100 Most Influential People In Healthcare
THE DISRUPTER IN CHIEF 1 DONALD TRUMP PRESIDENT OF THE UNITED STATES
IN HEALTH POLICY CIRCLES, President Donald Trump can be viewed as the other side of the same coin from his predecessor, Barack Obama. Both have caused seismic shifts in the healthcare landscape but in different ways.
“President Obama developed an entirely new national health insurance system,” said Sara Rosenbaum, a professor of health law and policy at George Washington University. “President Trump has demonstrated just how easy it can be to tear it apart.”
Since Trump took office, work requirements have started to be imposed on some Medicaid expansion enrollees, cost-sharing subsidies on the individual market have been canceled, risk payments to insurance companies have been turned off and then on again, funding has plummeted for navigators who help people sign up for coverage, and the penalty for noncompliance with the individual mandate was zeroed out.
“The actions of the Trump administration all share a common theme: halting and reversing the historic progress the U.S. has made in reducing the ranks of the uninsured,” said Edwin Park, a Georgetown University professor of public policy.
Others argue that Trump’s focus hasn’t been on clawing back coverage gains made under Obama but creating a healthcare system that’s more affordable with coverage options that consumers actually want. To that end, states are now allowed to define essential health benefits that individual and small-group insurers must offer. His administration also extended the availability of short-term plans and is hoping to do the same with association plans.
Also, coverage protections for people with pre-existing conditions and the ability for individuals up to the age of 26 to stay on their parent’s coverage remain intact.
“The way to think about the Trump administration’s relationship with the ACA is that it’s separating the wheat from the chaff,” said Christopher Pope, a senior fellow at the Manhattan Institute, a conservative think tank. “He is focusing on which things provide the best value and which are more burdensome than beneficial.”
There’s been so much focus on Trump’s ACA-related work, that other things haven’t been properly noticed, according to Robert Graboyes, a senior researcher at the free-market focused Mercatus Center. Those topics include the drive to reduce legal and regulatory burdens on healthcare stakeholders. Trump also signed into law right-to-try legislation enabling gravely ill patients to get experimental treatments more easily. “It’s still early, but if the Trump administration has an enduring legacy in healthcare, these non-ACA actions will likely be the reason,” Graboyes said.
Trump is also trying to follow through on a campaign promise to find ways to lower drug costs for consumers and the federal government. A rule is now under review at the White House that aims to remove legal protections for drug rebates. Drug companies now pay rebates to pharmacy benefit managers to either make their products the only ones available for coverage to consumers or to make the co-pay less than those for competing products. But these discounts aren’t always passed on to consumers. The average large PBM generates 15% to 20% of its total profits from retained rebates and associated administrative fees, according to a Barclays analyst note.
The CMS is also now planning to allow Medicare Advantage plans to impose prior authorization requirements on Part B drugs. The plans currently have this ability for Part D drugs. Humana has claimed the idea could save Medicare as much as 23% on immunology drugs like Remicade, Stelara and Simponi in 2019.
This approach separates the Trump administration from prior ones, according to Lindsay Bealor Greenleaf, a director of healthcare consulting firm ADVI. Instead of merely condemning the drug industries for prices, it is angling to use the drug supply chain to reduce costs.
“The FDA has started exploring what they can do on drug pricing, and HHS has at least rhetorically shifted attention to drug pricing in a way that prior administrations haven’t been able to,” said Yevgeniy Feyman, a Republican health policy analyst.
Politics aside, it’s Trump’s broad impact on the entire industry that landed him atop 2018’s 100 Most Influential People in Healthcare ranking.
2 THE CLASS OF DISRUPTERS MARK BERTOLINI Chairman and CEO Aetna INSURER CROSS-CUTTING DEALMAKER
One of the architects of the proposed CVS Health-Aetna merger, which has the potential to reshape the industry.
JEFF BEZOS Chairman and CEO Amazon SUPPLIER/ VENDOR CASTING A BIG SHADOW
Amazon’s multiple forays into healthcare have everyone watching for its next move, particularly in care delivery and the supply chain.
BRUCE BROUSSARD President and CEO Humana INSURER STEPPING FURTHER INTO CARE DELIVERY
Humana’s investments in Curo Health Services and Kindred Healthcare pave the way for creating the country’s largest hospice operator.
TIM COOK CEO Apple SUPPLIER/ VENDOR CONNECTING PATIENTS TO PROVIDERS
Apple hopes that the iPhone can do what the industry can’t (so far): break through the interoperability barrier.
DR. DAVID FEINBERG President and CEO Geisinger Health PROVIDER GENOMICS, QUINOA AND TIME
Feinberg was the first patient to sign up for a new Geisinger DNA screening program, one of several innovative initiatives in place at Geisinger, which includes getting patients to eat healthier and ensuring geriatric patients aren’t rushed through their doctor visits.
DR. MARC HARRISON President and CEO Intermountain Healthcare PROVIDER MAKING A SPLASH IN THE DESERT
During Harrison’s less than two years at the helm, Intermountain has tackled major projects, such as working with other health systems to create a drug company, widely expanding its use of telehealth and seeking to reduce opioid prescriptions by 40% this year.
DR. ROD HOCHMAN President and CEO Providence St. Joseph Health PROVIDER DISRUPTION FOR ALL
Hochman, an early adopter of disruptive strategies, also has been outspoken on national issues, calling for protection of socalled Dreamers under the Deferred Action for Childhood Arrivals program, while the health system has been at the forefront of addressing gender diversity in the C-suite.
DR. STEPHEN KLASKO President and CEO Thomas Jefferson University and Jefferson Health PROVIDER
ADDRESSING ROOT PROBLEMS
Combining a major health system with a design school is part of Klasko’s plan to bring new ideas into the delivery system, one of them being the creation of a medical school curriculum that teaches empathy.
LARRY MERLO President and CEO CVS Health SUPPLIER/ VENDOR
STARTED BY SNUFFING OUT CIGARETTES
CVS Health’s push to buy Aetna created a stir in the industry this year, and followed other consumerfocused moves, such as banning the sale of cigarettes as far back as 2014.
LARRY RENFRO Vice chairman United-Health Group; Founder and managing partner
Optum Ventures SUPPLIER/ VENDOR
THE SLOW BUILD
As head of Optum, Renfro led the charge on several deals adding to the company’s vertical integration. Earlier this year, Renfro shifted roles to lead the organization’s venture capital arm, Optum Ventures.
ANTHONY TERSIGNI President and CEO Ascension PROVIDER
LEADING BY DOING
Beyond one of his more recent moves, helping to try to create a provider-owned drug company aimed at bringing down prices, Tersigni continues to diversify the nation’s largest Catholic health system.
BERNARD TYSON Chairman and CEO Kaiser Permanente PROVIDER
A STEP AHEAD
Tyson’s leadership of the integrated system has included taking a bold and aggressive stance on the nation’s mental health problem, with Kaiser Permanente redesigning care models to better integrate mental health into primary care and other settings.
14 R. MILTON JOHNSON Chairman and CEO HCA Healthcare PROVIDER
15 ALEX AZAR Secretary HHS GOVERNMENT
16 JIM SKOGSBERGH Co-president and Co- CEO Advocate Aurora Health PROVIDER
DR. NICK TURKAL Co-president and Co- CEO Advocate Aurora Health PROVIDER
18 SEEMA VERMA Administrator CMS GOVERNMENT
19 DR. SCOTT GOTTLIEB Commissioner
Food and Drug Administration GOVERNMENT
20 LLOYD DEAN President and CEO Dignity Health PROVIDER
21 RICK POLLACK President and CEO American Hospital Association ASSOCIATION
22 DR. RICHARD GILFILLAN CEO Trinity Health PROVIDER
23 GAIL BOUDREAUX President and CEO Anthem INSURER
24 STEFANO PESSINA Executive vice chairman and CEO Walgreens Boots Alliance SUPPLIER/ VENDOR
25 EUGENE WOODS President and CEO Atrium Health PROVIDER
26 DAVID CORDANI President and CEO Cigna INSURER
27 NANCY HOWELL AGEE President and CEO Carilion Clinic PROVIDER
28 EMMA WALMSLEY CEO GlaxoSmithKline PHARMA
29 ANDREA WALSH President and CEO HealthPartners PROVIDER
30 JIM HINTON CEO
Baylor Scott & White Health PROVIDER
31 SEN. LAMAR ALEXANDER Chairman, Senate Health, Education, Labor & Pensions Committee ( R-Tenn.) GOVERNMENT
32 PAULA STEINER President and CEO Health Care Service Corp. INSURER
33 CHIP KAHN President and CEO Federation of American Hospitals ASSOCIATION
34 DAVID WICHMANN CEO UnitedHealth Group INSURER
35 MAUREEN TESTONI Interim president and CEO 340B Health ASSOCIATION
36 DR. SACHIN JAIN President and CEO CareMore Health INSURER
DR. ATUL GAWANDE 37 CEO
Still-unnamed health venture by Amazon, Berkshire Hathaway and JPMorgan Chase
38 WILLIAM CARPENTER III Chairman and CEO LifePoint Health PROVIDER
39 DR. JOHN NOSEWORTHY President and CEO Mayo Clinic PROVIDER
40 KEN PAXTON Texas attorney general GOVERNMENT
41 JUDITH FAULKNER Founder and CEO Epic Systems Corp. SUPPLIER/ VENDOR
42 STEPHEN UBL President and CEO Pharmaceutical Research and Manufacturers of America ASSOCIATION
43 SEN. MITCH MCCONNELL Senate majority leader GOVERNMENT
44 MICHAEL DOWLING President and CEO Northwell Health PROVIDER
45 DR. JAMES MADARA Executive vice president and CEO American Medical Association ASSOCIATION
46 PATRICIA MARYLAND Executive vice president, Ascension; president and CEO, Ascension Healthcare PROVIDER
47 DREW ALTMAN President and CEO Kaiser Family Foundation POLICY/ RESEARCH
48 DR. LAURIE GLIMCHER President and CEO Dana-Farber Cancer Institute PROVIDER
49 SEN. RAND PAUL ( R-Ky.) Senate Health, Education, Labor & Pensions Committee GOVERNMENT
50 GOV. MATT BEVIN State of Kentucky GOVERNMENT
51 PETER FINE President and CEO Banner Health PROVIDER
52 DR. PATRICK CONWAY President and CEO Blue Cross and Blue Shield of North Carolina INSURER
53 DR. DAVID TORCHIANA President and CEO Partners HealthCare PROVIDER
54 WRIGHT LASSITER III President and CEO Henry Ford Health System PROVIDER
55 DR. DONALD RUCKER National coordinator for health information technology HHS GOVERNMENT
56 PETER LEE Executive director Covered California GOVERNMENT
57 MADELINE BELL President and CEO Children’s Hospital of Philadelphia PROVIDER
58 HOWARD KERN President and CEO Sentara Healthcare PROVIDER
59 XAVIER BECERRA California attorney general GOVERNMENT
60 DR. PAUL ROTHMAN CEO Johns Hopkins Medicine PROVIDER
61 THOMAS ZENTY III CEO University Hospitals PROVIDER
62 STEVE NELSON CEO UnitedHealthcare INSURER
63 ALAN MILLER Chairman and CEO Universal Health Services PROVIDER
64 KENT THIRY Chairman and CEO DaVita PROVIDER
65 MARK GANZ President and CEO Cambia Health Solutions INSURER
66 BYRON JOBE President and CEO Vizient SUPPLIER/ VENDOR
67 DR. GARY KAPLAN Chairman and CEO Virginia Mason Health System PROVIDER
68 SCOTT SEROTA President and CEO Blue Cross Blue Shield Association ASSOCIATION
69 PAMELA CIPRIANO President American Nurses Association ASSOCIATION
70 DEBORAH DISANZO General manager IBM Watson Health SUPPLIER/ VENDOR
71 MICHAEL NEIDORFF Chairman and CEO Centene Corp. INSURER
72 LAURA KAISER President and CEO SSM Health PROVIDER
73 WAYNE SMITH Chairman and CEO Community Health Systems PROVIDER
74 MARIO SCHLOSSER CEO Oscar Health INSURER
75 DR. ERIC TOPOL Founder and director Scripps Translational Science Institute RESEARCH
76 DR. JOANNE CONROY President and CEO Dartmouth-Hitchcock and Dartmouth-Hitchcock Health PROVIDER
77 KEVIN LOFTON CEO Catholic Health Initiatives PROVIDER
78 SUSAN DEVORE President and CEO Premier SUPPLIER/ VENDOR
79 DR. GEORGES BENJAMIN Executive director American Public Health Association ASSOCIATION
80 DR. TEJAL GANDHI Chief clinical and safety officer Institute for Healthcare Improvement QUALITY
81 DEBORAH BOWEN President and CEO American College of Healthcare Executives ASSOCIATION
82 RANDY OOSTRA President and CEO ProMedica PROVIDER
83 DR. TOMISLAV MIHALJEVIC President and CEO Cleveland Clinic PROVIDER
84 DR. MARK CHASSIN President and CEO Joint Commission QUALITY
85 BRENT SHAFER Chairman and CEO Cerner Corp. SUPPLIER/ VENDOR
86 LEAH BINDER President and CEO Leapfrog Group QUALITY
87 DR. STEVEN CORWIN President and CEO New York-Presbyterian PROVIDER
88 DR. PENNY WHEELER President and CEO Allina Health PROVIDER
89 MARK TARR President and CEO Encompass Health PROVIDER
90 KENNETH RASKE President and CEO Greater New York Hospital Association ASSOCIATION
91 DR. MITCHELL KATZ President and CEO NYC Health & Hospitals PROVIDER
92 DEBRA CAFARO Chairman and CEO Ventas SUPPLIER/ VENDOR
93 DR. OLIVIER BRANDICOURT President and CEO Sanofi PHARMA
94 DR. KENNETH DAVIS President and CEO Mount Sinai Health System PROVIDER
95 DR. BRUCE SIEGEL President and CEO America’s Essential Hospitals ASSOCIATION
96 MATT EYLES President and CEO America’s Health Insurance Plans ASSOCIATION
97 VICE ADMIRAL DR. RAQUEL BONO Director Defense Health Agency GOVERNMENT
98 DR. FARZAD MOSTASHARI Co-founder and CEO Aledade SUPPLIER/ VENDOR
99 DEREK FEELEY President and CEO Institute for Healthcare Improvement QUALITY
100 DR. MARK SCHUSTER Founding dean and CEO Kaiser Permanente School of Medicine EDUCATION