Elena Cecila Castaneda, Managing Director of Practice Acquisitions at ChenMed

ChenMed is a primary care provider on a mission to provide affordable VIP care to seniors. Founded in 2013, the Miami-based company is a fully capitated, Medicare Advantage-focused medical group with over 70 centers in 10 states. The Pulse writer Jeremy Rubel sat down with Managing Director of Practice Acquisitions Elena Cecilia Castañeda WG’14 to discuss her career and the company.

The Pulse: Can you give an overview of your background and how you came into your current role at ChenMed?

ECC: I was always interested in health care growing up. I thought I might become a physician, but I realized I was more interested in making a systemic impact. I studied bioengineering at Harvard and then consulted for life sciences companies. I absolutely loved it. At this time, the ACA was coming into the fray, and I wanted to learn more about the powers at play. So, I made a professional transition to business school to expand beyond life sciences. Honestly, after visiting several business schools, there was no question that Wharton’s Health Care Management (HCM) program was the best one out there. I enrolled and I loved everyone that I met, all with a great passion for health care.

My first job out of MBA was at ChenMed. They were launching a management services organization (MSO) and I was asked to lead physician incentives. It was a big jump to go from the lofty theoretical readings we did in school to the messy business of understanding primary care physicians. I was working with physicians who had no idea how value-based care works, and many still do not. Long story short, I am back at ChenMed after some time at a startup and then Optum, and now I am leading practice acquisitions for the company.

The Pulse: Before ChenMed, you helped manage Optum’s value-based care provider network. How does ChenMed’s approach to value-based care compare to a national payer-provider like United-Optum?

ECC: At Optum, many providers have been acquired over time and they are not all fully capitated. I worked across Optum’s 20 medical groups and saw a lot of variation. At ChenMed, we are an entirely staffed model. ChenMed is entirely senior-focused while Optum accepts the full range of patient ages and their corresponding insurance. This can make managing spend more difficult because you need to be totally committed to value-based care. Not just the physician, but the whole practice needs to focus on care coordination, follow ups, and evidence-based treatments. I sometimes compare Optum to the Articles of Confederation with different colonies and charters, while ChenMed is more like the United States operating under one Constitution.
The Pulse: How do you identify attractive physician groups to acquire?

ECC: Of course, we look at the size of the practice, how well they are run, and their location. But often we convince new physician groups to join ChenMed because of our mission. Physicians love that we are a PCP-led organization and the idea of working at a company that wants them to be the best PCP they possibly can be. Many physicians realized during Covid that fee for service is not working and have rethought their businesses. There is something wrong when you pay for the services completed rather than for the outcomes. These realizations have led to several attractive acquisition targets because the physicians now understand the differentiated value proposition of joining ChenMed.

“Physicians love that we are a PCP-led organization and the idea of working at a company that wants them to be the best PCP they possibly can be.”

The Pulse: After ChenMed acquires a physician group, how do you integrate the group?

ECC: We have a turnkey training program for physicians. We make sure physicians feel like they have a say as they are brought into the organization, and that is not hard to do in a physician-led company. Naturally, we integrate the contracts, and we make sure patients have all their questions answered.

Very importantly, we integrate the IT. We have a common electronic medical record (EMR) system across our organization. It has taken years to develop internally. Our EMR program was built from the ground up for a value-based care environment. I have seen a variety of EMRs, and many are usually just fancy billing systems. We do not believe in that at ChenMed. That is not in the interest of the patients. So that is a critical component of the integration.

The Pulse: Can you say more about how ChenMed’s EMR works and how it contributes to success for the organization?

ECC: We do a lot of design thinking. What does the physician need to know about the patient? How are they doing? What is going on in their family environment? We try to record all the factors that might influence the patient’s well-being. The patient may have come in for a cold, but that does not mean we should ignore other conditions. The EMR is designed to encourage us to think about the patient holistically every time we see them.

The Pulse: ChenMed emphasizes its strong physician culture. What do you do to create a strong culture and how is this a competitive advantage as a value-based care provider?

ECC: Physicians are at the helm of everything we do. We design everything by asking how to make this a great place for physicians to work. Besides the fantastic value proposition and smaller patient panels – just 400-500 patients to allow for deeper relationships – we have community events like Wellness Wednesdays and support continuing education with time off. We are mission driven and many PCPs became doctors because they are mission driven. Our physicians have a happier experience and a better lifestyle.

The Pulse: What is ChenMed doing to help fight the pandemic and keep vulnerable seniors safe?

ECC: Our organization focuses on a needy population, low to moderate income seniors. During the pandemic, we had to quickly rethink how we care for patients. We started offering virtual visits to our patients. We redoubled our efforts to keep in contact with patients, establishing a check-in program called “love calls.” We have tried to lessen the burden of the pandemic by, in some cases, helping seniors with their laundry or their cooking. Our goal is to make sure our patients are happy and healthy. Whatever we need to do to achieve that goal, we have done it.

Additionally, our organization has invested in educating our patients about the value of the vaccine. Our patients trust us as their health experts. We have been working to make sure each of our patients has access to a vaccine in each of our markets and demonstrating the value of vaccines by getting our front-line staff vaccinated and sharing that with patients. The pandemic has disproportionately impacted the elderly and vaccines are one of our best tools for addressing the pandemic.

“During the pandemic, we had to quickly rethink how we care for patients. We started offering virtual visits to our patients. We redoubled our efforts to keep in contact with patients, establishing a check-in program called ‘love calls.’”

The Pulse: ChenMed is family-owned and family-managed. How does that impact the culture?

ECC: Because we are family-owned and privately held, it is that much easier to focus on our vision to to become American’s leading primary care provider. For our leadership team, this is not just a job, but a calling. It’s a fantastic culture that helps promote social justice through health care. We do not have to answer to Wall Street on a quarterly basis. We can focus on our vision and our mission and then just go do it.

The Pulse: What advice do you have for Wharton students about how to advance in their careers?

ECC: Take risks. Learn as much as possible. When you are in school, it is difficult to fully envision where you are going to be in 5 years. I never expected that I would go from one company, to a startup, to a public company, and then back to the same company I started at. But because I took risks, I have become more versatile. If you are in the Wharton HCM program, you have the raw skills to succeed in health care, but it is critically important to take risks and to be willing to learn. And frankly, health care needs the brains that the HCM program trains. There is no end to the challenges in delivering better health and the beautiful nature of caring for people continually inspires.