When it comes to professions and occupations in the world of industries, healthcare is as much like a pulse to the bodies that fill this planet. For Blair Fjeseth, the President and CEO of Mountain Health CO-OP, this heartbeat remains closer to the heart. Her journey into healthcare began at just nine years old when her family faced a crisis: the ill health of her father by kidney failure. He was a special education teacher fighting for his life. Blair’s family lost their health plan eligibility because of pre-existing conditions and went from comfort to instability and vulnerability. “Sadly, I was not alone in this experience; millions of Americans faced the same reality, one that is hard to climb out of,” says Blair.
However, Blair never thought that she would take up a career in health insurance. Her career movement was anything but progressive, as she went through several leadership positions in various fields. “What gives me joy and what I am passionate about is building teams and a culture that benefits the greater good,” says Blair. Her entry into the healthcare realm was serendipitous, starting with her involvement in the formation of the National Alliance of State Health CO-OPs (NASHCO) and later collaborating with the founders of the Montana Health CO-OP, now known as Mountain Health CO-OP.
“I was not searching for a specific healthcare role,” Blair recalls. “But when the CO-OP’s Chief Executive Officer, Richard Miltenberger, invited me to join, it seemed to be the right thing to do.” She started as a Director of External Affairs at Mountain Health CO-OP, moved into the Chief of Staff role, then COO, and was named CEO after an extensive national search. “I feel privileged to have been given an opportunity to really get to know this business before leading it,” Blair says, with genuine sincerity.
Blair’s story, therefore, affirms life’s unpredictability and its opening of doors that chart the course of human lives. As she steers Mountain Health CO-OP through the complexities of healthcare, her compass remains true: to try and lead a life that genuinely helps people when times are good and bad, listen to them, and act in their best interests. While it may be difficult to achieve such high goals, our commitment is to strive for them even though we may fall short.
Revolutionizing Healthcare
Mountain Health CO-OP operates with a clear mission: to offer non-profit member-owned health insurance and be an organization that empowers its members to be involved in the decision making process and have a say in how they receive benefits. Their vision goes further than a mere provision to promote innovational, member-oriented healthcare. This vision hinges on the triple aim: promoting the well-being of the populace, optimizing patients’ satisfaction with the care they receive, and combating for the costs of care.
“Our scoreboard is not about revenues,” explains Blair. “It’s all about making a meaningful positive impact to people’s lives and at the same time holding the marketplace accountable to help change the healthcare system to create one that works for the people that need it the most.” An example of this is Mountain Health CO-OP’s recent foray to Wyoming. By injecting competition into the market, Mountain
Health CO-OP slashed rates by approximately 12%, translating to millions in savings for Wyomingites. “When we look at success in this health industry, it’s often in lives covered and dollars made. I’d like to think success looks like “how much good did we do for the communities in this region,” Blair reflects.
Embedded in Mountain Health CO-OP’s model is the idea that everyone should have options regarding the healthcare they receive. Moreover, Mountain Health CO-OP does not only provide wide-ranging coverage options, but also has some unique fundamental benefits, such as free medications, including insulin. By Blair’s assertion, no one should have to give up basic needs in order to get basic needs, that is, medication.
“People shouldn’t have to decide between paying for their prescriptions or paying their rent. We go above the standard benefit model and pay people to get a dental exam, an eye exam, and a home health assessment,” shares Blair. Understanding the shortcomings of specialist appointments in rural fields, Mountain Health CO-OP acts proactively. They cover expenses for many members to travel for necessary complex treatments; meals, plane tickets, hotel – the whole kit and kaboodle.
Putting People First
At Mountain Health CO-OP, the board is not comprised of executives but is composed of members who pay premiums and utilize benefits. This unique perspective guides decision-making so that everyone has a chance to share their story and be valued. “That is why we focus not only on the claim but the person making it,” Blair noted. “Many times, they’re the ones left behind and struggle to find needed clinical and financial resources to become well.”
Unlike many companies, Mountain Health CO-OP doesn’t ask customer service employees to aim for short call times. Customer teams are encouraged to invest as much time as needed to support their members. “We understand we are not perfect so when issues arise, we treat them as opportunities to implement systemic changes that benefit the entire membership, rather than addressing them as isolated incidents,” Blair emphasizes.
Feedback isn’t just welcomed— it is an integral part of Mountain Health CO-OP. Members receive post-surgery calls, assistance with out-of-state care, and regular surveys. Utilization is tracked, website behavior is monitored, and focus groups are organized.” Our members have been excellent at sharing what they like and want to see improved,” Blair notes.
Despite covering thousands of lives, Mountain Health CO-OP maintains a personal touch. “Our size is our superpower,” Blair explains. “It allows us to forge genuine connections with our members.” Accessibility is also a key. Blair’s personal email is included in communications, ensuring members can reach out directly with their concerns.
Innovating Healthcare Access
Mountain Health CO-OP leads in innovative health care. Technical progress with AI and machine learning helps identify members needing intervention and encouragement to use benefits for preventive care like mammograms and other cancer screenings. Additionally, Mountain Health CO-OP is partnering with Uber Health to address transportation barriers to appointments. “We use technology to bring mental health and doctors into your home 24/7. In rural states where you drive hours to see a doctor, this is a game changer,” Blair shares.
Looking ahead, Mountain Health CO-OP will continue its efforts to strengthen members’ experiences. “We are working diligently on developing deeper partnerships with providers on medical management,” Blair states. “We ponder daily how to encourage people to see the doctor sooner, provide them with the best care, and eliminate barriers for members.”
But the work of Mountain Health CO-OP goes well beyond its own walls. The organization played a pivotal role in helping a nonprofit that provides eye exams and glasses to children across Idaho, Montana, and Wyoming. “Rural states like ours are often underserved in the health space, so we take our equipment, doctors, and staff on the road to screen kids’ eyes and get them in glasses without costing caregivers a dime,” Blair explains.
Overcoming Challenges and Embracing Change
Healthcare nowadays is characterized by never-ending changes in policies, and therefore succeeding in such an environment demands flexibility and creativity. Blair recognizes the delicate balance between compliance and progress. “Regulations are essential for consumer protection, but excessive red tape can stifle innovation,” Blair acknowledges. “Our mission is to help our members. We work with regulators to craft legislation that will work for them and not be a roadblock or self-promote regulation that increases complexity and decreases competition.”
In addition to dealing with the complexity of the industry, Blair also deals with biases against her gender and the expectations of society. “I was once asked about becoming the CEO, “Can you even do this job with three young kids?” I believe that more C-suite leaders should resemble the people they are serving,” she says. But Blair views her role as an opportunity to challenge norms and foster work-life balance. “Genuine leadership is about embracing life’s demands,” she adds. “It’s about driving minivans and coaching little league—it’s what humanizes us. I’d rather look like the people I am working for (our members) than someone out of touch with the reality of everyday people.”
One of the main elements of leadership, in the opinion of Blair, is listening. Too often, the industry dictates rather than listens. But true innovation emerges from dialogue and collaboration. “If leaders simply take time to listen to their members, staff, and partners, they can find common ground, innovation, and emerging trends,” Blair says.
In a rapidly changing, highly regulated environment, learning agility is essential. “More change is happening now than ever before,” Blair notes. “Success requires not only a long-term vision but also the ability to make quick decisions. Every day brings new challenges, and having a team willing and driven to solve them positively for our members is crucial.”
Measuring Success with 3Ms Framework
At Mountain Health CO-OP, success is assessed through a blend of qualitative and quantitative measures. Blair employs a unique “3Ms” framework to evaluate the organization’s activities. “We consider whether our actions align with our mission, achieve necessary metrics, and effectively serve our members,” Blair explains.
This comprehensive approach includes several key indicators: tangible improvements in individuals’ lives and the broader community, colleague satisfaction and fulfillment, financial stability without compromising service quality, program and service expansion, high levels of member satisfaction, positive feedback, and the promotion and recognition of innovative ideas throughout the organization.
Every day at the CO-OP offers something rewarding. Blair shares, “We start each meeting with a member success story. The amazing things our team does for those we serve make me excited to come back each day.” The resilience and struggles of the members drive her to continually strive for better solutions.
A particularly memorable moment for Blair was during a legislative hearing in Montana. “We listened to Montanans talk about rationing insulin because of the cost,” she recalls. “We were the only ones who could say, ‘We offer insulin free to all our members.’ These added benefits may eat profits/margins, but for me, being a part of a team knowing we have done right by the people we serve is a great feeling.”
Future Horizons
The healthcare field holds remarkable growth and transformation over the next 20 years with the leadership of millennials and women. Blair looks into these changes optimistically and with great insight. She says, “Reflecting on the past, we’ve witnessed significant changes driven by regulation, consolidation, medical breakthroughs, technological advancements, and the impact of a global pandemic.”
Looking forward, the industry will continue to adapt to artificial intelligence, cybersecurity demands and costs, specialty drugs, and continued medical advancements. “Our industry and society will evolve in ways we can only begin to imagine,” Blair predicts. With these changes on the horizon, Mountain Health CO-OP remains committed to its.” We are ready to embrace new challenges and opportunities. The future is full of possibilities,” Blair concludes. “And together we’re excited to be part of shaping it.”
For More Info: https://mountainhealth.coop/