In fall 2019, when Don Moulds joined CalPERS as chief health director, he had already established an extensive career working on health insurance and health care policy issues. Before taking on his new role, Don spent a decade on the East Coast working for the Department of Health and Human Services in the Obama Administration and at a health care think tank, the Commonwealth Fund.
As chief health director, Don leads the $9.2 billion CalPERS Health Benefits Program serving 1.5 million members. We recently sat down with Don to learn more about him and why he’s excited to be at CalPERS.
You have a Ph.D. in philosophy. How did you choose that field of study?
Both of my parents were very active in politics. I grew up around politics working on campaigns, walking precincts, and stuffing mailers. Fast forward to college, where I got really interested in the underlying questions. When picking a major, I originally thought I would end up with a degree in political science. But political science led to political theory, which led to philosophy.
How did a degree in philosophy lead to a career in health?
I thought I was going to be a philosophy professor. Along the way, I entered the California Senate Fellows program and worked on health insurance and health policy issues.
What took you to the Health and Human Services Agency?
I moved from Sacramento to Washington, D.C., to take an appointment with the Obama Administration. They were looking for people with experience in health insurance from state government because the knowledge didn’t exist at the federal level. Before Obamacare, insurance was regulated entirely by the states. The administration was looking for someone to help run the policy office, and my experience working at the state capitol was the right fit.
What was it like to be on the ground floor of Obamacare?
I had the privilege of working with dedicated, uber-smart people who had been trying to expand health coverage on smaller levels for a long time. It was one of those times in my career where I worked all the time, every single day, but I loved every minute of it.
You worked for the Secretary of HHS on various health issues. What was one of them?
There was a very innovative collaboration between HHS and the Housing and Urban Development Agency. Our two departments partnered on important work to address homelessness, which at that time was improving, as well as novel strategies to help elderly and disabled people live in the community and avoid institutions.
Tell us about your work on Alzheimer’s disease.
I led the National Plan for Alzheimer’s Disease on behalf of the secretary and the president. This was an exciting project aimed at changing the trajectory of Alzheimer’s disease and related dementias. The main efforts focused around advancing research for drugs more quickly and to improve care. Things like sharing best practices in nursing homes, curbing use of antipsychotics for people with dementia, and initiatives that helped caregivers.
What drew you to CalPERS?
CalPERS is the second largest purchaser of health insurance in the country, so there are tremendous opportunities to change the health care market for the better. Its history of innovation attracted me. The opportunity to work on programs to improve our members’ health and lower the cost of health care. I am also passionate about retirement security, so, many reasons drew me here.
How do you see your work at the Commonwealth Fund aligning with CalPERS?
The focuses are similar—containing costs without sacrificing quality and improving health outcomes. At the Commonwealth Fund, we looked at different ways to reduce pharmacy costs, referencing pricing programs, price variation for health care services, and competition, all areas CalPERS is addressing as well. We also looked at non-medical health interventions, things like rides to doctors appointments and tools to help people with multiple chronic conditions improve their health and lower their costs. I’m hoping we can work with our health plans to integrate some of these innovative models into our plan design.
What do you hope to accomplish at CalPERS to address rising health care costs?
Health care costs are increasing for everyone. Our challenge is to use our size and strength to improve care and contain costs. One way is using our data to work with health plans to improve health outcomes in cost effective ways. We have a clear picture of how our health dollars are being spent. But there’s more we can do to ensure every decision we make is rooted in data.