years ago that included these elements with consumers at the center.5

Defining the population up front (assigned vs attributed) allows organizations to understand their populations, stratify risk and preference for engaging so that when crafting and triaging individuals to programs and tools, the programs and tools are those that consumers want and need.

Programs and tools must be available to address the full continuum of care whether to maintain health, address an acute event, support chronic care management or support comfort at end of life. Furthermore, solutions must include a multifaceted approach depending on where an individual is on the care continuum, their life goals and their preferred means of engaging. Studies by the PEW Research Center have demonstrated consistent increasing uptake in technology for seniors 6,7 including 53% owning a smart phone and 59% having broadband access.7 Addressing barriers such as trust, cost and tech support will likely fuel further adoption among all income and educational levels. In recognition of this trend, many organizations are deploying blended high touch and high tech strategies in their senior health programs.

Finally, a focus on the endgame of outcomes across populations will ensure success with multiple value based contracts. The population health management model has always had a focus on outcomes that include clinical, utilization, satisfaction and experience of care and cost metrics.  When staff deploy consistently high quality evidence based care that achieves consumer goals, the likelihood of missing mutually agreed-to standard metrics in a value based arrangement as a result of inconsistent care, lack of consumer engagement or gaps from confusion when doing different things for different populations is bound to decrease.

Executing well on solutions that solve needs and preferences

The need to execute well in a world of high visibility of alternatives for care, experience ratings and mounting pressure on cost transparency cannot be overemphasized.  Executing well no longer means getting ID cards and EOBs out on time and finding an opening for the consumer in the same week to be seen by a PCP or specialist.  It will command listening to what consumers desire to achieve, such as return to playing tennis, being able enough for air travel, controlling their diabetes versus diabetes consuming their life with too many appointments and tests, reducing days not feeling well enough to enjoy getting out and living life or just living long enough to see a marriage or birth. Furthermore, living life involves conserving seniors’ financial resources as well through optimized care, lower total cost of medications and value-added supplemental benefits such as concierge services and care management, home modifications, light housekeeping, transportation and nutrition support.  Scan Health Plan recently announced expanded benefits for seniors to age in place at home.  This followed a market survey confirming the trend in which 88% of their addressable market in Southern California expressed a desire to stay in their homes.8

As leaders, promoting common understanding of what it means to deliver value and how to get there

As leaders we need to guide the discussion on value amongst our colleagues, all payers and the public at large.  Value based care is not about the contract itself. The contract is a financial lever under the umbrella of population health management. it is about delivering value (quality and affordability) to each healthcare consumer, the payer customer, and keeping those that bear risk whole and flourishing as they serve at the front line of healthcare transformation.




  1. CMS Value based care programshttps://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/value-based-programs/value-based-programs.html updated 5.17.2019.
  2. CMS QPP Resource Center https://qpp.cms.gov/about/resource-libraryupdated 7.29.19.
  3. The Intersection of Heath + Care: Value Based Care Report 2018. http://valuebasedcare.humana.com/wp-content/uploads/2019/04/2018-VBC-Report.pdf
  4. Accountable care organizations: Transforming care delivery to support members, increase cost savings https://news.aetna.com/2018/02/accountable-care-organizations-transforming-care-delivery-support-members-increase-cost-savings/February 12 2018
  5. Population Health Alliance Population Health Management  model https://populationhealthalliance.org/research/understanding-population-health/
  6. Anderson M and Perrin A. Tech use climbs among seniors. Pew Research Center May 17, 2017https://www.pewinternet.org/2017/05/17/technology-use-among-seniors/
  7. Anderson M. Mobile Technology and Home Broadband 2019Pew Research Center June 13, 2019 https://www.pewinternet.org/2019/06/13/mobile-technology-and-home-broadband-2019/
  8. SCAN Health Plan Addresses Seniors’ Desire to Remain at Home With Expanded Benefits, Reduced Costs Nov 14, 2018, https://www.prnewswire.com/news-releases/scan-health-plan-addresses-seniors-desire-to-remain-at-home-with-expanded-benefits-reduced-costs-300750108.html

Reprinted with permission Better Medicare Alliance