Jeff Ross is a healthcare executive with deep experience leading growth, strategy, and value-based care across the Medicaid and Medicare sectors. He currently serves as Senior Vice President of Growth at Homeward. Ross has previously held leadership roles at agilon health, Healthfirst, Clover Health, and the Urban Health Institute. He holds an MBA from The Wharton School, a JD from Emory University School of Law, and a BA from the University of Virginia.

Homeward Health provides tech-enabled, human-centered healthcare for rural Americans, partnering with payers and providers to deliver care through a hybrid model of in-home visits, virtual appointments, and community health workers to manage chronic conditions, handle post-hospital transitions, and address social determinants of health (SDOH).

The Pulse: Could you briefly walk us through your career path and what led you to Homeward Health?

Jeff Ross: After Wharton, I started out in finance before identifying healthcare as an opaque, high-opportunity space during the rollout of Obamacare. I entered healthcare at Cooper Hospital in South Jersey, working at the Urban Health Institute, which was closely connected to the Camden Coalition and known for its forward-thinking approach to care delivery and cost containment for complex Medicaid, Medicare, and dual-eligible populations. That experience gave me my first real exposure to population health and the challenge of bending the cost curve for vulnerable patients.

I then joined early-stage startups, including Clover Health as employee #10, which was a wild ride. After that, I moved into a more structured environment, holding senior leadership roles at Healthfirst, where I ran Medicaid for New York City’s largest Medicaid plan. While it was an incredible learning experience, I ultimately wanted to return to faster-moving environments.

Ultimately, I decided to make the move to Homeward because the problem felt compelling. At Healthfirst, I had been focused on urban challenges. When you start to look at rural populations, they seem very different on the surface, but the underlying issues are the same—they just show up differently. Access to care, fewer resources, and limited ability to address needs all lead to worse outcomes. I didn’t fully appreciate how severe those gaps were until then. It felt like the right blend of opportunity and my skill set, so I made the jump, and it’s been a great ride.

The Pulse: Homeward Health provides tech-enabled, human-centered care for rural Americans through an extremely robust hybrid model. At a high level, like, what is one thing that people working in healthcare get wrong about serving rural areas?

JR: The perception that rural healthcare has an inability to scale. It’s the reason why most organizations focus on urban populations. What Homeward has learned is that technology alone isn’t enough. AI has to be combined with boots-on-the-ground, local resources that understand community nuances and can help overcome reluctance toward new technology. But once you do, the use of technology can really direct care to those who need it most.

Those boots-on-the-ground are community health workers who are Homeward employees. Whether they’re working in the home or telephonically, they really serve as the interface that makes care more palatable and understandable for members. A lot of the time, when we talk in healthcare or insurance language, it can get really confusing. I’ve been in the industry for years, and even I still look at my benefit card and think, “What do I get? Where do I have access?” It takes real effort to figure out what you can do, what you can’t do, and how things work.

For someone who isn’t used to navigating that system, especially in rural areas, where people until fairly recently haven’t had much exposure to Medicare Advantage or managed Medicaid—understanding what resources are available and what’s even possible is very new. That’s really what we’re doing: we’re bridging that gap.

The Pulse: As a technology-enabled company, how are you using AI to create more value for patients or streamline internal operations?

JR: Our team likes to say, “If you give me any kind of repetitive activity, we can do it better with AI.” And, then AI can learn as it goes.

We use a lot of claims data, a lot of third-party external data, and HIE data to really understand the member. In our rural populations, our dataset now includes over 100,000 lives, so we’re really honing in on the real rural signals – their likes, dislikes, and how to engage them.

Engagement is usually the key with patients. So then it’s questions like: “Is the most effective way to reach them direct mail? Is it a text message? Is it an email campaign? Is it Facebook messaging?” We try multiple channels, and then our AI models learn what the most effective channel is for this type of person, at this time, with this clinical event.

With respect to clinical extension, AI is really about surfacing issues to clinicians. With our virtual care, sometimes navigators go into the home and then we’ll have nurse practitioners and MDs remoting in. The AI surfaces next-best actions, but the provider still has to guide it and act on it. We don’t want anyone to think the AI is doing everything on its own; it’s surfacing what probably should be happening, or what could be happening, with that member. That’s been very impactful.

Essentially, we are using AI more with our internal teams to accelerate services adoption and care, as opposed to deploying a tool directly for the member to use.

The Pulse: How does Homeward approach delivering a technology-forward care model in rural settings where broadband access and connectivity are often limited?

JR: This has always been a challenge we think about. If you go somewhere like rural Mississippi, you can be 20 miles outside the airport and have basically no internet at all, so we design everything assuming low bandwidth. Our navigators go into the home with tools that are set up for offline use. They download what they need ahead of time, work offline if they have to, and then sync back up later when there’s Wi-Fi or connectivity, sometimes using hotspots. When it comes to clinical visits, we stay really flexible, using video when it works, audio when it doesn’t. We pair our navigators with remote clinicians. The goal is always to use the lowest-cost, most practical way to meet the member where they are, instead of forcing some tech solution that doesn’t fit their reality.

The Pulse: Homeward takes on full risk in a value-based care model. What aspects of your approach make that particularly effective, especially for the populations you serve?

JR: Especially specific to rural, it’s really the geographic approach. We’re looking at the community the same way the community looks at itself. You’re supporting providers in that area, and when you take full risk, you’re really putting your money where your mouth is. You’re saying, “We’re all in—we’re really trying to drive change together.” When the community feels like an entity is truly behind them, you start to see these follow-on effects, like support from local organizations.

On top of that, AI is top of mind for everyone right now. Even if people are a little nervous about it, they don’t want to get left behind. They know that if they want to really uplift their communities and take advantage of what’s out there, they need to figure out how to make it work for their benefit. Otherwise, they risk being left behind entirely.

The Pulse: Given your background working in both urban and rural environments, do you think the same geographic-first approach could also be effective in rolling out value-based-care in urban environments?

JR: I don’t think it works. In urban environments, you have so many stakeholders and micro-stakeholders, all with competing interests. It’s very crowded. In rural communities, it’s not as crowded, so it’s easier to coalesce around a direction and agree on what’s going to happen. When I was at Healthfirst in the city, I probably spent 60–70% of my time on stakeholder management rather than actually optimizing performance, and that’s a very different dynamic.

The most fragmented piece in rural areas is usually individual primary care providers. In those cases, you may have some providers who are older who haven’t bought into value-based care. They just say, “I’m not changing. I don’t believe this is good care.” At the same time, you have newer generations of providers who look at the data and, we say, “If you really look at your panel, 30% of your patients have diabetes, and you can actually improve those outcomes.” Partnering with providers is probably the hardest part of rural from a stakeholder engagement perspective, but when you compare it to urban markets, it’s still much simpler.

Another difference is access to care. In urban markets, you can actually have too much access, which drives higher costs. People use urgent care or the emergency room when it really should be a primary care visit. In rural areas, you don’t see that as much because a provider might be 50 minutes away, so people aren’t overusing the system. Instead, you get different problems, like poor coding and poor risk adjustment, because patients haven’t seen a doctor in 20 years.

The Pulse: As we look towards 2030 and beyond, what structural barriers to rural access are still the biggest roadblocks?

JR: Reimbursement policy. Fee-for-service is still a big problem. If providers are instead paid based on how their patient panel actually performs, it aligns incentives around outcomes, which ultimately leads to better care delivery. For me, that would be the biggest shift.

The Pulse: Are there specific innovations that you’re excited to bring to the patients Homeward serves?

JR: I’m most excited about the pace of change in technology, both in diagnosing clinical issues and improving engagement. Engagement is where real impact happens. When you can meet people in the way they want to be engaged, rather than how others think they should be engaged, outcomes really start to change.

The Pulse: So, what’s next in terms of growth at Homeward?

JR: There are a number of new states on our roadmap. You’re going to see us in the Southeast, and I’ll even tell you that you’re going to see us in Mississippi next. We’re also going to continue expanding throughout the Midwest.

You’re going to see us start to come forward with other rural-focused products as well, especially around supporting small rural hospitals. The way we see it is that for Homeward—and for rural healthcare overall—to be successful, the entire rural health ecosystem has to be successful. That means these small rural entities, which have really been the backbone of their communities, need to continue to exist, and we’re pushing to bring technology to support them.

On the value-based care side, I’d say you’ll continue to see innovation in how we touch the member and how we improve quality of care and cost of care. I’m very excited about the next five years. There’s going to be a lot of growth.