When Nirav Vakharia,, M.D., was recognized by Managed Healthcare Executive (MHE) as an emerging leader in its inaugural class of 2017, he was a rising clinician administrator at Cleveland Clinic who deeply believed in the promise of population health. Nine years later, he is the chief operating officer of Marathon Health, a value-based provider, overseeing a national network of nearly 700 centers serving 3 million members while maintaining a part-time clinical role at Marathon. His belief hasn’t faded — it’s only sharpened.
“If you swim upstream and focus on getting people to engage more in preventive care, in learning how to manage their own health through improved lifestyle, addressing some social determinants that cause health risk upstream and actually do successfully build a model that does that, then it is a bulletproof conclusion that all the good stuff we thought was going to happen can happen,” says Vakharia.
Vakharia says the core principles of a population health model have staying power, but because of how U.S. healthcare is structured, it isn’t easy to put those ideas into practice.
That realization gave him a new kind of focus. In 2017, Vakharia told MHE that he thought of population health as a big, complex system that depended on large care teams. He says he still values that broad approach, but his experience has changed how he thinks about what can actually work at scale. Population health needs to get people more vested in preventive care, he says.
Vakharia has arrived at some conclusions about other key ingredients. “Just keep it super simple. Build trust, because you’ve got great providers [where] there’s stability, [which] builds trust with the patients. They keep coming back, and the more they come back, the data show, the better the results are,” he says.
Another lesson learned: centering care around the patient. There’s plenty of lip service to that orientation in U.S. healthcare, but the reality leaves a lot to be desired. After years of watching care become harder for patients to navigate and just as challenging for clinicians to deliver, Vakharia has focused on a leadership approach that puts both groups first.
This outlook is a priority for him at Marathon Health, where he has been chief operating officer since September 2025 after joining the company approximately a year earlier. Vakharia says he sees firsthand how decisions about staffing, scheduling, technology and benefits affect a patient’s visit. His goal now is to take what works in one exam room and apply that across Marathon Health’s locations nationwide. He says he is excited about melding hands-on clinical insight with big-picture thinking. “As a practicing physician, you have that really intense experience in an exam room where you’ve been able to connect with the patient, you’ve been able to address something that’s on their mind, maybe start to achieve some behavior change that is really what you’re trying to drive long term, and you can kind of experience how all the different parts of the system line up to help make that moment possible,” he says. “Now the question is, if that’s possible, how do you replicate that 1,000 times, 10,000 times, a million times by building a system that more predictably and consistently drives that?” If that seems overwhelming, Vakharia says one place to start is to conceive access as a “large and wide front door to care.”
His “customers”
Vakharia traces his leadership perspective back to his early career, which began outside of medicine. After earning a bachelor’s degree in biomedical engineering from Case Western Reserve University in 1997, he taught middle school math and science at John Philip Sousa Middle School in Washington, D.C. But after two years in the classroom, Vakharia switched to medicine, earning his medical degree from Harvard Medical School in 2006. He completed his internal medicine residency at Brigham and Women’s Hospital in 2009 and served as chief medical resident from 2009 to 2010.
“Before I became a middle school teacher, I was an engineer. Over time, I realized medicine was the perfect fusion of what I loved most about both worlds: the science, complex problem-solving and first-principles thinking of engineering, paired with the human connection and purpose of education.
Even though I left the classroom, I never really left teaching. Medicine gave me a way to keep doing it — teaching patients, collaborating with and learning from peers and committing to lifelong learning myself.
Over time, my longer-term focus also became how we design better systems that improve health at scale — bringing together the engineering mindset and the educator’s heart in service of better outcomes.
That’s also why our mission resonates so strongly with me: enabling millions of people to live their healthiest lives, one patient at a time.”
Vakharia joined Cleveland Clinic as a primary care physician in 2012. Within a few years, he advanced into leadership roles focused on quality, population health and value-based care, including serving as an associate chief quality officer, vice chair of population health for the Medicine Institute and president of the Medicare accountable care organization. Moving from engineering to teaching through medical training to system-level leadership has molded how he approaches care delivery, patient experience and organizational decision-making, he says.
In his current role, Vakharia focuses on the people he calls his “customers”—patients and care teams—and tries not to let insurance rules or opaque healthcare financing rules get in the way. He shares that focusing on what truly benefits the patient helps guide every decision.
At home, Vakharia, 49, balances work with family life. He lives in Shaker Heights, Ohio, an inner-ring Cleveland suburb, with his wife, Aarti, who works for a local consulting firm focused on innovation strategy, Newry Consulting. They have three children: Raina, a college freshman; Sonia, a high school sophomore; and Shail, a sixth grader. The family enjoys travel, tennis, board games and training for half-marathons together. Vakharia said that blending family, work and wellness has strengthened his leadership style, teaching him the value of empathy, presence and patience.
He also makes time to stay connected to the front lines. He regularly
visits local health centers in the Marathon Health network to observe patient care and team workflows. Although these visits are not urgent tasks, he believes they are crucial for long-term impact. He encourages other leaders to make small, consistent efforts to focus on what is most important every day.
Looking ahead, Vakharia sees the future of U.S. healthcare returning to the basics. He calls this approach “boldly basic”: pairing medicine’s oldest promise, the health touch, with the smartest technology to expand access, elevate experience and improve quality without losing what makes care personal. In practice, this means doubling down on fundamentals: accessible care, trusted providers and a relentless focus on prevention.
“Anchor on your core customer, which is the patient … [and] build the system to make that possible. Do not overload the people who are meant to deliver care with too many patients, too busy a schedule, not the right tools, not the right training … [Do] what we know works,” he says
