At Blooming Day 2025, two influential voices in healthcare—Karen Ignagni, Executive Chair of EmblemHealth, and Vicki Shepard, CEO of the Healthy Aging Coalition came together for a candid, insightful, and powerful conversation about the intersection of social care, leadership, and the future of healthcare delivery in America.

Leading Through Mission

Karen began by sharing her perspective on leadership, especially in times of transition. “You don’t need to have ‘CEO’ next to your name to be a leader,” she said. Her advice? Anchor everything in mission—and make that mission crystal clear and actionable.

At EmblemHealth, that mission is creating healthy futures for members and communities. Karen shared how EmblemHealth transformed from a legacy health plan into a tech-forward organization with 21st-century capabilities, including the retirement of every legacy system and the launch of a unified data lake. This transformation didn’t just modernize operations, it empowered EmblemHealth to connect with communities in more meaningful, human ways.

Investing in Community: Social Care in Action

One standout example is EmblemHealth’s 15 neighborhood care centers—open to everyone, not just members. These spaces offer everything from SNAP enrollment assistance and stress management classes to Zumba and cell phone literacy. As Karen put it: “You can’t talk to someone about diabetes if they’re hungry or don’t have a stable place to live.” That ethos is foundational to Emblem’s model—meeting people where they are, and removing real-world barriers to care.

The 1115 Waiver: Urgency, Opportunity, and What Comes Next

Karen spoke at length about New York’s bold 1115 waiver, calling it “pathbreaking” for its acknowledgment of the structural barriers that prevent people from accessing healthcare. But she also issued a call to action: the current federal administration has signaled it may not extend the waiver beyond 2027.

“We can’t wait until 2027,” she warned. Instead, health plans and community-based organizations must start planning now—so that the gains made under the waiver don’t vanish when funding ends. Emblem’s own care centers are already qualified as CBOs, and Karen emphasized the importance of maintaining strong partnerships with social care networks and leveraging interoperable data systems to track progress.

Accessibility, Language, and Strategy in a Changing Political Climate

In a frank discussion about healthcare access, Karen underscored the importance of grounding conversations in facts about disparities, not just abstract principles. “We have significant disparities in health care… and we can’t improve healthcare without addressing them.” Whether someone is a rural white American or a Black resident in an urban neighborhood, the barriers are real and often geographic, economic, or social.

Karen offered a tactical insight here, too: in politically sensitive climates, shifting language to “attacking disparities” or “investing in healthier communities” can help build broader consensus, especially outside the traditional healthcare bubble.

Following a tragic shooting of a health plan executive, the session turned to prior authorization and utilization management, topics that often stir frustration among patients and providers. Karen acknowledged the pain and emotion surrounding the issue but urged the health plan community to be more transparent.

Prior Authorization, Transparency, and Trust

“Prior authorization began as a safety tool,” she explained, “but we need to explain why we use it, how we use evidence-based guidelines, and what happens if we don’t have these checks.” At Emblem, for example, they routinely drop prior authorizations for services they approve 95% of the time. Still, more public dialogue and education are needed to restore trust.

Closing Reflections: Leadership with Heart

The session closed with reflections on legacy and leadership. Vicki praised Karen’s calm, solution-oriented style—even amid the chaos of the Affordable Care Act’s passage. Karen, in turn, reminded attendees that communication is a core leadership skill, especially in a time of rising polarization and misunderstanding.

As one audience member asked: What happens after the 1115 waiver? Karen’s answer was simple: health plans have the infrastructure and visibility to lead—and they must do so in partnership with organizations across the care ecosystem.

Blooming Health's Role in the Future

As Vicki noted in her final remarks, Blooming Health is one of those organizations rising to meet this moment. Like EmblemHealth, Blooming Health is focused on connecting health and social care, enabling community-based organizations with technology, and driving the kind of scalable, human-centered change our systems so urgently need. Contact us today to learn more.

The headwinds are real—but so is the momentum. And as Karen reminded us, with clarity of mission and collaboration across sectors, we have the tools to create healthier futures for all.