In Conversation: Dr. Nathan Chomilo, Medical Director of Minnesota Medicaid

April 7, 2023 · Amy Maciejowski

A relentless pursuit: Strong leaders need this in order to effect change. Two public policy leaders—motivated by change—sat down for our most recent NCQA Fireside Chat to exchange ideas and inspire new ways of thinking.

NCQA’s President Peggy O’Kane hosted Dr. Nathan Chomilo, Medical Director for Minnesota Medicaid, in a discussion about his work to improve the health of Minnesotans.

Peggy and Dr. Chomilo shared how best practices can address disparities, and how building partnerships throughout the health care system and communities is vital to improving health outcomes.

Nathan Chomilo, MD, FAAP, FACP, Medical Director, Minnesota Medicaid

As Peggy says, “We have a collective responsibility to get the word out on what’s effective.”

The discussion is available to view in our video gallery. We’ve summarized key points below.

“Building” Comes First

As a policy leader in his state, Dr. Chomilo is what you’d call a “grass roots thinker.” He believes that building a natural identification and connection with the health care system makes providers more effective. For example, he says providers can use recommended pediatric visits to identify gaps in families’ access to resources, and connect them to available resources.

Building those relationships is just as important for being a patient advocate and for instilling the will to change. Many conversations that address systemic racism are difficult ones. Dr. Chomilo had mentors who encouraged him to keep an open mind, and suggested entering using a simple statement—“I’m interested”—to keep the lines of communication open.

“There are many ways to get to equity—but we should prioritize the communities being affected and their experiences,” says Dr. Chomilo. He shared that although Minnesota is still looking for the “sweet spot” of how health can play a role in addressing social determinants, there is broad opportunity. Only about 20%–30% of a person’s health is impacted by health care, so discovering that spot might take time—and trial and error. But “if we can meet the needs of those who have been left behind historically,” says Dr. Chomilo, “everyone will benefit.”

Extending Pandemic Lessons & Connections

As Minnesota’s COVID-19 Vaccine Equity Director, Dr. Chomilo drew on his experience as a practicing physician to introduce broad policy changes in his state. He was able to depend on an established partnership with the state Medicaid and public health departments to collect demographic data on state residents. The opportunity now lies in replication: Extend the connections beyond the pandemic.

“We should work more with the public sector to make connections together,” said Dr. Chomilo, highlighting accountability as vital to any partnership. “We can look at things honestly together and move forward together.”

Practical Policies

During their chat, Peggy and Dr. Chomilo focused on the innovative paper he co-authored, and which won Minnesota a Medicaid Innovator Award. Building Racial Equity into the Walls of Minnesota Medicaid: A focus on U.S.-born Black Minnesotans urges community engagement efforts to address health equity. The paper is a call to address social drivers of health by:

• Increasing enrollment in Medicaid.
• Focusing on culturally relevant care.
• Creating the infrastructure for engaging with community members.

The paper has had an impact: Many of its suggestions were included in the state budget this year—a crucial step in maintaining the partnerships needed to address health equity.

Visit our video gallery to watch the full Fireside Chat.