Jennifer Strohecker is Utah’s new Medicaid director. Before she was appointed by Governor Spencer Cox, Strohecker was the director of the Bureau of Healthcare Policy and Authorization and the Medicaid pharmacy director.
In this Q&A, Strohecker discusses her priorities in her new role, addressing the opioid crisis in the state, and preparing for the end of the public health emergency period.
State of Reform: What are some of your main priorities as the new Medicaid director?
Jennifer Strohecker: “I am about one week into my role. So I am still very much getting my feet under me. First and foremost, I think the goals of Governor Cox on his One Utah roadmap and also his strategic Health Care Collaborative are to address some critical problems that we have in health care today. That [includes] the rising cost of health care and our lagging value of quality that we’re seeing. So, some of the key things that I’m aligned with the governor on include looking carefully at value and quality as key indicators while using data to guide our decisions.
I think there are two big issues right now that our Medicaid program is facing. We are still in the midst of our COVID response and a pandemic period, which for two years has really impacted our programs significantly. [This is especially] with regard to our staff and the work that the staff does around coverage and eligibility. Eventually, [we will need to deal with] the unwinding of our COVID effort and the work that’s going to require from our staff.
The second thing is the consolidation of the Department of Health (DOH) and the Department of Human Services (DHS) that we’ve been working on for the last year. This is very important work as we bring together both the behavioral and physical aspects of health care, under one umbrella of the Department of Health and Human Services.
This is also really important as we approach patient care differently to address the needs of a Medicaid member holistically to improve outcomes of care delivery. With this merger, we also will embrace lots of change as we bring in new staff and bring different staff together to bring about positive change. This will allow everyone to have a seat at the table to foster productive conversation around change so that we collectively can achieve our goals of improved care.”
SOR: How will the upcoming department merger affect your day to day for the next few months? What efforts do you plan to make to ensure a smooth transition?
JS: “There are many details to ensure a successful merger. But on a larger level, there was important work put in place around a leadership structure and the organizational structure. The work we are doing now is to ensure that our staff know where they belong and how and what their working units will look like. Work before my time has been done around a unified mission, vision, and culture that really describes our consolidated Department of Health and Human Services. There’s been a lot of engagement with our staff to solicit feedback and get input on these key decisions, even things as simple as the logo and what it represents. Things like that are really important to help ease our staff into this transition and help them embrace the change.”
SOR: How do you think Utah Medicaid should respond to the upcoming end of public health emergency (PHE) and the potential redetermination drop off concern?
JS: “Because the PHE has moved forward a number of times, we were uncertain when that end date would actually occur. So, this has been something that we’ve been thinking about, and we’ve been planning now for many months. We have a very strategic approach to manage this change when this change occurs. We work very closely with the Department of Workforce Services who manages eligibility, and we’ve conducted many meetings and agreed upon a process by which we will conduct this unwinding. With that, we can ensure a smooth member transition and they may move from one type of Medicaid coverage to another and have clear communication to members on the status of their Medicaid eligibility. This is still in our work groups right now and is not publicly available yet.”
SOR: How do you plan to reduce the use of prescription opioids among Utahns through your new role as Medicaid director?
JS: “I’ve been with Medicaid for four years and joined the Medicaid program as a pharmacy director. Some of the work that we’ve already done with the Medicaid program establishes a comprehensive opioid policy that ensures a safer and evidence-based approach to opioid use among the Medicaid population. With this policy, we’ve partnered with our providers, stakeholders, and work very carefully when we implement policy to ensure that our providers are aware of any policy changes that are occurring. Then, they’re given the opportunity, for example, to put in a policy exception request or a prior authorization when it’s needed.
We have made enormous strides in the last three years with our opioid policy and consequently, we’re seeing changes in opioid prescribing. We’re seeing less use of dangerous combinations of opioids and benzodiazepines that can lead to harm among the Medicaid population. I think we’ll continue forward in that path.”
SOR: Can you tell me a little bit more about these opioid policy changes that you are thinking about?
JS: “Certainly, our approach has been to again address inappropriate prescribing or overuse of dangerous combinations, but also ensuring that there’s access to opioids for those who need it, because there’s still chronic and acute pain that is effectively managed with opioids. It’s about striking the right balance around creating policies that support safe new therapies, but also allowing pathways for policy exceptions for patients who need higher doses or perhaps longer durations of therapy.”
This interview was edited for clarity and length.