A physician, health equity executive and Baltimore native is now overseeing healthcare coverage for more than 330,000 of the most vulnerable individuals in Maryland.
In August, Elevance Health tapped its inaugural chief health equity officer, Darrell Gray II, MD, to lead its Medicaid plan in the state, Wellpoint — a move he told Becker's came only after "much prayer" and careful consideration of his own mission and values.
Now at the helm in his home community, Dr. Gray has taken on the colossal task of Medicaid redeterminations, alongside an industrywide reckoning on how to tackle inequalities in some of the nation's most marginalized communities.
Question: After serving as chief health equity officer at Elevance Health for the last two years, what are you most proud of accomplishing?
Dr. Darrell Gray II: It's so hard to whittle it down, and there were many things that were shared successes across our vast enterprise. To mention a few, we positioned maternal health equity as a strategic priority. We enhanced our accountability to that through integration of metrics specific to severe maternal morbidity and preterm birth rates in our internal incentive structure for associates and leaders. We've also integrated those metrics into our business goals and clinical programming. That's led to positive trends among segments of our member populations, which is incredibly exciting.
A second thing that I wouldn't put in an order of priority is our "health equity by design" approach and applying a health equity lens to all that we do. That is evidenced in our data collection and value-based care programs, the innovation we've done across digital and AI platforms, and many philanthropic and volunteer efforts as well. A highlight is how it is part of our annual business planning.
A third and important accomplishment is our NCQA health equity accreditation, which Elevance Health attained across 22 Medicaid plans in 2022. This was an industry first and really a testament to both the rigor of our "health equity by design" approach and the commitment of our cross-functional teams.
Q: How did the NCQA health equity accreditation achievements come about?
DG: It's a testament to our people and evidence of how we come together. I have to give a huge shoutout to Tammy MacDonald, our staff vice president for accreditation and quality, who really organized us around meeting NCQA requirements. She not only helped to pull together the story of what we were already doing, but she really pulled the proof points of evidence we have, whether it's around race, ethnicity, sexual orientation, etc.
The storytelling we were able to do with the NCQA was only because we have been doing this work for a long time, which is evidence of commitment from our organization, our CEO and our board around really reducing health inequities. We've doubled down on this in recent years, and that's really what allowed us to be effective in this space.
Q: What attracted you to the top job at Wellpoint Maryland?
DG: I'm from Baltimore originally, and I've had family and friends who have been on Medicaid in Maryland. This was incredibly meaningful for me to have this opportunity to step into a role where I could impact the health of people like those who were my neighbors, who have been in my church pews and who I played with growing up.
I was recently in the Park Heights area at Park West Health System, a federally qualified health center in Baltimore City. We were having a celebration about this health center expanding behavioral health services and upgrading their building, and this was literally blocks from where I used to get a haircut as a child. That's a very meaningful experience.
Having an understanding of the neighborhoods, the people, and the community champions in the churches really positions me to be an ally and partner with the community. It is a tremendous blessing to serve people in communities that have been among the most proximal to health inequities and to learn from the seasoned and compassionate team that we have at Wellpoint. And it is powerful to be able to leverage my experience as a physician, a public health practitioner, an executive and a Baltimore native.
Q: States are in the midst of Medicaid redeterminations. How concerned are you with some of the early rates of procedural terminations that we're seeing?
DG: What it illustrates to me, especially as I look at other states, is that Maryland can be a model for how to navigate the redetermination process. More importantly, it shows how critically important that decisions made around redeterminations are not made in silos. What we're doing in Maryland is a partnership with the other Medicaid managed care organizations that includes regular conversations with the state. We're also leveraging Wellpoint's resources to ensure that we are informing the community about the importance of assessing whether they're eligible and to reenroll if necessary. The early data also reinforces the importance of having very strong leadership at the state level, because the Maryland Department of Health is regularly exchanging ideas with HHS and CMS, which I think has been a game changer.
Q: What do you think your industry peers don't discuss enough?
DG: I think what is lacking in our conversations is around what the actual outcomes are across the industry from the efforts and investments that are being made.
I am not discouraged by that. As we are advancing health equity, it takes time to see changes in outcomes after centuries of inequities and divestments in neighborhoods and marginalized populations. Improving the health outcomes of such populations is not something that happens overnight or one annual earnings report — it's something that we have to plan for over the long term. As I look across the ecosystem, particularly our industry, I don't see a lot of reports on the outcomes or positive improvements that have occurred since shifting and adopting health equity frameworks. What I am excited about is how I've seen and heard our peers actually making meaningful investments in this space, so I'm looking forward to the outcomes. Certainly, we have started to see positive trends in certain spaces, but that's what I hope to see more of as I look across our peers.