For more than 25 years, Kristin Lewis has helped shape health care policy across New England. From helping implement Massachusetts’ landmark 2006 health reform law to leading public affairs and community initiatives at Point32Health today, she has spent her career focused on improving access to care and advancing healthier communities.

As executive vice president and chief public and community affairs officer at Point32Health, the nonprofit parent company of Harvard Pilgrim Health Care and Tufts Health Plan, and president of the Point32Health Foundation, Lewis believes improving health requires looking beyond the traditional health care system. While coverage remains the foundation for accessing care, health is also shaped by the economic, social, and community factors that influence people’s daily lives.

We spoke with Lewis about the role of health coverage, the challenges communities face today, and why building healthier communities requires creative solutions that extend far beyond the doctor’s office:

Q: Why is affordability such an important part of the conversation around community health?

KL: Affordability is one of the biggest challenges people and communities are facing today, but it’s about much more than the cost of health care alone. It’s the affordability of housing, food, transportation, and all the other everyday expenses that can place a strain on individuals and families.

Those pressures have a direct impact on health and well-being. Take housing, for example. If you don’t have stable, affordable housing, your health is going to suffer. The same is true when people are forced to make difficult choices because of financial strain. The challenge of affordability isn’t just about whether someone can afford to access health care, but whether they have the stability and resources needed to live a healthy life.

The solutions aren’t easy, but it’s critically important that we continue working to make health care more affordable while also recognizing that overall cost of living plays a significant role in people’s ability to stay healthy. If we don’t, it will become increasingly difficult for individuals, families, and communities to thrive.

Q: As president of the Point32Health Foundation, you work closely with nonprofits across New England. What have community organizations taught you about improving health and well-being?

KL: One of the things I’ve learned is that community organizations often have the deepest understanding of the challenges people face every day. Through my role with the Point32Health Foundation, I’ve had the opportunity to meet with many of our nonprofit partners, whether through site visits, convenings or by inviting grantees to speak with our Foundation board. Seeing their work firsthand has given me an even greater appreciation for the impact they have on the people and communities they serve.

These organizations are deeply connected to the communities they support, working every day to address challenges that affect health and well-being. That’s one of the reasons the Foundation embraces a trust-based philanthropy approach. We often provide multi-year funding to local nonprofit organizations with the flexibility to use those resources in ways that best advance their missions, rather than prescribing exactly how every dollar must be spent.

Because Point32Health is a nonprofit, it is a priority to support this work which we could not do without strong community partnerships focused on building healthier communities.

Q: What makes the health care system so difficult for many people to navigate?

KL: The health care system remains highly fragmented, with limited coordination across the continuum of care. As a result, it can be incredibly difficult for people to navigate.

Many individuals are focused simply on getting through the door and finding a provider, but they’re not always thinking about receiving the right care, in the right place, at the right time. As a health care sector — plans, providers, pharmaceutical industry — we still have work to do to help people better understand their options to access the level of care that best fits their needs and circumstances. With routine care, for example, a community hospital closer to home may be able to provide the care someone needs without the added time and expense of traveling to a major medical center further away. When people have the information and support to make informed decisions, it can reduce confusion, improve access, and lower costs by connecting them with the most appropriate setting for their care.

Of course, that’s often easier said than done because the health care system itself is incredibly complex. Health care is frequently described as difficult to understand and even more challenging to navigate. Patients are expected to coordinate among coverage options, providers, facilities, and services that do not always work seamlessly together.

I have spent most of my career in health care, and even I find the system frustrating and confusing. If those of us who work in the industry struggle to navigate it at times, it’s easy to understand why so many patients do as well.

We need to create a more coordinated, connected experience that removes unnecessary complexity and makes it easier for people to get the care they need. But no single organization can do that alone. Meaningful progress will require collaboration across health plans, providers, employers, policymakers, and others throughout the health care system.

Q: Where do you see the biggest gaps between how the health care system is designed and how people actually experience it?

KL: From a delivery perspective, I think one of the biggest gaps is that we still don’t focus enough on whole-person care. We’ve learned so much about the connection between physical and mental health, yet too often those needs are addressed separately rather than as part of a person’s overall well-being.

Part of that challenge comes back to fragmentation. People don’t experience their health in silos. They’re not thinking about one issue at a time or separating their physical health from their mental health. They’re managing all of those things simultaneously, often while balancing work, family responsibilities, financial pressures, and other demands in their daily lives.

There is an opportunity to create a more coordinated experience that reflects those realities, and it’s one Point32Health is committed to advancing. When we better understand the full picture of what a person is experiencing, we can do a better job connecting them with the care, support, and resources they need.

Q: What does supporting health beyond the doctor’s office look like in practice?

KL: If we truly believe that health is influenced by more than clinical care alone, then we also must think differently about how we support our members. 

One example that comes to mind is our behavioral health service navigation program. Access to behavioral health care is more than whether a provider exists within a network. People also need help identifying the right provider for their unique needs and circumstances.

We all know someone or we may be experiencing behavioral health challenges, and finding a therapist or psychologist can be overwhelming, particularly when someone is already struggling. Our navigation program helps connect members with providers who are available and, just as importantly, who may be the right fit for them. To me, that’s a powerful example of supporting health beyond simply administering benefits.

More broadly, it’s a reminder that helping people stay healthy isn’t always about delivering more care. Sometimes it’s about making care easier to find, access, and navigate.

Q: Many of the factors we’ve discussed — from access to care to coverage and affordability — are influenced by public policy. How do those decisions ultimately affect people’s health and well-being?

KL: Public policy shapes far more of the health care experience than many people realize. It influences who has access to coverage, what services are available, how care is delivered, and ultimately whether people can get the care they need when they need it.

Throughout my career, I’ve seen how policy decisions can have a direct impact on people’s lives. We often discuss policy at a high level, but at the end of the day, these decisions affect whether someone is able to keep their health coverage, manage a chronic condition, access preventive care, or receive treatment before a health issue becomes more serious.

As a nonprofit, Point32Health evaluates policy through the lens of affordability, access, and quality. We ask how a policy will affect our ability to provide affordable coverage and support healthier communities. Ultimately, the goal is not simply to advance a particular policy position, but to help ensure people have access to the coverage and care they need to live healthier lives.

Q: What gives you hope when you think about the future of health and well-being in our communities?

KL: With every crisis comes an opportunity. And when I look at where we are in health care today, it’s clear that we can’t continue doing things that add costs, make it more difficult for people to access coverage, or create additional barriers to care.

I am proud to work alongside colleagues, and be part of an organization, who are confronting this challenge head-on and translating our commitment to affordability into meaningful action. We are making measurable progress, including achieving the lowest approved premium rate increases in the region, reflecting our focus and commitment on delivering value while helping members and customers access the high-quality care they need. While we are encouraged by this progress, we know there is still significant work ahead. 

What gives me hope is the potential for innovation to improve how people experience health care. Advances in technology, medicine, and treatment are creating opportunities for care to become more tailored to people’s individual needs and ultimately help them live healthier lives.

At the same time, we have to make sure those advances remain affordable and accessible. That’s the challenge in front of us, but it’s also an opportunity. If we can find ways to improve how people access care, stay covered, and navigate the health care system while also making it more efficient, we have an opportunity to build healthier communities and a stronger future for everyone.

Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, is a leading nonprofit health and well-being organization dedicated to delivering high-quality, affordable health care. Serving nearly 2 million members, our purpose is to guide and empower healthier lives.