From intern to COO: Believing in the business

David Schepp
The Journal News

Kevin P. Nelson began his career at Hudson Health Plan in 1992, joining the then fledgling, Dobbs Ferry–based health insurer as an intern fresh from Yale University graduate school. Today, as executive vice president and chief operating officer, he is responsible for developing and managing employee evaluation processes and tools, among other duties. The Journal News recently meet with Nelson in his Tarrytown office with its commanding view of the Tappan Zee Bridge, to talk about the current state of health care. Here are excerpts from the interview.

Q: What is Hudson Health Plan?

A: Hudson Health Plan is a not–for–profit Medicaid, managed–care organization. We provide comprehensive health coverage to more than 60,000 individuals in New York’s Hudson Valley region. To be eligible, you have to be in one of New York’s three government–funded programs: Child Health Plus, which is New York’s version of the federal insurance program for children; Medicaid; or Family Health Plus, which is an extension of the Medicaid program for uninsured adults. We were founded by community health centers in the mid−’80s, actually. We’re very much a community–based plan. By that I mean we’re really into the community, getting to know the community, having the community get to know us. So outreach is very important.

Q: How do people find out if they qualify for your programs?

A: They can call directly, 800-339-4557, and when you call, anyone who calls will speak with an internal representative who actually puts you in touch with someone in the field, who will meet with you in many locations in the county. And now that we have the Community Outreach Vehicles, we can go to you, if you can’t come to us. We sit down and talk to you and find out if you’re eligible and enroll you if you are. And if not, direct you to some other resources that you can take advantage of.

Q: How did you get started with Hudson Health Plan and how long have you been here?

A: I’ve been here a long time. It speaks to how I feel about the organization and all that it’s done. When I started—I’ve been here for almost 15 years—and I was actually a grad student at Yale and I was looking for internship. And somebody told me about a managed–care company. Medicaid managed care was very new at that time. And it was very questionable in terms of its success. Someone said there was a New York state plan that was starting up—HealthSource was the name of it at the time—they were looking for someone to help them implement the Child Health Plus program, that we offer now. I came here as an intern to do that project, and there was about 18 people on staff, and we had less than 1,000 members, and it was wonderful. It was fun.

I liked the idea of starting up something brand new and something that was questionable but has clearly been successful.

Q: And where do you and the company stand today?

A: Well, for both, we’ve grown tremendously. Again, when I started we had 18 people. We had a tiny office in Dobbs Ferry. Now we have six offices and we have 62,000−plus members, and we have a wide variety of staff doing many different things. The organization is also now able to serve more people—not just in numbers but in terms of what we can do for them. We’ve also contributed to the community in terms of employing people who are in the community.

Q: Health care reform is very much in the news, and President Bush recently offered his own version of reform during his recent State of the Union address. What is your perspective?

A: Reform is long overdue—we need change. There are a lot of opinions about what will work and what won’t work. Generally speaking, at Hudson Health Plan our mission is to promote and provide excellent health services for all people. So anything that reduces barriers to health care (and) improves access to quality health care for everyone regardless of economic status is obviously something we support. Anything that has to do with streamlining enrollment and the eligibility determination process, which is something that New York state is talking about, that’s something that we support. And that allows more individuals, who are uninsured but eligible for these programs, to get insured.

Q: In terms of Hudson Health Plan’s business model, do you think a non–profit model is better than a for–profit model, or is it simply an augment?

A: It’s a different model. It serves a different population so it needs to be different. The commercial model serves people who are at a higher income level, have access to services and support staff that this population does not. So it has to be different. It is different, and to that end I think it’s very effective. Hudson Health Plan is unique within that niche itself. We’re motivated in how we do it. We’ve developed a few things − an electronic application, for example, within the last few years, software that actually allows us to enroll individuals at a faster pace than the paper applications—something we developed called FEEA (for Facilitated Enrollment Electronic Application). Last year, we introduced Community Outreach Vehicles, COVs, and that’s in order for us to get out to the community, so that we don’t have to wait for people to come to us—we can go to them.