Lexington, Ky. – A physician with more than 30 years’ experience in health policy and health benefits has been named chief medical officer for Baptist Health Plan and Baptist Health Community Care.
Thomas James III, MD, assumed the CMO position on Aug. 31. reports to Isaac J. Myers II, MD, chief health integration officer for Baptist Health and president of the Baptist Health Medical Group. In the position, Dr. James provides leadership for all clinical and pharmacy activities for the Baptist Health Plan and Baptist Health Community Care.
“Dr. James’ experience will be invaluable in leading our population health service organization, called Baptist Health Community Care,” said Dr. Myers. “Baptist Health Community Care is the hub for our population health strategies, value-based care and wellness initiatives, supporting physicians and providers across the state and using a more proactive approach to improving the health of the communities we serve.”
Baptist Health Community Care, housed at the Baptist Health Plan offices on Perimeter Drive in Lexington, has launched a pair of Care Advising programs to work one-on-one with plan members with have multiple or chronic health conditions, and with their providers as well.
Dr. James has firsthand insights into population health and clinical medicine, as he practiced internal medicine and pediatrics part-time during much of his career. While at his most recent post – corporate medical director for clinical policy with Philadelphia’s AmeriHealth Caritas – he also worked in an after-hours clinic.
When it comes to population health, “we think in terms of each patient as an individual, but also collectively,” Dr. James said. “If a program helps one person with diabetes, then maybe the program can help everyone with diabetes.”
The Louisville native launched his medical career from the University of Kentucky College of Medicine after earning a bachelor’s degree from Duke University. He served internal medicine residencies at Temple University Hospital and Pennsylvania Hospital, plus a pediatric residency at Children’s Hospital of Philadelphia.
Seventeen years of his career have been spent in Louisville, first as medical director for HealthCare of Louisville (later known as HealthAmerica Kentucky), then several positions with Humana, leading up to the post of medical director, national network. Between those Kentucky positions, Dr. James spent a decade in Virginia, serving stints as medical director for Maxicare-Virginia/HealthAmerica, Sentara Health Plan and Travelers’ Health Network.
In his most recent position with AmeriHealth Caritas, Dr. James was responsible for crafting clinical policy and overseeing coding, claims and network contracts. He was also AmeriHealth’s representative to a number of National Quality Forum work groups, including chairmanship of the National Quality Forum Health Plan Council. (His term ended In March.)