Brad Johnson, Market President, CenterWell

Invest: sat down with Brad Johnson, market president of CenterWell Senior Primary Care, to discuss how value-based care, workforce culture, and technology-enabled clinical workflows are shaping healthcare delivery as the Raleigh-Durham region’s senior population continues to expand. “The key in value-based care is threading the needle of great outcomes and great culture to ensure a great place to work,” Johnson said.

What shifts or trends have you noticed over the past year that are impacting how CenterWell operates and serves its patient population?

Broadly, there is more pressure on the healthcare system because of the aging population. That pressure is showing up in capacity, workforce, and in how seniors approach their healthcare decisions. One of the most noticeable changes this year has been a shift in buying behavior during the Medicare Annual Enrollment Period (AEP). Over the last five years, we saw more seniors choose Medicare Advantage preferred provider organization (PPO) plans because they valued choice and flexibility. This year, there was a meaningful shift back toward Medicare Advantage health maintenance organization (HMO) plans.

The reason is that benefits that used to be richer in PPO plans shifted back into HMOs. Seniors followed those benefits. The practical difference is that PPOs generally provide more freedom to select providers, while HMOs typically require patients to select a primary care provider and stay within that ecosystem. In an HMO structure in particular, the intent is coordination, and that fits our model well.

That structure allows us to better quarterback care. When care is coordinated properly, primary care can guide the patient experience, coordinate specialty needs, and keep the overall plan of care connected. That is aligned with what we are designed to do in a value-based environment.

We also face the same workforce challenges the industry is experiencing. Provider access continues to be a challenge. There are shortages of physicians, including geriatricians, and the same pressures exist for RNs, LPNs, and medical assistants. As the population grows, we have to stay focused on recruiting and retaining talented clinicians so we can keep up with demand.

What makes the Raleigh-Durham region an ideal market for CenterWell to be positioned, and how does it compare to other markets where the company operates?

Our approach is intentional. We put our Senior Primary Care centers in places where there are access challenges. When we evaluate markets, we start with the senior population and whether there are sufficient resources to support them.

North Carolina has experienced strong growth in the 65-plus demographic over the last several years. Raleigh-Durham has grown even faster. That combination of population growth and need creates a compelling investment case for expanding access points.

Raleigh-Durham also has qualities that attract and retain population. The universities, research presence, and large healthcare systems create amenities and stability that make the region appealing, including for older adults. When you combine demographic growth with that ecosystem, it becomes a strong place for our model to work, and it reinforces our focus on putting centers where need is highest.

How do you define healthcare equity, and how does that show up in your work locally?

Equity is often discussed through social determinants of health. That includes food insecurity, transportation challenges, and health literacy. Those are real barriers, and they absolutely matter when you are trying to deliver care effectively.

For our team, equity also includes whether patients have the right health plan and the right support for their specific situation. We want to make sure we are not only serving people broadly, but that we are helping patients understand their options and connect to resources that match their needs.

For example, if a patient has chronic conditions such as congestive heart failure or diabetes, they may qualify for a plan designed to provide additional support and resources. When we help patients assess their needs, understand options, and connect them to the right resources, that is also a meaningful part of equity. The goal is not just access, but access to the right care model and the right support.

Are there any services where you are seeing the most demand right now, and how are you scaling to meet evolving needs?

Chronic condition management is at the top of the list. Our patients tend to be older and often manage multiple comorbidities. That can include cardiac conditions, diabetes, kidney disease, or cognitive concerns. Social determinants play a role as well, including loneliness and difficulty accessing transportation and healthy food.

Our model is built to manage that complexity in a coordinated way. The center-based approach supports primary care under one roof, and it also supports coordination with other services. The goal is to meet patients where they are and help reduce barriers that keep them from staying engaged in care.

A major difference in a value-based model is that patient panels are typically smaller than in a traditional fee-for-service environment. That allows clinicians to spend more time per patient and treat individuals more holistically. We may see fewer patients in a day, but we are focused on proactive management. That proactive approach helps slow the progression of disease. We are not eliminating disease, but we are trying to delay progression by addressing needs early, coordinating care, and staying on top of risk.

How do partnerships enhance the care experience for seniors, and what areas are you focused on as you build those relationships?

Partnerships matter because healthcare is fundamentally about relationships. When you see people consistently, the goal is to build trust, and partnerships are an extension of that idea. Strong partnerships allow us to coordinate care more effectively and connect patients to the right expertise.

Oncology is one area where partnerships can strengthen continuity of care. When patients need specialized expertise, we want that handoff to feel coordinated, not fragmented. Looking ahead, kidney care management is another area of focus because so many disease states are influenced by kidney health. These partnerships help us get patients to the right resource quickly and ensure coordination across the care journey.

Workforce challenges are impacting every healthcare organization. How are you approaching recruitment, retention, and training in this environment?

Our philosophy can be summarized through what I call the three R’s. We want to select right, train right, and treat right. If you want sustainable outcomes, culture has to be strong. You can drive outcomes in the short term without culture, but it is not sustainable.

Culture becomes a recruitment engine. When people believe it is a great place to work, providers refer other providers. Leaders and teams build momentum because they feel respected, supported, and aligned around the mission. That starts with hiring the right people, but it continues with training and ongoing support, so the work environment remains strong as the organization grows.

In health care, we often say patients come first, and that is true. But if you build a great place to work, relationships between providers and patients become stronger, and that is where real impact comes from. When clinicians have the time and support to build those relationships, it improves outcomes and helps retention at the same time.

Rising costs and inflation are affecting every sector. How are you navigating those pressures from an operational and investment standpoint?

Because we are value-based, our success is tied to patient success. That means we have to be proactive and intentional about how often we see patients and how we manage risk. High-risk patients need to be seen more frequently. The cadence matters. When we build trust between provider and patient and coordinate care proactively, we can reduce avoidable utilization.

That allows us to create margin. Margin is not the goal in itself, but it funds growth and supports expansion. We can reinvest in communities, open additional centers, and expand access as the senior population continues to grow.

How are you using technology and data analytics to support efficiency, manage costs, and improve care?

There is no shortage of data in healthcare. The challenge is how you use it and how you operationalize it. We use data to understand where there is a need and where access constraints exist. That informs decisions about where to place centers and how to allocate resources.

On the clinical side, we capture data at each appointment and use it to support coordination across services. We also recently migrated our electronic health records, and inside that system we now have AI capabilities that support documentation workflows.

With patient consent, ambient AI can capture and summarize notes, which providers then review. The value is that it supports eye-to-eye interaction. One risk in healthcare is that the provider is focused on the computer while the patient is in the room. The technology is designed to reduce that burden so the relationship stays between clinician and patient, with the system acting as support, rather than distraction.

That also connects back to the workforce. Making the job more efficient and more focused on relationships improves clinician satisfaction. Providers go into medicine to take care of people, and when administrative burdens decrease, they have more time and energy to focus on the work that matters.

As you look ahead over the next two to three years, where do you see CenterWell headed in this market?

Brand recognition will continue to grow, and so will the need for senior primary care. Our value proposition is still relatively new compared with long-established brands, but the need for coordinated senior care continues to increase. 

We also expect to find more synergies across our care ecosystem and to deepen coordination across services. There is meaningful opportunity to improve how the system supports seniors, not just in terms of access, but in terms of quality and experience. The data and technology tools we are implementing will support that goal.

And ultimately, the key in value-based care is threading the needle of great outcomes and great culture to ensure a great place to work, because when that balance is strong, sustainability follows. If it is a great place to work, it is a great place for patients to receive care, and excellence builds over time.