Moshe Pinto: “Last mile of healthcare”

We need a new social compact, one that recognizes that good health starts with a healthy community and neighbors feeling some measure of responsibility towards, and community with, their neighbors. This would enable more seniors to age in place and with grace while curbing our care costs. As a part of my interview series with leaders […]

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We need a new social compact, one that recognizes that good health starts with a healthy community and neighbors feeling some measure of responsibility towards, and community with, their neighbors. This would enable more seniors to age in place and with grace while curbing our care costs.

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Moshe Pinto, CEO of Wider Circle.

Moshe is the co-founder and CEO of Wider Circle, an innovative community care program working with health plans nationally to connect members with familiar neighbors to inform, support and motivate the most vulnerable populations. Whether face to face, over the phone or via online communications, Wider Circle is building trusted relationships in more than 135 communities across the country to inform and support individuals on their path toward improved health.

Prior to Wider Circle, Moshe founded Spiracur Inc., a company focused on advanced wound care systems. During that time, he led the organization through a 65M dollars investment round and spearheaded product commercialization efforts. Additional healthcare experience includes leading HD+ (now Outset Medical), a company focused on the development of technologies to address the needs of patients with kidney failure.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

My father wanted me to be a lawyer and work on Wall Street, but I had different aspirations. I came to Stanford University from Israel because I wanted to be an entrepreneur. At Stanford, serendipity steered me to the right people at the right time and they got me involved in healthcare, where I discovered my passion.

In 2007, I launched my first company, a diabetes startup, from my dorm room. I sold it in 2014. In 2011, I led a turnaround of healthcare company developing a novel dialysis platform, which recently went public at a 2-billion dollars valuation. In 2015, after visiting my mother in Israel, I decided to take on the challenges of social isolation and loneliness among seniors, which led me to found Wider Circle.

Can you share the most interesting story that happened to you since you began leading your company?

Wider Circle provides a community-based solution that brings together groups of neighbors on a regular basis to build trusted support systems for one another. Several years ago, one of our groups in Venice Beach, California, included two recent widows, one of Israeli descent, and the other Palestinian. The two widows initially harbored animosity towards each other based on their historical backgrounds, but over time, their feelings changed. Eventually, they both reached a point where they could no longer afford to continue living alone in Venice Beach. The Wider Circle facilitators nudged them to move in together — and they did. We were able to bring peace between these two, helping them overcome their long-standing animosity, and enabling them to see the humanity in each other.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

In the early days of Wider Circle, we were trying to group people by interest. Redwood City had contracted us to find out why seniors were not using the city’s senior centers, so we decided to survey them to find out what they were interested in. It took us a while to realize that people wanted to impress us with their answers; they were choosing options that made them look smart and sophisticated but did not really reflect their interests. For example, we organized some groups around poetry, and it turned out that most of the attendees actually hated poetry — they had never read any poems and had no interest in talking about them. We made quite a few of those funny mistakes in the early days.

What do you think makes your company stand out? Can you share a story?

We are willing to go to places that others do not. Our approach is unique in that it meets people where they live by focusing on their communities and relationship building. Our model is built on the idea that trust is the key — that personal relationships can be incredibly powerful tools to motivate people to take action. When a group of neighbors form a bond, members take better care because they want to fit in with the other members who are doing it as well. Wider Circle realized that the “last mile of healthcare” — people’s homes and their neighborhoods — may be the most important care setting of all, and we have incorporated the key insights from the psychology of influence with a network of team members in every community who build trust in that last mile, wherever it is.

What advice would you give to other healthcare leaders to help their team to thrive?

Have big, hairy, audacious goals and a humble demeanor. I was hospitalized for an extended period of time when I was younger, and I can still remember the fear, hopelessness and alienation that I felt within the system that was trying to care for me. Those memories are what drive my commitment to ensure that the well-being, dignity and humanity of our members are always front and center of what we do.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

The U.S. ranks so poorly in healthcare because of several fundamental design flaws in its system. First, the economic incentives of the payers, device makers, drug manufacturers and providers are what govern the system– and this fee-for-service approach is the root cause of everything that is wrong. Most doctors are not paid on whether they deliver improved health. Their income largely depends on whether or not they saw the patient or performed the surgery, regardless of patient outcomes.

Health illiteracy is another big problem. Many Americans lack the ability to read, understand and use the information necessary to obtain adequate healthcare. This has a significant effect on their health status, because limited health literacy is highly associated with poor health.

The U.S. has not yet achieved its goal of coordinated, value-based care that ensures that patients get the right care at the right time, rather than unnecessary tests and services. We need to change the perverse incentive structure that drives up our health costs.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

We need a new social compact, one that recognizes that good health starts with a healthy community and neighbors feeling some measure of responsibility towards, and community with, their neighbors. This would enable more seniors to age in place and with grace while curbing our care costs.

We need to adopt a new patient-driven payment model that addresses perverse incentives by prioritizing patient needs over service volume. Further, we need to align incentives with caring for the patient as a whole by addressing non-clinical factors such as loneliness and isolation, food insecurity, etc., that often are more determinative of how healthy we are than the care we receive when we get sick.

We should make health education a priority from an early age — not just teaching children about practicing healthy habits, but teaching them how to engage in preventive care, how to carry themselves in a healthcare encounter, what to expect, what to ask and how to navigate around primary sources to find information.

We need to develop effective, cost-efficient, community-based solutions that address the key Social Determinants of Health affecting the wellbeing of American seniors.

Ok, It’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

We should redesign Medicare Advantage and Medicaid with more intent focus on addressing logistical challenges at the community level, which requires true cultural competence. One way to do that is to commit resources to creating forums of like-minded people that are a source of information, logistical support and problem-solving at a community level.

We should incorporate health literacy into schools’ curricula nationwide, making it as fundamental as math, English and other core subjects.

We should leverage community-based solutions like Wider Circle to provide a neighborhood safety net for seniors, one in which people are incentivized and motivated to check in on one another on a regular basis to ensure they are healthy and safe.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

I think there is a tendency in our current system to “professionalize” mental health problems too quickly. Many of us experience behavioral health issues at times in our lives, such as depression or mild bipolarism, but these conditions are often situational and do not necessarily mean we need to immediately seek therapy. Many times, emotional support from friends and family can be more effective than professional therapy in helping us through these episodes.

Today, getting professional treatment can be difficult and time-consuming. Payers have erected all sorts of barriers to mental health care: screening, sorting, referral. Treatment programs are expensive and inaccessible to many.

An alternative would be to leverage a community-based approach, using lightly trained lay people for screening, and establishing community support groups, consisting of trusted neighbors, as safety nets. These community groups are far less expensive than traditional treatment programs, and, as Wider Circle has proven over its years of operation, they are highly effective in providing the emotional and other support individuals need to maintain their mental health.

How would you define an “excellent healthcare provider”?

To me, the ideal healthcare provider is someone who combines deep empathy with technical excellence and is skilled in delivering care. Healthcare is very personal, and it is important that a provider understands you as a person, not just as a patient.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

My favorite quote is from Teddy Roosevelt:

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

It is deeply relevant to me because being an entrepreneur is a lonely endeavor. You are putting yourself out there, alone, risking it all for an idea — “daring greatly,” as Roosevelt says.

Are you working on any exciting new projects now? How do you think that will help people?

I am excited about the work that Wider Circle is doing in Michigan, serving the largest Muslim community west of the Middle East, as well as other minority groups in the region. Together with our partner we are endeavoring to address one of healthcare’s thorniest problems, which is inequality in access to health resources. Minority communities have traditionally had less access to health resources, and the problem has been so difficult because of how culture and education affect health utilization. We are learning how to approach things like colorectal or breast cancer screening in different cultural contexts. I think it will help people because many of them will get lifesaving screenings and treatments through this endeavor.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

Influence: The Psychology of Persuasion by Robert Cialdini, is a profoundly important work about what moves people to change their behavior, which is at the core of Wider Circle’s business model. Made to Stick by Chip Heath and Dan Heath is a fascinating, provocative book about what makes something “sticky” — that is, unforgettable and impactful — which is also important to our work.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Heal the broader fissures in American society by providing forums for people from disparate (and often antagonistic) communities to learn about each other and see one another through a human lens.

How can our readers follow you online?

Readers can connect with me on LinkedIn. They can also learn more about Wider Circle by visiting and following us on Facebook, LinkedIn and Twitter.

Thank you so much for these insights! This was so inspiring!

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