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The Accidental CEO

How one Penn Nursing alumna is centering healthcare around NPs, leading to happier providers and healthier patients.

By Christina Hernandez Sherwood

Early on in the COVID-19 pandemic, around the birth of her third child, Sylvia Hastanan Nu’04, stepped back to reflect on her career. Educated as a nurse, Hastanan had spent years as a strategist, helping physician groups, health plans, and hospitals improve health care delivery on a system level.

“In my seat within these medical groups, I noticed that nurse practitioners were underutilized and overlooked,” Hastanan said. “There was an opportunity to wrap our arms around nurse practitioners and enable them to work at top of license.”

Her realization gave way to Greater Good Health, now a two-year-old, Los Angeles-based health care company that works to give nurse practitioners a front seat in the delivery of care. With the nation facing a shortage of primary care physicians, and the health care system moving toward a value-based care model, Hastanan said nurse practitioners are well positioned to take a greater role.

Greater Good Health partners with risk-bearing entities, such as insurance plans or other groups with financial responsibility for patients, then builds programs that supplement traditional physician care. The company employs more than two dozen nurse practitioners who facilitate these “embedded services,” such as in-home and telehealth primary care.

Its next effort—a collaboration with a major national insurance payer—involves building nurse practitioner-led practices in underserved areas. In these markets, where there is a large population but a too-small primary care presence, the wait time for a doctor appointment can reach six months or more. “This insurance payer sees that there’s a shortage,” Hastanan said. “They want to provide good access and patient experience—that’s their livelihood—and they need to partner with providers that can do that.”

“We want to be an employer of choice for nurse practitioners. If we can create a work environment where providers are happy, that in turn yields healthier patients.”

Because 26 states now allow nurse practitioners to operate more independently, Hastanan said nurse practitioners will be the primary providers in these practices—taking full accountability for their patients. The first four practices are expected to open in Montana this year.

At a time when patient-centered care is a major trend in health care, Greater Good Health is flipping the script to center around nurse practitioners. “We want to be an employer of choice for nurse practitioners,” Hastanan said, adding that the crushing burnout during the COVID-19 pandemic highlighted the importance of a healthy workforce. “If we can create a work environment where providers are happy, that in turn yields healthier patients.”

Hastanan, who calls herself an “accidental CEO,” credited her education at the University of Pennsylvania with her innovative approach to her nursing career. She supplemented her Penn Nursing classes with business courses, and noticed the striking juxtaposition between the sophisticated financial world and the antiquated health care system.

“I probably wouldn’t have been exposed to all that if I didn’t go to Penn,” Hastanan said. “I love all the cross-pollinating programs [Penn has] because it yields more well-rounded and better understood leaders.”