LOUISVILLE, Ky. — Humana Military, a wholly-owned subsidiary of Humana Inc. announced today the appointment of Alefiyah Mesiwala, M.D., MPH, as Humana Military’s new Chief Medical Officer. Effective March 15, Dr. Mesiwala will serve as a member of the Humana Military leadership team and report to Brent Densford, President, Humana Government Business, Inc. – Humana Military.
Humana Military has a long history of partnering with the Department of Defense and the Defense Health Agency to administer health coverage for U.S. Military active duty service beneficiaries, retirees, and family members through the TRICARE health program. Humana Military is a convener of care for the TRICARE East region, serving the physical and mental health and well-being needs of beneficiaries through 500,000 health care provider partnerships.
As the Chief Medical Officer for Humana Military, Dr. Mesiwala will provide strategic leadership and direction for medical management and clinical operations of the TRICARE contract to ensure the delivery of high-quality integrated health care. She will lead the large-scale transformation of the Humana Military business towards value-based care delivery, leveraging Humana’s significant capabilities in population health management and integrated care to better serve the physical and behavioral health needs of the TRICARE population. Humana’s population health management capabilities, which include chronic disease management and data analytics, are focused on working with community-based organizations, business and government leaders, and health care practices to co-create clinical solutions to address population health at a local level.
The Defense Health Agency has stated the importance of integrating value-based care programs and alternative payment models (APMs) into the TRICARE 5th generation (T5) contracts through recent draft requests for proposals. Humana is one of the nation’s leading companies for entering into value-based agreements with physician groups to serve its Medicare Advantage members. In 2019, 2.41 million Humana individual Medicare Advantage beneficiaries receiving care from primary care physicians in value-based payment models experienced, on average, better health outcomes, lower costs, and more preventive care, as opposed to fee-for-service models.
Dr. Mesiwala joins Humana Military from the University of Pittsburgh Medical Center (UPMC) Health Plan, where she has served since 2017 as Senior Medical Director for Value-based Care and Innovation for UPMC Health Plan. At UPMC Health Plan, Dr. Mesiwala led the clinical design and implementation of primary care and specialty-focused alternative payment models. Additionally, she led programs to support providers and physicians across the network in practice transformation and clinical quality improvement.
From 2015 until 2017, Dr. Mesiwala served as Senior Policy Advisor in Healthcare to former President Barack Obama at the White House, where she was responsible for furthering the Administration’s progress in health care policy. As the health care leader for the White House National Economic Council, Dr. Mesiwala launched a multi-stakeholder public-private partnership to further kidney care and organ transplantation and also launched a national provider-focused collaborative to collectively address workforce challenges in health care. From 2011 to 2015, Dr. Mesiwala worked at the Center for Medicare and Medicaid Innovation (CMMI), where she served as a Medical Officer and Senior Advisor to the CMMI Director. In this capacity, Dr. Mesiwala led the development and implementation of new models including specialty-focused accountable care organizations and the CMS healthcare innovation awards program.
Dr. Mesiwala received her M.D. from the University of Michigan Medical School and a master’s in public health from Johns Hopkins Bloomberg School of Public Health. She completed her clinical training and residency in general medicine and preventive medicine also at Johns Hopkins and currently is a fellow of the American College of Preventive Medicine.
Dr. Mesiwala is a frequent speaker at national conferences. She is also an active member of professional organizations, various national committees, and advisory groups. She lives with her husband and two kids in Pittsburgh, PA.