Humana Military Names Alefiyah Mesiwala, M.D., Chief Medical Officer
Humana Military, a wholly owned subsidiary of Humana Inc. (NYSE: HUM), announced today the appointment of Alefiyah Mesiwala, M.D., MPH, as Humana Military’s new Chief Medical Officer. Effective March 15, Dr. Mesiwala will serve as a member of the Humana Military leadership team and report to Brent Densford, President, Humana Government Business, Inc. – Humana Military.
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Alefiyah Mesiwala, M.D., MPH, Chief Medical Officer, Humana Military (Photo: Business Wire)
Humana Military has a long history of partnering with Department of Defense and the Defense Health Agency to administer health coverage for U.S. Military active duty service beneficiaries, retirees and family members through the TRICARE health program. Humana Military is a convener of care for the TRICARE East region, serving the physical and mental health and well-being needs of beneficiaries through 500,000 health care provider partnerships.
“Humana Military has been a proud partner of the Defense Health Agency for 25 years, helping the agency develop solutions to support six million TRICARE active duty, retiree and their family beneficiaries to achieve better health outcomes, receive improved quality of care and lower care costs,” Densford said. “Humana Military is excited to have Dr. Mesiwala join our team and strengthen our partnership with the DHA. Dr. Mesiwala’s background as a physician, combined with her experiences in integrated payer and provider health, Federal government, and preventive medicine, will make her a critical leader on our team. Dr. Mesiwala’s proven track record in alternative payment models and clinical quality improvement will support DHA and Humana Military navigate a critical and important shift towards value-based care for the TRICARE population.”
As the Chief Medical Officer for Humana Military, Dr. Mesiwala will provide strategic leadership and direction for medical management and clinical operations of the TRICARE contract to ensure the delivery of high quality integrated health care. She will lead large-scale transformation of the Humana Military business towards value-based care delivery, leveraging Humana’s significant capabilities in population health management and integrated care to better serve the physical and behavioral health needs of the TRICARE population. Humana’s population health management capabilities, which include chronic disease management and data analytics, are focused on working with community-based organizations, business and government leaders, and health care practices to co-create clinical solutions to address population health at a local level.
The Defense Health Agency has stated the importance of integrating value-based care programs and alternative payment models (APMs) into the TRICARE 5th generation (T5) contracts through recent draft requests for proposal. Humana is one of the nation’s leading companies for entering into value-based agreements with physician groups to serve its Medicare Advantage members. In 2019, 2.41 million Humana individual Medicare Advantage beneficiaries receiving care from primary care physicians in value-based payment models experienced, on average, better health outcomes, lower costs and more preventive care, as opposed to fee-for-service models.
“Humana Military has done an outstanding job working with the Defense Health Agency through TRICARE to serve the health needs of its beneficiaries,” said Dr. Mesiwala. “My expertise in clinical payment innovation and my on-the-ground experiences working closely with providers in value-based care will support the Humana Military team as we partner with DHA to transform the care for the TRICARE population towards the Quadruple Aim. The military members who defend our nation and their families deserve the best health care possible and it is my honor to serve them.”
Dr. Mesiwala joins Humana Military from the University of Pittsburgh Medical Center (UPMC) Health Plan, where she has served since 2017 as Senior Medical Director for Value-based Care and Innovation for UPMC Health Plan. At UPMC Health Plan, Dr. Mesiwala led the clinical design and implementation of primary care and specialty-focused alternative payment models. Additionally, she led programs to support providers and physicians across the network in practice transformation and clinical quality improvement.
From 2015 until 2017, Dr. Mesiwala served as Senior Policy Advisor in Healthcare to former President Barack Obama at the White House, where she was responsible for furthering the Administration’s progress in health care policy. As the health care lead for the White House National Economic Council, Dr. Mesiwala launched a multi-stakeholder public-private partnership to further kidney care and organ transplantation and also launched a national provider-focused collaborative to collectively address workforce challenges in health care. From 2011 to 2015, Dr. Mesiwala worked at the Center for Medicare and Medicaid Innovation (CMMI), where she served as a Medical Officer and Senior Advisor to the CMMI Director. In this capacity, Dr. Mesiwala led the development and implementation of new models including specialty-focused accountable care organization and the CMS healthcare innovation awards program.
Dr. Mesiwala received her M.D. from the University of Michigan Medical School and a master’s in public health from Johns Hopkins Bloomberg School of Public Health. She completed her clinical training and residency in general medicine and preventive medicine also at Johns Hopkins and currently is a fellow of the American College of Preventive Medicine.
Dr. Mesiwala is a frequent speaker at national conferences. She is also an active member of professional organizations, various national committees, and advisory groups. She lives with her husband and two kids in Pittsburgh, PA.
About Humana Military
Humana Military, a wholly owned subsidiary of Humana Inc. (NYSE: HUM), partners with the Department of Defense and the Defense Health Agency to administer the TRICARE health program for six million U.S. Military active duty, retirees and family member beneficiaries in the East Region. For the last 25 years, Humana Military has strived to create better health outcomes and simplified experiences for millions of beneficiaries across the United States through TRICARE and other military health care programs. For more information, please visit www.humanamilitary.com.
Humana Inc. is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.
To accomplish that, we support physicians and other health care professionals as they work to deliver the right care in the right place for their patients, our members. Our range of clinical capabilities, resources and tools – such as in-home care, behavioral health, pharmacy services, data analytics and wellness solutions – combine to produce a simplified experience that makes health care easier to navigate and more effective.
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