Dr. David Kelley Brings Rural Roots to Enhance Pennsylvania’s Health Policy

“At Ben Taub (Hospital), we saw patients who had never seen a doctor until a crisis brought them in,” he recalled. “Meanwhile, private hospitals were actively transferring unstable patients to the VA—just to avoid liability. That made the flaws in our system undeniable to me.”

Those early experiences galvanized his transition from clinical medicine to public administration. After treating patients with HIV/AIDS in central Pennsylvania and witnessing the isolation many faced due to stigma and lack of family support, he moved deeper into systems work, joining Hamilton Health Center, engaging with Medicaid populations, and becoming a faculty member at Penn State University, where he focused on inpatient quality and utilization management.

But it was at the Pennsylvania DHS, where he has served for over two decades and most recently as Chief Medical Officer, that Dr. Kelley made his most far-reaching impact. Here, his work has touched nearly every corner of the Medicaid landscape: from improving childhood nutrition and tobacco cessation policies to ensuring equitable access to dental care and behavioral health services.

"I really saw this as a huge opportunity to come back to my foundational roots and where I was really committed,” Dr. Kelley said of the transition. "I view Medicaid as public health, and I wanted to get back into public health and population health."

Dr. Kelley serves as the chief medical officer for DHS’s Office of Medical Assistance Programs (OMAP), overseeing the clinical and quality aspects of the medical assistance programs that provide health benefits to over 2.5 million recipients.

In the past 10+ years OMAP has increased the Medicaid program’s effectiveness, healthcare quality, cost-efficiency, and system modernization. For example, the program has expanded adult Medicaid and postpartum coverage, implemented an integrated behavioral and physical health quality incentive program, established a pediatric behavioral health telephonic consultation program for primary care practitioners, and helped establish the statewide PA Perinatal Quality Collaborative. To evaluate programs and policies put into place, he helped develop the Medicaid Research Center with the University of Pittsburgh.

He was a key architect of many of the value-based payment programs, including the patient-centered medical home program, which has improved outcomes by fostering comprehensive, team-based care, particularly for individuals with complex needs.

“We had to move from volume to value,” he said. “These programs are about holding systems accountable for the quality, not just the quantity, of care.”

Dr. Kelley also deployed programs to meet the opioid epidemic head-on. Under his guidance, Pennsylvania launched its Centers of Excellence program, which prioritized medication-assisted treatment and care coordination for people with substance use disorders. Additionally, he advocated for eliminating prior authorization requirements for critical medications like naloxone, an emergency treatment that rapidly reverses opioid overdoses, enabling faster, life-saving intervention when every second counts.

"We’ve developed quality improvement incentive programs for providers, managed care organizations, dental providers, and hospitals to reduce preventable admissions,” Dr. Kelley said. “We stood up the Centers of Excellence program as part of the response to the opioid crisis, opening up quick access to care and pushing the use of medication-assisted treatment."

Technology, too, has been central to Dr. Kelley’s strategy. He championed efforts to expand telemedicine access, particularly in rural and underserved communities, and helped direct over $500 million in incentives to hospitals and Medicaid providers for the adoption of electronic health records. During the COVID-19 pandemic, his team’s early investments paid off: telehealth became a vital link for behavioral health services, maternal care, and pediatric well-child visits.

He oversaw the development of PA Navigate, a health information exchange initiative that screens for social determinants like housing and food insecurity, linking individuals to resources that address the root causes of poor health. He also notes that one of his proudest achievements is the increase in the number of Pennsylvania children accessing dental care.

"When I started 20 years ago, less than a third of our kids were accessing dental care. We’re now at probably 60-some percent accessing dental care on an annual basis,” Dr. Kelley said.

Never one to accept the status quo, Dr. Kelley brought a proactive, strategic mindset to Medicaid policymaking. He worked on national quality improvement boards, including the National Quality Forum and National Committee for Quality Assurance, ensuring that equity metrics and performance data drove funding decisions and care models. In collaboration with managed care plans, he designed adjustments that saved Pennsylvania over $2 billion, cutting down on preventable hospital admissions and inappropriate pharmacy use.

His recent focus includes expanding access to GLP-1 medications for diabetes and streamlining approvals for continuous glucose monitoring devices, vital tools in the fight against chronic disease, particularly among Medicaid populations disproportionately affected by it.

Central to Dr. Kelley’s success has been his steadfast commitment to collaboration. He praises partners like the Jewish Healthcare Foundation, whose work on demonstration projects, quality collaboratives and end-of-life care has helped elevate Pennsylvania’s health outcomes. Together, they have advanced initiatives like behavioral health collaborative care models, the maternal health TIPS line, Teaching Nursing Home Collaborative, PA Perinatal Quality Collaborative, Patient-Centered Medical Home Learning Network, OUD Centers of Excellence Learning Network, and enhanced patient safety efforts across care settings.

“The Jewish Healthcare Foundation has been an important ally,” he said. “Their ability to bring people together—from community partners to policymakers—has strengthened everything we do.”

Dr. Kelley has also been a consistent and reliable ally of health foundations across the Commonwealth through the PA Health Funders Collaborative. Through these types of public-private collaborations, new ideas to improve the quality and safety of the 2.3 million Medicaid members can be quickly tested, scaled, and sustained.

Even as he reflects on decades of progress, Dr. Kelley remains focused on the road ahead. Future priorities include improving Medicaid redetermination processes through community engagement and technology, advancing maternal and behavioral health services, and addressing rural health challenges.

“The work is never done,” he said. “But when we collaborate across sectors—with data, compassion, and purpose—we can move the needle toward a more just healthcare system.”

In a field often overwhelmed by complexity, Dr. Kelley stands out not only for his clarity of vision but for his deep, unwavering commitment to the people behind the policies. For him, public service is not a job, it’s a mission. And Pennsylvanians are healthier for it.