Medical

Q&A: Dawn Maroney, CEO of Alignment Health Plan

Dawn Maroney is CEO of Alignment Health Plan and oversees Alignment’s growth and expansion, in all areas from sales strategy, product strategy, market expansions and acquisitions.

Q. Can you give us a summary of your background and what brought you to this position?

A: I was motivated to pursue a career in senior healthcare due to the early loss of my grandparents, an experience that made me passionate about serving seniors. With over 30 years of experience in the Medicare Advantage space, I have focused on driving product innovation, growth initiatives, and enhancing member satisfaction and retention rates. Every role I have held has prepared me for my current position at Alignment Health.

Q: You have deep experience with Medicare, including being chief Medicare officer for Blue Shield – a massive system. How has that trained you for this position?

A: In my capacity as Chief Medicare Officer at Care1st Health Plan (subsequently integrated with Blue Shield of California), I had the privilege of overseeing the management of over hundreds of thousands of Medicare and Medicaid beneficiaries across various regions. The CMO role allowed me to gain comprehensive expertise in all Medicare operations. My key responsibilities encompassed a wide range of critical areas, including strategic planning, marketing, operations, growth, and revenue management. Under my leadership, the company experienced notable membership expansion, significantly enhanced its CMS star rating, and achieved substantial revenue growth.

This period of growth was marked by the implementation of forward-thinking strategies and a deep understanding of the complexities inherent in Medicare Advantage plans. Additionally, my tenure as Chief Sales & Marketing Officer at CareMore Health Plan further enriched my experience. In this role, I spearheaded initiatives that led to historic growth and solidified the organization’s position as an identifiable brand and a leader in the industry, even as it sits as a division under Elevance. This experience underscored my commitment to excellence and innovation in the Medicare Advantage sector.

Q: Please give an overview of Alignment Health, what it covers and what it offers?

A: Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. We offer a wide range of Medicare Advantage services that use technology, support healthcare providers, and prioritize the well-being of seniors. Our proprietary AVA® technology processes data from 200+ sources against 170+ AI models, enabling our employed care teams to identify and proactively engage the sickest and most vulnerable members.

Q: You are the CEO of Alignment Health Plan. What is that, specifically?

A: Alignment Health Plan is Alignment Health’s core Medicare Advantage plan, offering a diverse portfolio of Part C and Part D benefits to qualified Medicare beneficiaries. As President, Markets for Alignment Health, I oversee all aspects of Alignment Health Plan, including growth, sales strategy, product development, compliance, regulatory affairs, pharmacy, network management, and more. My focus is on driving innovation, marketing, and aligning our various channels with our extensive network of providers, health plans, and hospital systems.

Q: Alignment Health Plan is available in which states?

A: Alignment Health Plan is currently available across six states – Arizona, California, Florida, Nevada, North Carolina, and Texas. Seniors in these states have the option to choose from a diverse portfolio of Medicare Advantage plans and benefits that meet their health and care needs. 6. Describe Alignment Health’s “seniors first” concept. The “seniors first” concept at Alignment Health stems from our personal experiences witnessing the complexities seniors face in healthcare. We recognize that seniors often have unique health needs, requiring coordination of patient-centered care that addresses physical, mental, and emotional health as well as social determinants of health such as economic insecurity and transportation. Our role is to advocate for seniors, designing health plans that cater to their unique needs. Our platform and benefits are consumer-centric, allowing us to listen and understand our members, providing holistic, high-quality, and affordable care.

Q: What have been the greatest challenges for patients and healthcare providers when it comes to Medicare and Medicaid? Provider shortages are a significant challenge in the healthcare sector, particularly in rural and underserved areas.

A: Alignment Health Plan aims to address this by offering wraparound services, including virtual visits and at-home care. This is designed to improve access to care, lower costs, and keep patients out of hospitals. 8. Years ago, I did an article about a physician who was trying to achieve price transparency in the U.S. healthcare system. At that time, none existed but the hope was leveraging Medicare to get some ability to know what something will cost before you’ve committed to it. Has that improved? While price transparency in the U.S. healthcare system has evolved, improvements have been made, including price transparency tools on many plan, provider, and hospital websites. Consumer education about urgent care versus the emergency room has also advanced transparency efforts.

Q: Describe Alignment Health’s ESG initiatives.

A: The cornerstone of our ESG approach is leading with a serving heart. How we serve is through our three strategic pillars: Serving People, Serving the Environment, and Serving Responsibly. Serving is built into our business model and day-to-day operations. Whether it is addressing social determinants of health and improving health outcomes, building inclusive and diverse teams, being transparent of our compliance program and corporate governance practices or measuring our GHG emissions, we are committed to growing our business responsibly without losing sight of putting the member at the heart of everything we do.

We have an ESG Steering Committee comprised of cross-functional leaders across the organization that help oversee and assess our ESG commitments and strategy. They helped to create our six core goals that we will work toward through 2025. More information can be found on our website and annual ESG Report at www.alignmenthealth.com/ESG.

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Debra Amato, California Business Journal

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