Not play­ing by the rules

We broke tradition for this year’s most in­flu­en­tial per­son


There’s an ex­cep­tion to ev­ery rule, and we made a big one when we chose Chief Jus­tice of the United States John Roberts as the most in­flu­en­tial per­son in health­care for 2012. Roberts wasn’t nom­i­nated by our read­ers in the spring, nor did he make our bal­lot of 300 read­ers voted on through mid-June. But he un­doubt­edly be­came the most in­flu­en­tial per­son in the in­dus­try June 28, when the U.S. Supreme Court re­leased a se­ries of six opin­ions that up­held most of the key pro­vi­sions of the Pa­tient Pro­tec­tion and Af­ford­able Care Act.

Roberts cast the de­cid­ing vote in the 5-4 de­ci­sion up­hold­ing the re­form law’s in­di­vid­ual health in­sur­ance man­date. In do­ing so, Roberts gave the go-ahead for other key pro­vi­sions of the law such as the em­ployer in­sur­ance man­date, the ac­count­able care or­ga­ni­za­tion pro­gram and all the new busi­ness and un­der­writ­ing rules for health in­sur­ance com­pa­nies.

Taken to­gether, the law’s pro­vi­sions reach into ev­ery cor­ner of the $2.7 tril­lion health­care in­dus­try and, ab­sent be­ing re­pealed by Congress and the next pres­i­dent, will change the lives of pa­tients, providers, pay­ers and sup­pli­ers for­ever. That’s influence, and that’s why we broke with tradition and named Roberts No. 1 on this year’s rank­ing of the 100 Most In­flu­en­tial Peo­ple in Health­care.

As for de­ter­min­ing the other 99 power­bro­kers on the list, here’s how we did it. We an­nounced the call for nom­i­na­tions in the March 12 print edition of the mag­a­zine, on our web­site and in all of our daily e-news­let­ters. The nom­i­nat­ing pe­riod con­tin­ued through April 20, with 21,678 nom­i­na­tions sub­mit­ted. The top 300 can­di­dates, based on those nom­i­na­tions, made up the fi­nal bal­lot for this recog­ni­tion pro­gram, our 11th an­nual. Read­ers then voted for the five can­di­dates on the bal­lot of 300 who they be­lieved were the most in­flu­en­tial in the in­dus­try. Some 220,330 votes were cast dur­ing the vot­ing pe­riod from May 7 through June 15. Reader votes counted to­ward 50% of the out­come; the se­nior ed­i­tors of Mod­ern Health­care de­ter­mined the other 50%.

Of note on this year’s rank­ing are the ex­ec­u­tives whose com­pa­nies likely will be most di­rectly af­fected by Roberts’ influence. Mark Ber­tolini from Aetna, Ge­orge Halvor­son from Kaiser, Stephen Hem­s­ley from Unit­ed­Health, An­gela Braly from Wel­lPoint, Michael McCal­lis­ter from Hu­mana and Patricia Hem­ing­way Hall from Health Care Ser­vice Corp. rep­re­sented half of the first 12 slots on this year’s rank­ing. How the ex­ec­u­tives are re­act­ing to the re­form law from a busi­ness per­spec­tive earned them their spots on our list.

For ex­am­ple, Ber­tolini en­gi­neered Aetna’s pro­posed $5.7 bil­lion ac­qui­si­tion of Coven­try Health Care, a lead­ing Med­i­caid man­aged-care op­er­a­tor. But even be­fore that, Aetna jumped into the ac­count­able care or­ga­ni­za­tion busi­ness with the cre­ation of a des­ig­nated busi­ness unit called Aetna Aligned Care So­lu­tions, which part­ners with in­di­vid­ual hos­pi­tals, health sys­tems and med­i­cal prac­tices to cre­ate pri­vate-sec­tor ACOs. Its busi­ness part­ners in­clude such lead­ing or­ga­ni­za­tions as Aurora Health Care, Inova Health Sys­tem, Ban­ner Health and the Car­il­ion Clinic. McCal­lis­ter, mean­while, has Hu­mana snatch­ing up physi­cian prac­tices across the coun­try through a sub­sidiary called Con­cen­tra, an op­er­a­tor of ur­gent- and oc­cu­pa­tional-care clin­ics that Hu­man bought in 2010. And Halvor­son has Kaiser on the cut­ting edge of in­for­ma­tion tech­nol­ogy, giv­ing its clin­i­cians and pa­tients the lat­est elec­tronic apps and plat­forms to share per­sonal med­i­cal in­for­ma­tion.

What those in­sur­ance com­pany ex­ec­u­tives as well as the other lead­ers on our list have in com­mon is a cer­tain fear­less­ness. Rather than play it safe and hope the storm passes, they’re em­brac­ing the changes in the in­dus­try. They’re grab­bing the clouds, re­shap­ing them and mak­ing it rain for their or­ga­ni­za­tions, pa­tients and con­stituen­cies.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.