Steve Calvin M.D. on pregnancy care, health care reform, and innovation

A New Inspiring Primary Care Model

A week ago I heard a couple of speakers at an Ashoka Fellows symposium in St. Paul.  One was Dr. Rushika Fernandopulle, founder of Iora Health  (   Rushika is a talented and articulate physician who is starting from scratch with a new primary care model.   It is a team approach that moves beyond the fee for service payment system.   It is a model that is long overdue.  He has been at this for a decade and is getting real traction with successful clinics in four locations across the country – with plans for many more.

I was inspired by Ruskika’s passion and tenacity.  I’d recommend listening to some of the online videos featuring him.  He is improving primary care in the ways that we envision improving maternity and newborn care.   Just tweaking the current broken system gets us nowhere.  In late September and early October I presented our vision to the American Association of Birth Centers conference (with Amy Romano) and to the University of Minnesota Nurse Midwifery program symposium (with Tanya Muller, our midwife director at the Minnesota Birth Center).  It was very encouraging.  There are many fired up folks ready to make big changes to improve the care of mothers and babies.

I am excited to see what comes next.


  1. Olga Ryan says:

    It sounds like a provider’s dream job. He seems to very purposely have avoided using RN’s as the health coach. Is it purely less cost or is there more to that decision?

    The only (other) thing missing is that the patient isn’t also the end-consumer so ultimately still a third-payor system.

    Olga in Tucson (RN)

    • Steve Calvin says:

      Thanks for commenting. As I understand it Iora Health uses culturally matched non-medical health coaches as an integral part of the their team. By coming alongside patients and understanding their circumstances they are able to have a significant positive impact on outcomes. I believe that similar “maternity care guides” will benefit mothers with complicated medical/social situations. It is true that the patient isn’t directly paying for care. Although the customers are ultimately the individual patients Iora Health contracts with self insured unions and employers to provide comprehensive primary care for a defined population for a defined period of time. Getting away from from fee for service has allowed them to save 10-15 percent for their customers-while dramatically improving health outcomes.

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