Managing the Shift to Healthcare at Home

In this Q&A, Kaiser Permanente Executive Angel Vargas MBA ’12 reflects on how his Baylor MBA prepared him to lead in the rapidly transforming home health industry. 

The COVID-19 pandemic accelerated the growth of home health services, making the possibility of receiving care in the comfort of home more feasible and appealing than ever. At the same time, it created a vast array of operational and staffing challenges. 

Below, we sat down with Angel Vargas, vice president of Care at Home at Kaiser Permanente, Southern California & Hawaii, to hear his thoughts on the future of home health and the role his Baylor education has played in his journey to leadership.  

What are the key drivers that are fueling the growth of home health care in the U.S.? 

Put simply, the healthcare sector cannot afford to build hospitals any longer and most patients prefer to avoid hospitalization. When given the choice, most patients would choose to be treated in the comfort and dignity of their own home. They want to sleep in their own bed, watch their own TV and stay near their family. Hospitals will always exist for emergencies, complex cases and procedures, but the cost of building hospitals that can service every need has become prohibitive. Home health is ideal for low- to medium-acuity patients. Twenty to thirty years down the road, I anticipate technology so advanced that you can prick your finger or use the bathroom at home and have the results of a blood or urine test sent to a doctor. There will not be much that cannot happen at home. That is not in the immediate future, but we have to declare the future in order to make it a reality.

Can you walk us through your career journey to this point?

I gained a broad range of experience in my teens and twenties. I ran a small computer service business, sold phones for Verizon, sold perfume and cologne and worked as a dispatcher at a truckloading company. In 2003, I was the single father of a young daughter and I needed a new direction. That was when I started my career in healthcare as a Medicare billing clerk. For three years, I learned billing and compliance and managed accounts. I worked my way up to become a state-licensed administrator before joining the United States Air Force in 2007. For the next decade, I served as an active-duty Air Force Medical Service healthcare administrator in the ambulatory arena. My role involved a blend of logistics, IT, human resources, group practice management and data analytics. In 2018, I left the military to join Kaiser Permanente’s Home Care Services. Since then, I have led the strategic and operational delivery of home health, hospice and home palliative care across the Southern California and Hawaii markets for my company. I never expected to build a career in healthcare, but it turned out to become a large part of who I am. 

Can you explain the relationship between home health and telehealth?

These two areas often overlap but are very different. Home health is a post-acute, at-home service, regulated by the Centers for Medicaid & Medicare Services, that provides skilled nursing, therapy and other discipline interventions in the home for an “episodic” period of time.  It is primarily an in-person service that aims to provide direct relief to hospital bed days. On the other hand, telehealth serves ambulatory and home health by providing virtual encounters to patients via video or telephone chat. It is not episodic and is more of an alternative to an in-person ambulatory visit (services performed on outpatient basis without hospital admission). Telehealth is great for symptom management, escalations and education, while home health is required for a wound dressing change or physical ambulation of a patient. 

What are the greatest challenges you face in your role as a Vice President for KP Care at Home?

When I first joined KP Care at Home, our organizational structure was highly decentralized. My team spent the first several years reorganizing our model into a unified service line that is different from a hospital-based home health model. It was a game changer for the organization to have standardized policies and procedures, especially during COVID-19. 

The main pain points I confront today fall into the standard three buckets: people, process and systems. On the people side, it is a constant challenge to recruit and retain clinical staff. This is the same across the U.S. The U.S. needs more work visas for foreign nurses, as well as more targeted expanded nursing schools to help us end the nursing shortage once and for all. When it comes to process, we are always adapting to new rules and regulations surrounding home health. 

In terms of systems, we are looking for technology that can make a difference in the way we serve our patients. AI has so much potential, but for now, it is somewhat overhyped. I have personally been hearing about AI for the past five years and have seen multiple demos. Many AI firms have done a lot of good by providing assisted automation and algorithm-based tools, but I have yet to see a program that can live up to the hype by scanning an electronic medical record, identifying markers that a patient will soon have a heart attack, or predicting cancer risk based on patient data. In the immediate future, it would be more feasible to see a computer-based AI assistant who can direct patient calls to the right place with empathy and efficiency. 

How did your Baylor MBA experience help set you up for future success?

My Baylor experience equipped me to connect the dots between what I was learning and what I was doing in the real world. My professors brought real industry experience to the table, which made the courses they taught incredibly dynamic. My course in healthcare systems,  taught by Forest Kim, PhD, was the single most useful class in my program because it helped me navigate the complexity of payment cycles and structures. To this day, I pull out that textbook and use it. From an analytics standpoint, I am still using conceptual models I was taught in a statistics and quantitative methods course. Overall, I became a stronger, more confident leader through my experience at Baylor. To lead well, you need not just the will but also the skill. I came to Baylor with the will, but Baylor fortified my skills and boosted my confidence. 

What’s Next

 Are you ready to lead in an evolving healthcare landscape? Learn more our healthcare administration options:

Click here: Robbins MBA Healthcare Program for full-time, early career healthcare administration.

Click here: Executive MBA in Healthcare Administration for working professionals.

Click here to fill out a form to speak to one of our Enrollment Coordinators.