Get to Know Our CHO: An Interview with Dr. Nirav Vakharia

Marathon Health is proud to welcome Nirav Vakharia, MD, as our new Chief Health Officer! 

As our CHO, Dr. Vakharia is responsible for the clinical strategy development and management of Marathon Health’s population health model of care. In addition to being a practicing primary care physician, he brings a wealth of experience in value-based care, quality and safety improvement, practice management, and innovative clinical program design.  

He received his MD from Harvard Medical School and completed training in internal medicine and a chief residency at the Brigham and Women's Hospital in Boston, MA. Before entering medicine, he worked as an engineer, then as a middle school math and science teacher in Washington, DC. 

He has helped to build and scale primary care systems in the U.S., U.K., Peru, Rwanda, Malaysia, and the Middle East, and noticed that the same issues exist everywhere. He was drawn to Marathon Health because of our ability to improve the health and well-being of millions of people in a sustainable way for providers and care teams.  

We sat down with Dr. Vakharia to hear what he has to say about his interesting journey into healthcare, his thoughts on current challenges within the industry, and the role Marathon Health can play in the future. 

You have an interesting background, spending time in a few different roles before becoming a physician. What led you to take the step into medicine? 

My original career was as an engineer, actually, then I became a middle school teacher. I mention that because the decision to then move into medicine was sort of reflecting on both of those experiences and feeling like medicine was a nice hybrid or combination of the two.  

So, engineering was all the science and first principles thinking around how you solve complex problems. The middle school teaching was the humanistic side. It was all about thinking about the whole child and the community — not just seeing yourself as a classroom teacher but as a social worker or a big sibling, too. You get to play a lot of roles as you get embedded in the community.  

Those things I mentioned — from both of those experiences — were my favorite parts and I started thinking about how to pull those together. I chose to go into medicine as the perfect application of science towards the betterment of people and the human experience. 

Why did you choose to join Marathon Health? 

I’ll explain in a second, but Marathon Health has built a care model that’s asked and answered the necessary questions to make primary care work for patients, employers, and providers. I decided to come on board to be part of rethinking and rebuilding primary care. 

The backdrop of this goes back to my core identity, as I’m still a practicing primary care physician and I have been for almost 18 years now. What I’ve seen happen during that time to the availability of high-quality primary care services on a national scale has been, honestly, upsetting to me. All the data says primary care is a fundamentally good health service that drives things that society cares about — longer life expectancy, better health, lower cost…you name it. So, people want more of it, insurance companies want more of it, government wants more of it…and yet it’s shrinking. Why? 

If it’s that good, can’t we figure out how to make more of it available to people? We know that the more people experience it the healthier they get. There are obviously a lot of things that drive outcomes, but primary care is a key piece that I’m interested in based on my own experience with it. Currently, we have a primary care industry that struggles with how it’s paid for, causes burnout in providers, extinguishes their passion for serving patients, and destroys trust between patients and providers. That model isn’t working, so I began looking for one that is. Something sustainable. Something that can grow.  

Marathon Health has built a care model that’s asked and answered the necessary questions to make primary care work for patients, employers, and providers. I decided to come on board to be part of rethinking and rebuilding primary care. 

I found the direct primary care movement particularly interesting as this version 2.0 of how we scale primary care in this country. Primary care is a fundamentally good thing, no one would say we need less of it. But how we’ve built it is pretty broken. As a result, it’s not having the impact that it needs to. So direct primary care represents going back to the drawing board and saying, “How would we go upstream and pay for this differently, organize it differently, and deliver differently in order to get the result we are looking for?”  

I’m excited about the answers we’ve found at Marathon Health and how we can continue to grow and develop our model. 

How can Marathon Health be a driver of direct healthcare and affect the rethinking of primary care? 

By continuing to build on our model that masters the basics of what makes primary care such a good thing, but that can be delivered nationally without losing its ability to meet the local needs of the people it serves. It’s a challenge to do so. Healthcare is huge but also very, very local. You need something that can grow to meet the size of the problem, but still allow the local clinicians and the folks who run the operations of a health center to tailor things to the needs of the population they serve. That’s key. It allows for mastery of the basics — having accessible, high-quality primary care services and building trust with the patients that are served. Because healthcare has lost that trust. So, we’ve got to restore it by building something accessible to the patient, but then driving improvement in quality so that we can make sure when patients see their providers it’s what is good for them. The core of primary care innovation right now must be returning to a mastery of the basics. Accessibility. Quality. Trust. A model built on that, like we have at Marathon Health, will help drive the change we need. 

Where are you most excited to get started as CHO? 

I think it’s a really exciting time at Marathon Health and we get to really grow and build on the strengths of two separate organizations, pulling them together into one company to really partner with our clients and patients to make an impact for them. We can begin to push primary care from a “diagnose and treat” model of care to a “predict and prevent” approach, better equipping us and our clients to solve the problem of unsustainable rises in healthcare costs.  

We also have an opportunity to, as a company, think about what a return to mastery of the basics is for ourselves. Such as how we are enabling our team members to wake up with a passion to serve patients and making sure we’ve built a model that lets that passion burn the whole day. I’m very mindful of never wanting to extinguish that. I want to make sure we don’t lose the essence of why people show up, because that’s how we make a difference. 

How can we best help organizations navigate the current healthcare landscape? 

Something I’ve learned as I’ve gotten to know our own clients and their motivation is that organizations really care about their employees and their dependents and want to help them stay well. We have the ability to partner with them to provide access to high-quality care, then help drive engagement and wellness in their workplaces. We have proven that doing so can flatten, if not bend down, the rising healthcare cost curve through increased access to our model. We can flatten the curve by providing care that can adapt and tailor to the local needs as I mentioned before. By meeting our patients where they are in a way that supports both them and their organization. By doing so, we equip our organization and their people with a path forward to primary care that achieves its purpose.