Rachel Tobey

With JSI since 2010

Director of the JSI San Francisco officeRachel Final 1

You’ve been the Director of the JSI/San Francisco office for several years now – how is it going?

I love it – exhausting and exhilarating at the same time! We have a great team—everyone in the office is passionate about the work we do and works really hard. After 5 years in California, I can say we have established ourselves, have won many new projects in innovative areas, and are waiting to hear about a few more.

How did you find your way to JSI?

I always sensed JSI was a place I would love to work. JSI paired the consulting work of being able to work on a variety of interesting questions with the mission-driven environment I had always enjoyed when working in the safety net. However, for a few years, JSI and I had a number of “near misses.” I am so happy that both JSI and I were patient until the opportunity came up to lead JSI’s San Francisco office.

But didn’t you spend some time in Denver?

Yes, I was in Denver for about four years working at Kaiser Permanente while my husband did residency at Denver Health.  I worked for Kaiser first in Oakland [California] starting in 2004 and then moved to Denver where I worked through 2009. I had begun working for Kaiser out of graduate school because I wanted to work in a place that was an integrated delivery system, healthcare. In 2004, I viewed Kaiser’s approach—in which a salaried group of primary and specialty providers and partner hospitals provide a coordinated continuum of services to a population under a global budget, with a deep commitment to quality and service and facilitated by technology—as the optimal delivery model for American healthcare going forward.  It is exciting to see that the call for more value-based care that we have seen in the last decade is leading us toward more integrated delivery systems in the private and public sectors.

“I always sensed JSI was a place I would love to work.”

What did you do during your time at Kaiser Permanente?

In Oakland, I consulted for the medical group on a variety of projects from strategic planning to project management for endeavors related to quality improvement, prevention, and optimal management of patients with chronic conditions—very similar topics to what JSI is doing with more of a safety-net focus. I ended up as the Director of the Value Metrics Program in Colorado, a program where I was leading a group that was essentially measuring the Triple Aim (improved cost effectiveness, quality and patient experience for a population) before Don Berwick had widely

Rachel and her family

Rachel and her family

disseminated the idea of the Triple Aim as a guiding vision for healthcare reform.

So how did you get from Kaiser in Denver to JSI San Francisco?

Via a year-long stint in New Zealand.

Really? What were you able to do?

I worked a couple days a week for JSI on a New Access Point application for one federally qualified health center (FQHC) and researching performance-based compensation systems for another FQHC. I was sitting in New Zealand interviewing people at the U.S.’s leading health centers, the VA [Veterans Administration] and Kaiser on Skype, a true sign of how technology can facilitate global business.  I also worked for the CFO of the regional health district where we lived.  It was fascinating to see that in New Zealand, where they spend approximately a third of the dollars per capita on health care as in the U.S., they were tackling many of the same issues that JSI helps clients with – from reducing health disparities to reducing hospital readmissions.

You had worked for Planned Parenthood early in your career, didn’t you?

Yes, I worked at Planned Parenthood in San Francisco for 2 1/2 years after I graduated from Stanford. I worked on three big projects, including building the local agency’s first website in 2000, a fascinating experience because we tried to bring a cutting edge (for 2000) highly interactive format and design. We were pretty surprised when the site won the “Webby Award” in the health category, and I found myself accidentally sitting next to Craig (of Craigslist) at a ceremony.

I also did work around collecting and utilizing data for inter-agency, state, and national level efforts and using data for quality improvement and financial management in ways that had not been done before. I learned a lot about how health clinics/systems operate in my time at Planned Parenthood—and I loved being able to go to sleep each night knowing that my work was, hopefully, helping to make the world a slightly better place.

Your mom was a teacher. What did your dad do?

My mom taught World History and Psychology for seventh and twelfth graders and ran a community service program at the school where she taught. My dad was a school psychologist in a nearby school district. I am extremely grateful to both of them for prioritizing supporting my sister and me in our various activities and for teaching us the importance of service to others.

Is your sister also working to improve health of under served populations?

From a different angle, very much so!  My sister, Kirsten, co-founded Revolution Foods, a company that provides healthy school lunches predominantly to schools where the majority of students qualify for free and reduced lunch (they also have a line of packaged healthy meals and snacks that my kids adore).  I am so proud of her and her business partner as they have built an idea into a company that now serves a million meals a week to kids all over the country. They are making a daily impact on health of populations of kids and families.

And you have two small children?

Yes, a younger son and an older daughter.  They keep my husband and me grounded and on our toes with their perspectives and questions.  I love wrestling with the question of how can primary care be the fulcrum of a transformed delivery system achieving the Triple Aim by day and being stumped by, “Who spoke the first words?” “Why do people fight wars?” or “How is dirt made?” at night.

A Project to Remember