When it comes to professions and industries, healthcare is as vital as a pulse to the human body. For Blair Fjeseth, President and CEO of Mountain Health CO-OP, this connection runs deep. Her journey into healthcare started at just nine years old when her father, a special education teacher, was diagnosed with kidney failure. Her family lost their health plan eligibility due to pre-existing conditions, plunging them into instability. “Sadly, I was not alone in this experience; millions of Americans face the same reality, one that is hard to climb out of,” says Blair.
Blair never envisioned a career in health insurance. Her career path was unconventional, spanning leadership roles in multiple industries. “What gives me joy and what I am passionate about is building teams and a culture that benefits the greater good,” she says. Her introduction to healthcare was unexpected, beginning with her involvement in the formation of the National Alliance of State Health CO-OPs (NASHCO) and later working with the founders of Mountain Health CO-OP.
“I wasn’t looking for a specific healthcare role,” Blair recalls. “But when the CO-OP’s CEO, Richard Miltenberger, invited me to join, it felt like the right thing to do.” She started as Director of External Affairs, advanced to Chief of Staff, then COO, and was named CEO after an extensive national search. “I feel privileged to have had the opportunity to deeply understand this business before leading it,” she shares.
Revolutionizing Healthcare
Mountain Health CO-OP operates with a clear mission: to offer non-profit, member-owned health insurance while empowering members to participate in decision-making. Their vision extends beyond simply providing coverage to fostering innovation and prioritizing member-oriented healthcare. This vision aligns with the triple aim: enhancing overall well-being, optimizing patient satisfaction, and addressing the costs of care.
“Our scoreboard isn’t about revenues,” Blair explains. “It’s about making a meaningful impact in people’s lives while holding the marketplace accountable to create a system that serves those who need it most.”
A prime example is Mountain Health CO-OP’s recent expansion into Wyoming. By introducing competition, the CO-OP helped reduce rates by approximately 12%, saving residents millions. “Success in healthcare is often measured in lives covered and dollars made. I believe success should be defined by how much good we do for our communities,” Blair reflects.
Mountain Health CO-OP is built on the belief that healthcare should provide choices. The organization offers broad coverage options and unique benefits, such as free medications, including insulin. “People shouldn’t have to decide between paying for prescriptions or paying rent. We go beyond the standard benefit model, even paying members to get dental exams, eye exams, and home health assessments,” Blair emphasizes.
Recognizing the challenges of accessing specialist care in rural areas, Mountain Health CO-OP covers travel costs for members requiring complex treatments—including transportation, lodging, and meals.
Putting People First
Unlike traditional insurance companies, Mountain Health CO-OP’s board consists of members who pay premiums and utilize benefits, ensuring decisions are member-driven. “That’s why we focus not just on claims, but on the people behind them,” Blair notes. “Many struggle to access the resources they need to become well.”
Customer service at Mountain Health CO-OP is unique. Representatives are not pressured to keep calls short; instead, they are encouraged to spend as much time as necessary assisting members. “We know we’re not perfect, so when issues arise, we treat them as opportunities for systemic improvements rather than isolated incidents,” Blair explains.
Feedback is integral to operations. Members receive post-surgery calls, assistance with out-of-state care, and regular surveys. “Our members are fantastic at sharing what they like and what they want to see improved,” Blair shares.
Despite covering thousands of lives, the CO-OP maintains a personal touch. “Our size is our superpower,” Blair states. “It allows us to build genuine connections with our members.” To ensure accessibility, Blair includes her personal email in communications so members can reach her directly.
Innovating Healthcare Access
Mountain Health CO-OP is leading the way in healthcare innovation. AI and machine learning help identify members who may need intervention, encouraging preventive care like mammograms and cancer screenings. Additionally, the CO-OP partners with Uber Health to address transportation barriers. “We use technology to bring mental health and medical services directly into members’ homes, which is a game changer in rural states,” Blair notes.
Looking ahead, Mountain Health CO-OP is focusing on deeper partnerships with providers and enhancing medical management. “Every day, we think about how to encourage people to see a doctor sooner, provide them with top-quality care, and eliminate barriers,” Blair says.
Beyond its own initiatives, the CO-OP has supported nonprofits that provide eye exams and glasses to children in underserved rural areas. “We take our equipment, doctors, and staff on the road to screen kids’ eyes and get them glasses at no cost to caregivers,” Blair explains.
Overcoming Challenges and Embracing Change
The healthcare landscape is constantly evolving, requiring adaptability and creativity. Blair acknowledges the challenges of navigating regulatory complexities while fostering innovation. “Regulations protect consumers, but excessive red tape can hinder progress,” she says. “We work with regulators to create legislation that benefits our members without increasing complexity or reducing competition.”
Blair has also faced biases as a woman in leadership. “I was once asked, ‘Can you do this job with three young kids?’ I believe more C-suite leaders should resemble the people they serve,” she says. She views her role as an opportunity to challenge norms and promote work-life balance. “Leadership is about embracing life’s demands. It’s about driving minivans and coaching little league—it’s what humanizes us.”
For Blair, one of the most critical aspects of leadership is listening. “Too often, the industry dictates instead of listening. True innovation comes from dialogue and collaboration,” she asserts.
Measuring Success with the 3Ms Framework
Mountain Health CO-OP evaluates success using Blair’s “3Ms” framework: mission alignment, achieving necessary metrics, and effectively serving members.
Key indicators include improvements in individuals’ lives, team satisfaction, financial stability, program expansion, high member satisfaction, and fostering innovation. “We start every meeting with a member success story. The incredible work our team does keeps me excited to come back every day,” Blair shares.
One moment that stood out for Blair was during a legislative hearing where Montanans spoke about rationing insulin due to costs. “We were the only ones who could say, ‘We provide free insulin to all our members.’ These benefits may cut into margins, but knowing we’ve done right by the people we serve is incredibly rewarding,” she reflects.
Future Horizons
Blair anticipates tremendous healthcare transformation in the next two decades, particularly with advancements in AI, cybersecurity, specialty drugs, and medical technology. “Our industry and society will evolve in ways we can only begin to imagine,” she says.
As these changes unfold, Mountain Health CO-OP remains committed to innovation and member-first healthcare. “We are ready to embrace new challenges and opportunities,” Blair concludes. “The future is full of possibilities, and we’re excited to be part of shaping it.”