Member Spotlight: Alexander Billioux

August 08, 2018 | ASTHO Staff

Alexander Billioux, MD, DPhil, is assistant secretary of health for the Louisiana Department of Health's Office of Public Health. Billioux is an internal medicine physician focused on improving individual and community health through innovative public health approaches, including cross-sector population health strategies, business and community engagement, and sharing data to foster coordinated learning health systems. Prior to his current appointment, he served as a senior advisor to the director of the CMS Innovation Center and director of the Division of Population Health Incentives and Infrastructure. Billioux was a 2015-2016 White House Fellow, serving at HHS under former HHS Secretary Sylvia Mathews Burwell.

What was the experience or motivating factor that compelled you to become a state health official?

I’ve shaped my career around the goal of expanding opportunity through health. During medical school and residency, my focus was on diseases of poverty internationally, which ultimately led me to spend a year in rural Uganda engaged in health system strengthening and implementation science research on tuberculosis care. Upon returning, my focus broadened to include domestic diseases of poverty like diabetes and heart disease, while my approach shifted from evidence generation to policy development. I had the privilege of serving in the federal government for three years, including two years at the CMS Innovation Center leading the Accountable Health Communities Model and designing the Integrated Care for Kids Model. When the opportunity arose to join Secretary Gee at the Louisiana Department of Health and move from incentivizing the changes needed in our health system to my current role working with communities to make those changes happen, I leapt for it.

Was there someone who influenced you to lead a health department?

I am forever indebted to Josh Sharfstein for recommending me for this job and sharing his wise counsel on issues great and small. I was also greatly influenced by Karen DeSalvo, who was my first boss at HHS. Her experiences as health commissioner of New Orleans clearly informed her priorities and approach as a leader at the federal level and gave her an understanding of the challenges on the ground.

What is your morning ritual?

I am a bit of a night owl, so I generally get up between 6-6:30 a.m. My wife and I get our daughters ready for school and I drop them off before going to the office.

What do you do to stay healthy?

I try to run when I work closer to home in New Orleans. The whole family goes to the gym on the weekends. Also, my wife and I love spin classes.

What are your favorite hobbies?

I find raising children to be pretty fun and never dull. I love popular science writing and compelling storytelling. Fortunately, my long commutes to Baton Rouge give me plenty of time to catch up on audiobooks and wonky podcasts. My wife and I also love to travel, which is good because our families are spread across the globe.

What is the best part of your week?

The best part of my week is the weekend when I get to spend all day with my family. The best part of my work week, though, is Friday, when I have meetings with members of my senior leadership team.

How is your state helping to build healthier, more resilient communities? Describe any steps you are taking in general or as part of the 2019 ASTHO President’s Challenge.

Louisiana’s public health infrastructure is centralized in the office of public health, so we have to make it a priority to listen and partner at the community level. Fortunately, we have nine outstanding public health leaders serving as directors of our nine public health regions. Each of them has spent years building relationships with local leaders, businesses, and communities that enable us to partner more closely in each community. This structure has allowed us to set new goals to innovate, partner, and lead to improve Louisiana’s health. We are innovating by applying new strategies to tackle some of our biggest health challenges, like launching our house call-based syphilis treatment program for pregnant women and their partners. We are partnering with health systems and providers across the state by sharing local health data and helping set targets for care improvement, as in our perinatal quality collaborative focused on reducing Louisiana’s high levels of maternal mortality in partnership with 31 birthing facilities across the state. And we will lead by engaging businesses, schools, and local governments across the state to establish policies and programs addressing the social determinants of health, such as by helping establish more smoke-free zones.

What are your primary public health priorities?

Our top priority is the elimination of hepatitis C as a public health threat in Louisiana by the end of 2024 through our innovative drug access agreement and public health led community-to-clinic treatment and prevention program. In addition, we are integrating this public health moonshot with our program to end the HIV epidemic and address the statewide opioid epidemic. We are also focused on addressing social factors driving poor health across the state. We recently launched a new program called CareConnect that aims to identify and address individual health-related social needs among Medicaid members and under/uninsured Louisianans. While we have seen many groups—health insurers, hospitals, and community health centers—engage in the individual level intervention, public health seems best suited to link that work to deeper community-level investments. Finally, we are working across the office of public health and the Louisiana Department of Health to more directly address health equity through internal and external policies and programs. We cannot improve the health of Louisiana until we address the barriers to wellbeing and opportunity for all Louisianans.

What do you love most about the public health work you do?

Our job is to protect and promote the health of every individual and community in Louisiana. I can’t think of a better mission to take on every day! But while that mission gets me fired up, it’s the people I have the privilege to work for and with that make my job so fun.

What do you find most challenging about public health?

I think the biggest challenge in public health is the paradox that when we are doing our jobs well, we are invisible. Under-investment in public health has led to a resurgence in sexual transmitted infections, youth vaping, vaccine hesitancy, as well as obesity, diabetes, and heart disease. We need to communicate with health insurers and systems taking risks on our states’ populations so that more of the $3 trillion spent on healthcare in this country is applied upstream.