Delivering Value in Health Care: Lessons from the Mashantucket Pequot Tribal Nation with Dr. Setu Vora

Welcome to another episode of Impact Unfiltered, where we spotlight voices making real change. In this special “Tribal Impact” series, host Philippe sits down with Dr. Setu Vora, Chief Medical Officer for the Mashantucket Pequot Tribal Nation in Connecticut. Dr. Vora shines a light on the tribe’s innovative, holistic approach to healthcare a journey that spans over three decades. He walks us through the evolution of Pequot Healthcare, a tribally owned system that not only serves its own community with independent health plans and in-house pharmacy services, but also extends support to other small businesses and tribal nations. Together, Philippe and Dr. Vora discuss the impact of accessible, quality care, the power of self-governance, and what it means to create lasting value in healthcare, both for the tribe and beyond. Whether you’re interested in health innovation, tribal self-determination, or building systems that put people first, this episode delivers inspiring insights on making an impact where it matters most.1-Introduction and Podcast Overview  - Dr. Setu Vora's professional role as Chief Medical Officer of Mashantucket Pequot Healthcare.2. Background on the Mashantucket Pequot Tribal Nation and Its Healthcare System  - The tribe as innovators in both gaming and non-gaming enterprises.  - The tribe’s strategic objective: prioritizing health for tribal families and communities.  - Establishment and evolution of Pequot Healthcare over 30+ years.      - Independent, tribally-owned third-party administration for self-funded health plans.3. Dr. Setu Vora’s Role and Mission  - Responsibilities as Chief Medical Officer: steward and resource for the tribal council’s health objectives.  - Focus on delivering better value health and applying this mission to both tribal and non-tribal clients.  - Emphasis on delivering quality, safety, and a better experience at a lower total cost.4. Pharmacy Services and Pandemic Response  - Explanation of PBM Solutions' offerings (by Phillippe) related to pharmacy programs, assistance programs, TPA setup, and pharmacy buildouts.  - Mashantucket Pequot’s large in-house pharmacy team (10+ pharmacists).  - Key role of the clinical pharmacy team during the COVID-19 pandemic:      - Leading vaccination programs across the tribal nation.      - Establishment and operation of one of Connecticut’s largest mass vaccination sites in partnership with state and local healthcare systems.5. Engagement at the Tribal Self-Governance Conference  - Explanation of the tribe becoming a Title V tribal nation and transition from Title I contracting.  - Self-governance compact with the Indian Health Service achieved in October 2022.  - Greater engagement at the national level, including sponsorship and leadership at the conference.  - Councilor Michelle Scott’s role in health and human services and her contribution as an opening speaker.  - Importance of legal counsel in unlocking self-governance advantages.6. Conference Takeaways and Reflections  - Value of networking and meeting other innovators at the conference.  - Recognition of entrenched healthcare systems and the challenge of delivering value in those systems.7. Meaning of Impact in Tribal Health Context  - Dr. Vora’s vision for impact: improving tribal community access to care, empowerment, and leadership in health solutions.  - Extending services and solutions to other tribal nations and self-funded American businesses.8. Measuring Success: Return on Health (RoH) vs. Return on Investment (ROI)  - First focus is on RoH: patient well-being, outcomes, and experience.  - Designing systems to achieve RoH typically brings ROI, achieving better care at lower cost.9. Closing and Final Thoughts  - Dr. Vora’s call to action: Find and collaborate with likeminded individuals to tackle healthcare cost drivers and barriers to care.  - Emphasis on partnerships and alliances for sustained progress.