Changing Healthcare From the Inside

Cheryl Pegus, MD, MPH ’89

When Cheryl Pegus was a child, her grandfather got sick and she soon realized that her family’s socioeconomic situation was affecting his healthcare. “We couldn’t afford care,” she says. “As a kid, I was changing wound dressings and helping make doctors’ appointments.” Pegus, raised by a single mom, immigrated to New York City from Trinidad and wanted to become a doctor.

Eager to change the world, Pegus, at just 16, enrolled as an undergraduate studying premed at Brandeis University. She soon learned that becoming a doctor wouldn’t be enough to change a system that had failed to meet her grandfather’s needs. Between her residency and a cardiology fellowship, she enrolled at Columbia Mailman School, where she was impressed that the students had such varied backgrounds—there were former Peace Corps workers, social workers, and budding epidemiologists. Her epidemiology and biostatistics training presented a very rational way to fight for healthcare access and improved equity. “It’s just, ‘Trust the data, and use it to improve outcomes,’” she says. We will see gains as a healthcare community and country if we trust the data.”

After getting her master’s, Pegus came across a report in the New England Journal of Medicine showing that Black men in Harlem were less likely to reach age 65 than men in Bangladesh. “It was 1992, but it rings true today,” she says. The research made her realize that better health didn’t just “happen” when you got to the doctor’s office, but much earlier, in your community, and that there were bigger issues to solve and other stakeholders needed to cause change. So Pegus went to work for large corporations that could have a big impact: Pfizer, Aetna, Walgreens, and Walmart. At Pfizer, the company performed, along with the National Institutes of Health, one of the first and largest clinical trials looking at hypertension in African Americans. “This type of partnership is critical to fund the trials we need in science,” Pegus says.

Later at Aetna, the company became the first to collect race and ethnicity information on its 30 million members. “We did our analysis by women, by race, by ZIP code, and by using data began offering personalized solutions while measuring results. Jack Rowe, MD, the CEO, championed these efforts,” Pegus says. (Rowe is now Julius B. Richmond Professor of Health Policy and Aging at Columbia Mailman School.) At Walmart, she helped oversee its COVID-19 vaccine rollout, finding innovative partnerships to push back against vaccine hesitancy. “Housing communities, pastors, hair salons and barbers, NASCAR, NBA … we worked tirelessly with whoever was the most trusted,” Pegus says.

Pegus’ most recent job is as managing director with Morgan Health, created by JP Morgan Chase in 2021. The startup aims to bring value-based healthcare to employer-sponsored plans, where physicians are compensated based on the quality of the services they render rather than the quantity. “Value-based care has stretched into Medicare Advantage, but not employer health insurance,” she says. “So how do we get that to 16- to 64-yearolds? How do we improve the quality of their care in an equitable way?”

Thirty years into her career, Pegus still relishes searching for those solutions. “I am optimistic,” she says. “Change is occurring and I want to go faster.”