The United States spends more on healthcare than other comparatively wealthy countries such as Switzerland and Germany. It is also the only developed country without a universal healthcare system with a significant number of Americans lacking health insurance. Since the nation’s high health expenditure doesn’t translate into better overall health outcomes, government programs such as Medicaid and Medicare provide more comprehensive care for the elderly and low-income individuals. Issues such as access to care and quality of services obstruct the efficacy of these programs.
At the intersection of business, innovation and healthcare, Dr Toyin Ajayi is improving health outcomes for systemically marginalized populations. Her $6 billion healthcare company Cityblock is driving health equity by focusing on underserved populations who rely on Medicare and Medicaid.
“Do I believe that healthcare is a right, that should be available to all people, irrespective of their ability to pay and then it should be distributed equitably? Yes. 100%. And there are a lot of ways of achieving that. I come to this work as a physician, I’m deeply passionate about caring for underserved communities. I come to this work from a place of real heart. This is my life’s work and my mission,” Ajayi said about her inspiration to provide equitable healthcare.
Growing up in Kenya during the peak of the HIV-AIDS epidemic, Ajayi witnessed the impact that healthcare inequalities have on certain social groups. This stark preface to life prompted her interest in providing equitable healthcare. She earned a bachelor’s in Human Biology from Stanford University, a master’s in Development Economics and International Development from the University of Cambridge, and a Doctor of Medicine from King’s College London. Ajayi completed her residency training at Boston Medical Center and went on to work at Commonwealth Care Alliance in various capacities.
Working in healthcare, Ajayi saw how the system mistreated patients from marginalized communities. From the harmful language used in describing patients to outright discrimination, the space was unsafe for racial minorities and LGBT patients. Moreover, transportation hardships and stringent work schedules meant that patients had inadequate access and time in the busy doctor’s offices. Ultimately patients from minority communities found themselves in the emergency room with escalated health issues.
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“When we launched the company, there was just so much resourcing and attention and talent focused on improving care access and experiences for people who already had resources, who are privately insured, who were digitally savvy, who sat at the top of the life expectancy curve based on their demographics and their income. We saw a real opportunity to say, ‘Well, let’s focus on bringing all of these tools and focus them on people who need it the most, and people who are so often left behind.'” Ajayi explained why Cityblock Health specifically serves marginalized and underserved communities.
Ajayi conceived the idea of a value-based care model that could improve health care for patients nationwide while working at Commonwealth Care Alliance. She knew that Medicaid often left underserved patients without the necessary care and created a business prototype that could end the status quo of healthcare inequities. In 2017, Ajayi co-founded Cityblock Health, a tech-driven healthcare provider for Medicaid, dually eligible and lower-income Medicare beneficiaries in underserved communities. Ajayi initially served as the company’s president, overseeing its growth and clinical model. During the pandemic, the company grew its annual revenue five-fold and doubled its membership. She took over as CEO in 2022.
Cityblock Health applies technology in engaging with communities and patients. They use data science to identify insured patients with unfulfilled healthcare needs and bring them on board. This data ensures that Cityblock’s staff knows the patient’s medical history beforehand and can prioritize patients with urgent healthcare needs. Consequently, patients cared for by the Mobile Integrated Care visit the emergency department less often.
When venturing into new markets, Cityblock partners with managed care organizations, Medicaid or dually eligible individuals. The company then provides care for the insurer’s highest-risk populations. Understanding that the majority of their target clients have had negative experiences with healthcare providers, Cityblock employs its community health partners and outreach specialists in building a trusting relationship with patients. This strategy also ensures that the unique needs of a particular community are addressed.
With a current valuation of nearly $6 billion, Cityblock has established itself as the healthcare leader for marginalized populations. The company’s 2023 Equity in Action report reveals that Washington, D.C. experienced a 15 percent reduction in emergency department visits after the launch of an Advanced Behavioral Health program. A primary healthcare service, 74 percent of Cityblock’s members qualify for financial assistance and 77 percent of its clients are a racial or ethnic minority.
Through Cityblock, Ajayi is transforming how underserved communities interact with healthcare. She is making medical services more accessible and equitable.