Blaire Bernard – Iora Health

Your physician has made an unsettling diagnosis. It may not be life-threatening, but it needs attention quickly and the care isn’t fully covered by your Medicare insurance plan.

The resulting stress—wondering when the bills will arrive, and how to decipher and pay them—is a nerve-wracking experience shared by millions of Americans.

Blaire Bernard | Senior Vice President and General Counsel | Iora Health

Since 2011, Boston-based Iora Health has sought to flip that script, disrupting the healthcare industry through the way it gets paid, engages patients and uses technology for Medicare-eligible patients at more than 45 locations in eight states.

“Iora is a company dedicated to transforming the way health care is delivered and the way our patients experience the healthcare system,” says Blaire Bernard, Iora’s senior vice president and general counsel. “Everything I do is in support of that mission. I spend a lot of time thinking about how to navigate around potholes or speed bumps. I’m all about getting to ‘yes’ in negotiation and resolution.”

Ways to disrupt

Instead of getting paid on a service-by-service basis, Iora is paid a predetermined amount for the care provided to its primary care patients.

“It’s a value-based care arrangement involving Iora taking financial risk based on how successful we are in managing that patient’s health,” Bernard explains. “Iora implements preventative remedies first to mitigate that risk and to provide high quality care.”

Those patients also work with health coaches who team with providers and nurses to set goals and keep their patients active participants in their well-being. Behavioral health is fully integrated into the care programs, with specialists offering short-term counseling, assessments and referrals on-site.

Iora’s also a disrupter in how it shares health information with its patients, using its own software to create a “collaborative care platform” comprised of a communication hub and dashboard detailing health information and accessible records.

Push to reform

Bernard brings a disruptive approach in her legal role, too, as Iora’s process also requires navigating state and federal regulations.

“In a highly regulated sector, some rules have not kept pace with how health care is delivered and what’s needed in the future,” Bernard says.

Before the coronavirus pandemic struck, she and her team were already talking with state insurance regulators about laws that impact how Iora operates. Bernard also represents the company in a group of healthcare providers seeking to amend federal tax rules so individual health savings account holders can sign up for plans such as Iora’s.

When COVID-19 arrived, Bernard and her colleagues focused on telehealth, particularly issues about ensuring that insurers would pay for services provided to patients living in urban areas. Rural telehealth was already covered in some instances, but the pandemic underscored the need for urban residents to gain the benefits of telehealth without worrying about the cost.

Even a requirement as simple as patient signatures on forms before a visit needed to be reimagined. As telehealth becomes more widely used, ways to modernize these rules—such as accepting digital signatures—need consideration, she suggests.

In this way, COVID-19 has resulted in myriad changes in policies and regulations for providing health care. Bernard is happy with those results and confident the modernization will last.

“COVID-19 really accelerated the progression of telehealth,” she says. “Telehealth is here to stay. I think insurance companies understand this and the need to pay for it. I don’t think we’re ever going 100 percent back to the way things were before COVID-19.”

Iora partners with Ropes & Gray LLP as outside counsel to support its efforts to transform health care. Bernard, once an associate at the firm, says its expertise is wide-ranging.

“They’ve supported me in getting up to speed when I began here and they’re a true partner, helping with everything from questions that need just a 15-minute consult to detailed fundraising transactions,” Bernard says.

The last round of fundraising brought $126 million in February.

“We’re proud to work for and with Blaire and Iora Health as she and the company drive innovation in health care,” says Ropes & Gray partner Dan Evans. “Blaire is focused on Iora’s vision for transforming health care, and she uses her skills and outside counsel to help Iora modernize the relationship between medical providers and patients, especially during this period of crisis.”

A bigger cause

Iora is also fighting for racial justice and expanding diversity, and Bernard is proud of its initiative spearheaded by company President Alexander Packard and Senior Vice President of Talent and Culture Clark Curtis.

As a member of Iora’s executive team and the leader of the all-female legal and compliance team (and the mother of two teenage daughters), Bernard is happy to lend her insight. It’s sometimes as simple as encouraging everyone to vote, but making a deeper impact also entails taking a visible, active role in the fight against any and all forms of discrimination, she adds.

“We’re still in the process of learning where there are opportunities for improvement,” she says. “If a company were to come away from an exercise like this saying, ‘We’re good. No need for improvement here,’ that would tell me that the company’s culture leaves something to be desired.”

A native of Connecticut, Bernard has never strayed very far from New England. She earned her bachelor’s degree in philosophy from Dartmouth College in New Hampshire.

After graduating, Bernard joined the American Medical Association’s Council on Ethical & Judicial Affairs and was encouraged by an attorney there to pursue a legal career. In 1999, she enrolled at Boston University School of Law, earning her JD in 2002.

From there, she joined Ropes & Gray, and came in-house in 2006 as an associate general counsel at Lahey Health.

“It’s a different way of practicing law, a different pace,” Bernard explains. “To be effective, I have to understand all aspects of the business and be comfortable giving advice on the spot.”

In 2013, Bernard joined NxStage Medical Inc. as senior counsel, and in 2016 she became general counsel and compliance officer at Iora.

Though there’s been tangible and beneficial progress in how Iora operates both internally and in bringing its model to the healthcare market, Bernard sees plenty more opportunities to grow.

“It’s rewarding to provide guidance to an innovative, growing healthcare company,” she says. “If what we are doing paves the way for other providers to care for patients the way we do, then I’ll be humbled to have played any part in that success.”