OneCare Vermont is pleased to announce that Dr. Carrie Wulfman, MD has been named the accountable care organization’s chief medical officer (CMO). Dr. Wulfman is a family medicine physician of 30 years, currently practicing at Brandon Primary Care in Addison County and will continue to practice while holding the position of chief medical officer at OneCare Vermont. As CMO at OneCare, Dr. Wulfman will provide overall clinical leadership and direction and serve as the senior clinical representative with government, public, and commercial insurers.
We sat down with Dr. Wulfman and asked a few questions to help you get to know her better.
What led you to become a physician?
I didn’t decide to go into medicine until my sophomore year in college. I had thought about a variety of different jobs or careers and gradually moved in the direction of a field where I could be helping others. A field that included science and solving problems—and then I had a few personal experiences and read some books that all pointed me in the direction of medicine. I didn’t immediately know I wanted to be a primary care physician, however. I considered becoming an OBGYN, and also thought I might like to go into surgery, but I eventually gravitated toward a field where I could treat any sort of person, with a variety of issues, and feel like I was addressing the health of the whole person instead of just one body system. And what I mean by addressing the health of the whole person is looking at the social determinants of health—or what we used to call the “bio-psycho -social aspects of health”—for individuals and family systems.
I also had mentors along the way that nudged me in the direction of primary care—notably my own family physician in my hometown in Indiana. I did a rotation with him and he was definitely an influence to go into the family medicine field.
What is your approach to practicing medicine?
I ask a lot of questions, but mostly I listen to the patient because they often will share a social determinant that is impacting their health on their own if I give them time to talk about their health in a variety of ways. They often share what’s going on in their family or with their job, or why they can’t exercise—or what their trials are in both preventing health problems and improving their health. So being a good listener as a physician I think is more important than asking questions—usually if I listen to patients long enough, they’ll tell me what’s wrong. And along with that, building relationships with my patients so there is trust leads them to open up and share with me the issues that are on their mind.
When I identify a need that is more of a social than a medical need, I have, throughout my 30 years in primary care, taken it upon myself to help my patients connect with the food, housing, transportation, or safety resources they may need. Thankfully, however, we are now building a support team around each provider in our practice who can help us with some of those things—so we have a care manager in my practice, a behavioral therapist, a dietitian, and also a pharmacist now who comes half a day a week. And those have come to us through healthcare reform dollars—both OneCare and the State of Vermont’s Blueprint for Health. Having this full team has definitely impacted how I can take care of patients and really shows a model for what value-based care can look like at its best. Getting a team built around a patient panel definitely helps address more of the social determinants of health than we ever could before—and I’m excited to be part of expanding more of this team-based care approach throughout the state in my new role at OneCare.
How did your interest evolve to get into healthcare reform in addition to practicing medicine?
Most importantly, it’s the philosophy that there isn’t a lot of pleasure to be gained from sitting in my office and hoping somebody gets sick or gets hurt and needs to come in and see me. That’s not very satisfying to me. It’s much more satisfying to be able to address patients’ lifestyle health and talk to them about disease prevention, safety, healthy relationships, and so on. I really enjoy helping patients evaluate their lifestyle proactively instead of hoping that 20 people come to my office so that I can bill for services provided and thereby make my income. It is much more fulfilling to do it the other way around.
I have thought this way for many years that our health care system seems to be backwards—the way the business of health care is structured, it’s almost like we’re promoting poor health instead of good health. And so this is what led me to get involved with the work OneCare Vermont is doing to efficiently spread value-based care throughout the state. My role over the last year as population health physician liaison for OneCare Vermont and the UVM Health Network has been an important position for me to dive deep into helping expand the work of OneCare and I look forward to deepening and expanding my liaison role as OneCare’s chief medical officer.
What is your vision for the future of value-based care in Vermont?
Vermont is a relatively small population and therefore we can be more nimble and perhaps move more rapidly into value-based care than other locations. I truly believe in the power of an entity like OneCare who can provide the infrastructure to efficiently shift into value-based contracts with all payers—Medicaid, Medicare, and commercial insurers—and pull together a network of providers that can share best practices and learn from each other. With the support of OneCare, health care providers in Vermont can deliver the right kind of care, in the right place, at the right time, in the way that the patient desires to have it—not always just in the way we think they need it, by listening to what the patients say they need and building the support team around them.
And I will add, this OneCare model really allows us to be responsible stewards of our health care dollars. It is part of the definition of value-based care, but I think it just needs to be stated that while we want to improve the health of our population in Vermont, we also want to do it in a more cost efficient manner. In the long-term, this will allow us to invest back into community health and team-based care to support the whole patient.
What excites you about this new role of chief medical officer?
I’m excited to bring my 30 years of experience in primary care into the role and the value-based care work that is going on in the state of Vermont. Right off the bat, building relationships with community health care entities is something I will focus on in the first three months. And then I plan to redesign our committee structure so that we make sure everyone’s voice is heard and that we are able to maximize input and knowledge from those throughout the state who are also working on changing the way health care is paid for and delivered.
Another part of the role I look forward to working with the OneCare team on is evaluating quality metrics and looking at the data analytics to help decide where we need to focus on health care improvements. Do we need to focus on senior care? Do we need to focus on pediatrics, etc? Really analyzing the data to see where we’re struggling and where we can make the biggest impact.
I see the CMO role as a facilitator—an informant. From my primary care viewpoint and experience, I will be a facilitator and promoter of value-based care involvement by all the members throughout the state—spreading the message, spreading the work, and sharing the benefits.
And to stay grounded in the provider experience, I will continue to see patients on Tuesdays and Thursdays at Brandon Family Practice. Seeing patients is still the most rewarding and important work to me and I will not give that up. It’s what keeps me knowledgeable about patient needs. It’s what was really my first love in medicine, and I want to maintain credibility in the new role as CMO at OneCare by continuing to work clinically.
About OneCare Vermont
OneCare partners with health care providers to transform the health care system to one that focuses on health goals and fosters better outcomes for all. By giving health care providers actionable data and analytics, paying for health care value, and managing ACO network performance, OneCare supports participating providers in their work to provide excellent health care to Vermonters. Through this partnership, OneCare moves Vermont toward a trusted, equitable health care system where patients and providers work together to achieve optimal health and an exceptional care experience. Learn more at onecarevt.org.
Visit our Media Center and find “fast facts” for accurate reporting, images and graphics for utilization in your coverage, and recent media hits and releases.