Welcome to another episode of Impact Unfiltered, where we spotlight voices making real change. In this special “Tribal Impact” series, host Philippe sits down with Dr. Setu Vora, Chief Medical Officer for the Mashantucket Pequot Tribal Nation in Connecticut. Dr. Vora shines a light on the tribe’s innovative, holistic approach to healthcare a journey that spans over three decades. He walks us through the evolution of Pequot Healthcare, a tribally owned system that not only serves its own community with independent health plans and in-house pharmacy services, but also extends support to other small businesses and tribal nations. Together, Philippe and Dr. Vora discuss the impact of accessible, quality care, the power of self-governance, and what it means to create lasting value in healthcare, both for the tribe and beyond. Whether you’re interested in health innovation, tribal self-determination, or building systems that put people first, this episode delivers inspiring insights on making an impact where it matters most.
1. Introduction to the Podcast and Series
- Introduction to the special “Tribal Impact Series Live from Self Governance in 2025.”
- Spotlight on tribal healthcare leadership, self-governance, and value-driven innovation.
- Guest: Dr. Setu Vora, Chief Medical Officer of Mashantucket Pequot Healthcare.
2. Guest Introduction: Dr. Setu Vora
- Overview of Dr. Vora’s professional role as CMO for Mashantucket Pequot Tribal Nation.
- Focus on serving as a steward of tribal health strategy and value-based care delivery.
3. Background on the Mashantucket Pequot Tribal Nation
- History of the tribe’s continuous presence in Connecticut.
- Pioneers in both gaming and non-gaming tribal enterprise.
- Strategic priority: advancing health and well-being of tribal members and their communities.
Sub-topics:
- Founding and 30+ year evolution of Pequot Health Care.
- Structure as a tribally owned, independent third-party administrator (TPA).
- Services extended to small and midsize non-tribal businesses.
- National network access (e.g., UnitedHealthcare, Cigna).
- In-house clinical pharmacy, PBM, and mail-order service run by tribal teams.
4. Dr. Vora’s Role and Vision
- Responsibilities as CMO: advising tribal council, aligning care with cultural values.
- Focus on better-value healthcare for both tribal members and external clients.
- Commitment to quality, safety, and experience—at a lower total cost of care.
5. Pharmacy Innovation and Pandemic Leadership
- Overview of PBM Solutions and custom pharmacy programs.
- Mashantucket Pequot’s pharmacy team: 10+ pharmacists supporting integrated care.
Key pandemic initiatives:
- Led COVID-19 vaccination across the tribal nation.
- Operated one of Connecticut’s largest mass vaccination sites in partnership with state and local health systems.
6. Self-Governance Milestone and National Engagement
- Transition from Title I contracting to becoming a Title V tribe.
- Execution of self-governance compact with Indian Health Service in October 2022.
- Enhanced national leadership: sponsorship and presence at the Tribal Self-Governance Conference.
- Highlight: Councilor Michelle Scott’s opening remarks and leadership in health and human services.
- Legal counsel’s critical role in unlocking self-governance benefits.
7. Takeaways from Self-Governance 2025
- Value of peer connection and knowledge exchange at the conference.
- Reflections on the challenge of driving transformation in entrenched healthcare systems.
- Need for collaboration among likeminded leaders to shift resources toward unmet healthcare needs.
8. Defining Impact in Tribal Healthcare
- Dr. Vora’s vision of impact: expanding tribal access to care, community empowerment, and health sovereignty
- Extending Mashantucket Pequot’s model to serve other tribal nations and self-funded American businesses.
9. Measuring Success: Return on Health (RoH)
- Primary focus on Return on Health: improved outcomes, experience, and well-being.
- RoH as a foundation that naturally supports ROI.
- Emphasis on building systems that are non-extractive and reinvest in community health.
10. Closing Reflections and Call to Action
- Dr. Vora’s call to collaborate with others committed to reducing cost drivers and eliminating care barriers.
- Encouragement to form strong partnerships and coalitions for sustainable progress in tribal health.
