Rural care, real impact. Discover Dr. Jaren Trost’s mission to deliver care—starting with just his car and a calling.
Episode title: The Road to Wellness: Reimagining rural health
Guest: Dr. Jaren Trost
Duration: ~27 minutes
Theme: Purpose-driven care, clinician well-being, and the power of value-based care in underserved communities.
Episode overview
This episode dives deep into Dr. Trost’s journey from burnout to purpose, highlighting how Optum’s value-based care model empowered him to deliver meaningful care to rural and underserved populations. Through personal stories, he illustrates how data, leadership support, and infrastructure can transform clinician experience and patient outcomes.
Key topics & timestamps
00:00–00:45
Introduction to Clinician Real Talk
00:45–02:04
Dr. Trost’s early career & burnout
02:04–03:01
Leadership support & growth opportunities
03:01–05:18
Driving across New Mexico to reach patients
05:18–07:28
Value-based care as a sustainable mission
07:28–09:39
Solving local problems with national resources
09:39–11:06
Balancing autonomy & infrastructure for contracted clinicians
11:06–13:12
Tools that simplify practice
13:12–15:29
Streamlining workflow & emotional impact
15:29–18:05
Connecting patients to resources
18:05–21:03
Encouraging clinicians to join VBC
21:03–26:36
Personal growth & patient story
26:36–27:37
Closing thoughts & call to action
Episode highlights
Resources & Links
Welcome to Clinician Real Talk, a new show where we bring you authentic, unscripted conversations with real clinicians on how to thrive in today's increasingly complex care delivery landscape. Our goal is to provide clarity, honesty and real world insights from clinicians who are on the frontlines. No sugarcoating, just real talk about how to truly make health care better in these changing times and why partnering with Optum is worth it.
Today we're joined by Doctor Jaren Trost, senior medical director for optimize IPA in New Mexico and Arizona. Jaron story is one of purpose and persistence, bringing care to rural communities that often go unseen and underserved.
So, Jaron, tell us about your early days as a clinician, like right out of finishing training. What were those experiences like? It. It was tough. Yeah. I think finishing residency and fellowship. Five years of training after medical school. I remember the day finishing fellowship was supposed to be an exciting time, and I was feeling a little burned out.
Right. And part of the reason why I joined Optum was the idea that, is it really true that I could see less patients per day and spend more time with them? Right. It was that question I had in my mind. And so it was kind of like a breath of fresh air. Once I started at Optum, because I could tell that was the way the company was moving a lot different from other places that I interviewed.
Yeah, that would put me in a clinic and I would see 30 to 40 a day. I honestly felt that Optum cared about my physician well-being. Right. So I wasn't cured of burnout. Day one, but it started to be on the road of, hey, this is really what I want to do. And Optum helped me accomplish that. Yeah.
So as you went deeper with Optum, what started to change with you with the work that you were doing? Tell us more about that. I think that I started doing a lot of work like these were all home visits, and I started to get a lot of leadership buy in early. I would talk to really top leaders in the company,
they they really cared about my vision and how they could help with that. And so I always felt I'm like, the leaders are there for me to grow me. And I started going to the partnership forums every year. I got into the Sequoia Fellowship, which is where Optum, it's a cohort of clinicians that want to be leaders, and the amount of resources they give to somebody with passion who is really good.
And so part of the one reasons to join Optum is to understand that the top leader of the of the company in Optum wants you to do well and wants you to be happy in the exam room, because guess what? A happy doctor is a happy patient. Yeah, definitely.
What inspired you to start driving across New Mexico to reach patients? Yeah. Great question. You know, I started with Optum in July of 2020. And I remember vividly the feeling I would get driving home from clinic. And it's something that I hate to admit, but it's true, is that I felt a little burned out.
Yeah. And what in a lot of studies about what makes clinicians happy, one consistently rises to the top and it's spending time with patients. Yeah. Yeah. Having that time. And so working in a value based care arrangement within Optum gave me access to unique data about where our sickest members live. Yeah.
looking back at this now. We had a team about four people.
And we actually had a list of where our most complex patients were living. And I could tell based on claims data that they were going in the hospital a lot and they weren't getting refills and not going to the doctor. And I literally took the top ten, and I got in my personal car, went to go visit them.
Amazing. How was that received. Like what. What happened the first time that you knocked on someone's door. They it was hard. The patients didn't understand. But if you know me I'm very extroverted. I have an outgoing personality. I, you know, I had I had some tenacity. I would not take no for an answer. Yeah. Right. And so I would explain myself.
Had a stethoscope around, I would I was in scrubs, I would knock on the door and I can't tell you every single person let me in the house. Right. And, and once you're sitting in their home environment. Yeah. It's kind of emotional because you see the struggle of the day to day. Right where they have grandkids crawling on the floor.
And I'll never forget one story I. I'm traveling to Las Vegas New Mexico. And I'm sitting at the, I'm driving into this trailer home and there's all these puppies that come around my car. And in these rural areas, you can't afford to spay your animals, right? And so I'm doing a visit called an RV, which is called an annual wellness visit.
It's something that we give to our members to help with chronic screenings and stuff like that. And I'm sitting with the patient and they have all these puppies are climbing, climbing over me. And it was an emotional time because I'm like three years prior, I was so burned out. And then with Optum help, I was able to find my purpose.
And I'm sitting there with all these puppies around me and I'm like, teary eyed being like, I found my purpose in life is to help these people. Yeah. So is that what keeps you going? That has the has value? How is value based care made that mission more sustainable that, you know, in a value based care? What I, what I like to say about value based care is it gives voices to the patients that don't even know they don't have a voice.
Yeah. They don't even know. Yeah. How does that play out? Like, how do you see that working when you. When someone actually has a voice as opposed to when they didn't? It doesn't look like it's an emotional thing because these patients don't even know where to ask for help. They don't even know where to ask for help.
And so when you're there kind of walking them through every step of the process, you start to see their eyes light up that someone cares about them. Yeah. You know and, and I'll say like when I take care of these patients, I saw these patients a couple weeks ago. I call them on the phone and I'm like, hey, how's it going?
And it's almost silence on the other end because not a lot of doctors do that. Yeah. Yeah. Yeah, I remember one experience getting a call from the nurse practitioner. And I didn't expect to. She hadn't told me she was doing it, but she was like, I just wanted to make sure that you knew what was happening. Yeah, and that's so meaningful.
So I can see how, like, when they pick up the line, they're like, oh, yeah, this guy actually, maybe he cares. He actually cares. Yeah. So how has the program expanded? Like, has it grown? Do you have more folks working with you doing the same kind of work? I do. And so we hired, two nurse practitioners do this work full time.
And so I'm always, you know, it's one thing to have a mission, but it's another thing to have other providers want to join that. Yeah. Right. And every single provider who does this, they come back and they tell me and they're like, Jaron, that was an awesome experience. And they're starting to do it on their own. And so what's great is that, I'm with the team now.
We have medical assistance that go out. We have all the screening equipment. We have mobile vans that go out to these rural areas now. And I think that one medical assistant in particular, after we were done seeing a patient, was saying how she can't wait to do this with me again. And I said, I'm people are working on Saturdays to do this.
I mean, but it talks about the if if an employee is connected to a mission. Yeah. They're not going to think about it as a job. Like, for me, this is a calling to take care of these people. And, imagine if we did that across the country with hundreds of thousands of employees. Yeah. Well, what that would mean for our patients.
Yeah. So, now that you have a group of folks working with you, what would you say that value based care has allowed you and the nurse practitioners working with you to do? That wasn't possible with a fee for service model. It's such a good question. I think it's two parts. One, it's the data. So in a value based care arrangement, I have claims data about when they go to the hospital or when the last time their primary care doctor visit was.
So it lets me kind of risk stratus stratify. What patients we need to spend resources on it. Right. So it helps me get to that. 5% of patients in America that are causing 85 to 90% of the spend, right. Yeah. Right. And so someone my parents thank God or healthy. Right. But they don't need to see a doctor every month.
Right, right. But the the patients I see in rural areas, value based care lets me see them once a month.
Can you, share a story? Dig it. Let's dig into that a little bit more about how having access to those national resources has really helped solve a local problem.
Like, is there an example you can think of a million examples. Yeah, I'm Rolodex in my brain when I could do it. So in New Mexico we have one of the highest proportions of patients that are on Medicaid. Okay. We're a very poor state. And part of what drives me to work there. Yeah, a third of our IPA are called Folks Federally Qualified Health Centers.
Got it.
within our population, Optum has members under their roofs. Okay. And so when I started engaging these clinics, they're very local. They're state government funded. They're local.
they're actually reinvesting that back into the community of Albuquerque in New Mexico in those rural areas, whether that's opening a new clinic in the rural area to get more access. So through Optum, I'm actually helping everyone. Yeah, every patient, every human being, no matter race, gender, whatever it means.
Yeah, I'm actually on the front end of opening a new clinic in Las Vegas, New Mexico. Yeah. Which could give access to the people, the patients that I see in the home. Yeah. Yeah. That's amazing. So there are all these resources that are available to you, when you're part of this, this network. But how does Optum strike the balance between autonomy and infrastructure for contracted clinicians?
Yeah, I love that question. It's so good. You know, when I go into an IPA clinic and I start talking to them about how Optum can help them, every single IPA clinic is different operationally, right? They have different doctors, different number of staff, different staffing ratio. And what we always say is we have an operational capability that works.
We know it works because Optum also in employed space. Right? We know what works in an employed structure.
But we know that will never work on the IPA side. But we try to give them those same resources about make sure to check the blood pressure three times. Yeah. Because maybe it's called the white coat hypertension. Right. Like a lot of my patients have it.
Right. And so checking the blood pressure three times, making sure that the colonoscopy is a part of the order set, making sure the mammograms part of the order set. So but that comes from Optum to give them those resources to make it easier for them on a day to day, to spend more time with their members. So my whole sales pitch is I'm here to help you spend more time with your patients.
And that's kind of at the at the base at the foundation is what Optum does really well. Cool. So, you've given us a bunch of examples and I want to hear more. So let's talk about the the day to day. Like what tools or systems have helped simplify your practice and reduce the administrative burden. Yeah. So a huge thing is coming out with scribes, AI scribes optimize investing a lot into AI scribe capabilities.
Tell me more about that. Yeah. So it's rolling out currently across the market. Docs Copilot. But it's really going to help cut down clinicians know writing time, write in an ability to spend more time with their members. Yeah. And I will say that in Optum, in the IPA and employed space, the vision is that a physician, it's the right patient at the right time.
Right. So if I see 12 to 14 patients a day, but those are the high risk patients that I need to see, and I'm spending 45 minutes to an hour with them. Optum is done its job. Yeah. We have something called an annual wellness visit that's recommended for every single patient,
And those visits should be an hour.
Yeah, an hour. So I always ask this question when is the last time you spend an hour with your doctor. It's been a while. It's been a while. But at Optum that is the vision. Yeah. So it's not, it's too full. We're fixing the burnout for clinicians because they're spending more time with their patients right. We're also giving them resources on the back end to help them care for that high risk patient.
And they can see that heart failure patient every month.
But it's I love what Optum says. It's like the right patient at the right time and in the right setting.
Yeah, right. So if someone's getting a surgery I want them to go to a value based care oriented surgery center. Or if they don't need to go to the E.R., can I get them into my clinic for diuresis. If they have heart failure, I don't need to send them to the E.R.. They don't need to go into the hospital for a week.
Right. So I always love the right patient, the right time without forgetting it needs to be the right setting. Yeah. So can you share a moment where streamlined processes played out in your day to day and helped you focus on what really mattered? So like maybe an example of, something that you so you mentioned the AI scribes.
Has that been tested? Like have folks been already working with them around the country? They're starting to work, in New Mexico, Arizona. It's first starting. Okay. So we're gonna have tons of stories in the next month or two about, you know, I was at the partnership for the Partnership Forum in Las Vegas, and they started talking about it, and the clinicians were glued to their chairs because this is something that they need, right, is help with that.
But but again, in terms of streamlining workflow, what the data within value based care does, is it if it lets me know where the sickest members are, I could have an APC nurse practitioner or physician's assistant. I could have them go see a patient enroll New Mexico.
they see three members, but that's more rewarding to them and to our business.
Rather than seeing 40 patients that they don't need to see. Right, right. So it helps me streamline because I'm like, I know exactly. I know where exactly these patients live. I joke right next time I need it. But I at that time, I didn't have any approval. I didn't have anything. It was just my heart telling me, yeah, I need to do something more to to satisfy this.
Yeah, this is what needs to happen. So what needs to happen? Yeah. That's so cool. So why do you stay in it? What keeps you going? Like, why do you. I know you've moved on to the a different role, a slightly different role than when you started. But what keeps you there? It's an emotional question. I think that when you're,
Yeah. When you, when you see these members and you're helping them at their most vulnerable. That feeling would last a lifetime for me if I did that one time. If I did that one time. Yeah. And so sometimes when I'm in the, I say the exam room when I'm in their living room. It seems to me I'm not doing much right.
But when you give them a hug and you know that like extra hug that they're like that, they just like they needed you. Yeah. That hug for me will keep me a physician forever. Yeah. Doing that with Optum just because. And you know what I'm talking about. It's like you see on a patient's eyes. Yeah that they're that they just they're so happy you're there.
But they're so happy that you found them because they didn't even know. They can't call and say, can Doctor Charles come visit me today? I mean, it's too hard,
Yeah I mean it's so we can get so used to when we are encountering the healthcare systems, just like accepting passively whatever comes.
So I can imagine when someone actually takes the time to, to come in and sort of bust through that model of like blindly moving through the system or not encountering the system at all. It's really meaningful for both of you. So that's what I'm hearing. And and I want to know a little bit more about, how does Optum model align with that mission to serve communities?
I know we've touched on it a few different times, but, tell me a little bit more about about how Optum works and facilitates that. The biggest thing is that, you know, I remember a visit, I was in a trailer home and, you know, Las Vegas, New Mexico. And the biggest thing for me if I can do is connect this patient to the Optum resources, whether that's a social worker or a case management or something like that.
Yeah, right. And so my whole goal in that whole visit is to figure out where do I send this patient to, to to get them the most care they need. And that's what Optum does. I'm just that little connecting link. But Optum has all these resources. Yeah we know where the patients live I know exactly what trailer home they're in and what parking space right in Las Vegas.
Right now we have a great program called House calls and we do stuff like that. And so we have that link. But it's really I would also argue the follow up right when I call these patients after and just say hello, how are you doing. Yeah that matters. Yeah.
What have you seen when you when you do the follow up like what's different between what what was happening before and what's happening now? I think it's, it's trying really to connect them back to an IPA clinic near them
it's hard to take care of a sick patient every single day, especially in a rural area.
And so what we're starting to do is work with folks in these rural areas. And
I have a patient here that needs a PCP.
But because Optum contracted with these clinics, Optum able to be that connecting link to that first choice in the patient. Yeah. Yeah. That's like a that's like that warm handoff situation where it's like sometimes we just need somebody to say, hey so-and-so, meet so-and-so here. They're going to help you now. Yeah. Rather than being like, go take care of it yourself, which is so intimidating.
So that's it's great to hear that. So what would you say, to someone, a clinician who's unsure about making the leap to VBC? Especially in a resource limited setting, which you are very familiar with? I would say, call me on my cell phone and come, come to a real visit with me, because that's really going to show you what value based care does.
I could talk on and on about what it does with the data and the resources that Optum has. Yeah, but you need to come see it for yourself because they say a picture is worth a thousand words. I think an experience is worth a million words. Yeah. Right. Where you're actually experiencing that visit. And of course that's not possible.
Right. I hope my, my phone rings off the hook after this and I get to do that. But yeah, it's one of those things that you have to experience value based care in your bones about why it's best for the patient and the doctor, everyone. It's a win win. Yeah,
So you said that you had leadership that was really receptive, to you being able to suggesting things to going to conferences like what were those conversations like? It was just like heartwarming. Yeah.
our one on ones would turn into him how we could help grow me.
And it was a lot. I would say that every single leader I've met with an optimum is selfless. And that's not normal, right? When you get to a huge company.
And so they're just there for me and my questions and how I get resources and the whole companies like that.
And so to get an idea of, of a clinician having an idea that would maybe help improve the efficiency of their clinic. Yeah. Optum is going to listen to you because I'm living, breathing proof that they listened to me, my crazy ideas of rural health and they started to go with it. Yeah. That's amazing. So you've described a little bit of the culture.
So to someone, to a clinician who hasn't experienced Optum yet, what does that feel like? I think it's a very good experience. I think it's it's almost like a warm hug. Honestly to work for Optum and it's it's something that there's a lot of competition in health care. It's hard to run an IPA clinic. It's hard to be independent now.
And I think that Optum just provides that service that we can work together to achieve our goals. Right. It's not Optum coming in and saying, let's do it our way, and it's not the IPA coming in and saying let's do it my way. Optum creates that platform to have a partnership that ultimately the end of the day can be for the benefit of the patient.
Yeah. Yeah. Are there any other opportunities that you've come across that maybe would be appealing to someone who thinking about joining Optum. There's there's some great leadership opportunities within Optum, whether that's the Grove Leadership program and then Sequoia I'm meeting with my cohort later this afternoon. We're all on a group tax. So we're leaders scattered around the country.
There's so many resources I have my eye on something else. Right. Within within Optum to do next year. And it's just one of those things that there's an endless. Like Rolodex of opportunities. Tell me about the growth you mentioned, Grove. What is. Yeah. So Grove is, leadership, cohort fellowship. Where clinicians who are interested in leadership, it's kind of like the first foray into, like how to be a leader, how to lead teams, like what you need to do.
And then after that, there's a more competitive program called Sequoia, where it's an application process, just like Grove was. But you need letters of recommendation for Sequoia, stuff like that. And so but it puts you on that path to leadership and more importantly, it gets doctors who want to be leaders. Right. So Optum does a great job of kind of self-selecting clinicians who want to lead the next generation, because it's perfectly fine to do clinic and do that stuff.
But there are clinicians that want to move up in leadership to help make a broader impact. Yeah, yeah. And that was kind of me. I kind of grew up like wanting to change the world. I still hope I can, but I think that Optum gave me a platform to change the world that I wasn't getting by in other places.
Yeah, yeah, I was going to ask, like, were you someone who always saw yourself as a leader or, you know, it was something that came came up as you started working at Optima. That sounds like it's something that you've always kind of wanted to do. I've always kind of wanted to do it, but I joke and I'm an identical twin, and he was a much better student, growing up.
And so I know I'm going to show my mom this and she'll laugh. But if you would have told my mom, like, when I was 17. Yeah, that I would be doing something like this. It was, it's cool that that my mom and dad get to see that. Yeah. And that Optima is a big part of that because I was always a doctor with a lot of energy.
As you can tell. Yes. I always put patients first, but Optum just combine those skills in me like no company ever could. Yeah, right. I had all the ingredients, but they made the pie. Yeah, it sounds like it's a great, great fit. Yeah. So
shifting gears a little bit, is there a specific patient story that really resonates with you.
Like you've been through all these different trainings, you've had all these different opportunities within all that, you know, getting back to the patient, is there one specific story that has really just stayed with you? There is. It happened earlier this year. Like I said, I do home visits every quarter, probably a week, a quarter.
one was we were in Las Vegas, New Mexico, and my team does a great job now of giving me the addresses on where to go. And they give me time to drive home Google maps, all the addresses like normal people I'm googling at. Well, this last home that we were going to didn't show up on Google Maps and so in my mind, I could have turned back.
It was getting late in the day and it was about a two hour drive
And so my teams there, my team all drove up with me because we were taking care of patients together.
We're in multiple cars and we're on phones and we can't find the house. And so we turn in to the gas station and they all know each other in these small communities. They're like, oh, Mr. So-and-so lives here. Just go there. Okay, we did that. Turn next to the softball field, right?
And so we're turning into the neighborhood, still couldn't find them. And then they say, oh, turn at the white tires. And we're like, where are the white tires? Where are we? Turn it in here. Right. And what happens is someone else from the neighborhood drives up on the other way, and we both roll down our windows and we're like, where's Mr. So-and-so?
And they're like, oh, yeah, go here, go here, drive down through the what do all this stuff. And so we end up showing up to this guy's trailer home. And what I saw there will stick with me a long time. You know he's emaciated. He is a really tall, slender looking man. Really nice. I could see in his eyes that it was just hard.
Yeah. And so I walk in the house I do this whole visit I talk about diabetes and heart failure and COPD and his history of cancer and all this stuff. And I go and I'm not connecting with him really like I normally do. It's hard. So I look at him in the eyes and I say, what do you need from me today?
Like I'm talking to you about diabetes and medications and what do you need from me? And he goes, I need food. And so I, I lean back in my chair and I'm like, I've been talking to this guy for 40 minutes and he's hungry. He's hungry. And so what we did at the end of that is my whole team went to this grocery store.
We, like, clean out the grocery store
we're all sitting as a team eating peanut butter and jelly sandwiches. I remember that forever just sitting in the gas station and we go drop off the food and, just really emotional him taking the food because they don't. It's hard. Yeah. Right.
Yeah. And we end up driving back and I'm on the freeway and it's dark and like, in New Mexico's beautiful. You can see the stars, right? It's just a beautiful, clear sky. And, it was silent. I wasn't listening to music. And I'm driving back and I'm thinking to myself, I'm like, man, I always told myself as a kid, I want to change the world.
And I think I just did that right. And it was the first time in my life that I was like, Maybe I'm on the road to doing something really special. If I could scale this program and every patient could have the same experience that that man had. Yeah. And it was just an emotional thing about where I am now in my career, what Optum has done for me without Optum, infrastructure, with the leadership programs, with the data, with the team, with everything.
And so it turned into just, me being with Optum forever. I hope, because I'm that happy. Yeah. Thank you for sharing that beautiful story. Thank you. I am also getting teary because that was amazing. It's really it's amazing to hear that. And it's amazing to hear that the resources exist to help that help facilitate that happening more as much as possible.
Thank you. Yeah, I always say I think we're we're going to be judged as human beings and as a society by how we treat our most underserved humans. And I think and Optum lets me treat these patients like they're human beings and they deserve it. And the patients are forever grateful for it. Yeah.
Awesome. Well Darren thank you for sharing your story and your impact. And if you are a clinician who knows you need
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