Beth Ratliff is the Chief Operating Officer at Premise Health, the largest direct healthcare provider for large, self-insured employers in the country. Beth began her career as a physical therapist and grew passionate about delivering quality care to patients after navigating insurance reimbursement difficulties for her services. Beth made unconventional lateral career moves to expand her skillset and develop the tools to become the healthcare leader she is today. Beth resides in Nashville and enjoys the live music scene outside of work. Beth has been a C200 Member since 2026.
Eva Glassman: What is your day-to-day like as COO of Premise Health? What do you love about your role, and what are some challenging aspects?
Beth Ratliff: I am the Chief Operating Officer at Premise Health. We are the largest direct healthcare provider in the country. We partner with large, self-insured employers to deliver advanced primary care to their people. We operate about 850 wellness centers, primary care centers, pharmacies, and fitness centers across the country. We also deliver virtual health coast to coast.
What’s different about our model of healthcare is that we’re not fee-for-service. We’re actually paid directly by our clients, who are really looking to solve problems with access, healthcare equity, or cost for their organization and their people. We’re not paid by insurance, which frees us up to take great care of patients—that means things like same and next-day appointments, quick wait times in the waiting room, more time in the exam room with your provider. On average, we’re spending about thirty minutes with the patient when they come in and we’re focusing on their whole health: physical, mental, and social. We work in a team with a behavioral health provider, a pharmacist, a care manager, and a primary care provider for the patient.
Years ago, I first went into healthcare as a physical therapist because I wanted to take great care of patients. As I was practicing, I encountered a lot of limitations caused by insurance reimbursement. In contrast, the model of care we deliver at Premise Health allows us to deliver amazing outcomes and experiences for the patients we serve. That’s what I love most: making things happen and serving the teams that provide the care.
On the flipside, it’s challenging to ensure we have the right balance of quality and access. We can’t ever lose sight of doing what’s right for the patient, and that becomes more complex as healthcare continues to grow and evolve in this country. You’re always having to balance risk, access, and quality of care. Ultimately, we know that if you do what’s right for the patient, everything else follows.
EG: You mentioned you started your career in healthcare as a physical therapist. Was being a healthcare leader always your goal? How did your idea of what you wanted to do evolve as you went through your career?
BR: I went to school to be a physical therapist, and I started my career treating patients. I had a passion for patient care, but I eventually burnt out because of the insurance reimbursement system that I was working in; I felt like I couldn’t take great care of patients because of that system.
I eventually took a new job working at Toyota, caring for their injured workers. When I got there, they told me right away, “Don’t worry about the insurance reimbursement; just worry about getting the patient better.” That was music to my ears!
I was super intrigued by that model of care and grew interested in Toyota’s manufacturing process—the model of continuous improvement and lean quality. It inspired me to evaluate how we operated in the physical therapy department and apply that on a broader scale.
Eventually, an opportunity emerged for me to take a leadership position. On paper, I was not qualified for this position; I didn’t check every box, but I raised my hand anyway. From my experience up to that point, I knew that you could take great care of the patient and optimize the outcomes when the entire system is cared for. I also had the confidence to know I could figure the rest out.
I think that’s something women don’t do often enough. We wait until we’re absolutely qualified for everything in the job requirements before we raise our hand, rather than apply even if we don’t meet some of the requirements. I give lots of credit to some of my early mentors for encouraging me to bet on myself and apply for the role.
EG: Tell me more about those mentors. Did you have any women mentors at any point in your career? What was your experience like trying to find and connect with other professional women?
BR: I was lucky enough to have some strong mentors along the way, both men and women. I had some professional and personal connections outside of the work environment with other women professionals, not always in the healthcare space. Early on, I took an approach that I would now call a “personal board of advisors,” where I worked with a variety of different mentors and regularly consulted them about what was going on in my career and really took their input.
My board of advisors has changed over the years, but it’s always a cross-functional team, comprised of men and women. It’s not unusual for me to pick up the phone and call someone with experience in banking or another professional service consulting healthcare professionals and ask them for advice, recommendations, or an introduction to a new connection. It has been a rewarding way to look for mentorship. It doesn’t have to be in your own organization; it doesn’t even have to be in your own field.
EG: Speaking of building your network across organizations and industries, how did you discover C200? What drew you to join, and what are you most excited about as a new Member?
BR: I’m connected professionally with Mary Tinebra, a C200 Member, who reached out to me about learning more and joining. She called me at the exact right time. Every year in the fourth quarter, I jot down some professional and personal goals to start building my plan for the following year. One of those goals in 2026 was to do some networking outside of healthcare. I have quite a large network in the healthcare field—I’m very active in Nashville Healthcare Council and sit on other healthcare associations—but I was interested in meeting women leaders outside of healthcare. When Mary called, I told her, “It’s almost like you were reading my notes!” It was just perfect timing.
As a new Member, I’m looking forward to learning from women leaders in other industries than mine, those who are creatively solving problems and willing to share those experiences. I would also love to mentor other women facing challenges like ones I’ve faced. That exchange of knowledge is so valuable.
EG: What does being a “woman in business” mean to you? How does that impact your work and leadership?
BR: I don’t lead with being a woman in business. I lead with being a trusted leader and professional who shows up to contribute value in whatever room I’m in. I focus on earning trust, communicating with clarity, and providing perspective based on my knowledge, skills, and experience.
The fact that I’m a woman certainly does not go unnoticed, but it is not what I choose to lead with. I have had experiences where I’ve been the only woman in the room, certainly early on in my career, and had to learn to navigate those rooms and spaces. I had to make sure I was showing up, providing value, and giving a competent opinion or service.
I would also say that I’m a very transparent leader and person in general. I am not afraid to talk about the tough things that I have faced as a woman, as a mother, as someone who’s been in recovery for over thirty years, as someone who has battled cancer. I bring those experiences to the table and use them to not only make me stronger as a leader, but to make our organization stronger as well.
I have a responsibility as a leader and as a woman leader to bring others along with me. I spend quite a bit of time mentoring women, both in and out of my organization, in my particular field. I also do a lot of work with women outside of the traditional mentoring structure, like in the recovery space with women who have struggled with issues like homelessness or substance abuse. I’m always looking for ways to be of service to someone else. When I am focused on doing that, it makes me stronger as a leader and gives back to others.
EG: Outside of work, how do you spend your free time? What do you like to do for fun?
BR: I love live music. I live in Nashville—who doesn’t love a good live music venue? I love the energy at any sort of live event; if they made watching paint dry a sporting event, I’d probably go watch that.
I love to hike. I love to read. I am an amateur special effects makeup artist, so Halloween is my favorite time of year.
Currently, my husband and I are on the hunt for the world’s best street tacos. When we have nothing else to do, we spend a lot of time going to one taco truck to another, buying one taco, and doing a taste test.
Lastly, I love spending time with my two daughters and two grandkids.
EG: Earlier, you mentioned that you spend a lot of time mentoring women both in and out of your organization. What are the types of conversations you’re having with these rising women leaders? What sort of guidance are they seeking, and what advice are you sharing with them?
BR: The women I talk with are rising leaders and trying to understand how they can advance their career path. We spend a lot of time evaluating what motivates them. Often, I notice they want a promotion, but they don’t understand why they want it. Is it about the title? Money? Particular interest or span of control? I try to help them refine what they want, not only for their next step, but ultimately their entire career. From there, we put together a plan, which includes discussing and viewing other opportunities within their organization through different lenses.
It’s easy to see things as very black and white and think, “Well, I haven’t done X, so I’m not qualified for Y.” I like to push back on that and talk through the ways in which what you have done might apply to this opportunity and why. Maybe you haven’t done X, but you’ve done something else that makes you a stronger candidate if you position your experiences properly.
I have taken some lateral moves in my career that might have looked very questionable from the outside looking in. For example, I’ve stepped out of a senior role to run a project with no guarantee of a role for me at the end; I’ve moved from clinical to operations to an IT enterprise project; I’ve done post-acquisition work. However, I always had a purpose. It wasn’t necessarily to get a promotion, but to learn more about the organization and develop stronger networks within it. That would either help me advance my career within the organization or build necessary skills and knowledge to take me somewhere else if I chose to do that.
I never said yes to an opportunity that didn’t intrigue me in some way; the ones I took I often wasn’t fully qualified for. For example, I’m not a technology person, but I once took on a massive technology project. I’d never done merger and acquisition work before, but I once stepped into that role. I knew it was something that would stretch me in a way that I hadn’t been stretched before. If you want to grow your career, you have to be willing to take a risk and be intentional with it.
Watching someone succeed is one of the most satisfying things I get to experience in my career.
C200 is a 501(c)(3) nonprofit organization with a mission to inspire, educate, support, and advance current and future women entrepreneurs and corporate profit-center leaders. The views and opinions expressed in this article are those of the individuals quoted or featured and do not necessarily reflect the views, policies, or positions of C200.