The next year holds many changes for the healthcare industry: the implementation of higher spending caps and flexible spending account limits, preparation for ICD-10 and health insurance exchanges, and further consolidation from health systems and insurance companies. Here are 50 people with considerable sway over healthcare policy, operations and opinion in 2013.
Joel Allison. Mr. Allison is president and CEO of Baylor Health Care System in Dallas, which operates a network of 27 owned, joint-ventured or affiliated hospitals; 26 ambulatory surgery centers; and the Baylor Research Institute. Mr. Allison has led the non-profit system since 2000. In the last year, the system has undertaken under $1.2 billion in projects, joining a Dallas-area push by local health systems to grow market share. The system's plans include a joint venture with for-profit Emerus for several free-standing emergency departments, each of which could cost at least $12 million. Mr. Allison, who joined Baylor in 1993, has been in healthcare for three decades. He serves on the Healthcare Leadership Council, the Joint Commission Board of Commissioners and is a member of the United Surgical Partners International board.
Mark T. Bertolini. Mr. Bertolini is the chairman, CEO and president of Aetna, a health insurance company with more than $33.7 billion in 2011 revenue. Aetna posted a third quarter increase of 11 percent over the third quarter of 2011, driven by growth in healthcare premiums. The company's membership is expected to grow significantly in mid-2013, when the company completes its $1.5 billion acquisition of Coventry Health Care. The acquisition will increase Aetna's member base by more than 20 percent. Responding to the re-election of President Barack Obama in an interview with the Wall Street Journal, Mr. Bertolini said the shape of health insurance exchange is still unclear. "There are still a lot of regulations to be proffered," he said. "We'll see a flood of those coming out in the next three months." Mr. Bertolini has held executive positions at Cigna, NYLCare Health Plans and SelectCare. He was named CEO of Aetna in November 2010.
John Boehner. Mr. Boehner is the 61st and current Speaker of the United States House of Representatives and a member of the Republican Party. He assumed office in 2011, taking over for Nancy Pelosi. Mr. Boehner has come into conflict with President Barack Obama over the Patient Protection and Affordable Care Act, which he said in June he "respects" but will work to repeal. Despite calling healthcare reform the "law of the land" in a recent interview, Mr. Boehner remains committed to the law's repeal. "It is costing us jobs and threatening healthcare," said Kevin Smith, the Speaker's communications director, to NBC News. "Speaker Boehner and House Republicans remain committed to repealing the law." Prior to his position as Speaker of the House, Mr. Boehner served as House Minority Leader for four years and House Majority Leader for one.
Richard M. Bracken. Mr. Bracken is chairman and CEO of HCA, the largest private operator of healthcare facilities in the world. Based in Nashville, Tenn., the system currently manages 162 hospitals and 112 freestanding surgery centers in the United States and United Kingdom. The health system has frequently been listed among the leading providers in the nation, with the Joint Commission naming 96 HCA hospitals to its list of 620 Top Performers in 2012. HCA posted a profit in the third quarter of 2012 that rose almost 500 percent and reported an increase in same-facility equivalent admissions.
William F. Carpenter. Mr. Carpenter has served as CEO of Brentwood, Tenn.-based LifePoint Hospitals since June 2006 and assumed the additional position of chairman of the board in 2010. He currently serves as chair of the Federation of American Hospitals, the national representative of investor-owned or managed hospitals and health systems. LifePoint's third quarter earnings fell 51 percent in 2012, after what Mr. Carpenter called a "challenging quarter." Acquisition expenses, higher operating costs, lost revenue from Hurricane Isaac and experiences with Medicare Recovery Auditors all took their toll on the health system, causing net income to plunge from $38.8 million in the third quarter of 2011 to $19.2 million this year.
Benjamin K. Chu, MD. Dr. Chu is president of Kaiser Permanente Southern California Region and chairman-elect of the American Hospital Association, an organization representing hospital and health system interests in the United States. He will take over for current chair Teri Fontenot, president and CEO of Louisiana's Woman's Hospital, at the end of 2012. In his role at Kaiser, Dr. Chu directs hospital and health plan operations for 14 hospitals and 168 medical offices, serving more than 3.6 million members in both locations. Prior to joining Kaiser, he served for three years as president of New York City's Health and Hospitals Corp. Dr. Chu is a primary care internist by training.
Carolyn M. Clancy, MD. Dr. Clancy was appointed director of the Agency for Healthcare Research and Quality in February 2003 and reappointed in October 2009. A general internist and health services researcher, Dr. Clancy focuses on improving healthcare quality and patient safety and reducing care disparities based on race, ethnicity, gender, income and education. As director of AHRQ, she launched the first annual report to Congress on healthcare disparities and quality. In September, AHRQ announced a 40 percent reduction in central line-associated bloodstream infections, saying that the improvement has saved more than 500 lives and $34 million in healthcare costs. "Until recently, these infections were thought to be an unfortunate consequence of care," Dr. Clancy said at a news conference. "Our work … demonstrates definitively that they are not."
Francis Collins, MD, PhD. Dr. Collins was sworn in on Aug. 27, 2009, as the 16th director of the National Institutes of Health, nominated by President Barack Obama and unanimously confirmed by the U.S. Senate. In this role, he actively shapes the agency's activities and outlook, seeks advice from experts on the Institutes' policies and activities, and communicates with HHS and Congress. He is also responsible for advising the President on his annual budget request to Congress. Since 2011, Dr. Collins has led an effort to open the National Center for Advancing Translational Services, a project inspired by his frustration with the declining productivity of the pharmaceutical industry. In its first few months, NCATS has launched research initiatives on therapeutic uses for existing molecules and the use of tissue chip for drug screening. Dr. Collins recently started a blog on the NIH website, where he comments on health issues and government policy.
David Cordani. Mr. Cordani is president and CEO of Cigna, a role he has held since December 2009. He was named to the helm of the company at a pivotal time, as Cigna transitions from a traditional health insurance company into a global health service company. The company continues to look for growth by acquiring healthcare companies in the U.S. and abroad and maintains that India and Turkey are ripe for growth. According to Mr. Cordani in an interview with The Courant, Cigna is pursuing three "strategic categories" of mergers and acquisitions: furthering the company's global footprint, entering the U.S. seniors' market and expanding retail capabilities. Cigna announced November 1 that the company will cut 1,300 jobs worldwide now through June 2013, mostly in Europe.
Delos "Toby" Cosgrove, MD. Dr. Cosgrove is president and CEO of the Cleveland Clinic, a multi-specialty academic medical center currently regarded as one of the top four hospitals in the United States, as rated by U.S. News & World Report. As CEO, Dr. Cosgrove presides over a $4.6 billion healthcare system, comprised of the Clinic, nine community hospitals, 14 family health and ambulatory surgery centers, and several extensions of the Clinic in Florida, Toronto and Abu Dhabi. The Clinic recently released a list of the "best medical innovations" for next year, including a hand-held scanner that detects skin cancer, a device to relieve severe headaches and new drugs to treat advanced prostate cancer. Dr. Cosgrove is among several big names in healthcare who will appear in a new HBO documentary, "The Big Picture: Rethinking Dyslexia."
Lloyd H. Dean. Mr. Dean is president and CEO of Dignity Health, formerly Catholic Healthcare West, a California-based non-profit company that operates hospitals and ancillary care facilities in California, Arizona and Nevada. Dignity Health is the fifth-largest hospital system in the nation. In 2012, the company changed its name to better reflect its ministry as a non-profit organization. Officials said in a statement that Dignity Health was not immune to fluctuating volumes and a poor economy in 2012. "The majority of the drop in income [from $917 million to $132.5 million] was a decrease in investment earnings, which is directly related to the poor performance in the stock market overall," said Michael Blaszy, senior executive vice president and CFO for Dignity. Towards the end of the year, the health system broke off acquisition talks with Ashland (Ore.) Community Hospital, the first hospital with which Dignity talked about partnership after its re-branding.
Ralph de la Torre, MD. Dr. de la Torre is the president and CEO of Boston-based Steward Health Care System, a two-year-old hospital system formed by the sale of Caritas Christi Health Care to Steward in 2010. Since its inception, the 10-hospital system has attracted providers from Massachusetts-based Tufts Medical Center, Partners HealthCare and Beth Israel Deaconess, and was named a participant in the Medicare Pioneer Accountable Care Organization Program in late 2011. The system also recently established a health plan called Steward Community Choice. Dr. de la Torre, who was the youngest chief in cardiac surgery in the history of any Harvard teaching hospital prior to joining Steward, established the hospital's cardiovascular institute. Dr. de la Torre has made a name for himself as an outspoken leader; in August 2012, the CEO lambasted Rhode Island Attorney General Peter Kilmartin for an "unwelcome attitude to Steward" and disappointing behavior in mediating an agreement with Blue Cross Blue Shield of Rhode Island.
Nancy-Ann DeParle. Ms. DeParle is the current deputy chief of staff for policy in the administration of President Obama, a position she assumed in January 2011. Prior to that, she served as director of the White House Office of Health Reform, leading the administration's efforts on healthcare issues. She has also served as the director of the Health Care Financing Administration, administering the Medicare program for the Clinton administration. She has been suggested as a replacement for HHS secretary Kathleen Sebelius, should Ms. Sebelius choose to step down from her current position.
Thomas C. Dolan, PhD, FACHE, CAE. Dr. Dolan is the president and CEO of the American College of Healthcare Executives, an international professional society of more than 40,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE's goal is to be the premier professional society for healthcare executives dedicated to improving healthcare delivery and endeavors to keep its finger on the pulse of hospital leaders' concerns. Dr. Dolan served as ACHE's executive vice president prior to being named president and CEO and has also held a variety of teaching, research and administrative positions at St. Louis University, the University of Missouri-Columbia, the University of Washington and the University of Iowa.
Trevor Fetter. Mr. Fetter is the president and CEO of Tenet Healthcare Corp., an investor-owned healthcare system based in Dallas. Tenet owns and operates 49 acute-care hospitals in 11 states and 90 outpatient centers in 12 states, with a majority of these hospitals in California, Florida and Texas. Tenet has had a tumultuous year; eighteen months ago, the health system rejected a $3.5 billion, all-cash offer from Community Health Systems, and has since experienced a stock decline of $1 billion. According to a statement released by Mr. Fetter on Oct. 1, the company has a new plan to raise money, acquire hospitals and buy back more shares to raise the system's stock price. Mr. Fetter also said, post-election, that the healthcare reform law should be a "material positive driver" to the company's earnings over the next few years.
Teri Fontenot, FACHE. Ms. Fontenot is chair of the American Hospital Association and the president and CEO of Woman's Hospital, a 350-bed regional referral hospital for obstetrics, newborn and women's care. In August 2012, the hospital completed its $340 million replacement campus, which increases the capacity for current services and new growth opportunities. Ms. Fontenot will step down from her position as the chair of the AHA Board of Trustees at the end of 2012. She has also chaired the Chief Executive Officers Committee of the American College of Healthcare Executives and has served on its board and Office Nominating Committee. Ms. Fontenot recently spoke at a Becker's Hospital Review event on the future of healthcare, saying, "We already are working very hard to be held more accountable … We know that the current cost structure for care in our country is completely unsustainable."
Thomas Frieden, MD. Dr. Frieden is director of the U.S. Centers for Disease Control and Prevention, a position he has held since May 2009. Prior to his current position, he served as the New York City Health Commissioner, a position in which he introduced the city's first comprehensive health policy targeting ten leading causes of preventable illness and death. He was also an active proponent of electronic health records, launching the nation's largest community-based EHR project. Dr. Frieden has worked to control both communicable and non-communicable diseases in the United States and internationally and regularly comments on health issues affecting the American people, such as obesity, end-of-life issues, vaccines and food quality.
Atul Gawande, MD. Dr. Gawande is a surgeon, writer and public health researcher who practices general and endocrine surgery at Brigham and Women's Hospital in Boston. He is also a professor of surgery at Harvard Medical School and a professor in the Department of Health Policy and Management at the Harvard School for Public Health. Dr. Gawande has written three New York Times bestselling books on healthcare: "Complications," "Better" and "The Checklist Manifesto," and has been a staff writer for New York Magazine since 1998. His research work currently focuses on systems innovations to transform safety and performance in surgery, childbirth and care of the terminally ill. Dr. Gawande recently spoke on coaching, success and failure at the Harvard Graduate School of Education's Askwith Forum, saying that proper mentorship is the key to replicating excellence.
Alex Gorsky. Mr. Gorsky, CEO of pharmaceutical giant Johnson & Johnson, was named to the helm of the company in February 2012, succeeding William Weldon. His current tenure with the company is Mr. Gorsky's second stint with Johnson & Johnson; he originally served as company group chairman of J&J's pharma business in Europe, the Middle East and Africa before leaving to join Novartis in 2004. He returned to J&J in 2008 to become company group chairman of Ethicon. The company recently rejected a call by a Goldman Sachs analyst to break up into smaller companies, as some of its competitors have done. The comments came after the release of J&J's first quarterly earnings report of 2012, which one analyst called its best in five years. Mr. Gorsky said in July 2012 that the company was better equipped to serve its customers as a large, diversified company.
Glenn Hackbarth, JD. Mr. Hackbarth is chairman of the Medicare Payment Advisory Commission, more commonly known as MedPAC, which recommends reimbursement rates to Congress. He previously served as CEO and one of the founders of Harvard Vanguard Medical Associates, a multi-specialty group practice in Boston that serves as a major teaching affiliate of Harvard Medical School. Mr. Hackbarth recently commented on Medicare Advantage, which costs the government approximately 14 percent more than standard Medicare. A proposed program would provide bonuses to health insurers who beef up Medicare Advantage plans by limiting hospital re-admissions, increasing preventive care and achieving high patient satisfaction ratings. Mr. Hackbarth told HHS officials that the program does exactly the opposite of its intention, amounting to a "mechanism to increase payments" that "lessens the incentive to achieve the highest level of performance."
George C. Halvorson. Mr. Halvorson is the chairman and CEO of Kaiser Permanente, a role he will hold through the end of 2013. Kaiser Permanente announced on Nov. 5 that Mr. Halvorson will be succeeded by Bernard J. Tyson. With more than nine million members and nearly $50 billion in annual revenue, Oakland, Calif.-based Kaiser is the biggest system that combines insurance plans and healthcare providers under a single umbrella. The model is becoming more popular nationwide as health systems look to take on risk and blur the lines between the two businesses.
Margaret Ann Hamburg, MD. Dr. Hamburg serves as commissioner of the U.S. Food and Drug Administration, the agency of HHS responsible for regulating and supervising food safety, tobacco products, dietary supplements, drugs and other products. She was one of the youngest people ever elected to the Institute of Medicine and is a highly-regarded expert in community health and bio-defense, including preparedness for nuclear, biological and chemical threats. U.S. and state health regulators have recently called on Congress to strengthen federal oversight of compounding pharmacies, following a deadly fungal meningitis outbreak linked to a compounded steroid. The FDA faces legal restrictions in regulating drug compounders such as the facility where the outbreak started.
Stephen J. Hemsley. Mr. Hemsley has been CEO of UnitedHealth Group since 2006 and joined the company in 1997, prior to which he served as managing partner and CFO at Arthur Andersen. UnitedHealth Group serves approximately 70 million individuals nationwide and is the parent of UnitedHealthcare, the largest single health carrier in the country. In 2011, he was named by Forbes Magazine as the country's highest-paid CEO, bringing in an estimated $48.8 million in total compensation that year. UnitedHealth recently reported a jump in third-quarter earnings, coming in at 23 percent higher than last year, thanks in part to Medicare and Medicaid business growth. In July, the Obama administration announced an innovative partnership with UnitedHealth Group, as well as Humana and WellPoint, to track medical claims in real time and better identify suspicious billing patterns.
Charles "Chip" Kahn III. Mr. Kahn is the president and CEO of the Federation of American Hospitals, whose member companies own nearly 20 percent of all American hospital beds. Mr. Kahn and the FAH represent their members on issues such as healthcare reform and hospital care quality improvement. Mr. Kahn also serves as a member of the governing board of the National Quality Forum, helping to build consensus on national priorities for quality reform and reporting. Despite lobbying Congress on behalf of Republican-leaning for-profit hospital businesses, Mr. Kahn recently stated that Democratic healthcare policies may be more beneficial for the country's bottom line. In an industry panel for the Nashville Health Care Council, he said the Affordable Care Act should prove "good for business" by creating opportunities for entrepreneurs.
Sister Carol Keehan, DC. Sister Keehan is the ninth president and CEO of the Catholic Health Association of the United States, a ministry of the Roman Catholic Church that comprises more than 600 hospitals and 1,400 long-term care and other health facilities in all 50 states. The association is the largest group of non-profit healthcare providers in the nation. Sister Keehan has openly supported President Obama's healthcare reform act, which the United States Council of Catholic Bishops opposed. Sister Keehan has said the continued roll-out of the Affordable Care Act is critical due to the spread of insurance coverage to 30 million more people. Despite this support, she has spoken out against PPACA's mandate that all private employers provide co-pay-free contraception, sterilization and abortion-inducing drugs in their employee health plans — with a narrow religious exemption for houses of worship and institutions that employ and serve people of the same religion.
John Kitzhaber, MD. Dr. Kitzhaber is the 37th and current governor of Oregon and the first person to be elected to the office three times. Prior to becoming a politician in Oregon, he was a practicing emergency room physician. During his tenure in the Oregon State Senate, to which he was elected in 1980, Dr. Kitzhaber was the chief author of the state's government-funded healthcare plan, the Oregon Health Plan. In 2006, he launched the Archimedes Movement, an organization that seeks to maximize the health of the population by creating a sustainable system that uses public resources spent on healthcare to ensure that everyone has access to a defined set of health services. Dr. Kitzhaber has also garnered $1.9 billion in federal funding to implement coordinated care organizations across Oregon. The push towards single-payor healthcare is alive and well in the state, led by Rep. Michael Dembrow (D-Portland), who plans to re-introduce single payor legislation in February.
Jeremy Lazarus, MD. Dr. Lazarus, a Denver psychiatrist in private practice, was inaugurated as the 167th president of the American Medical Association, the nation's largest and most influential physician organization, in June. Dr. Lazarus was first elected to the AMA Board of Trustees in 2003 and has served as speaker and vice speaker of the House of Delegates, the association's primary policy-making body. In a speech at the House of Delegates on Nov. 10, Dr. Lazarus outlined the AMA's plans following President Obama's re-election, saying the AMA will continue working with Congress to implement health system reform and protect the interests of physicians and patients. In October, the association, along with 110 other societies, wrote to Congress outlining principles to transition to a new Medicare delivery system. He also outlined three areas of focus for the next five years: improving health outcomes, accelerating change in medical education and helping physicians to navigate delivery and payment models.
Daniel Levinson. Mr. Levinson has headed the Office of Inspector General for HHS since 2004. As Inspector General, he is the senior official responsible for audits, evaluations, investigations and law enforcement efforts related to HHS programs. Prior to his appointment at HHS, he served for four years as Inspector General of the U.S. General Services Administration. According to a recent video presentation posted to the agency's website, Mr. Levinson plans to focus on Medicare overbilling and fraud in 2013. The work plan, released in October 2012, may be a reaction to a letter written by HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder in September, in which the officials warned healthcare provider associations to crack down on fraud. The OIG will focus much of its attention next year on the role that EHRs play in Medicare overbilling.
H. Stephen Lieber, CAE. Mr. Lieber has served as president and CEO of Healthcare Information and Management Systems Society, since 2000. Founded in 1961, HIMSS is a non-profit organization dedicating to improving healthcare quality and access through the best use of healthcare IT and management systems. The society includes more than 35,000 individual members. During his tenure, Mr. Lieber has more than quadrupled the organization's size and expanded its scope to encompass ambulatory IT issues and healthcare business information systems, in addition to HIMSS' historical leadership in the acute-care clinical information systems area. Mr. Lieber has recently launched HIMSS conferences and exhibitions in Europe, Asia and the Mideast; the U.S. educational conference and trade show is the world's largest in health IT, attracting over 32,000 healthcare professionals annually. In 2013, HIMSS plans to assist the healthcare industry in reaching ICD-10 compliance.
Steven H. Lipstein. Mr. Lipstein is president and CEO of BJC Healthcare, based in St. Louis, a health system with annual revenues of $3.5 billion and more than 26,000 employees. Its teaching hospitals, Barnes-Jewish Hospital and St. Louis Children's Hospital, are consistently ranked among the nation's best medical schools and research institutions. Mr. Lipstein has served as president of the health system since 1999, in addition to his work with the St. Louis Regional Health Commission and the Missouri Hospital Association. The boards of BJC HealthCare recently approved a new partnership, BJC Collaborative, made up of St. Luke's Health System, Memorial Health System and BJC. The partnership aims to rein in healthcare costs by combining negotiating power and was initiated by Mr. Lipstein this year in response to the Affordable Care Act.
Kevin E. Lofton. Mr. Lofton has been president and CEO of Englewood, Colo.-based Catholic Health Initiatives since 2003, having previously served as the system's COO and in other executive positions. Active with the American Hospital Association, he served as the 2007 chair of the AHA Board of Directors and currently serves as chair of the Committee on Nominations. In October 2012, he led the system in its largest bond issue in CHI's history, which he called "an essential investment in our future." The bonds will finance a wide array of strategic initiatives in 2013 and beyond, including virtual technologies, physician integration and partnerships and alliances in key areas across the country. CHI merged with Jewish Hospital, Saint Mary's Healthcare and Saint Joseph Health System in January to create KentuckyOne Health.
Charles N. Martin, Jr. Mr. Martin has served as Vanguard Health Systems' chairman and chief executive officer since the company's inception in 1997. Prior to forming Vanguard, he served as chairman, president and CEO of OrNda HealthCorp. Under his leadership, OrNda grew from revenues of $450 million to $3 billion in three years, becoming the nation's third-largest investor-owned hospital management company. Vanguard Health Systems, based in Nashville, owns 28 hospitals in five states and recently merged with Connecticut-based Waterbury Hospital. While the hospital system got off to a rough start in its first quarter of 2012, posting a $21 million loss, Vanguard had bounced back by the same quarter of 2013, reporting a profit of $13.9 million.
Farzad Mostashari, MD, ScM. Dr. Mostashari serves as National Coordinator for Health Information Technology within the Office of the National Coordinator for Health Information Technology at HHS. He joined ONC in July 2009, having previously served at the New York City Department of Health and Mental Hygiene. Dr. Mostashari, a vocal proponent of data and analytics in the improvement of healthcare, recently commented on the role that data played in the campaign and re-election of President Barack Obama. "It was something of a relief that data matters, that science matters, that predictions can be based on evidence," he said in the Nov. 7 meeting of the federal advisory Health IT Policy Committee. He added that the re-election gives the Obama administration more time to finish the job of implementing health IT initiatives. Dr. Mostashari also plans to launch an internal review to determine whether EHR systems prompt some providers to overbill Medicare or "upcode" for procedures.
Gary D. Newsome. Mr. Newsome became president and CEO of Health Management Associates, based in Naples, Fla., in 2008. Prior to that, he was employed by Community Health Systems. Health Management Associates is a for-profit corporation that operates or provides services to 66 hospitals in 15 states, including the former Wuesthoff Healthcare hospitals, which were purchased by the company in 2010. Mr. Newsome said in a recent statement that the company will continue in 2013 to focus on patients, managing costs and investing resources, as well as building partnerships with other facilities. "This culture and track record of solid operating performance is … attracting a significant number of hospitals and health systems that are seeking a strategic partner," he said. HMA recently entered a new corporate partnership with St. Petersburg, Fla.-based Bayfront Medical Center.
John H. Noseworthy, MD. Dr. Noseworthy is president and CEO of Mayo Clinic, a Rochester, Minn.-based health system routinely recognized as one of the top providers in the country. Dr. Noseworthy began his career as a neurologist and holds the title of editor-in-chief of Neurology, the journal of the American Academy of Neurology. Last year, Mayo Clinic initiated the Mayo Clinic Care Network, which aims to extend the hospital's expertise to outside physicians and providers. So far, the network has added a number of members, including the Dartmouth-Hitchcock healthcare system, St. Alexius Medical Center and St. Elizabeth Hospital. To help the network be as effective as possible, Mayo has developed electronic consulting tools such as the AskMayoExpert database, which help outside providers connect with Mayo Clinic specialists on questions of patient care.
President Barack Obama. President Obama is the 44th and current President of the United States and the first African American to hold the office. In 2010, President Obama passed the sweeping Patient Protection and Affordable Care Act, which expands healthcare coverage to 35 million individuals and sets up health insurance exchanges to lower the price of health insurance, among other measures. In November 2012, President Obama was re-elected to his position, beating Republican candidate Mitt Romney by a wide margin — 332 electoral votes to 206. Following President Obama's re-election, polls have found that support for repealing the Obama healthcare law has dropped to a record low, at just 33 percent. In the wake of the election, states that previously adopted a "wait and see" approach to implementing health reform measures have started scrambling to make plans. Many states must decide whether to establish their own programs for residents and businesses to buy insurance, through programs that will begin in 2014.
Thomas M. Priselac. Mr. Priselac has been president and CEO of Cedars-Sinai Health System in Los Angeles since January 1994, with an association to the health system going back to 1979. The health system is among the nation's leading providers of healthcare services, medical education and research, and Cedars-Sinai is the largest private hospital in the western United States, with revenues over $1.7 billion. Ms. Priselac has also served the healthcare industry in other roles, as past-chair of the American Hospital Association Board of Trustees and past-chair of the Association of American Medical Colleges. In March 2012, the system completed a seven-phase, five-year effort to buy and roll out a commercial EHR system with a hospital-wide implementation of computerized physician order entry, 10 years after an infamous failure to implement CPOE through a "big bang" strategy.
Kenneth Raske. Mr. Raske has been president of the Greater New York Hospital Association since 1984 and is a recognized expert on healthcare policy and finance. He has been instrumental in growing GNYHA to the nearly 250 hospitals and continuing care facilities in the New York metro area and throughout the state. On the federal front, GNYHA has been a leading advocate in the fight for relief from deep Medicare and Medicaid cuts that threaten healthcare communities every year. Mr. Raske also created The Health Economics and Outcomes Research Institute, which analyzes and interprets fiscal data and economic trends affecting healthcare providers. Mr. Raske sought federal financial aid on behalf of New York's hospitals following Hurricane Sandy, saying hospitals that evacuated lost revenue and others were burdened with additional patients due to closures.
Ian Read. Mr. Read is chairman of the board and CEO of Pfizer, one of the world's leading biopharmaceutical companies. Prior to his current position, Mr. Read served as senior vice president for Pfizer and group president of the worldwide pharmaceutical businesses. He joined the company in 1978 as an operational auditor and has taken on roles of increasing responsibility since then. Pfizer experienced a boost in late 2012 after the approval of its drug Xeljanz for rheumatoid arthritis, which followed a string of setbacks with drug approvals that raised concerns in the industry. The company also wrapped up 2012 by resolving several government and civil lawsuits involving numerous medicines, for which Pfizer expected to pay approximately $825 million.
John Roberts. Chief Justice Roberts is the 17th and current Chief Justice of the United States, a position he has held since 2005, having being nominated by President George W. Bush. In June 2012, he delivered the majority opinion in the Supreme Court case that upheld the Patient Protection and Affordable Care Act by a 5-4 vote. The Court ruled that although the law's "individual mandate" component of the act was unconstitutional according to the Commerce Clause, it could be construed as a tax and therefore valid under Congress' authority to "lay and collect taxes." President Obama commented on the decision, saying, "I think Justice Roberts made a decision that allowed him to preserve the law but allowed him to keep in reserve the desire, maybe, to scale back Congress' power under the Commerce Clause in future cases." Although the Supreme Court upheld the Act in June, some of its core provisions still face challenges in courts at the state level.
Nancy Schlichting. Ms. Schlichting is CEO of Henry Ford Health System in Detroit, Mich., a $4 billion healthcare organization with 23,000 employees. She is credited with leading the health system through a dramatic financial turnaround and for implementing award-winning patient safety, customer service and diversity initiatives. She joined the system in 1998 as senior vice president and has accepted roles of increasing responsibility ever since. Henry Ford Health System is currently planning a "mega-merger" with Detroit's Beaumont Health System, touting better and more convenient care for metro Detroit residents as a key selling point. The systems would also share electronic medical records to offer a safer and more efficient way to look at patient history. The merger should not result in any changes to Health Alliance Plan, the state's second-largest health insurance company, which is owned by Henry Ford. Ms. Schlichting called the merger a partial response to the "tsunami coming with Medicare."
Kathleen Sebelius. Ms. Sebelius currently serves as the 21st Secretary of Health and Human Services. She also served as the second female governor of Kansas from 2003 to 2008 and the chair-emerita of the Democratic Governors Association. Sec. Sebelius has been responsible for implementing many reforms under the Patient Protection and Affordable Care Act, including policies that place emphasis on wellness and prevention, support adoption of EMR and train more primary healthcare providers. At the end of 2012, Sec. Sebelius and HHS decided to extend the deadline for states to submit plans for state-based health insurance exchanges, an issue that has been contentious as many Republican-led states chose to "wait and see" the results of the presidential election before taking action. Sec. Sebelius emphasized in the deadline extension that the Obama administration "is committed to providing significant flexibility for building a marketplace that best meets your state's needs."
Gov. Peter Shumlin. Gov. Shumlin is the 81st and current governor of Vermont, having previously represented his Vermont Senate District for eight non-consecutive two-year terms. He was re-elected as governor of his state in November 2012. In 2011, Gov. Shumlin led the state in passing legislation that would establish a single-payor healthcare system, making Vermont the first state in the nation to make healthcare "a right and not a privilege," said Gov. Shumlin. The Vermont legislature and his administration are currently working on setting up a state health insurance exchange under the healthcare law, building a potential platform for a state-based single-payor system in the future. "This Vermont boy wants to implement that single-payor healthcare system tomorrow, and I don't know why you guys want to stop me from doing that," Gov. Shumlin said at a recent Politico health policy panel. "It's the right thing to do. The rest of the world has figured it out. Let's grow up and join them."
Wayne Smith. Mr. Smith joined Community Health Systems in 1997 and has since become the system's chairman of the board, president and CEO. He worked for insurance company Humana for 23 years before joining CHS. CHS, based in Franklin, Tenn., is the largest non-urban provider of general hospital healthcare services in the United States, in terms of acute-care facilities. In the third quarter of 2012, the system reported $3.2 billion in revenue. Commenting on the potential outcomes of the presidential election on an investor conference call in late October 2012, Mr. Smith said, "If it's a Romney win, you're going to test our ability to continue productivity and develop new strategies around reductions in cost and how we can better deliver our care at a lower cost. If President Obama is re-elected, then we'll continue to work on the revenue side."
Glenn D. Steele Jr., MD, PhD. Dr. Steele is president and CEO of Geisinger Health System, a position he accepted in 2001 after a tenure at the University of Chicago. He is past chairman of the American Board of Surgery and is widely recognized for his investigations into the treatment of primary and metastatic liver cancer and colorectal cancer surgery. More recently, he has concentrated on innovations in healthcare delivery and financing. In late 2012, he led Geisinger in a bid for Altoona Regional Health System, a 380-bed non-profit hospital operator, competing against UPMC and Highmark. The system was also recently chosen as one of six nationwide to provide heart surgery services for Walmart associates and their dependents enrolled in the company's medical plans.
Joseph R. Swedish. Mr. Swedish became president and CEO of Novi, Mich.-based Trinity Health in December 2004 and has since led the organization through many initiatives to improve clinical and business processes. Under his direction, Trinity Health has improved financial and operational performance while focusing on seven imperatives: community benefit ministry, excellence in care, financial stewardship, accelerated integration, physician alignment, best people and accountable health networks. He is currently leading the Catholic hospital system through two major changes: the move of its headquarters from Novi to Livonia, Mich., and a potential merger with Pennsylvania-based Catholic Health East. Together, the two hospital systems would form one of the nation's largest Catholic health systems and the 10th-largest U.S.-based hospital chain overall.
Marilyn Tavenner. Ms. Tavenner is the current acting administrator for CMS, succeeding Donald M. Berwick, MD, who resigned in December 2011. Ms. Tavenner has nearly 35 years of experience working with healthcare providers, previously serving as principal deputy administrator for the Medicare program and HCA's president of outpatient services. She has stated her opposition to converting Medicaid to a block grant program, saying "the only way to stabilize costs without cutting benefits or provider fees is to improve care to those with the highest health costs," according to a Washington Post interview. In October, 60 members of Congress wrote to Ms. Tavenner urging CMS to table a proposal expanding multiple procedure recommendations, which apply when the same physician performs multiple services to the same patient in the same session on the same day. CMS plans to expand MPPR and propose a 25 percent reduction on the technical component for the less expensive service.
Anthony Tersigni, EdD, FACHE. Dr. Tersigni serves as president and CEO of Ascension Health Alliance, whose subsidiaries include Ascension Health, the nation's largest Catholic and non-profit health system. Dr. Tersigni is the first president and CEO of the Alliance, which began operations on Jan. 1, 2012, as part of an organizational redesign to increase clarity and accountability in the changing healthcare environment. He previously served as interim CEO for the system, starting in January 2004. In November 2012, he led the St. Louis-based system in signing a memorandum of understanding with Oklahoma-based Marian Health System to acquire the three regional health systems that comprise the Marian system.
Richard Umbdenstock, FACHE. Mr. Umbdenstock is president and CEO of the American Hospital Association, the nation's primary organization for promoting policy that supports hospitals and health systems. Prior to joining the AHA, Mr. Umbdenstock was executive vice president of Providence Health & Services in Spokane, Wash. Mr. Umbdenstock has said Medicaid expansion in the states is a top concern for the American Hospital Association in 2013, especially the issue of undecided states that may require individual conversations with HHS officials. He said that while implementation of the national health reform law is a top priority, the AHA is willing to work on tweaking parts of the 2010 law on Capitol Hill, including repeal of IPAB. He also recently led the AHA in suing HHS over Medicare payment denials for audited outpatient procedures.
Chris Van Gorder. Mr. Van Gorder is president and CEO of Scripps Health in San Diego. He was integral to the system's turnaround in 2000 and is currently leading the system through an expansion plan for the San Diego region. In October 2010, Mr. Van Gorder announced a new direction for the system, turning "the organization on its side" to create a horizontally matrixed management structure. This change was intended to identify and significantly reduce unnecessary variation in patient care and healthcare operations. The new "One Scripps" approach led to more than $70 million in performance improvements in the first year.
50 of the Most Powerful People in Healthcare FeaturedWritten by Rachel Fields | Wednesday, 21 November 2012 09:39
The re-election of President Obama in November 2012 means the solidification of change for the healthcare industry; since the polls closed, support for the repeal of the Affordable Care Act has dropped to its lowest level since the law was passed, according to a Kaiser Family Foundation poll. Republican Speaker of the House John Boehner recently called PPACA "the law of the land" — a statement that, while he backtracked several days later, suggests that measures proposed by the law will be implemented nationwide regardless of party lines.
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