Healthcare and Columbia: A Family Affair

Without the knowledge he gained at Columbia University, Carlos A. Cuevas `CC05 `12IA `12PH said he would not have had the professional tools and insights to help improve health care for millions of poverty-stricken New York State residents or the knowledge to advise the state of New York about its response to COVID-19. In gratitude for the expertise he gained while at Columbia, Carlos has planned a future gift to the University and is serving as the chair of the Mailman School of Public Health’s 1754 Society Participation Drive—part of a University-wide campaign to encourage volunteers and donors to include Columbia in their estate plans.

 

“The generosity of the Columbia community changed the course of my entire family’s life,” says Carlos, whose grandparents (paternal and maternal) attended Columbia. “It is so rewarding to be able to use what I learned at Columbia to improve the health care of underserved populations—including members of my own extended family. Columbia has done much for me. In return, I want to do much for Columbia and for the next generation of Columbians, so that their impact can go even further.”

 

Carlos says it took him just 20 minutes to make his gift, a beneficiary designation of retirement funds, and join the 1754 Society, which recognizes those who make estate and other planned gifts to Columbia.

 

“You may think you have to change your will or go through an expensive and time-consuming process involving accountants or attorneys, but the process was much easier than I expected,” Carlos says. “I just designated a portion of one of my retirement accounts, and I became a member of the 1754 Society. Everything was done online and was seamless.  For many of us, we can’t possibly give as much now as we will be able to in the future through our estates. As I watch my nest egg grow, I know that a part of it will be helping Columbia. Meanwhile, I get to meet and share experiences with donors, like me, whose gifts help ensure the future of our Columbia community.”

 

From hedge fund analyst to public health expert

Carlos’s degrees from Columbia include a bachelor’s degree in economics from Columbia College (2005), an MPA (master in public administration) in economic analysis from the School of International and Public Affairs (SIPA), and an MPH (master in public health) in health care management from the Mailman School of Public Health (2012). Soon after his undergraduate experience, he assumed career success would be measured by amassing a large amount of money, and he worked for three years as an analyst at a hedge fund in New York City. Shortly after, the Great Recession of 2008 hit the U.S.

 

“Many of my family members lost their jobs and had trouble accessing health care,” Carlos recalls. “While helping them get health care, I realized that few people understand how financing determines the kind of health services you can access. In New York, half of all births and half of all children receive health coverage through Medicaid. I decided I wanted to become the Medicaid expert of my generation.”

 

Carlos went back to school to earn his two master’s degrees and his timing was perfect. The Affordable Care Act was passed while he was in school in 2010, and in 2011 New York began restructuring its Medicaid program. Shortly after graduating in 2012, Carlos went to work for the New York State Medicaid Office and within a year was promoted to senior policy advisor to the Medicaid director.

 

Carlos is passionate about transforming health care from a fee-based structure to a value-based structure—meaning that doctors and medical facilities are compensated not based on how many services they provide, but rather, on how healthy they keep their patients. Carlos currently works for SOMOS, a network of over 2,500 diverse, community-based providers that deliver culturally-competent health care to predominately low-income and minority communities in New York City. SOMOS’ patient population comprises over 20% of the New York City Medicaid population; a population that faces significant challenges accessing and maintaining care, including language barriers and social determinants of health. At SOMOS, Carlos is responsible for helping community-based providers transition and thrive in an era of new payment models by negotiating and implementing value-based payment contracts where physician reimbursements are tied to outcomes rather than volume.

“The emphasis is on keeping a patient healthier through primary and preventative care,” Carlos explains. “If the person stays healthy, there is a greater probability of preventing expensive adverse health care events.  If physicians are able to maintain quality outcomes, while reducing overall costs, they share a percentage of overall savings generated from reducing utilization of more costly, unnecessary services.

 

Because of his expertise, Carlos was asked in May 2020 to join the New York State Department of Health’s COVID Response Team. He had personal as well as professional reasons for joining.

“I lost my grandmother to COVID-19 in early April 2020 and had several close family and friends get very sick from the virus,” Carlos said. “I saw first-hand the devastation COVID causes. I’m not a clinician, but as a public health professional I wanted to do whatever I could to help.”

He volunteered with the team for four months, helping to establish best practices for COVID testing and working on the state’s “surge and flex” strategy, in which facilities rapidly expand their capacity to care for more patients in a safe manner.

His understanding of the health care system, along with his wife’s medical training—Diana Mosquera is an anesthesiologist—saved the life of his father-in-law. Diana’s dad, living at the epicenter of the pandemic in Queens, New York, is a building maintenance worker who came down with a severe case of COVID-19. When he was about to be hospitalized at an overwhelmed hospital and would likely need a ventilator, Carlos and Diana whisked him away from New York City to their house in Philadelphia—driving with their car windows down and dressed in PPE to avoid infection. Diana’s father spent two weeks isolated in a spare bedroom that had its own bathroom and thankfully recovered.

 

“My wife is an immigrant from Colombia who grew up in a family of four living in a one-bedroom apartment in NYC,” Carlos says. “We were very lucky to now have the space, knowledge and other resources necessary to care for her dad. If COVID had happened a few years earlier, Diana and I would’ve not had the skills and resources to help her family. While the situation could’ve been a lot worse for our family, there are many families facing similar or worse challenges with far fewer resources. Therefore, Diana and I are grateful for our education and other opportunities that have allowed us to overcome some of life’s obstacles. My family’s story has shaped my professional story and, while it may have proven challenging at times, drives my passion to help people overcome obstacles that hinder their access to high quality health care.”

 

A family background that inexorably led Carlos to Columbia

Carlos’s grandfather on his mother’s side grew up destitute in Puerto Rico and came to New York City for a better life. He dreamed of becoming a chemist, but had a thick Spanish accent and no money. He worked as a cab driver and an elevator operator until he got a job as a pharmacy assistant. The two owners of the pharmacy quickly recognized his talent and offered to pay his way through Columbia’s School of Pharmacy. He graduated in 1933 and became a registered pharmacist and a leader in his community.

Meanwhile, Carlos’s paternal grandmother, was born in Spanish Harlem to immigrant parents and received scholarship assistance to attend Columbia’s School of Social Work.

“Columbia forever changed my family’s trajectory,” says Carlos.

 

Carlos has found multiple avenues to stay connected to his school: He has participated in and led several alumni groups and has also served on many volunteer committees. He was awarded the Columbia Alumni Association Richard E. Witten ’75CC Award for Volunteer Leadership in 2015. He is now involved in the drive to increase membership in the 1754 Society.

“You may not be able to give a large sum in any given year; but if you develop a plan, you can build resources and give more than you thought was possible through an estate gift,” Carlos says. “When you do that, there is this amazing society that you can join and enjoy its membership benefits right away. It’s good for the school and good for the donor.”