Marko Mijic: The Future of Health Ep. 11: Health Beyond The Hospital

A stroke gets treated in a hospital, but recovery can fall apart at home because of mold, missed meals, or the fear of eviction. That’s the gap we dig into with Marko Mijic, Vice President for Community Health at Kaiser Permanente, whose path to national health leadership starts in HOSA Future Health Professionals and a mentor who taught a surprisingly powerful lesson: how you show up matters.

We trace Marko’s journey from thinking he would go to medical school to finding his calling in health policy, including work at the US Department of Health and Human Services and the California Health and Human Services Agency. Along the way, he shares what it means to be a first-generation American who immigrated as a refugee, and how mentors helped him navigate the doors he didn’t even know existed. The conversation gets practical fast as we break down social determinants of health and why clinical care can be only a fraction of what drives outcomes. If we want better community health, better health equity, and lower costs, we have to connect healthcare, public health, and social services.

We also look forward: expanding access to coverage and access to care, tackling affordability, addressing the healthcare workforce crisis, integrating behavioral health, and preparing for an aging population. Marko closes with advice for students who want to shape the system beyond the bedside: bring your lived experience, stay curious, innovate, and give back through mentorship. Subscribe, share this with a future health professional, and leave a review, then tell us what community change would improve health the fastest where you live.

Marko's Linkedin: https://www.linkedin.com/in/markomijic01/

HOSA Podcast Page: https://hosa.org/podcast/

Transcript

SPEAKER_00 0:04

Okay, welcome to the HOSA podcast on Idea Gen TV. Today I'm honored, privileged, thrilled to have with us Marco Midgick, Vice President for Community Health at Kaiser Permanente. Marco, welcome.

SPEAKER_02 0:20

Thanks, George, for having me. I'm really grateful to be on the show today.

SPEAKER_00 0:26

Marco, you actually started you started your leadership journey in HOSA, Health Occupation, Students of America, as a high school student, HOSA Future Health Professionals. That's what it's called now, right? And as a high school student in Utah, looking back, how would you say, how would you frame those early experiences that helped shape your interest in health policy and the work you're doing today at Kaiser Permanente?

SPEAKER_02 1:00

Well, George, I mean, I think that as I kind of reflect on my journey, I thought going out of high school and going into college that I was going to go to medical school. And I realized quickly after organic chemistry that there was no way that I was going to do that because it was just not my forte. And I quickly drew, got drawn to the policy space. But my my the foundation, the bedrock around why health and why healthcare, I think it was really stemmed from HOSA. And I joined HOSA at Northridge High School in Leighton, Utah. And my HOSA advisor, Mrs. Davidson, Mrs. Kristen Davidson, really was the um the foundation to I think my leadership style and I think my trajectory in the health care and health policy space. And I think to put it a little bit more bluntly, you know, her, I had her for medical anatomy and physiology. And, you know, the first day you you're ready with your textbooks, you think you're going to be learning medical terminology. And the first thing she asked us each to do is to actually walk out of her room and walk back into her room, properly shaking her hand and introducing ourselves to her. And I think that moment uh really has stayed with me for quite a bit of time. It wasn't anything related to medical anatomy and physiology. It was more about your presence, it was more about how you showed up in certain settings and the ways in which you handled yourself. And I think that was the foundation for me when it came to this work. Um, and also was, I think, the the impetus for why I felt HOSA was the right place for me uh to learn and grow as both a leader and an individual.

Mentors And A Refugee’s Path

SPEAKER_00 3:15

You know, uh you bring up Ms. Kristen Davidson, what a what an incredible leader, uh truly, uh, in every sense. And that example, um it's amazing how it you know sticks with you, right? Where you remember that moment. I mean, there she probably and so many other teachers probably said and did so much, and it's fascinating to think that that struck you. So, what she did was instilled that leadership component. She told everyone, walk out of the room, come back, and shake my hand properly, right? That's leadership, that was a leadership lesson, and it sounds simple, uh, but some of the most profound lessons are simple, I believe. And so, mentors, Marco, you've spoken about the influence of mentors and the influence and the impact they have had early on in your career, Kristen Davidson being one. What role, perhaps in addition to what you just highlighted, did mentorship play in helping you navigate your path from HOSA student to national health policy leader today?

SPEAKER_02 4:36

Well, I mean, I think to me, I I I'm a big believer in mentorship, and I um I don't think I would be where I am today if it was not for mentors like Mrs. Davidson. And um, you know, I'm a first-generation uh American. I immigrated here as a refugee. Um, I'm first to go to college in my family. Um, I didn't realize kind of the thing, you know, I didn't have a family that was wealthy or connected. I um didn't know what I didn't know. And so it was people like Mrs. Davidson who really opened those doors for me. So that analogy with regards to you know, walking out of her door and walking back in and opening that door, I do think that she played a pretty significant role in terms of um, you know, creating a core in me and a belief in me, and seeing something in me that perhaps I didn't see in myself or didn't have people around me to show me, um, and really uh drove that in a really powerful way. Uh, and so I think she's one of many different individuals. You know, we're recording this in March, and it's Women's History Month. And I do think like women have played a pretty profound role in being my mentors, and Mrs. Davidson won. Uh, Mrs. Kenniger is another, you know, the very first five-star restaurant that I went to was with Mrs. Uh Kenniger. And I remember thinking, like, what do you use all these utensils for? And and I think it was um, it was it was teaching me very simple things that I think have played a very important role. And for someone like myself, a kid who's whose parents didn't have the means or the resources, even how you dress and how you show up, that all mattered. And to me, in the moment in time, was like, this is silly, but I think it set the foundation in a pretty meaningful way. And so I think to answer your question more bluntly, I think I wouldn't be here if it wasn't for those women and if it wasn't for those mentors.

From Government Policy To Kaiser

SPEAKER_00 7:02

You know, Marco, that's uh extraordinary perspective. Uh, it really is. As you think about those that have helped impact and shape your career and your leadership skills all combined to take you where you are today, is is truly inspiring. And so you've worked, Marco, at the federal level, at the U.S. Department of Health and Human Services, and later as undersecretary at the California Health and Human Services Agency. Marco, how did those policy experiences shape the way you think about improving health outcomes across communities today in your role at Kaiser?

SPEAKER_02 7:44

Well, look, I think my journey in this space, you know, spans, as you alluded to, both the federal and state landscape. And now I have the privilege of being in an integrated care and coverage system and and looking at this as someone who's really focused on trying to figure out how do we enable the conditions in the community for people to be healthy. I think fundamentally there are I think a few different things that um that have led me in into this work. One, as I alluded to earlier, I am an immigrant, a refugee, and this country has given so much to me. And being part of government and focusing on policy was a way for me to give back to a country that has given so much to me. And so uh I felt it was kind of on my duty and my obligation to really um deliver and be part of a government that was for the people, by the people. I think that was kind of the first piece. The second piece really was that when you when you think about healthcare, when you think about medicine, um, we can have the best uh healthcare delivery system, we can have the best doctors in the world, and that is important. And what we find most often is that uh 20% of an individual's actual health outcomes, right, whether or not they end up being healthy is related to the actual care or the medicine that they take. The remaining 80% has nothing to do with the four walls of a clinic or a hospital. The 80% has everything to do about the neighborhood that you live in, the type of housing you have access to, the type of food you have on your table. And so for me, I think a big lever of being in government and now being at Kaiser Permanente is about trying to figure out how do we enable those social drivers of health, right? Access to food, access to housing, access to transportation in a meaningful way in order for us to leverage the world-class healthcare that we have in this country so that we can create communities that are healthy and thriving. And so, to me, really this work has been all about trying to figure out how do we lift up the most marginalized or those that have been forgotten. And when they are healthy, when they do well, we collectively do well. And so the health and well-being of communities has been really uh at the heart of my journey, my career journey at the state, federal, and now uh nonprofit uh private sector level, to be able to really kind of think about how do we connect the dots between healthcare, public health, and uh social services in a much more intentional way to serve the whole person.

Social Drivers In Real Life

SPEAKER_00 11:07

You know, Marco, that's such incredible perspective. And you know, you have your current role at Kaiser Permanente, and in this role, you're leading these national initiatives, addressing the social determinants of health. For those students specifically listening, for the students out there, the hundreds of thousands of millions of students, host of future health professionals. What does that really mean in practice? And why is it so critical to improving health outcomes?

SPEAKER_02 11:41

Well, I will just say I get to work with some of the most brilliant people and the brilliant minds at Kaiser Permanente and in our markets across the country every single day. And I'm learning every day. Um, you know, what it means practically, it means that we may have an individual who shows up in a clinic or in the hospital who may present with an acute care need. They may have a stroke or they may have a heart attack, and we do a very good job of stabilizing that individual and setting them up to success. But if that individual um gets discharged and gets discharged to, for example, uh a home or an apartment that has mold or they are food insecure and you know they are not really having food on the table, um, that is going to have a direct impact on the care that we provide it to them. And so our work really in community is about trying to build up the community in a way that says, if you are food insecure, how do we in a humane way connect you to the resources in the community to make sure that you have access to healthy foods, fresh fruits and vegetables? If you're an older adult and you're cycling in and out of the hospital because you perhaps are on the brink of homelessness because you can't afford to pay your rent, what are we doing to support you to make sure that the stress of housing is eliminated and that we actually connect you with a community-based organization who can find ways to uh uh to house you appropriately uh with the necessary services and supports. And so, to me, what this work really is about is finding ways in which we truly build community across the ecosystem in the places that we as Kaiser Permanente uh serve. But it's also about trying to figure out how we deliver on this notion of value-based care. And to me, a fundamental principle of the beauty of Kaiser Permanente and this notion of value-based care is what happens outside the four walls of our clinic and hospital. And it is our team's role and responsibility to try to figure out how do we lift up the non-for-profit organizations that are doing this work, how we connect the dots between public health and healthcare. How do we ensure that we are creating those conditions for people who may get world-class care in one of our clinics or hospitals, have the ability to go into a community that equally supports them, just like we did within the four walls of our institutions.

SPEAKER_00 14:50

Marco, you know, what incredible insights and candidly invaluable uh from my perspective and vantage point in Washington to be helping uh those future health professionals that are part of this pipeline that is HOSA, the only only pipeline pre-post-secondary that's all healthcare on the planet, um, to hear from you and those perspectives is truly um extraordinary. What, Marco, are some of the most promising approaches you're seeing currently? And what are you seeing coming around the corner in terms of expanding access to care and improving community health across the nation?

Workforce Behavioral Health And Aging

SPEAKER_02 15:41

Well, George, I I think that as I reflect on you know the almost two decades of work that I've um that I've had the privilege of being part of, uh, both at the federal state level and out at Kaiser, I think that um access to care continues to be a challenge for millions of Americans. And so really continuing to think about how do we enable people to have access to coverage. So, how do we ensure that someone has uh health insurance? And then, you know, having health insurance is just one step. Then we say, how do we ensure that people have access to care? Uh and to me, I think um we have a lot more work to do in both of those uh from a national perspective. Uh, affordability continues to be a really significant challenge for people. Uh, we know that millions of Americans can't afford their uh co-pays or deductibles, and many are choosing um between putting food on the table or paying for a prescription. And so I think that as we continue to think about um our collective work, we're gonna need to think about it across multiple dimensions. I will also say that, you know, uh this is gonna require all of us rolling up our sleeves and thinking very creatively about how we ultimately meet this moment. So this cannot just be on government to solve alone. I think we have to really think about how does government show up, how does philanthropy show up, how does the private sector show up? Uh, and we all have a duty and obligation to really think about how we create this environment to really improve access to coverage, access to care, and really drive down costs. I think as I think about the future, I think there are a few things that I think I'm spending time really thinking about that I think are going to be an important part of this conversation. One, I think we have a profound workforce crisis. Uh, I think COVID-19 certainly exacerbated this crisis. And um we are we have seen for years shortages of physicians and nurses and other high allied health professionals. And I think um the reality is we're gonna have to get very creative in thinking about new models of care uh that enable us to think differently about how we ultimately uh leverage the people that we have in order to expand access to care and drive down costs. So I think that's one. I think the workforce bucket is going to be an important piece. The second piece is that we really have got to figure out how we further integrate behavioral health within healthcare and how we think about social health as part of that three-legged stool. It's not good enough, to my point earlier, to just focus in on the social or the healthcare pieces because we know that 20% of someone's outcomes are related to healthcare. It's also about what happens outside the clinic, how do you uh manage your anxiety or your depression? So I think thinking about how we blend these three together and really think innovatively about what we do there. And then third, we have an unbelievably important moment where we have an aging population. And um, aging is an important part of our journey, life journey, and we are gonna be dealing with a with a profound issue on older adults needing care. That is our parents, our grandparents, um, our neighbors and and loved ones. And I don't think we're ready collectively as a system of how we need this moment to support older adults in a meaningful way. And so I think we're gonna need to think about what kind of models, community-based models, and how we finance those models is gonna be important because uh we have a whole generation of folks that are in my uh in my generation, where which I call the sandwich generation, and that's people who have older parents that they're dealing with and younger children. So I'm dealing with elder care and daycare at the same time, and this is going to proliferate even more, and that has implications on our economy, uh on the communities that we're in. So to me, access affordability, George, are gonna be important things that we collectively are gonna need to grapple with. I think government can't solve this problem on its own. It's an important player, but we all have to roll up our sleeves. And then as I think to the future, workforce, behavioral health, social health, healthcare, and then how we think about older adults in this ecosystem is gonna be uh an important um aspect of the work that we collectively need to be doing in the coming years and months.

SPEAKER_00 21:15

You know, Marco, that's again, um thank you. Thank you for all you're sharing here because it's truly invaluable for all of the host of future health professionals and many whose members, many, if not all, aspire to careers in health healthcare. But oftentimes they don't or may not realize the impact they can have in policy or community health, which is what you just described. What advice I know you have so much, but what key piece of advice uh will you give students who want to shape the healthcare systems beyond just the clinical settings?

Advice For Students And Real Hope

SPEAKER_02 22:00

I would encourage every HOSA member, and I would encourage every individual who's in the healthcare space to leverage their lived experience. The things that we uh have on our shoulders show up in the rooms that we're in, and to really think about how we uh innovate and think differently. I would encourage every HOSA member to really be curious and leverage that experience with a sense of curiosity. And I would encourage every HOSA member to really think outside the box to meet this moment. No idea is going to be a crazy idea. We really have to push the boundaries of innovation for us to be able to think differently about how we deliver care and how we show up in community. And so, to me, I think leverage this time that you have with HOSA to build the connections, to understand and be curious about the things that you are working on competing and learning about. And then once you get into the professional setting, find avenues where you're not just focused on the things that are right in front of you, uh, dealing with the things that you have to do, but that you're on occasion uh looking up and thinking about the ecosystem as a whole. How does my work connect to the public policies around healthcare and social services that are going to be that are being implemented? How should I be thinking about my parents' needs outside of the four walls of a clinic or hospital? What can I do to advocate for the next generation of leaders? Um, and then the last thing I will just say is that uh give back, be a mentor to somebody else uh who is uh doing this work because I think part of this is us stepping up in this moment in time and also showing up. And so if that means um showing up and being part of a HOSA alumni chapter or being part of a HOSA alumni effort, I think that that is a big opportunity for us to reinvest in an organization that has invested in us and thinking about really how we further the conversation around some of these big systemic issues that we've been dealing with for a really long time.

SPEAKER_00 24:34

And so as we uh close out this interview, uh I'd like to close with this question, which is Marco, when you think about the next decade of healthcare, specifically in the United States, what gives you the most hope? And where do you see where are those outliers of opportunity for the next generation of leaders to come in and make an impact?

SPEAKER_02 25:08

I I have hope is an interesting thing, and I've been trying to read up and and study hope a little bit. In fact, there's a whole body of science around, you know, and research around hope. And I, despite the world that we're in, and despite everything that is happening, I do have quite a bit of hope in this moment in time. Uh, you know, Mrs. Davidson uh uh taught me an important lesson, and that lesson, uh she taught me many lessons, but one lesson really was that HOSA was about uh not only about advisors and an organization, but about youth and young people leading a movement. And so what gives me hope is the fact that HOSA continues to grow. What gives me hope is the diversity and the strength and the depth of the people that are showing up and are being part of HOSA. Uh, and what gives me hope is that look, we are resilient people, and um I think that resilience will continue to drive us. And so I think having conversations, connecting with people that might be of a different background, that might look different than you, that might be studying a different field, I think that is what really has created is the magic sauce behind HOSA. And so I am most hopeful because I know organizations like HOSA, who I've had the pleasure to benefit from, uh, are stepping into a moment in time where I think there might be uncertainty, there might be chaos, there might be a division, but I think that um we really have an opportunity through organizations like HOSA to lift up people and create a sense of hope amongst ourselves. And so I actually am very excited about what the next decade holds for us. And I am quite hopeful about what the future is because of the you know 400,000 individuals that are part of HOSA and growing. Um, because I think this movement is not but led by an advisor or an organization, it is led by students all across the country and chapters all across the country who want to make a profound difference in the world. And um, this is our moment, this is their moment to make that difference in the world.

SPEAKER_00 27:34

Marco Midgick, Vice President, Community Health Kaiser Permanente. Thank you so very much for this incredible interview. Thank you for the insights, and thank you for your leadership, Marco. It's been a sincere pleasure and incredibly inspiring. Thanks, George. Thanks for having me. Appreciate it. Go, Josa.