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The reasons that initially drew Mara Wilber to the law are still what drive her today. The associate general counsel at Cleveland-based MetroHealth never intended to go in-house, but when a role opened at the safety-net health system, Wilber knew it was one of only a handful of roles she could imagine that would get her to leave private practice.
“It was not a goal of mine to wind up in-house,” Wilber explains. “But MetroHealth specifically is an organization that I was interested in based on the kind of work they were doing. They’ve been serving Greater Cleveland since 1837, and they are focused on serving the most at-risk members of our community.”
The AGC says that the mission is only part of the selling point. What really set the organization apart was its willingness to be innovative and take risks in new projects, particularly those centered on population health. MetroHealth has dedicated programs through the Institute for H.O.P.E.TM focused on the creation, infrastructure, and development of partnerships necessary to improve healthcare outside hospital walls. MetroHealth has also been successful in advancing its value-based and risk-based contracts under both governmental and commercial programs to enhance care coordination and clinical quality with the goal of improving health outcomes while appropriately reducing the total cost of care.
Wilber came to MetroHealth with previous healthcare regulatory and transactional experience at Jones Day and Proskauer Rose. And over the last nearly five years, Wilber has used that expertise for the benefit of a health system responsible for looking after Cleveland’s most vulnerable.
In addition to her population health and managed care work, a cornerstone of Wilber’s contribution has been as the legal lead for MetroHealth’s institutional participation in the federal 340B drug pricing program, a lifeline for safety-net hospitals like MetroHealth. Created in 1992 in response to rising drug costs unsustainable for safety-net providers, the program allows qualifying hospitals, grantees, and clinics to purchase covered outpatient drugs at discounted prices, the manufacturer’s average price reduced by the government-set rebate percentages, so they can reinvest the savings into patient care and community programs.
“The 340B program doesn’t always make the headlines, but it’s critical for hospitals like ours,” Wilber explains. “Savings from these discounted drugs help us fund essential services that might not otherwise exist—financial aid for patients, pharmacy outreach, community health programs, and other care programs for people who can’t afford their medications or that experience other barriers to care.”
The legal oversight is complex, bridging compliance, ethics, and policy, but Wilber loves the challenge. It’s an exercise in stretching scarce resources as far as possible to make the biggest impact.
Nationally, the 340B program helps offset unreimbursed medical costs for underinsured and uninsured patients without burdening taxpayers. Hospitals like MetroHealth reinvest the savings into financial assistance, expanded pharmacy and clinical access, food and housing programs, mental health services, and care coordination. These may not be profitable enterprises, but they’re the kind that innovative health systems need to engage in to care for underserved communities.
MetroHealth’s Institute for H.O.P.E.TM, short for Health, Opportunity, Partnership, and Empowerment, embodies the system’s mission to improve population health by addressing social drivers of health like food insecurity, financial education, and housing insecurity and safety. The programs include offering services such as screening for essential health-related social needs and offering related support, both directly and through strong community partnerships, such as job training, legal assistance, financial literacy sessions, housing support and navigation, social connection programs, and grocery access. This kind of tangible infrastructure is aimed at the institute’s mission to deliver more holistic and equitable care by integrating social drivers of health work into system operations.
“Greater Cleveland has some of the best healthcare institutions in the world. Yet it also has some of the worst health outcomes across its population,” the organization’s website reads. “While medical quality care is essential, it’s not nearly enough.”
These are the issues that spurred Wilber to pursue law in the first place. During her undergrad years, the Affordable Care Act dominated national discussion, and Wilber was captivated by questions of balance: how to reconcile healthcare as both a public good and a regulated business. After earning a master’s in bioethics at Case Western Reserve University, she pursued her JD at Columbia Law School.
As her healthcare practice and expertise has expanded, so has her mentorship. Wilber connects with other local attorneys to promote mentorship and ethical service through the Cleveland Metropolitan Bar Association. At MetroHealth, she co-developed a legal externship program with local law schools, providing real-world experience in health law and public interest practice.
“Mentorship has been foundational to my own career,” Wilber says. “There’s a high learning curve in healthcare law, and I’ve been fortunate to have mentors who helped me navigate it. Now I want to pay that forward.”
The externship, which began with a single law school and now spans all major Cleveland-area institutions, attracted fifty-one applicants for its summer cohort last year.
Wilber also leads the legal department’s inaugural community outreach and
engagement committee, which coordinates volunteer efforts, such as through the Greater Cleveland Food Bank, Institute for H.O.P.E.TM, and other partners. The AGC says it’s easy to get lost in the details of legal work, but that the volunteer work helps the department to reconnect with the people and the community they ultimately serve.
The AGC has a lot to look forward to in the near future. Most importantly, she’s expecting her first child. But the attorney is also focused on extending MetroHealth’s reach and impact. She believes that lawyers serve an essential role as advocates for the organizations they serve and for the community as a whole. She will continue looking for new ways to develop stronger community partnerships, refine the health system’s approach to data-driven care, and continue building partnerships across the organization.
“We can’t do everything alone,” says Wilber. “By finding the right partners, dedicating our resources strategically, and staying focused on the people we serve, I’ve seen that we can make a real difference.”
The Alinea Group strengthens and sustains 340B programs through collaborative, mission-driven partnership. We go beyond traditional consulting by working alongside Covered Entities to enhance program performance, ensure compliance, and safeguard long-term integrity. Our expert team provides tailored guidance, operational support, and strategic solutions designed to increase revenue, reduce risk, and empower organizations to fully realize the value of the 340B program while expanding access to care in the communities they serve. Together, we can elevate your 340B impact and help Covered Entities achieve lasting success.
