Since then, Cuevas has worked in various healthcare spaces, including the New York State Department of Health. He is currently the executive vice president of SOMOS Independent Practice Association (IPA), which supports solo and small group physician practices predominately serving the Medicaid population in New York City. Cuevas spoke with SIPA News about his work helping the health department during the COVID-19 pandemic, his experience with SOMOS, and how Columbia supported his career.
What was your experience on New York State’s COVID-19 response team?
I was a member of the New York State Department of Health’s COVID-19 response team for four months from May to August 2020. I had been working remotely like everybody else when the COVID outbreak started in NYC and watched the daily briefings by Governor [Andrew] Cuomo. Prior to my current position at SOMOS, I had worked for the Department of Health and knew a lot of my friends and former co-workers were on the frontlines of the public health response. In late April, I received a call from my former boss and mentor, Dr. Howard Zucker, the New York State Health Commissioner, who asked if I would be willing to volunteer with the department’s COVID Response Team.
By the time I received the call from Dr. Zucker, I had seen first-hand the devastation of COVID. I had lost my grandmother to COVID in early April and had several close family and friends got very sick from the virus. I’m not a clinician, but as a public-health professional I wanted to do whatever I could to help.
In my four months volunteering with the team, I helped out with various aspects of the response, including helping to memorialize best practices on testing and contact tracing. A majority of my time was spent working with senior DOH leaders on the state’s “surge and flex” strategy. During a public-health emergency, healthcare facilities across the state needed to prepare to rapidly expand their capacity in a safe manner to meet the potential demand in health care services. In cases where health care facilities and regions are not able to meet potential capacity needs within existing facility structures, “flex” strategies need to be implemented. Examples of this include moving patients to other facilities with capacity and setting up alternative-care sites like the Javits Center in New York City.
What was the most eye-opening part of your experience?
Something that really stood out to me was the dedication of public servants and how tirelessly the responders worked, and continue to work. My first day on the team, I arrived at the DOH Command Center at 9 a.m. on a Monday morning and there was already a full crew of people there. That first day, there was so much going on I didn’t leave until 3 the next morning. I took a nap, took a shower, and I was back in the office at 7 a.m. And people had been working at that pace seven days a week for two months prior to my arrival. They’re probably still working long hours to keep the public safe. All our decisions relied on science, not politics, but above all we tried to make the most informed decisions. At every step of the process, there was tremendous effort to review best practices and constantly improve. The thoughtfulness, the insight, the dedication of the entire New York State COVID response team was truly amazing.
How did you get into healthcare?
The 2008 financial crisis really impacted my family and my Latino community. As I worked to help family members gain access to healthcare and other government assistance, I learned about Medicaid. I realized that everyone uses the healthcare system, but so few understand how it works. Many people don’t understand how to sign up for Medicaid, if they’re eligible, or what it covers. In helping my own family, I realized I could help other people in the same position gain access to quality health care services.
After attending SIPA, I went to work in the New York State Medicaid office. It was a really meaningful experience working to help ensure quality health care and access across a state as diverse as New York, which has rural and urban areas and everything in between. You think of New York as a wealthy state, but a third of all New Yorkers receive their health coverage from Medicaid. There are a sizable number of New Yorkers who have food or housing insecurity and need public assistance. It’s been really rewarding to be part of the solution to ensure all New Yorkers have access to quality health care.
What is SOMOS, and what has been its role during the pandemic?
SOMOS is an independent practice association, which is like a collective bargaining unit or union for doctors. Underserved populations and communities that rely on Medicaid are often served by independent doctors who can have difficulty remaining independent businesses because of low Medicaid reimbursements and ever-increasing regulatory requirements. SOMOS helps such practitioners negotiate value-based contracts, so that doctors realize higher reimbursements for keeping their patients healthier. SOMOS has organized over 2,500 doctors in the NYC area to give them the support they need and make it more feasible for them to better serve their communities and be rewarded for their efforts.
Governor Cuomo called on SOMOS to conduct COVID testing in underserved areas, where there wasn’t much access to testing. SOMOS set-up culturally competent testing sites and, in certain communities, became the backbone of the state’s testing efforts. Our physicians also changed their service delivery methods and to include telemedicine appointments in order to ensure health care access for their patients.
It makes a difference when the doctors who serve disenfranchised communities can speak the language and understand the culture of the people who they are servicing. We work with many doctors — Latinos and Chinese Americans, for example — who are from the communities they serve, and still live and work there. They know the people they treat and that’s something really special about SOMOS.
How did SIPA prepare you for your career?
Healthcare is a highly regulated industry and the policies dictate the financing which, in turn, dictates where and how health care services are delivered. I knew the quantitative and policy rigor of SIPA would prepare me well to understand how the public health financing system worked.
What was really unique about my SIPA experience was the diversity in the student body — not just their personal backgrounds, but the experiences my classmates brought to school, and their goals afterward. I was interested in domestic healthcare, but there were people who wanted to do work in energy, monetary policy, security policy, and everything in between.
When you’re dealing with a public-health crisis, nothing is in a silo. My courses at SIPA, from management to decision modeling, brought together unique people, experiences, and perspectives, which really led toward better and unique solutions. That mindset at SIPA of working with diverse teams and listening to team members with unique perspectives really expedited my upward trajectory.
What would you say to students of health and public policy going into the field?
You’re needed more than ever. Health policy impacts all policy. With all the public health challenges we have before us, from COVID to obesity and the mental health crisis, we need policy makers with the knowledge and empathy to help solve these big issues of our time.
This interview, conducted by Aastha Uprety MPA ’21, has been edited and condensed.