We are a health equity and financial sustainability consulting firm

Pivot First Consulting & Management partners with healthcare entities and community-based providers who are working on the frontlines of care delivery. As a mission-driven social enterprise, we help our clients navigate public health systems, build equity-focused strategies, and grow sustainable businesses. Our work is rooted in the belief that there should be no tradeoff between financial sustainability and meeting community health needs.

What we do

Strategic Partnerships

We design and facilitate collaboratives and initiatives that are rooted in shared power and value alignment

Health Equity

We apply a Liberatory Design approach to disrupting structural racism in healthcare delivery, guided by data and client-defined health equity goals

Making Data Meaningful

We translate health related social needs, healthcare utilization, and environmental data into actionable insights

Community Workforce

We supply tactical tools and guidance for recruiting, retaining, and investing in community-based workforces

Healthcare Administration

We navigate clients through the business of healthcare by providing enrollment, credentialing, contracting and medical billing services

Learn more

“Through the Community Health Worker Capacity-Building Collaborative, Kussy led a process that educated our team and others in the state about a wide range of related topics, opening our minds to new ways to think about our planning. Kussy specifically turned me on to many public health data resources that I had never used, and guided me on how to use them to make our case. Having access to these resources helped me find new perspectives on the problems we were addressing.”
Nancy Halloran | Former Deputy Director | Alameda County Health Connect
“Kussy Mackenzie has been a transformative partner in our work to reduce disparities in healthcare for Medi-Cal patients. She led strategic initiatives to expand equitable access to specialty care and address social determinants of health, ensuring systemic change beyond siloed efforts. Her ability to engage leadership, patients, and care teams fostered a culture of inclusivity, accountability, and continuous improvement. Kussy’s leadership was pivotal in launching the UC San Diego Health Disparities and Inequities Taskforce, a cornerstone of the broader Anti-Racism Task Force. Her unwavering dedication to justice, equity, diversity, and inclusion made working with her both inspiring and deeply impactful.”
Shivon Carreño | Associate Director of Operations | Department of Orthopedic Surgery | University of California San Diego Health
“I had the privilege of collaborating with Kussy Mackenzie at the Center for Community Health, where her impact was profound. With nearly two decades of experience, Kussy demonstrated exceptional leadership in public health, excelling in fund development, partnerships, and transforming health systems. Her strong qualitative and quantitative data analysis skills were invaluable in advancing our health promotion, poverty reduction, and social justice programs. Kussy was a catalyst for change, leading efforts to dismantle systemic racism in health care through multidisciplinary team management and engagement. Her talent for authentic connection and storytelling, combined with her expertise in program design and evaluation, left a lasting mark on our initiatives and the communities we served.”
Blanca Melendrez, MPH | Executive Director | Center for Community Health | Altman Clinical and Translational Research Institute

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