American Healthcare Leader #27

As director of benefits administration at Texas A&M University System, Judy Cato knows firsthand the enormous value in feeling a sense of security

Seven more benefits-focused executives who lead by prioritizing their people

“Our system has thousands of employees who are in different stages of life and have different needs. We wanted a total rewards program that works well for everyone and provides increased choice.”

—Mario Ellis, Wellspan Health P18

“People thank us for the programs we provide. It means a lot to me to hear a program has changed a life.” —Judy Cato, Texas A&M University System P10

“I have nothing but admiration for our entire staff. They’ve been through a lot, and they’re tired. That means we need to treat them right.” —Bill Dinger, Providence P50

in this issue

The Path

Following a strong sense of duty, Ryan Macpherson spent time in the Navy before turning to a law career as a means to empower others ▶ 68

Paul Chatel helps deliver financial excellence at Becton Dickinson as the company works to redefine care with its breakthrough medical products 72

Deputy General Counsel Jennifer Fox uses her science background to help Emergent BioSolutions achieve its goal of protecting or enhancing one billion lives by 2030 76

The Issues

Karen Shahinian unites her passions for science and law to help Takeda Pharmaceuticals advance treatment innovation ◀ 90

Medtronic and Ishak Akyuz look to increase the number of robot-assisted surgeries with the new Hugo RAS system 94

At Keck Medicine of USC, Christian Aboujaoude focuses on enterprise-level solutions to help the organization adapt to any possible environment 98

Nicholas Barrett (Macpherson); Vail Fucci (Shahinian); Winni Wintermeyer (O’Meara)

The Business

Diane Psaras shares how VITAS Healthcare leverages culture and communication to enable employees to work better and safer 140

The Reason

Teresa Tonthat works to ensure that a worst-case scenario for the technology she oversees at Texas Children’s Hospital wouldn’t cripple the system 112

As CaroMont Health’s corporate counsel for legal affairs, Jennifer Blythe is fulfilling her passion to help at the intersection of health and law 120

At the age of thirty, Amy Farris Wolfe is already a general counsel at Aurobindo Pharma USA—but she’s too busy to slow down and celebrate ◀ 128

On the Cover

Judy Cato’s portraits are by Michael Starghill, a photographer based in Houston. To view more of his work, visit michaelstarghill.com.

The Impact

Amy Whitaker works to launch a new group purchasing organization that will benefit Bon Secours Mercy Health’s providers, patients, and communities 170

Michelle Garrison tackles dual roles at GetixHealth with the aid of a strong framework and playbooks she’s created ▶ 174

At North Kansas City Hospital, Amy Crawford focuses on the little things to ensure that patients have the best experience possible 180

As Castlight’s CEO, Maeve O’Meara carries out her vision for the company by harnessing the power of data and technology ◀ 148

Tracy Williams uses her finance and organizational skills to manage rapid growth and streamline systems at Penn State Health 160 Carmen Fascia (Farris Wolfe); Grady Carter (Garrison)

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P10

Judy Cato Texas A&M University System

P18

Mario Ellis WellSpan Health

Eight executives lay out their benefits strategies and explain how being a leader means making your people the priority

P24

Rebecca Gristina University of Virginia

P30

Nicole Cody International Paper

P44

Kimberly Young Pacific Architects & Engineers (PAE)

P36

Linda Nilsen Princeton University

P50 Bill Dinger Princeton

P60

Timothy Leier Ecolab

By Russ Klettke

Judy Cato teaches the value of benefits by promoting a sense of community and understanding within the expansive Texas A&M University System

Portraits by Michael Starghill

It’s easy to overlook the essential nature of employee benefits, even though they impact some of the most important moments in people’s lives. Medical coverage lessens the financial impact of disease, accidents, and having children. Family leave is for events that are both exquisitely joyful and filled with sorrow. Pensions and 401(k)s pay out at retirement. Life insurance pays out at a death. Educational benefits advance careers. Paid time off can involve epic discoveries in travel—or at the very least, provide a time for important physical, mental, and perhaps spiritual recharging.

Judy Cato, director of benefits administration at the Texas A&M University System, understands this well. Not only does she have more than thirty years of experience in the benefits industry but she’s also gained a personal appreciation for benefits after major events in her own life. Over the past three decades, she’s seen the evolution of what employees need, some of the escalating costs associated with those needs, and most recently, what benefits have meant in the time of a global pandemic.

Cato has experienced changes of her own during the pandemic: in the first quarter of 2021, she left a position at Arizona State University and moved from Phoenix to College Station, Texas, about one hundred miles from Houston, to work at the Texas A&M System.

She sees good benefits packages as a win-win for employers and employees alike. “The employer needs to provide what they can to attract talent,” she says. “And employees need the benefits. They ask about it, particularly as the package affects their families.”

Cato has had the luxury—and heavy responsibility—of working for several

large organizations prior to her university employers in Texas and Arizona. They include secondary school systems (Mesa, Arizona), hospital systems (Rady Children’s in San Diego and Phoenix Children’s), private industry organizations (Bechtel Corporation, Bank of America, and Amkor Technology), and a quasigovernmental health benefits administrator (TriWest Healthcare Alliance). These are organizations with sophisticated benefits offerings that are essential in the competitive talent marketplace.

In the past, Cato has often worked at places where she’d have direct, faceto-face interaction with employees and could see how their benefits worked for them on an individual level.

At the Texas A&M System, on the other hand, she oversees benefits administration to more than thirty thousand employees—a third of them retirees— in twenty-two separate entities under the system’s umbrella. She doesn’t meet personally with most of those employees, particularly under pandemic safety conditions, but she hears from them through the human resources offices at each of the system entities.

“People thank us for the programs we provide,” she says. “It means a lot to me to hear a program has changed a life.”

Perhaps Cato connects with that kind of feedback because of a life-changing experience of her own. In 2005, while traveling for work, she had an unexpected medical emergency that got very serious very fast. She became comatose, flatlined, and was resuscitated, she says. Her parents were contacted and told that her chances of survival were slim.

She survived and ultimately thrived, but the intensive medical care and time away from work could have been

Judy Cato Director of Benefits Administration Texas A&M University System

financially devastating. “I could have had large medical bills,” she says. “But I had a good medical plan and short-term disability coverage. I know from that personal experience it’s important to provide these kinds of benefits.”

Cato came into the industry gradually, somewhat by happenstance. After studying engineering for a few years in college and struggling through physics, she participated in a summer jobs program that placed her in the human resources department for the US Postal Service. There, she began to see a career opportunity. “I got a taste of that and refocused my education plans,” she says.

It took her a while to complete her first degree, a bachelor of arts in public administration with an emphasis in human resources. A master’s degree in educational technology followed, all while she was on an impressive career trajectory.

Throughout her decades in the industry and across the breadth of organizations, some aspects of benefits administration have been fairly consistent, Cato says. Fewer employers offer a pension (though Texas A&M does), and the funding sources differ between private and not-for-profit and educational institutions. But some things are true everywhere. Communicating the value of benefits and what is offered “is always a struggle,” Cato says.

The COVID-19 pandemic brought new kinds of changes, some of them unexpected. Utilization of standard healthcare service benefits actually went

“People thank us for the programs we provide. It means a lot to me to hear a program has changed a life.”

down in 2020 during the first phase of the pandemic. Cato says that’s because the lockdowns meant that many people put off things like regular checkups and elective surgeries. Later that year and into 2021, particularly when vaccinations became available, people made up for lost time and resumed getting elective and preventive care. Those who were sickened by the virus, of course, also made use of their medical and disability benefits.

But something else came to the fore with COVID-19: an increased need for mental healthcare.

“What has truly changed is that people now feel the freedom to talk about it,” Cato says. “People are willing to say they’re stressed. Michelle Obama said it publicly, saying ‘It’s okay to say I’m not all right.’ In the past we might have had EAP [employee assistance programs] in plans, but now we’re finding new ways to support mental healthcare.”

Speaking from her experiences in Arizona and Texas, Cato says organizations that had telemedicine functions in place already were well set up for pandemic working conditions. “Utilization of telemedicine was way up,” she says. That pertained to primary care consultations as well as mental healthcare.

She adds that benefits addressing wellness are also integral to mental health. “If you’re struggling with your weight, you might also be stressed,” she says. “That leads to other issues.” The A&M System offers wellness classes as well as virtual conferences on the value of

walking, meditating, and getting out of the habit of sitting too much. It also provides parents with counseling on how to limit their children’s cellphone use.

“In the time I have worked with Judy since she joined the A&M System, it’s clear that she prioritizes whole personal health as a key component of their benefits strategy,” says Jon Molberg, senior account executive at Express Scripts. “At Judy’s lead, we work together to provide simple, affordable, and predictable healthcare by ensuring personalized communications and tools to drive the best health outcomes for all Texas A&M System members.”

Cato has now earned a third degree, a master’s in theology that she began after coming out of her coma. “From my near-death experience, I felt called into the ministry,” she says. While she still works full-time for the university, she also manages to teach and preach in her church. In addition, she serves on community boards that are largely focused on health causes.

“I’ve been blessed with a diversity of experiences—including company mergers, working across different states, international benefits, and creating programs from the ground up,” she says. “People of all kinds have basic needs that have to be served.” AHL

Blue Cross and Blue Shield of Texas is committed to chronic disease management. We impact healthcare cost by providing services like navigation, cost comparison and adherence support. Judy Cato and Texas A&M have been stellar partners on this commitment. Together, we’re setting an example for Texas.

“The employer needs to provide what they can to attract talent. And employees need the benefits.”

By Zach Baliva

Mario Ellis leverages his unique experience in project management, IT, and ministry to redefine benefits and compensation at WellSpan Health

Mario Ellis didn’t start his career in healthcare, and he’s leveraging that fact to be an effective HR leader in the industry. Although he entered college to study computer engineering, counselors convinced him to make the transition to information systems. Upon graduation, Ellis worked in various fields as a consultant. He even earned a master’s degree in theology.

Today’s healthcare leaders need to think differently, and Ellis is drawing upon his unique blend of experiences to develop the effective benefits programs and recruiting strategies that give WellSpan Health success in the new normal.

In some settings, friends and congregants know him as “reverend.” Over the years, Ellis has served in various roles at numerous churches. He’s been a minister of music, a church administrator, a Sunday school teacher, and an outreach pastor. In 2010, he founded Refreshing Springs Congregational Church in the greater Chicago area, which is still in existence today.

Ellis sees a link between his degree in practical theology—which focuses on the link between spirituality, vocation, and everyday life—and his current work at WellSpan. “HR leadership in today’s world requires a holistic view because we are thinking about health equity, value-based care, and good stewardship,” he says. “We also want to ensure we take care of the whole person and value inclusion as we create benefits plans for our employees.”

Ellis’s winding career path has taken him through many cities and industries. His time as a consultant brought him from Chicago to Nashville and back again. During that era, he developed expertise in project management,

recruiting, sales and marketing, systems implementation, compensation, employee relations, and union negotiations. “I’ve had many jobs in various locations, but that has helped me learn broad skills, and my career path has given me an understanding of how markets, demographics, and corporate culture all factor into the HR conversation,” he says.

Ellis transitioned to healthcare in 2004 and worked in leadership roles at the University of Chicago Medical Center, St. Luke’s Health System, and the Cleveland Clinic before arriving at WellSpan Health in 2019 to design, grow, and implement system-wide total rewards benefits and compensation strategies. WellSpan is an integrated health system that serves the communities of central Pennsylvania and northern Maryland; it includes a regional behavioral health organization, a home care organization, eight hospitals, and more than two hundred patient care locations.

When Ellis arrived on-site, the organization already had a solid foundation, but WellSpan’s new leadership team wanted to take things to a new level. “WellSpan wants to grow into a market leader, and we knew a well-structured total rewards program would help us attract, retain, and develop the talent that can help us realize that goal,” says Ellis, adding that he moved to create, brand, and launch a total rewards platform tailored perfectly to WellSpan’s goals and culture.

As the vice president of WellSpan Health Total Rewards, Ellis is known for challenging the status quo and thinking outside of the box, which he says is key to success for any healthcare HR leader. “Healthcare is one of the most

Mario Ellis VP of Total Rewards WellSpan Health

dynamic fields—it is always changing,” he explains. “We’ll never emerge as leaders if we always rely on the same old way of doing things.”

For Ellis, HR leaders are more than administrators; they are change agents who can unite the right people to deliver the right results at the right time.

After examining the organization, the market, the patients, the structure, and the system, Ellis solicited feedback from employees and leaders. He then started working with WellSpan’s culture counsel to understand the makeup and needs of the organization. Finally, he engaged with other industry leaders to better understand competitiveness in the region and nationally. With that information in hand, Ellis and his team built the total rewards program, a robust package of benefit and compensation program created to support all WellSpan employees.

Its perks and incentives include standardized incentive programs, a choice of voluntary programs suitable for individual and family needs, and paid time off as well as more unique features like PTO bridging, through which eligible employees enter WellSpan’s PTO program with the ability to accrue at higher rates based on their previous years of service. In his role, Ellis says he and his colleagues often consider diversity and flexibility in plan design.

“Our system has thousands of employees who are in different stages of life and have different needs. We wanted a total rewards program that works well for everyone and provides increased choice,” he explains.

Employees select the benefits they want or need, and they can take advantage of optional features like educational assistance, loan forgiveness, flexible spending accounts, childcare

“Our system has thousands of employees who are in different stages of life and have different needs. We wanted a total rewards program that works well for everyone and provides increased choice.”

assistance, and discounted wellness or recreational programs.

Ellis demonstrated his ability to lead through adversity when the COVID-19 pandemic hit WellSpan’s market. He and his team used existing software and communications systems to field a high volume of employee requests related to childcare assistance, time off, and other emerging needs. WellSpan provided dependent care stipends, mental health services, and financial bonuses to qualified employees affected by the pandemic. HR also reviewed and updated PTO policies and other guiding documents.

Additionally, the organization raised its minimum wage, invested in its family assistance fund, and engaged a vendor, DailyPay, that allows employees faster access to their salary based on hours worked. Ellis expects many of these popular features to remain in place after the pandemic recedes.

Today, many of WellSpan’s team members are still working remotely, but Ellis thrives when he’s in the office with other employees. He also enjoys walking around WellSpan’s facilities when possible and seeing doctors, nurses, and patients.

As he watches those interactions, Ellis is filled with pride, knowing that his team has worked to help WellSpan continue its mission of improving health through exceptional care for all. AHL

Gallagher is proud to be a strategic partner of WellSpan Health. We support the mission of working together as one, to improve health. Our strategic partnership has allowed us to share our values and assist in “Finding a Better Way.” Congratulations to Mario Ellis for his continued leadership and innovative thinking.

By Zach Baliva

Rebecca Gristina walked away from a promising career to help her family through a difficult time. She now uses that experience to lead with empathy and design new benefits programs for the University of Virginia.

Rebecca Gristina Benefits Director University of Virginia

HR leaders and project managers must solve complex business problems and demonstrate advanced technical expertise, but Rebecca Gristina understands what’s really important— people and family. She left the workforce when her family needed her most. The experience changed the way she leads her team and designs benefits at the University of Virginia.

After graduating from Western Michigan University, Gristina took an entry-level position in a financial services call center, where she was on a very clear career path. She knew exactly what skills she needed to obtain and milestones she needed to meet to transition to higher-level roles. After a few years and several promotions, she was designing retirement plans, leading enrollment meetings, and learning how the HR function helps drive an entire organization.

Although her career was flourishing, it required Gristina to be on the road and away from her family. Back home, her children faced several medical-related challenges. One daughter developed an autoimmune disease. Her son received an autism diagnosis.

“It’s popular to talk about a good work/ life balance, but the reality is we can easily let work take over at the expense of life unless we’re very careful,” she says. Gristina decided to leave the career that she loved to focus on her family.

Dominique Attaway

In 2016, Gristina’s situation started to change. Her youngest child entered school full-time, and her family had settled into a rhythm to partner with care providers and manage autism well. She was ready to reenter the workforce.

As she met with teams and managers, Gristina explained her skills and qualifications. She talked passionately about her difficult decision to walk away from a promising career. And in doing so, she convinced leaders to hire her as a compliance specialist at the University of Virginia Physicians Group. She later became a benefits specialist for the university. Since 2018, Gristina has been designing and implementing programs as the university’s benefits director.

The public research university in Charlottesville, Virginia, has nearly 30,000 employees across its schools and health system. Gristina draws heavily on her life experience as she leads her team and designs benefits for this large, varied, and influential population.

“I used to be embarrassed by the twelveyear gap in my résumé, but now I embrace it,” she explains. “The experience changed me and made me into a vulnerable leader.”

That’s especially valuable now in a post-pandemic world, when many HR associates and university employees are dealing with issues similar to those Gristina once managed in her own

personal life. Those colleagues are balancing the demands of a career with increasing child care, elder care, and remote learning needs. These issues contribute to higher stress and burnout.

The Kaiser Family Foundation says that one in ten women reported quit a job because of the pandemic. Thirty percent have taken more time off (some without pay) because of school or daycare closures. More than half of all women say the situation has negatively impacted their mental health, but few have sought professional care.

While Gristina did the day-to-day work of streamlining and improving her

function by optimizing a newly implemented human resource information system to limit manual interventions, the new realities employees face compelled her to make a change in strategy. She initiated a survey to “take the pulse” of university employees and understand how her team could supply the new resources they now need.

In response to closures related to COVID-19, the University of Virginia implemented Aetna’s Teladoc Telehealth services as an alternative to urgent care. Growth in telehealth usage immediately peaked. The UVA health plan telemedicine utilization for primary care visits

“It’s popular to talk about a good work/life balance, but the reality is we can easily let work take over at the expense of life unless we’re very careful.”

Do it for you

and outpatient care increased by five hundred-fold from the previous year. The system also improved employee access to behavioral and mental health providers.

Gristina and her team also worked behind the scenes to help employees manage the complex world of the federal Family Medical Leave Act (FMLA). The benefits team partnered with Unum, its vendor for disability insurance, to manage the day-to-day administration and compliance with the FMLA. By outsourcing leave administration, UVA benefits counselors could spend time supporting employees through the leave process, addressing health plan benefits when necessary.

In 2022, Gristina is focused on improving the university’s value proposition for prospective employees. She’s also lobbying her counterparts in recruiting to find unconventional talent like her. “The pandemic has helped us see that there is a lot of talent we can tap into out there. We just have to look in unique places to find it,” she says.

This all comes on the heels of a system-wide HR transformation that introduced a new robust technology platform. The department now has all the tools in place to identify, onboard, and retain the top talent that will take the University of Virginia into the future. AHL

Rebecca, we, at Unum, are thrilled to see this recognition of your impressive work as an HR leader. We are inspired by your strategic vision for the employee experience at UVA. We are proud to work together to deliver cutting-edge benefits and transformative technology that improves processes and delivers value across your organization.

Aetna® is proud to support Rebecca Gristina and The University of Virginia Health Plan.

TIAA is proud to support the University of Virginia and congratulate Benefits Director, Rebecca Gristina, on her American Healthcare Leader spotlight. With over 100 years of financial expertise, TIAA can help you provide your employees a confident path to retirement.

TIAA.org/Healthcare

Their challenges never stop. Neither should their retirement income.

By Keith Loria

As director of global compensation and benefits at International Paper, Nicole Cody is dedicated to finding the best offerings for employees

Working in human resources wasn’t a part of Nicole Cody’s original career plan. But after graduating from the University of New Orleans with an English degree, she moved to Memphis, Tennessee, to work as a paralegal, and a friend she made there set her on a career path in which she has found great success.

Cody remembers the friend telling her about how much she liked her career in HR. “As it came to pass, she went to another company here in Memphis, in compensation, and they had a position where they were willing to take someone who wasn’t necessarily experienced and to train in a compensation role,” she says.

That job was at St. Jude Children’s Research Hospital in Memphis, and Cody discovered that she not only liked the work but also had a knack for analytics. After a few years in that role, she was contacted by International Paper.

“The reason I was interested in that position is because as a nonprofit, St. Jude had a pretty straightforward compensation program,” Cody explains. “I was interested in learning more about incentive plans, short-term and longterm. So I did make the change, and that’s where I’ve been ever since.”

Cody joined the International Paper team more than two decades ago in the corporate compensation department, and has since held numerous roles, including HR generalist, HR manager, business HR leader for global finance, and HR director for global manufacturing. She took on her current position, as director of global compensation and benefits, in August 2020.

“Our goals are to make sure that all of our benefit offerings are very tightly

aligned with the enterprise strategy,” she says. “That they are contributing to our employees’ physical, financial, and emotional well-being, that they are offerings that are valued by employees—if something isn’t valued, I don’t know why we need to do it—and that they’re fitting with our employee relations and labor relations strategy.”

When she started her tenure with International Paper as a compensation consultant, she focused on salary compensation surveys and annual increases. “I got the chance to work on a special project where we were hiring staff at a customer service center in Krakow, Poland, and I also served as the generalist for their Brussels headquarters,” she recalls.

Her first field assignment was at a manufacturing facility in Pineville, Louisiana, in 2008; she worked there and at another mill for about four years before returning to the company’s headquarters in Memphis. In 2018, she was promoted to HR director for International Paper’s Global Cellulose Fibers business.

Cody’s work has also been noted by her colleagues outside the company. “International Paper has a longstanding history of providing high quality and innovative benefit programs to their employees,” says Kelly Dill, senior vice president of Cigna National Accounts. “Nicole and her team are dedicated to the well-being of their employees. It’s a pleasure working with a partner where our cultures align. Cigna is proud to have been their partner since 2008.”

One important aspect of Cody’s work involves the Health Transformation Alliance, a cooperative of self-insured employers that consists of about fifty

companies across the United States and covers about four million people.

“What we want to do is work together to make sure that the healthcare system of today is really transformed going forward to one that is more transparent, more aligned with providing high-quality healthcare, and to help ensure against rising costs,” Cody notes. “Because when you think about healthcare, everybody expects that the cost goes up significantly year over year, and probably the only other area where such common increases are expected is in college tuition.”

She adds that there are a lot of incentives to keep that cost increasing, so one the company is also analyzing data to make decisions that are transparent and lead to better outcomes.

As someone who leads a team of twenty-two people in the United States, as well as another half-dozen employees around the world, mainly in Europe and Asia, Cody says that reminding herself she’s not the expert in all matters is key to her success.

“It’s important for me to ask a lot of clarifying questions to make sure that I really understand the background and the history of anything that we’re trying to accomplish before weighing in and saying, ‘Here’s the direction I think we need to go,’” she explains. “The only place where I do insert myself a little more is when we’re thinking about programs or initiatives that we’re rolling out that will require business participation or change management from our field HR team. They’re already so stretched that I want to make sure what we’re doing is understood, very much supported, and endorsed

Nicole Cody Director of Global Compensation & Benefits International Paper

Alex Ginsburg

by our business leaders before we implement something.”

She is also dedicated to helping others through Bridges USA, where she serves on the board of directors and executive committee. The organization supports high school students throughout Shelby County.

“They come together and work on their voices as leaders in the community, and how to develop their own skills as leaders and advocate for things that are important to them as youth in our city,” Cody says of the students who

participate in the program. “They interact with the city council and the mayor, and it’s just been really fulfilling to see how they develop those skills and get that experience.”

Cody has also been able to lend her HR expertise to Bridges USA. “They are a very lean organization, and they don’t have a dedicated HR staff,” she notes. “They’ve got some part-time folks and I’m able to help them with HR business partner questions, so it’s been a great way for me to keep my hand in that sort of broader HR support.” AHL

Willis Towers Watson is a proud partner of International Paper and congratulates Nicole Cody on her outstanding accomplishments as Director of Global Compensation and Benefits.

“It’s important for me to ask a lot of clarifying questions to make sure that I really understand the background and the history of anything that we’re trying to accomplish before weighing in and saying, ‘Here’s the direction I think we need to go.’”

NICOLE CODY PROVES THAT WORKING TOGETHER WORKS BETTER

Cigna congratulates Nicole Cody on her success at International Paper. Nicole always puts the International Paper employee first, implementing health and wellness initiatives focused on whole-person health. Cigna supports International Paper’s vision of being among the most successful, sustainable and responsible companies in the world. Together, we are making the world a happier, healthier place to live.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. 960148 10/21 © 2021 Cigna

By Natalie Kochanov

Linda Nilsen develops human resources initiatives at Princeton that reflect and reinforce the university’s mission

As the institution’s assistant vice president of compensation and benefits, Linda Nilsen knows Princeton University inside and out, from its people to its programs. She also knows what attracts new talent to the university—and how recent hires begin their own journey toward understanding campus culture.

“You go through a mission orientation when you join Princeton,” Nilsen explains. “People here are seeking more than just a job or benefits. People come here to be part of our culture and our mission. Every employee at the university has an impact on the student experience and the research happening here, no matter what their role is.”

Nilsen’s own role is to steer human resources initiatives that not only bring people to Princeton in the first place but also keep them there by furnishing them with the individualized support they need to thrive. To that end, she makes a point of prioritizing employee health and wellness and fostering a collaborative culture across the university.

On a day-to-day basis, Nilsen toggles between responding to critical priorities and meeting with vendors or staff. “I do meet with my staff quite often as well as with organizational leadership to share or collect information,” she says. “I’m often attending and sharing information as a subject matter expert, since many other areas touch benefits and compensation in some way.” Because of the fluid nature of those meetings, she often needs to operate in the moment, adapting as new items come her way.

Nilsen’s flexibility in her role mirrors the flexibility of the benefits Princeton makes available to its employees. “We make quite an effort to ensure that our benefits have the necessary variety to meet everybody’s needs. Everyone has different needs, and you do your best to provide balanced options for all people at the university,” she explains.

Nilsen highlights the wide variety of benefit options at Princeton as a key part of the university’s recruitment and retention efforts. Candidates learn about benefits during the recruitment process, and Nilsen has a tool under development to ensure those discussions are as catered as possible to the specific circumstances of each individual. Eventually, she plans to apply the tool to retention as well, so managers or HR generalists can help current employees better understand and optimize their benefits.

Linda Nilsen Assistant VP of Compensation & Benefits Princeton University

To set Princeton apart in the marketplace, Nilsen aims for the university’s benefits programs to be as unique as the needs of its employees. “We’re looking for distinct, differentiated programs that show who we are as an organization,” she confirms. “We care about each individual who works for us, and we want them to have the opportunity to be the best that they can be. If I do my job well, faculty and staff can focus on their contributions to the university without worrying about benefits.”

For example, Princeton’s Castlight and Picwell tools help employees choose the best programs for their needs while keeping costs under control. Employees also receive a monthly benefits newsletter outlining the ways Princeton benefits can help employees.

Jon Mahrt, chief operating officer at OptumRx, a pharmacy care services company, works closely with Nilsen. “Linda’s dedication to developing programs that reflect a campus culture rooted in care is inspiring,” Mahrt says. “Prioritizing unique and flexible health and wellness benefits enables employees to focus on doing their best work.”

Likewise, Nilsen strives to makes it easier for employees to take care of themselves through her work on health and wellness, including the creation of a center

consolidating all physical, mental, and financial health and wellness activities in one place.

“In terms of physical, mental, and financial wellness, we’ve taken the approach of providing education and resources. For instance, we provide on-site health coaching, and we give employees time off to see a health coach so that time is not an obstacle,” Nilsen says. In addition, she has made it possible for employees to obtain their annual physicals and to access mental health counselors on-site.

Based on how employees have embraced these resources, Nilsen believes they are much more likely to take advantage of programs that are offered at their workplace during regular working hours. She will therefore continue to focus on accessibility in future health and wellness initiatives.

On the education front, Nilsen has prepared further resources to help employees navigate the health care system, whether on campus or off it. From a company health advocate to a mobile application for finding and comparing doctors, the educational resources prepare Princeton workers to connect with the right providers at the right price. “We bring together all these great resources for a healthy life, and we talk with

“Every employee at the university has an impact on the student experience and the research happening here, no matter what their role is.”

Rethinking work and wellness

We are proud to celebrate Princeton University’s efforts to nurture a collaborative culture.

employees about them so they can take better care of themselves and their families,” Nilsen says. “We see it as just another extension of how Princeton cares for its employees and their health and well-being.”

The care that Nilsen talks about in relation to benefits and compensation gets at the heart of what Princeton represents as an institution. For Nilsen, the university is a place where people come together to solve problems and effect change. “Our culture is about helping each other to be successful and working toward the greater good,” she says. “Collaboration is an essential value in our culture; we value the diverse perspectives, knowledge, skills, and contributions of each colleague at the university.”

Nilsen’s colleagues outside the university have also taken note of her efforts. “Linda’s dedication to help all faculty and staff live their best lives—physically, intellectually, financially, and emotionally—empowers each to fulfill the university’s motto, ‘Princeton in the nation’s service and the service of humanity,” says Ted Borgstadt, CEO of the health behavior change coaching company TrestleTree.

Nilsen sees Princeton’s culture strongly reflected within her own team. “My team members are the most compassionate, caring, and thoughtful people that I know,” she says. “When they’re on the phone, they’re attentive and convey to employees that we understand their problem and we want to help them find a solution. And if we can’t find a solution through our normal course of work, we’ll go out of our way to do so.”

Nilsen reflects on her team with pride. “They’ve grown and developed their technical skills, their abilities, and their understanding of the market and of benefits,” she says. “They’ve really become strong professionals who provide advice at cross-functional committees and within HR as we design programs.”

As for her own achievements, Nilsen points to a healthcare strategy she implemented back in 2012 that is still going strong. “The strategy is based on providing education and resources to our faculty, our staff, and their families, so they can take the best care of themselves with regard to their physical, mental, and financial health. In so doing, we’ve been able to manage our costs without detracting from existing programs,” she says. “To develop that strategy, enact it, and see that it’s working for ten years now—that’s been huge for me.”

Nilsen will have no shortage of opportunities to develop similarly successful strategies in the future. “I intend to stay at Princeton for a long time,” she says. “I love where I work, I love the work I do, and I love the feeling of knowing that what I do matters.” AHL

“Collaboration is an essential value in our culture; we value the diverse perspectives, knowledge, skills, and contributions of each colleague at the university.”

By Billy Yost

With a wealth of industry experience gained over two decades, Kimberly Young is working to ensure that the benefits program is the best it can be at Pacific Architects & Engineers

Early in Kimberly Young’s career, she was charged with reenvisioning the benefits package for a company that had declared bankruptcy.

“I really learned the importance of negotiation, change management, and how at the end of the day, it’s about balancing the needs of the business and the people that make up that business,” Young says. “It was a pivotal point in my career.”

Fortunately, she hasn’t had that particular experience in her current role as vice president of global benefits at defense and government services contractor Pacific Architects & Engineers (PAE)—but the skills that came from it have still proved valuable in her four years with the company.

Upon being hired, Young got to work on creating an integrated benefits platform for PAE that would be competitive, affordable, and valuable to the company’s employees. “It really required a multiyear strategy approach that involved changing vendors, adding new clinical management services, outsourcing our pharmacy needs, and just doing a comprehensive inventory of where we were and where we were trying to go,” Young explains. “We wanted to be more competitive in the market and offer best-in-class benefits. And here we are today.”

“Here” includes earning recognition from Cigna for the PAE benefits program design and another award from Gallagher for PAE’s investment in its employee service and benefits. It’s the result of a comprehensive review

and redesign that includes major additions to the company’s benefits package.

“Kim developed an award-winning benefit program to retain and attract the very best talent for PAE,” says Karen Franklin, vice president of national accounts at Cigna. “We are honored to partner with Kim on this exciting healthcare journey.”

“We’ve implemented parental leave, which is new for us,” Young explains. “We’ve also added really significant clinical management programs to focus on chronic conditions in order to yield better outcomes. We’ve added a lot of voluntary benefits that give employees some choice as it relates to work/life balance.”

Additionally, PAE has made significant investments in a new employee assistance program provider that offers wellness tips and tools, student loan consolidation services, and the Virgin Pulse wellness platform to help employees become engaged in their own wellness journeys. Along the way, employees will have access to preventative screenings and other related services that drive engagement while also helping ensure better outcomes from a claims and wellness perspective.

Building a cutting-edge employee benefits package is difficult enough to start with, but over the past three years, PAE has also grown significantly through multiple acquisitions.

“That has definitely provided an additional challenge as we work to balance the needs of the acquired employees and understand that they’re going through a time of change,” Young explains. “At

the same time, we’re working to consolidate those existing benefits into the PAE structure, so there were a lot of challenges in times of working through the manual processes of the acquired assets, understanding their benefit structures, engaging with the different consultants who were on board, and going through all the different points of contact for the required compliance reporting.”

Young explains that the experience for an acquired company can be a difficult one: premium price tags are often lower and a different menu of benefits is on the table. The true test is creating a benefits package that borrows from the best of those options at a much larger scale for PAE’s more than twenty thousand employees.

The due diligence Young and her team had to conduct for compliance reporting would come in handy for one of the biggest moments in PAE’s history: it went public in February 2020 after sixty years as a private company.

“From our side, we had to make sure that all of our information was in order and that we fully understood our benefit costs. You obviously always want to know these details, but before an IPO, there’s just a whole new level of focus on the details,” Young says.

The successful IPO would be followed by the COVID lockdown just a month later, but Young says PAE was in a unique position to hit the ground running with employees being sent home. “We were already working on an initiative called Project Productivity to reduce our footprint and offer a lot of

Kimberly Young VP of Global Benefits Pacific Architects & Engineers (PAE)

Courtesy of Kimberly Young

our workforce the opportunity to work completely remotely,” Young explains. “So our infrastructure for that environment was almost entirely set up. There are obviously a number of challenges that come from working from home that all companies have felt, but we’ve found it to be incredibly successful both from a productivity and employee satisfaction standpoint.”

In fact, Young says something strange has come from being physically separated from her team. “I can honestly say that I think we’re probably closer than we were,” she says. “We’re always available on instant message and we’re doing Zoom calls regularly where we’re on camera with each other. I think those of us that like working from home will be

able to continue in this new environment we find ourselves in.”

Young’s four years at PAE so far have come with a series of challenges, but she and her team have worked nonstop to make a growing organization successful and competitive in the market, as well as more alluring to future recruits. AHL

Buck is an integrated HR, pensions, and employee benefits consulting, technology, and administration services firm. Founded more than one hundred years ago, we serve HR departments across the health, wealth, and career spectrum. Our areas of focus range from health and well-being to retirement and investment to pension and benefits administration.

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“We wanted to be more competitive in the market and offer best-in-class benefits. And here we are today.”

By Zach Baliva

Bill Dinger leverages his data expertise to help Providence care for its caregivers when they need it most

The TV mounted to the wall blared a home and garden show so loudly that nurses calling to waiting patients had to raise their voices. A mother soothed a crying infant while ringing telephones added to the cacophony of noise. Bill Dinger, who had finally landed an appointment after weeks of waiting, eyed the phone behind the counter. The busy receptionist walked away, oblivious to the incoming calls and the needs of the patients on the other end of the line.

Dinger took a deep breath in an attempt to remain calm. He had received a fairly serious diagnosis from a doctor who immediately handed him off to a nurse, giving little instruction for how to check in, follow up, or receive detailed information. He was worried. He was feeling ignored. And as someone working in healthcare, he was angry. For the first time, Dinger understood what it was like to receive poor care—and the experience birthed in him a passion for quality.

That was twenty years ago. Today, Dinger is the vice president of caregiver benefits and well-being at Providence, a nonprofit, Catholic health system of fifty-two hospitals and over a thousand physician clinics, senior services, and other health and educational services across seven states. He’s been in this key role since early 2021, and he keeps his personal experience in receiving care at the forefront of his mind as he analyzes existing policies and programs and considers improvements that will impact the 120,000 caregivers that form the Providence team.

“Our caregivers are the cornerstone,” he says. “Our top priority is to take care of them, because we know that when we do that, it will impact them, their

families, and the quality of care they offer to our patients and the community as a whole.”

Dinger is also importing experiences and lessons learned in other roles and industries to help him thrive at Providence. After his dreams of playing professional hockey never materialized, he went into public accounting, earned a CPA license, and started completing SEC filings for large public corporations. Although Dinger was a skilled accountant, he quickly grew tired of the rote, monotonous work that lacked innovation and creativity.

A quest for purpose took Dinger back to school. He enrolled at the Crummer Graduate School of Business and finished an MBA program at Rollins College. There, he learned new business skills he applied as a finance director at Rotech Healthcare. Dinger was building the durable medical equipment company’s inventory system, running financial operations, and helping the CFO find new strategies to drive value. In doing so, he was identifying problems and uncovering solutions in the healthcare field. Dinger had found a home in a new industry.

This realization coincided with his negative experience in the hospital waiting room and sparked a new era in his career. He started consulting and building himself a reputation as the go-to finance guy for healthcare companies. Soon, the Walt Disney Company came calling.

Disney’s benefits leaders faced an interesting dilemma. The company was one of Florida’s biggest employers and had a large population of employees working odd hours at parks and resorts. Those employees often lacked access to healthcare. Dinger worked with project managers and industrial engineers

to find a unique solution. He joined a team that was tasked with coming up with something truly innovative in an on-site health center where Disney “cast members” and their families could receive a full suite of medical services.

The team pitched the idea to Disney’s senior leaders, secured approval, commissioned design work, and managed the construction of what became known as the Center for Living Well. The 15,000-square-foot property is the largest employer-operated medical facility in the nation.

Putting a permanent, state-of-the-art medical facility in the Epcot parking lot was no small feat, but Dinger wasn’t satisfied once its doors were open. “We had an amazing building, but amazing buildings are nothing without quality clinicians, and I’ve focused on quality throughout my whole career,” he says.

Dinger and Disney worked out in the community to form strong partnerships with local hospitals and health systems. They eventually chose Premise Health to staff the center, which now completes more than fifty thousand primary care, radiology, wellness, behavioral health, and pharmacy visits each year. The project was so well received that Disney later opened a second Center for Living Well for its employees in Celebration, Florida.

Dinger then took a full-time role as director of healthcare innovation at Disney. During his tenure, he drove innovative solutions for two hundred thousand employees and implemented practices designed to reduce waste and increase quality, with a focus on diabetic and hypertensive patient conditions. In 2019, those efforts were recognized with the Employer/Purchaser Excellence Award

PROVIDENCE BY THE NUMBERS

120,000 caregivers

36,000 physicians

25,000 nurses

52 hospitals

1,000 clinics

25.6 million total patient visits

2.1 million covered lives

1 health plan

$1.7 billion in community benefit investments

from the National Alliance of Healthcare Purchaser Coalition for Disney’s efforts to improve the quality and efficiency of the healthcare delivery system.

For someone dedicated to quality and innovation in healthcare, the work is never done. After nearly a decade with Disney, Dinger was ready for a new challenge, and in early 2021 accepted his current role. He says Providence’s mission made the organization an ideal fit. “Part of the Providence promise is ‘know me, care for me, ease my way,’” he says. “I wanted to be a part of finding innovative ways to fulfill that commitment we make not only to our patients but also to our caregivers and our communities.”

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Learn more

ProvidenceHealthPlan.com

Providence traces its roots to 1856, when Mother Joseph partnered with four other Sisters to establish a network of hospitals and schools in the Pacific Northwest. Today, it serves Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington. In recent years, the system has grown, more than doubling its workforce over the last decade.

Dinger joined a growing health system and a growing workforce struggling to navigate an ongoing global health crisis—something his colleagues outside the system recognize.

“Bill joined Providence at a critical time, and his commitment to quality aligns with HealthEquity’s commitment to Providence’s caregivers,” says Dr. Steve Neeleman, founder and vice chair of HealthEquity. “We congratulate him on his success to date, and we look forward to our ongoing partnership.”

Dinger has spent the last year meeting with caregivers, managers, administrators, board members, and community leaders to assess how to ensure that the Providence family of organizations continue to provide a suite of competitive benefits for its caregivers. He’s slowly, carefully, and methodically building a strategy to integrate all benefits functions, engage caregivers, and take Providence’s benefits to the next level. As those strategies develop, Dinger is focused on completing a new Oracle implementation and building key partnerships to ensure long-term success.

“Bill is an innovator in delivering a data-driven, personalized health navigation experience for Providence employees,” says Todd Everett, regional director at Castlight Health. “Bill understands that helping frontline caregivers take care of their own health and well-being has a direct correlation

“I have nothing but admiration for our entire staff. They’ve been through a lot, and they’re tired. That means we need to treat them right.”

Cut through the complexity. Drive engagement, better outcomes, and meaningful savings.

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Flexible and future-ready

In uncertain times, flexibility is more vital than ever. Whether you’re looking to design benefits that inspire wellness and engagement, help your people plan for a healthy and financially secure retirement, or build an agile workforce for the future, we’re here to help.

Flexibility for the changing world of work.

to delivering a quality experience for the patients they care for.”

On January 20, 2020, Providence Regional Medical Center in Everett, Washington, treated the first known US COVID-19 patient. The system’s caregivers have been on the front lines of battling the virus ever since. They’ve faced PPE shortages and dying patients. They’ve sacrificed time with family and dealt with concerns related to their own health. They’ve even encountered hostile reactions and individuals who refuse to follow medical advice.

“I have nothing but admiration for our entire staff. They’ve been through a lot, and they’re tired. That means we need to treat them right,” Dinger says. He’s joined his CNO and behavioral health CMO to form a team to steward Providence’s No One Cares Alone program, which gives employees access to free sessions with mental health experts, behavioral health specialists, and chaplains. This year, Providence plans to roll out a new peer-to-peer counseling program to give caregivers additional opportunities to help each other deal with burnout and other issues related to the ongoing pandemic.

“Bill’s thoughtful and innovative focus on creating programs that improve the quality of Providence caregivers’ professional lives will not only benefit them directly—the ripple effects will enrich patient experiences in California’s healthcare system,” says Marilyn Dekeyzer, area vice president of Premier Accounts at Blue Shield of California, who manages the Providence employer account.

The industry is changing, and Providence is growing. Against this backdrop, Dinger is working with his counterparts in the organization to rethink workforce development and expand the talent ecosystem. The efforts will equip caregivers to meet the challenges of today and prepare them for what lies ahead in the future of healthcare. AHL

Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. At Sedgwick, caring counts; we take care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brands, and containing costs. As a proud partner of Providence, we thank Bill Dinger for his leadership.

Willis Towers Watson : “Working closely with Bill, we’ve been impressed by his passion for providing caregivers with the benefits they value as affordably as possible. As a leader he supports initiatives that stretch current thinking and encourage innovation. It’s a privilege and a pleasure to partner with him in these efforts.” —Jane

Jensen, Senior Consulting Actuary

Congratulations Bill Dinger and Providence St. Joseph Health (PSJH) for the well-deserved recognition you are receiving. Securian Financial is proud of its strong relationship with PSJH and looks forward to continuing to provide relevant financial solutions.

Providence Health Plan congratulates Bill Dinger, vice president of benefits for Providence St. Joseph Health, for being an outstanding strategic partner. We commend Bill for his ongoing dedication and commitment to overseeing the high-quality benefits that are available to caregivers and their dependents.

Castlight Health is proud to support Bill Dinger and Providence as they embrace datadriven navigation to ensure employees get the health and well-being care they need, at the right time. We believe Bill’s strategic vision and use of data-driven insights to continually deliver quality care and outcomes at Providence is core to value-driven care. With a comprehensive view of the needs of their entire population, Providence continues to set the bar high, meeting their employees where they are, for optimal health and well-being.

Healthcare is faced with many challenges today—burnout, turnover, COVID-19, and adapting to the new shape of work.  Mercer ’s expertise in workforce planning and management, and employee rewards helps provider organizations proactively address these issues. Mercer is proud to support Providence to ensure they continue to lead the industry.

A business of Marsh McLennan

Your success is at the heart of what we do

That’s why so many organizations count on Securian Financial as a long term collaborator for their Group life and voluntary benefits. Our adaptable, consultative approach puts your success first, so you get the most relevant solutions for your business and your employees, today and always.

Learn more at securian.com/ groupinsurance

Since December 2019, there’s been a 200% increase in people reporting symptoms of depression and anxiety.* But many people struggle in silence. They often don’t know their options, and even if they do, they may not understand them.

At Blue Shield of California, our behavioral health model is centered around customer care and the personal navigator to support our members – whether they need help understanding their benefits or guidance for the best treatment options. It’s all part of our commitment to ensuring our members and their families have the resources they need to improve their whole health.

Learn more about our mental health resources at www.blueshieldca.com/bewell/livehealthy/mentalhealth

© 2021 Blue Shield of California, an independent member of the Blue Shield Association * https://www.cnet.com/features/our-mental-health-crashed-in-2020-recovery-could-take-years/

By Keith Loria

Timothy Leier strives to make a difference for others as Ecolab’s director of HR international benefits

Timothy Leier began his career in 1993 as a consulting actuary for Deloitte while studying economics and mathematics at St. Olaf College.

“I had a passion for solving problems with science, and originally thought I would go into medicine,” he explains. “I wanted to help people, but soon realized that I didn’t want to be a doctor. After talking to several people, they convinced me that I needed to go into something where I could actually make a difference for people, solving problems and protecting their futures.”

He did this from the perspective of providing insurance and retirement products to help people ensure their future was set. At Deloitte, Leier learned the hard way that people need information and he needed to learn how to maneuver within the regulatory environment.

“You have to bring a healthy and respectful amount of skepticism to every question you get, otherwise you can get burned pretty fast,” he recounts. “I learned that despite the misplaced pessimism, most employees and employers have the same goals in mind as to where they want to get to.”

From there, he hung up his own shingle for fifteen years, working as a

consultant and owner of TRL Consulting, continuing to work with actuarial, financial, and human resource matters.

“I wanted to make a difference and bring in a true independence,” Leier notes. “I loved doing that and loved the flexibility.”

Although he enjoyed his job, Leier felt like he was missing the team aspect where he could have a long-term effect on a very defined group of people. So, when such an opportunity came up to work in his hometown of St. Paul, Minnesota, he jumped at the chance.

In 2019, Leier joined Ecolab, a global leader in water, hygiene, and infection prevention solutions and services. “This meant less travel, more time to spend with my family, and the ability to be in-house, helping to protect the future of more than forty-four thousand associates,” Leier says. “Ecolab gives me the stability and resources to make a real, tangible impact.”

In his role as director of HR international benefits, Leier is charged with focusing on international operations and ensuring the benefits side of the company’s total rewards package works for them. “[The job entails] providing benefits globally that are consistent with our mission and our ethos, but also meet the

Timothy Leier Director of HR International Benefits Ecolab

requirements of all our foreign jurisdictions, which is a pretty tall order,” Leier elaborates. “Approximately 50 percent of our associates are outside of the United States, providing services in 169 countries.”

Over the past two years, as Ecolab managed the impacts of the pandemic, Leier notes that the concept of wellness was expanded throughout the company.

“If we’re looking out for the overall wellness of our associates, they are better off and frankly, the company is as well,” Leier adds. “It’s truly a win-win and can really help protect everyone long-term.”

That also came into play when Ecolab looked to support its associates in obtaining COVID-19 vaccinations. “We’ve made a real concerted effort—both in the US and globally—to give people the information to be comfortable with getting the vaccines and to give them time to get vaccinated,” shares Leier, who notes that the company was over 90 percent vaccinated globally at the end of 2021. “I’m really proud of our team to get that done,” he says.

At Ecolab, the company offers flexible and custom benefit plans for its employees.

“Benefits were initially developed in a time when most people spent their career with one employer, so you would

Courtesy of Timothy Leier

As organizations navigate emerging risks and market volatility, Aon helps them understand their risk exposures by employing advanced analytics to reveal deep insights in their program.

Visit aon.com to learn how your organization can leverage data insights to persevere in a challenging risk landscape.

rely on your employer to provide benefits that took care of you through that life cycle,” Leier says. “Times have changed. People no longer spend an entire career with one employer.”

He notes that while some employees intend to stay through retirement, others may just be stopping by on their career journey. For this reason, offering flexible benefits helps meet the needs for everyone.

When looking at the future of his job, Leier believes personalization is going to be a bigger and bigger focus. “I believe personalization is going to be a hyper focus area for us because everyone brings something different to the workplace,” he says. “When you show them how they’re valuable to the organization and how they can balance work with their personal life, they will help our company continue to move forward.” AHL

Aon is in the business of better decisions.

“I learned that despite misplaced pessimism, most employees and employers have the same goals in mind as to where they want to get to.”

The Path

Every step executives take on their career journeys is pivotal to achieving their current successes. Along the way, individuals accumulate technical skills, foster relationships, and develop the leadership acumen that have turned them into pioneers of the industry.

66. Helen Peltekci Prime Healthcare

68. Ryan Macpherson DexCom

72. Paul Chatel Becton Dickinson

76. Jennifer Fox Emergent BioSolutions

80. Lori Mayall Gilead Sciences

84. Ted Borgstadt TrestleTree

Saving Lives by Saving Hospitals

How Prime Healthcare’s unique model is keeping quality care in the community, rescuing forty-five facilities on the brink of failure

By Zachary Brown

S

ince its start in 2001, Prime Healthcare has grown into one of the biggest hospital systems in the nation. The organization now operates nearly fifty facilities in fourteen states with a network of more than fifty thousand employees.

Still, leaders at Prime believe that healthcare should be local and attuned to the specific needs of the communities they serve. How do they live up to that stated belief as they drive continued growth?

Prime invests to save struggling hospitals to keep the delivery of care uninterrupted. Then, its leaders rely on the power of the Prime network as they strengthen each acquired facility with capital investments. In the past seventeen

years, Prime Healthcare has invested about $1.7 billion in these efforts as they’ve brought new technologies, modern equipment, increased efficiencies, and better care to thousands of patients.

Prime Healthcare has revived fortyfive hospitals in the United States. In 2020, its leaders announced that the US Bankruptcy Court had approved a deal for the $350 million acquisition of St. Francis Medical Center in Lynwood, California. Prime committed $47 million for technology and system upgrades, and Dr. Sunny Bhatia, Prime Healthcare’s Region I CEO and corporate chief medical officer, said the agreement “reflects our decades-long

mission of saving, improving, and investing in community hospitals.” St. Francis, a 384-bed acute care facility with one of LA County’s largest private emergency trauma centers, remained open and later played a major role in responding to surging COVID-19 cases in the area.

Helen Peltekci joined Prime Healthcare’s legal team as assistant general counsel for professional liability in 2020 to leverage her experience with medical malpractice, insurance bad faith, and professional liability. She previously logged more than eighteen years as a litigation attorney with Giovanniello Law Group. She’s helping Prime reduce risk and ramp up

education as part of a legal team dedicated to protecting its physicians in a time of increased growth.

An emphasis on lower costs and finding efficiencies helps Prime put itself in a position to invest in and save failing hospitals. In late 2021, the Lown Institute Hospitals Index ranked the system among its ten most efficient for costs. The index ranked three thousand hospitals while considering many factors including pricing and outcomes.

Five Prime hospitals—Saint Mary’s Regional Medical Center, Encino Hospital Medical Center, East Liverpool City Hospital, Centinela Hospital Medical Center, and Desert Valley Hospital—were included in the list of the twenty-five most cost-efficient hospitals in the United States.

“The best hospitals prove that you can save Medicare dollars and deliver great patient outcomes at the same time,” said Dr. Vikas Saini, president of the Lown Institute. “If we want to keep costs low for the Medicare program and provide quality care for the sixty million Americans who depend on it, hospitals must be as efficient as possible.” Additionally, Prime Healthcare received top Lown Institute marks for social responsibility.

One new and important Prime endeavor will further increase access and quality of care to patients. In late 2021, the health system’s leaders celebrated a collaboration with healthcare provider Carbon Health. The deal will introduce Carbon’s urgent care clinics to patients in Prime’s markets, offering instant access to care from virtual and in-person appointments.

“Our goal is to deliver exceptional care to patients based on their needs, whether in our hospitals, physician offices, urgent care centers, or through virtual visits,”

said Dr. Kavitha Bhatia, chief medical officer of strategy for Prime Healthcare. “Carbon Health’s innovative model enables patients to access care how and when they desire, creating an unparalleled patient experience. The partnership with Carbon Health expands Prime’s model and expands access to quality healthcare for all. We look forward to continuing to expand this partnership in communities across the nation.”

These creative partnerships will continue helping Prime Healthcare execute its turnaround model as rural community hospitals struggle. Even before the pandemic, critical access hospitals and other small facilities faced significant challenges. Many across the nation were closing, leaving patients without access to care and care providers without access to jobs and paychecks. In an April 2020 article Healthcare IT News pointed to several factors, listing “financial pressures, an aging population, tightened reimbursements, and even difficulties in attracting and retaining providers.”

Then COVID-19 hit. Struggling hospitals were overwhelmed. Many leaders, like the chief executive of a twenty-five-bed facility and outpatient clinics in Arkansas, turned to grants and loans Congress provided via the Coronavirus Aid, Relief, and Economic Security Act. “For us, this was survival money and we spent it already,”

CEO Paul Taylor told NPR, adding that he doesn’t know how he can reimburse Medicare for the $8 million borrowed.

This is the dilemma administrators face across the country. Closure threats are real, and death rates increase when hospitals close. That’s why Prime’s leaders are passionate about the company’s model to save hospitals and keep their doors open. To date, the organization has saved forty-five hospitals without ever letting one close. AHL

Anchored by Integrity

Following a strong sense of duty, Ryan Macpherson spent time in the Navy before turning to a law career as a means to empower others

By Marcos Chisholm

Ryan Macpherson Senior Director and Chief Compliance Officer DexCom Nicholas Barrett

R

aised in Portland, Oregon, by a middle school teacher and high school guidance counselor, Ryan Macpherson is no stranger to public service: giving back to his community has always been a way of life. “I think it really gave me an appreciation for education, as well as public service,” he says.

The decision to pursue a military career and enroll in Northwestern University’s Navy ROTC program came naturally for him. After graduating from Northwestern in 2001, Macpherson entered flight school in Pensacola, Florida, where he trained to become a helicopter pilot. However, his transition from the classroom to flying a $28 million SH-60B Seahawk helicopter wasn’t easy. And neither was his first naval leadership experience.

“They throw you in as a young, newly commissioned officer in your early twenties, your mid-twenties,” Macpherson says. “But you’re also in charge of a division of enlisted sailors. Often times, you’re in charge of sailors that are older than you.”

Still, after learning the ropes, Macpherson excelled as an officer— especially in a crisis. When the historic 2004 Indian Ocean tsunami devastated fourteen countries and took over two hundred thousand lives, he flew on relief missions from Hong Kong to Indonesia, delivering food and medical supplies from the USS Abraham Lincoln before evacuating locals to safer areas.

Macpherson spent nine years in the Navy, and says his time overseas

reaffirmed his sense of duty. He worked in the Pentagon as a naval operations officer, which he describes as “a really great window into how the Navy operates at a larger level globally.”

He then realized he was ready to explore an avenue outside the Navy that would allow him to empower others: the law. He enrolled in night classes at the Georgetown University Law Center in 2007 and taught a law class to at-risk youth and adults in Washington, DC.

“It’s important for leaders to recognize we don’t have all the answers. We don’t have a monopoly on good ideas.”

In 2012 Macpherson joined the team at DLA Piper as a litigator, focusing on litigation and internal investigations. He was exposed to the world of regulatory compliance for the first time—an area he’d return to six years later, when he was looking for a chance to lead with integrity at an organization that was as ambitious as it was altruistic. He wanted to leverage his legal and corporate compliance expertise at the right organization. In 2018, he joined DexCom—a leading manufacturer of CGM technology—as their director of compliance and litigation.

While many teams consider compliance a hindrance to innovation, Macpherson quickly recognized its inherent value to organizations. “If they have a perception about compliance, sometimes it’s that compliance is the police officer or the cop of the company,” he says. “Compliance is actually a strategic partner if used correctly.”

When Macpherson arrived, Dexcom was growing rapidly from a company generating less than $1 billion in annual revenue to a company that now employs close to six thousand staff members and earns more than $2 billion in annual revenue. To support such rapid growth, the company tapped Macpherson to be its chief compliance officer; his first initiative was to create and manage DexCom’s first-ever compliance department, which supports its rapid growth.

“When you’re running a compliance department and program, it’s not

enough to just have the program exist on paper,” Macpherson says. “We didn’t have a whole lot of compliance infrastructure or compliance personnel on board, but we had a great working relationship with the business.”

He launched DexCom’s global compliance department in 2020 and now leads its two teams: one that addresses data privacy and another that handles corporate compliance.

Doing more with less isn’t a new concept for Macpherson. “In the military, we used to call these force multipliers,” he says. “With two automated systems, you can make a staff of seven, eight, nine people look like a staff of twenty.”

Macpherson wasted little time putting force multipliers into practice, focusing on implementing a highly robust and efficient data infrastructure for his new department. During the pandemic, he integrated third-party automation tools and analytics platforms that empowered his teams to excel in their remote work.

With or without a global crisis, Macpherson knows giving his talented staff room to operate pays off. “It’s important for leaders to recognize we don’t have all the answers. We don’t have a monopoly on good ideas. So I’ve used that as my guide and tried to hire really smart, capable people and give them the tools to succeed,” he says. “A lot of the successes of our department are really due to the fact I have really smart, innovative people working for me who come to me with great ideas.” AHL

The Number One

Paul Chatel helps deliver financial excellence at innovator Becton Dickinson, rooted in his significant experience across many industries

By Billy Yost

The foundation of financial expert Paul Chatel’s career lies in demonstrating the impact and action of the financial space, then applying this to broader business operations. “In whatever industry, in whatever organization, that always hits home for me,” Chatel says. “It’s those principles that continue to ground me.”

When Chatel says, “whatever industry,” he’s truly speaking from experience. He amassed significant experience in tier-two automotive suppliers prior to moving into the semiconductor and then medical devices space. The automotive supply space is where he built a working knowledge of how to tie financials into the everyday actions of engineers and other stakeholders

outside the financial team. “It was a great opportunity to help bridge that gap of knowledge within the organization,” Chatel recalls. “I really enjoyed it but wanted to keep expanding my skill set.”

Chatel would next move into the semiconductor industry, where he was able to build out significant international experience, as the company’s primary products were made in Belgium and China. The job involved helping plants improve their operational effectiveness, primarily in waste and labor productivity areas. Once he found his footing in the medical devices space, Chatel claimed his first managerial role with direct reports and the opportunity to build out his

leadership skills. He went on to make an immediate impact that would resound across the company.

Chatel was asked to move with his family to Puerto Rico to help a struggling plant raise its manufacturing excellence standards. “I spent a lot of time partnering with the plant manager and the engineering leads, again driving efficiencies and really helping them reshape how they were seen in the company and delivering results,” he explains.

Just one year later, the company won the plant of the year award across the organization, a previously unheard-of turnaround. But more importantly to Chatel, he was able to help a direct report rise in the

organization. “This person was seen as someone who may not have developed to the point where they could take on a bigger leadership position,” Chatel remembers. “I got to watch him turn that around, and he eventually replaced me when I left.”

Chatel accrued even more international experience helping a joint-venture partnership in Japan increase its profitability and growth. While he didn’t have to relocate his family this time, he was pulling impressive monthly flights ranging from eleven to fourteen hours, depending on the tailwind.

“This was another opportunity to bridge a gap around mutual goals and find ways to reduce often lengthy

Paul Chatel Senior Director of Revenue Cycle Management Becton Dickinson

Courtesy of Paul Chatel

“I hope to get more involved in the health and economics area, to continue to help bridge that gap. It’s a complex area, and I enjoy those complexities.”

Japanese registration times,” explains Chatel, who was able to strengthen the partnership’s conversation around its sales growth trajectory. “I helped transition the new team and leader in Japan and was ready for my next opportunity.”

Today, Chatel is the senior director of revenue cycle management at medical tech firm Becton Dickinson (BD), leading a team of about 130. He says that continuing to build bench strength in the areas BD serves is a daily point of focus. “The medical devices area is a highly regulated industry. It can be challenging to find people with the right skill sets, but I feel like we’re in a good place there and have some really strong managers and leads to support them,” he says.

Chatel has also placed significant focus on operational efficiency. With a team as large as his, the senior director mentions that there is always pressure to take cost out of processes. The balancing act, however, is to ensure that removing those costs doesn’t put the organization in any compliance risk.

The answer has been to investigate areas where automation makes sense. The billed claims process was 100 percent manually managed, until Chatel challenged it and turned it around in just eight months.

“We spun up a development program with our internal team and our business leads and, right now, we’re at just under 70 percent of our billing claims process being automated,” he says.

Chatel and his team are also working to reduce the number of unpaid claims, some $10 million at time of speaking. It’s a pressure point for anyone in the industry, but Chatel says he’s confident he and his team will be able to start seeing returns to the P&L on that effort.

Amy Blackburn, senior client success manager at revenue cycle management company Waystar, shares this trust. “The results Paul and his team are seeing are amazing. By incorporating powerful, purpose-built automation into their claim billing processes, they’ve

been able to boost productivity, cut operational costs, and realize millions in additional revenue by limiting rejected and denied claims,” Blackburn says.

Outside of his revenue management, Chatel says that he’s excited about BD’s focus on a breakthrough product that he hopes will make life easier for an increasingly large segment of the aging population.

“This year, we’ve spent a lot of time on this fantastic product that addresses the complex needs of aging women that develop severe incontinence,” the senior director says. “We’ve received so many customer stories about how this product has changed people’s lives. Husbands weren’t able to sleep in the same bed with their wives, daughters were having to drive over in the middle of the night to act as caregivers for their mothers. We’re talking about quality and clinical elements that can be life-altering.”

The challenge, however, has been that Medicare doesn’t reimburse for adult disposables or paddings. Chatel and his team are working directly with Centers for Medicare & Medicaid Services (CMS) toward recognizing the necessity of covering these types of products.

“This product is something we feel like we’re able to demonstrate the medical necessity for and that it should be reimbursed by CMS and other payers,” Chatel affirms. “The female incontinence market is a $4 billion market and is something the entire company is in tune with, but it’s been a learning experience for me corresponding with medical directors and getting insight into how they think, what motivates them, and how to get us on the same page.”

If it’s not already abundantly clear, Chatel isn’t motivated by a title—he’s motivated by a challenge. “I just want to use my talents and adaptability to be able to correlate business operations with financial results,” the senior director says. “I hope to get more involved in the health and economics area, to continue to help bridge that gap. It’s a complex area, and I enjoy those complexities.” AHL

The Power to Protect

Jennifer Fox uses her science background and legal knowledge to help Emergent BioSolutions achieve its goal of protecting or enhancing one billion lives by 2030

By Zachary Brown

World events have kept Emergent BioSolutions at the center of the biopharmaceutical world for more than twenty years. It started as a private company that manufactured one product—BioThrax—to protect military members from anthrax exposure. After the attacks of September 11 and related anthrax letter incidents, production of the product (the only FDA-licensed anthrax vaccine) increased.

Since then, Emergent has continued its legacy of developing and producing vaccines and therapies to address ongoing

public health threats. After a decade of sustained growth driven by BioThrax, leaders diversified the organization, expanding Emergent’s products, facilities, and workforce. By 2020, the company had added well-known products like NARCAN (naloxone hydrochloride) Nasal Spray and created a robust portfolio of vaccines, therapeutics, devices, and drugs. At the end of 2021, the publicly traded company had approximately 2,400 employees and more than $1.5 billion in total annual revenue. When the COVID-19 pandemic hit, world events once again put Emergent

Jennifer Fox

SVP of Legal Affairs and Deputy General Counsel Emergent BioSolutions

Kevin Titus

in the spotlight. To date, the company has manufactured and released over 120 million dose equivalents of COVID19 vaccines and partnered with multiple innovators to produce antibody-based therapeutics against COVID-19.

Jennifer Fox is Emergent BioSolutions’ senior vice president of legal affairs and deputy general counsel. She’s helping the company pursue continued growth through its five-year diversification strategy.

“Times are changing, and biopharmaceutical companies have to meet demands like we’ve demonstrated the ability to do at Emergent BioSolutions,” she says. “Leaders in this environment have to plan for where they’re going to be instead of focusing on where they are.”

A unique background helps Fox guide Emergent through the ever-changing landscape. The legal leader has experience in many areas of the life sciences. She grew up in small-town Pennsylvania, and as the daughter of a chemist, inherited a passion for learning. She graduated from high school early and first studied architecture before switching to science. Fox earned a BS in biology and an MS in biochemistry and molecular biology. She published peer-reviewed papers, attracted recruiters, and eventually took a job as a staff scientist studying cytochrome P450 enzymes at the National Institutes of Health.

After two years, Fox moved to GSK to focus her research on endocrine cancers and metabolic disorders. She was more than a research scientist—she was becoming an inventor. Ongoing research and development slowly exposed Fox to

“Leaders in this environment have to plan for where they are going to be instead of focusing on where they are.”

patent law, and she started to collaborate with GSK’s legal intellectual property team. Those conversations sparked an interest, and before long, Fox was working as a patent agent at GSK.

The intersection of science and law intrigued Fox, and she enrolled in North Carolina Central University School of Law’s evening program. Upon graduation, she worked as an IP attorney at two different life science companies, then started a small law firm’s life sciences group, and later spent seven years at Brinks, Gilson & Lione, where she was cochair of the pharmaceutical and biotechnology practice group as well as a member of the board of directors and executive management team.

Fox joined Emergent in late 2018 to help the company diversify and grow. She’s calling upon all of her experience and expertise to help her legal team members support the products their business colleagues develop, manufacture, and sell. “Lawyers in this industry that also understand science can assess certain risks differently because we have a deeper understanding of potential technical challenges and outcomes, in addition to the business-related ones,” Fox explains. She doesn’t have to stop to learn the difference between mRNA vaccines and viral vector-based vaccines before advising on a licensing strategy for the respective technologies, for example.

Emergent has nearly two dozen candidates in its development portfolio. In addition to supporting their development, Fox is working to modernize the in-house legal team. She’s implementing

artificial intelligence tools and other emerging technologies to automate more routine tasks and make her department more efficient and more responsive, ultimately allowing the team to spend the majority of its time on high-value work rather than routine but important tasks.

The nimble department helps the company navigate multiple legal challenges and also plays an important role in supporting its core business through its government procurement contracts, its commercial product sales, and its contract development and manufacturing organization services, such as those provided to Providence Therapeutics for its mRNA COVID-19 vaccine candidate or to Humanigen’s for its monoclonal antibody product.

The development, Fox says, underscores Emergent’s commitment to innovation and technology. “We’ve always been committed to doing new things to address new problems that arise,” she says.

BioThrax is the only FDA-approved vaccine that protects against anthrax exposure. In 2015, it became the first vaccine to receive approval for a new indication under the FDA Animal Rule. Emergent has also developed public-private partnerships and a network of manufacturing campuses that harness single-use technologies to produce critical vaccines and therapeutics.

This is the infrastructure Emergent Biosolutions is leveraging as part of its goal of becoming a Fortune 500 global life sciences company that will protect or enhance one billion lives by 2030. AHL

We are proud to work with Jennifer Fox and the Emergent BioSolutions team to help them advance their strategic goals.

A Consumer Protection Mindset

Lori Mayall’s passion for consumer protection leads her IP efforts at Gilead Sciences

By Billy Yost

ori Mayall’s passion is what drives her. The senior associate general counsel for IP and head of anti-counterfeiting and brand protection at Gilead Sciences sees trademark law and the broad anti-counterfeiting measures her team has led as a vital layer of consumer protection—in particular, for the patients who are relying on the company’s medicines.

“I always enjoyed science growing up, and I just had this sense of wanting to help impact society in a positive way through science and medicine,” Mayall remembers of her early years. “In college, I initially thought that would mean pursuing a degree in molecular biology to focus on gene therapy, but the paths we set for ourselves early in our lives don’t always go the way we plan.”

The senior AGC still found a way to unify her interests, both old and new. Mayall went on to build out significant IP and trademark litigation experience at global law firm Cooley LLP. It’s where the lawyer discovered her passion for trademark law. When an opening at Gilead appeared, Mayall says the choice was simple because it spoke so clearly to her earlier path.

“The job really seemed like a holy grail opportunity for me,” the lawyer says. “This allowed me to jump back into science and work for a company whose mission really aligned with what I had wanted to do as an original career. And it’s trademark work. What a perfect match.”

The Front Lines of Patient Protection

When it comes to anti-counterfeiting work, it’s easy to hear Mayall’s commitment amp up. She says that counterfeits are among the worst kinds of fraud that a patient can experience. There’s a risk of harm and even death when patients are exposed to medications that aren’t what they claim to be.

There is something uniquely nefarious about duping patients out of medications they need. It’s not a suspect designer bag purchased from a street corner vendor for a few dollars, and in drawing the distinction, Mayall’s broader consumer protection instincts kick in.

“In a world where there is so much uncertainty about what’s true and what’s not, I feel like we as trademark and anti-counterfeiting attorneys play an important role in establishing that base level of trust,” Mayall explains. “We want to make sure that when a consumer, or in

“I always enjoyed science growing up, and I just had this sense of wanting to help impact society in a positive way through science and medicine.”

this case a patient, purchases a product, they’re getting what they expect.”

Protecting Gilead’s patients, along with the company’s IP, requires significant work across the business. This requires collaborating cross-functionally in a way that is both impactful and efficient.

“I think our team has done great work making sure we are communicating and looping in the right people at the right times,” Mayall says. “I’m so cognizant of people’s time, so I want to make sure that the connections I build are meaningful and authentic.”

Building that kind of trust is likely why Mayall has been promoted three times over seven and a half years and why the importance of IP, trademark, and anti-counterfeiting has become better understood across all of Gilead’s channels.

Geoffrey Potter, partner at Patterson Belknap Webb & Tyler, is Mayall’s go-to counsel for anti-counterfeiting

Lori Mayall Head of Anti-Counterfeiting & Brand Protection Senior Associate General Counsel, IP Gilead Sciences

and other brand protection issues. “It is always a pleasure to work with Lori and her team,” Potter says. “They are super smart, well organized, and always focused on finding the solution that best protects patients.”

Intentionality and Doing the Work

Mayall says her own leadership is a reflection of a particularly strong example she learned at Cooley from a partner who always provided practical and actionable advice for both her clients and associate attorneys.

“What always stood out to me most was that it was always clear that she had done the work,” Mayall explains. “I’ve always found that you need to stick your neck out, you need to try something new, but you always need to make sure that you’ve done the work to be ready to succeed in that opportunity. You’re never going to know everything, but you have to be purposeful. You have to back up your intention with research and preparation.”

That doesn’t mean forecasting the future—far from it. But it makes failures far less tenuous. If it doesn’t work, the decision was still made for all the right reasons. Failure can produce a much more meaningful lesson to learn from when its intentions and objectives were clear from the outset.

Direct mentorship isn’t something Mayall was offered much early in her career. She was the first in her family to attend college, there were no lawyers in her family, and she says her own leadership in law can be best attributed to drawing from the practice and approaches she saw in her orbit.

“I wouldn’t be where I am without the people around me and the people who believed in me,” Mayall says. “My father instilled in me that I could do anything that I wanted to. And I’ve just tried to borrow and apply the best parts of the strong leaders I’ve encountered.”

Mayall’s journey, she says, hopefully illustrates that one’s path can diverge significantly from its original path while still being meaningful and, ultimately, winding up at the right destination. The senior AGC found her way. AHL

Renee Padgett

We are thrilled to congratulate our colleague Lori Mayall of Gilead Sciences on this well-deserved recognition of her leadership and accomplishments.

Pat terson Belknap

A Passion for Holistic Health

CEO Ted Borgstadt founded TrestleTree to help people implement behavior change. The organization’s unique training and behavior change model has helped it to thrive.

By Andrew Tamarkin

Ted Borgstadt CEO TrestleTree

TrestleTree CEO and Cofounder Ted Borgstadt has always sought to impact communities, one life at a time. He’s spent more than forty years in the healthcare industry, and when he established TrestleTree in 2001, he fixed on a holistic approach to helping people take control of their health.

“I got out of school in ’83 and moved from Missouri down to northwest Arkansas,” Borgstadt says. His plan to follow in his brother’s footsteps on the premed route was derailed when he encountered organic chemistry, so he switched to business. After graduating, he spent eleven years building his business skills in management positions for a pharmaceutical company before going into business for himself.

In 1994, Borgstadt acquired a few retail pharmacies in northwest Arkansas, giving him an insider’s look into the health behavior challenges of his customers. When a patient leaves the physician’s office, their next stop is often the pharmacy. “Our pharmacists recognized that almost everyone understood what their physician had just instructed them to do,” Borgstadt explains. “The problem was nonadherence, which was prolific twentythree years ago and remains so today.”

Trying to solve the world’s problems while sitting on his back porch with colleagues and friends, he kept returning to the same question of how to help customers who know how to improve their health but are struggling to implement behavior change.

TrestleTree was born out of these back-porch exchanges. In March 2000, the dot-com bubble burst at the same time Borgstadt sold the pharmacies. He partnered up with his college friend Clint Gabbard, got investors on board, and launched the company in 2001. “The genesis of TrestleTree is still the nucleus of who we are today,” Borgstadt says.

TrestleTree developed a proprietary program that trains health professionals to build trusting relationships. “We equip health professionals to help people change behavior who struggle, who are stuck,

“ TrestleTree celebrates life as a mosaic, rich with messiness, meaning, and texture . What we do is train health professionals to value that messiness in people’s lives—not to clean it up, but in the midst of that messiness be able to build trust with someone.”

unmotivated. Typically [people] that healthcare isn’t quite sure what to do with—in fact, oftentimes seeks to avoid,” Borgstadt says. “We support physicianpatient relationships directly and work to extend and deepen the impact of adherence and behavior change within populations.”

Their first client was a Fortune 500 company with employees across the country. They’ve continued working coast to coast, engaging with employee benefit plans at a wide range of companies, universities, health systems, Federal Employee Health Plans, and hospitals.

The company takes a holistic and pragmatic approach to helping people improve their health. Their training incorporates select behavior change theories, including motivational interviewing and the theoretical model of change. TrestleTree health coaches undergo a rigorous two hundred hours of training before they begin coaching.

“TrestleTree celebrates life as a mosaic, rich with messiness, meaning, and texture. What we do is train health professionals to value that messiness in people’s lives— not to clean it up but in the midst of that messiness be able to build trust with someone,” Borgstadt explains.

Facing skepticism is common, since some patients have often undergone other behavior change programs and not seen the desired results. Plenty of organizations address condition management, population health, and health coaching; it’s TrestleTree’s approach that sets them apart. Their model meets people where they’re at and develops a strategy based on the individual’s own belief systems and life, so they can sustain behavior change when the coach is no longer there.

“It’s not just about health; it’s about relationships, work, family, [and] finance,” Borgstadt says. “They may come in for smoking, but if they’re obese, we’re going to be intentional about their weight. We’re going to treat the whole person.”

In the two decades since starting the organization, Borgstadt has seen a number of changes. In 2006,

Cofounder Clint Gabbard returned to academia and was replaced by Dr. Becky Parker, whose expertise of recruiting, training, and leading dedicated coaches has impacted many lives.

In 2014, a large federal employee health plan approached TrestleTree about licensing their training model. While the health plan had their own professionals, they requested that TrestleTree provide its expertise in changing health behaviors. By agreeing, Borgstadt expanded the influence of TrestleTree’s training program externally for the first time.

In 2015, TrestleTree became an independent whollyowned subsidiary of Harvard Pilgrim Health Care’s HPI, which sought to fill a gap around behavior change and population health. In turn, TrestleTree gained resources and a more expansive book of business. “It was a natural fit along those lines,” Borgstadt says.

As CEO, Borgstadt supports teams, sets strategic visions, and grows departments like IT, licensing, and sales/business development. “There’s so much opportunity because there’s so much need in our country for people to change poor health behaviors right now,” Borgstadt says.

Borgstadt points out that the COVID-19 pandemic has brought on stress and a “dramatic increase in weight in a country already horrifically obese.” With experience in struggling populations, TrestleTree is positioned to help curb this weight trend as the pandemic eventually subsides. “We’ve got another long, dark winter ahead of us,” Borgstadt says. “We have the chance to be a voice of encouragement and pragmatic hope.”

In-house, the cord of relationships that run through TrestleTree is fortified by integrity, authenticity, excellence, and belief in the model. “I’ve never been part of an organization that has this opportunity to help people and actually delivers,” Borgstadt says. “We are helping dads be better dads and moms be better moms. That’s what drives me.” AHL

The Issues

National, and even global, forces have an unmistakable impact on an executive’s work. Whether it’s a legislative change or an industry-disrupting technological breakthrough, executives must constantly adapt their business strategies to keep their company thriving.

90. Karen Shahinian Takeda Pharmaceuticals

94. Ishak Akyuz Medtronic

98. Christian Aboujaoude Keck Medicine of University of Southern California

102. Margarita Diaz MetroHealth System

107. Daniel Epstein Jazz Pharmaceuticals

Two Passions, One Goal

Karen Shahinian unites her interests in science and medicine as SVP of legal at Takeda Pharmaceuticals, a company working to fight rare diseases and advance innovation

By Zach Baliva

Karen Shahinian

SVP of Legal

Takeda Pharmaceuticals

Early in her career, anytime Karen Shahinian needed a bit of inspiration to get through a tough day at work, she would walk down a long hallway that connected her company’s corporate offices to its laboratory space. Oversized photos of patients lined the walls. Most of the children looking down at her suffered from Hunter Syndrome, a rare genetic disorder, which at the time had no treatment.

Those faces motivated Shahinian as she worked as an associate general counsel to help Transkaryotic Therapies Inc., and then Shire, develop and launch an enzyme replacement therapy physicians now used to treat the condition.

Almost eighteen years and two acquisitions later, Shahinian is senior vice president of legal at Takeda Pharmaceuticals. She’s stayed in the industry and grown alongside every iteration of the company because of its patient-centered focus. “The work that we do here can help improve the patient experience and hopefully change lives, and I’m grateful that I get to be even a small part of supporting that important work each and every day,” she says.

Shahinian’s father is a physician, and she always thought she would follow in his footsteps. She was premed, worked as a clinical research assistant in a prenatal screening laboratory, volunteered on the Brown University Emergency Medical Service during her undergraduate years, and completed a master’s degree in medicine, but ultimately decided to pursue a JD from Boston College. Her interest in biology and science remained strong, though. The young student planned to unite her interests in law and

medicine, working as a research assistant in the area of scientific evidence and the law, and seeking out a firm with healthcare expertise.

Upon graduation, she started her legal career at Ropes & Gray, splitting her time between the healthcare and corporate departments, and ultimately focusing her practice within the life sciences group. Although she contributed to a wide variety of projects, she found the most fulfillment while helping smaller up-and-coming companies in the life sciences space, where she had the opportunity to really learn the business and

“When the basic principles hold tight, and everyone around you remains committed to a common goal of working tirelessly for patients, a change in process or policy here or there is just background noise. You concentrate on the big picture and get on with the work of the day; that’s what’s important.”

understand the strategic priorities that underpinned her legal work.

The realization led Shahinian to pivot to her first in-house role. She had been at Transkaryotic for just nine months when Shire acquired the company, and was instrumental in helping the specialty pharmaceutical company, known primarily for its neurosciences business, establish itself as a leader in the rare disease space. To do so, she did what she likes best—digging into the business and science, understanding all aspects of therapeutic areas, and keeping all of that front and center alongside her legal analyses.

“It’s not always about a straightforward legal analysis. The challenge in this job, and what keeps it fascinating for me, is that there is so much more to consider: is it right for the company, is it right for the patient community, what precedent are we setting, and can we follow through long-term to ensure we maintain the trust of those we are trying to help?”

As Shire continued to grow, Shahinian took on roles of greater scope and responsibility. She led big transactions to bring more rare disease capabilities in-house and helped put forth the company’s first formal philanthropy program to provide drug access to patients in underdeveloped parts of the world. She continues this commitment to philanthropic efforts, serving on both Takeda’s Corporate Social Responsibility Committee and on the board of its Rare Disease Foundation. She is also active at the board level for a nonprofit research foundation in the rare disease space.

In 2016, Shire acquired Baxalta in a $32 billion deal that created a large

product portfolio with reach into more than 100 countries. Shahinian led the integration of two large global legal teams following that acquisition. Next, Takeda acquired Shire in 2019. Fortunately, having been through a number of integrations, Shahinian is comfortable managing change and transitions. “When the basic principles hold tight, and everyone around you remains committed to a common goal of working tirelessly for patients, a change in process or policy here or there is just background noise,” she says. “You concentrate on the big picture and get on with the work of the day; that’s what’s important.”

While legislative proposals and other factors will likely impact drug pricing and patient access, the patient-centric approach of the legal group remains steady, allowing them to optimize the support they provide to the business so Takeda can continue its work to help patients.

Although Shahinian has been through several acquisitions and moved offices many times, the original patient photographs from Transkaryotic Therapies are still part of the decor. And while the SVP has expanded her role, the importance of patients for her remains unchanged. Hearing their stories and those of their caregivers, knowing their bravery, inspires her. Shahinian recalled bumping into a visitor not too long ago at Takeda who looked vaguely familiar. It took her only a moment to place him and realize he was one of the children from the photos that inspired her so many years ago. “That was an incredible moment,” she says. AHL

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Robot Reboot

Only a small percentage of surgeries are robot-assisted, though the technology has been available for decades. Ishak Akyuz and Medtronic are looking to change that with their new Hugo RAS system. By Zach

Baliva

Medtronic’s Hugo system is making roboticassisted surgery more cost-effective and accessible than ever before. The modular and portable apparatus includes a tower, console, pedestal, monitor, surgical instruments, pedals, and four robotic arms that surgeons can control to perform minimally invasive medical procedures. It is equipped with 3-D visualization technology and cloud-based video capture capabilities. Hugo is one of the most elegant and complex medical devices on the planet—but Ishak Akyuz remembers when it was little more than duct tape, bolts, and two-by-fours.

Akyuz is Medtronic’s chief counsel, responsible for legal affairs associated with the company’s surgical robotics

business. He’s spent the last eight years in east coast labs helping a cross-functional team of mechanical engineers, electrical engineers, regulatory advisors, quality control inspectors, patient safety consultants, and medical affairs experts design, build, and test Hugo prototypes.

The sleek surgical robot started out as a sketch on a whiteboard. Akyuz was one of the first robotics employees at Covidien (which Medtronic acquired for $43 billion in 2014), and says the start-up atmosphere was full of inspiration, innovation, and ingenuity. Inventors, scientists, and engineers left no stone unturned. In the early days they experimented with off-the-shelf objects, brought tools from their own garages, improvised using parts from industrial

Chief Counsel Medtronic

Ishak Akyuz

Courtesy of Ishak Akyuz

robots, made last-minute trips to the hardware store, and tinkered after closing time.

It was all done in the name of science. Akyuz and his colleagues were on a quest to design the best product to decrease size, drive down costs, reduce the barrier to entry, and bring new possibilities to robot-assisted surgery. “Technology and robotics will change the future of healthcare, but current solutions are too expensive to use. We are changing that,” Akyuz says.

Minimally invasive surgery offers many benefits. Surgeons encounter fewer variables and enjoy greater control. Patients recover faster with shorter hospital stays, less pain, and smaller scars.

The Hugo project team set a series of short sprints with timed goals and went through about eight prototypes. Akyuz arranged legal protections for the novel ideas his colleagues generated and worked to negotiate and license existing software and technology, including IP from DLR—Germany’s research center for aeronautics and space.

Once they had a viable and working model, Hugo entered its testing phase. Surgeons entered Medtronic’s labs to test the device in various conditions, while control experts worked around the clock to ensure quality and reliability.

Finally, in 2021, Medtronic was ready to introduce Hugo to the public. While hospitals and health systems were receptive to the modular, upgradable, and open console design, Hugo still needed to prove its performance abilities and clear regulatory hurdles. In June, doctors in Chile first used the system for a prostatectomy. Later, surgeons in Panama performed a series of gynecological surgeries with the device. In October the Hugo system received the necessary CE mark approval to make it available in Europe and Akyuz says the team recently received approval to use Hugo in a clinical study in the United States.

These steps are helping Medtronic put pressure on Intuitive Surgical, whose $1.5 million da Vinci systems fill operating rooms around the world. Although

“We designed this robot with patients and surgeons in mind.”

Intuitive has enjoyed an uncontested monopoly for two decades, Hugo is built to compete. “We designed this robot with patients and surgeons in mind,” Akyuz says. Medtronic’s design team interviewed hundreds of doctors to build a user-friendly, patient-centered, cost-effective alternative to the market leader. Da Vinci is hard to move; Hugo is portable. Da Vinci is expensive to repair and maintain; Hugo features individually upgradable components. Da Vinci has an immersive console that makes collaboration difficult; Hugo has an open console, making it easy to share ideas and engage with the surgical team.

Despite the availability of da Vinci for over two decades, just a small number—Akyuz estimates 3 percent—of all surgeries are completed with robotic systems. That means Hugo has the chance to compete by expanding the playing field.

The global COVID-19 pandemic, skills shortages in healthcare, the increasing cost of care, and other factors are driving the demand for robot-assisted surgery to an all-time high. Some industry experts expect it to nearly triple, reaching 11.8 billion by the end of 2025. Akyuz believes Medtronic will be ready to meet that demand.

Data and analytics will be a key part of that process. Medtronic recently acquired Digital Surgery for its advanced video recording, storage, and data capabilities. Practitioners can use related solutions to get analytics and compare a surgeon’s performance against peers and industry benchmarks to advance training and align with best practices. Other pieces of software can prescan surgical areas and alert surgeons about possible polyps. While these innovative features ooze with potential and actionable insight, they also raise privacy and data security concerns that Akyuz diligently addresses.

It’s another way he’s helping Medtronic find a competitive edge, and in the “robot wars,” a little bit of competition is good for the industry. With new players entering and companies going head-to-head, patients come out on top. AHL

Guidance. Clarity. Direction.

Carter, DeLuca congratulates Ishak Akyuz, Chief Counsel at Medtronic, on his recognition in American Healthcare Leader and on his guidance and leadership at Medtronic.

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Planning a Route to the Unknown

At Keck Medicine of USC, Christian Aboujaoude focuses on enterprise-level solutions in order to adapt to whatever challenges the future may bring

By Billy Yost

Many organizations struggle with the ability to pivot quickly. Their operations run just fine until something changes—a crisis like a global pandemic, for example—and their current model no longer works. That’s where enterprise planning comes in, according to Christian Aboujaoude, chief technology officer at the Keck School of Medicine at the University of Southern California. Above all else, he says, technology leaders need to consider this: recognizing the ever-increasing rate of change in technology, are the solutions you’re designing now only suitable for now?

“It’s imperative for organizations to plan solutions that have the capability to scale and evolve,” he explains. “Building a solid, scalable foundation is always important, whether there’s a pandemic or not. As long as you’ve done that, you’re on the right track.”

Aboujaoude is an IT professional whose two decades of experience includes data centers, IT disaster recovery, server platforms, and vendor management. He seems incapable of burning out—a trait he attributes to his own curiosity and continued fascination with the technology space. It’s an attitude that has paid off for the evolution of Keck Medicine during an extremely challenging period for healthcare.

A Strong Foundation

Aboujaoude says Keck’s response to the COVID-19 pandemic, from a technology standpoint, has been bolstered by the fact

“If you want an organization that can scale and expand, you have to build enterprise solutions that can spread across your organization and accommodate challenges like the pandemic.”

that it was ahead of the curve in enterprise planning and cloud integration.

“This might be different from some other organizations, but I think we were already so far down the road on our cloud adaptation journey when the pandemic began that we were able to continue to evolve without being challenged with hardware needs and other concerns on that front,” he says. “We had resources and environments relatively stood up prior to the pandemic, which helped us accelerate the migration of our users and patients without impacting operations.”

That acceleration still required a huge investment by the IT team, and Aboujaoude says the bevy of cheat sheets and educational material the team rolled out to aid the migration— along with “how-to” documents and YouTube tutorials for users—was extensive. But while there were some major changes, the team found that many of its existing systems were able meet new challenges.

Aboujaoude believes the road map that the IT team had in place was critical to weathering the last two difficult years. In a period of high stress, it’s incredibly easy to lose track of just how teams, departments, and organizations found themselves in uncertain circumstances. A road map doesn’t just guide the journey to avoid potential obstacles, it also helps drive growth and evolution

Christian Aboujaoude

CTO

Keck Medicine of University of Southern California

Megan Jane Burgess

toward a technological destination. While that destination is never fixed in the world of tech, the vision and journey have to be planned and ready for alteration as necessary.

It’s a complex metaphor, but Aboujaoude has a simpler explanation. “Think about your PC. It wasn’t just built to run an Internet browser; it was built for so many different things. If you want an organization that can scale and expand, you have to build enterprise solutions that can spread across your organization and accommodate challenges like the pandemic.”

While many technology departments found themselves seeking out new vendors, new partners, and new answers for questions they hadn’t had to ask themselves before, Aboujaoude took a different approach. “I didn’t add any new vendors to my portfolio,” he says. “What I did was capitalize on the existing relationships with our major partners like Cisco and Microsoft to continue to build a scalable environment and infrastructure that is resistant to being derailed by events like the pandemic.”

A Constant Challenge

When it comes to the visionary thinking required of IT leaders, Aboujaoude says that people who are just beginning their careers may need to continue to challenge themselves to develop the skills

that enable them to look beyond the present moment.

“I think I struggled a lot before I learned how to do this,” Aboujaoude admits. “Someone who has just started in the space may not understand what enterprise planning really means. The idea is that you are able to envision and take action that will ultimately translate into less resource requirements and less impact and pressure on your team in the long run. If you’re thinking about today, think about today three or four years from now.”

It’s a skill he’s worked to build out with his team, and one that is imperative when implementing enterprise-level solutions. The team development, telehealth services ramp-up, and continued challenges of building a best-in-class technology organization in a pandemic environment don’t seem to weigh all that heavily on Aboujaoude.

While he acknowledges that his department has been extremely busy, Aboujaoude welcomes the challenge.

“It’s important that we are always engaged and working hard to push things forward,” he says. “As long as 30 to 40 percent of my day offers me the chance to tackle something new, it lets me know that I’m continuing to push and challenge myself. I love helping people, and I haven’t gotten tired of it after twenty-two years.” AHL

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Healthcare Is More Than Hospitalization

For nearly two decades, Margarita Diaz has worked at Cleveland’s MetroHealth System, where population shifts mean her health equity role is more important than ever

By Russ Klettke

Margarita Diaz Director of Inclusion, Diversity & Health Equity MetroHealth System

Brian Kauffman

C

leveland, Ohio’s Cuyahoga County became significantly more diverse in the decade preceding the 2020 US Census. The multiracial population nearly tripled, the Hispanic population more than tripled, and Asian residents increased by a third.

This bears significant importance in the administration of public health, a fact not lost on Margarita Diaz—who worked for the MetroHealth System in Cleveland for most of that decade. Now the director of inclusion, diversity, and health equity, she has spent a total of nearly twenty years working with the sprawling safety-net healthcare provider, which employs eight thousand people in four hospitals and across forty “touch points” in the communities they serve.

Hers is an important and powerful position, and it’s hard to imagine anyone better suited for it. Not only did she spend most of her two decades with MetroHealth in direct caregiving, but she also is the daughter of immigrants, raised in a community heavily populated by Puerto Ricans like her own family.

“I like to say I grew up at MetroHealth, where I volunteered my summers as a high school student ‘candy striper,’” says Diaz. She was then hired as an administrative assistant and moved up to medical assistant, spending nearly a decade with MetroHealth.

After earning her first nursing degree she spent a few years working for other providers, but returned to MetroHealth a decade ago as a clinical coordinator and

nurse manager for ambulatory surgical services. Diaz holds both nursing bachelor’s and master’s of science degrees, in addition to certifications and specialty training in multiple subjects. While she now works in management, she continues to wear her nurse credentials badge.

“Being here at MetroHealth feels like home,” she says. “Plus, my core values align with our mission and values. I love serving the MetroHealth community.”

The hospital has a 184-year history and is now building the Glick Center, a billiondollar facility, on its main campus. Within its patient population more than half (54 percent) are from marginalized groups, and two-thirds are either uninsured or on Medicaid or Medicare. The system’s mission includes the promotion of community health and wellbeing with affordable housing, a cleaner environment, economic opportunity, access to fresh food, convenient transportation, and legal help.

The Glick Center is being built in an EcoDistrict—the first in the US to be anchored by a hospital. EcoDistricts take a comprehensive approach to community planning that emphasizes health equity, resilience, and sustainability. Diaz values the fact that landscaping around the new facility is intentionally designed for optimal patient outcomes, a best practice in modern hospital design.

MetroHealth’s DEI (diversity, equity, and inclusion) programming intentionally mirrors national best practices.

“Being here at MetroHealth feels like home. Plus, my core values align with our mission and values . I love serving the MetroHealth community.”

A Leader in the Fight for Inclusion, Diversity and Health Equity.

Focused on building communities where differences are celebrated and everyone has an opportunity to be safe, loved and successful.

“Health systems have to reflect the communities that they serve,” says Diaz, elaborating that the organization adheres to National CLAS Standards: a framework of fifteen action steps that are culturally and linguistically appropriate and respectful of the beliefs, preferences, and communications needs of patient populations. Some of these standards are federally mandated for hospitals receiving federal funds (including Medicaid and Medicare), while others are voluntary or required by individual states.

But Diaz’s work goes far beyond simply meeting requirements. She’s extremely engaged in her job, occupying leadership positions with a number of initiatives and organizations that address equity concerns in very specific ways. She also speaks of certain events of 2020—the COVID-19 pandemic and the Black Lives Matter movement response to the murder of George Floyd in Minneapolis—as pivotal events with broad implications.

“In the wake of Mr. George Floyd, we as a system established nine equity goals to include racial equity,” Diaz says. “In those goals is a commitment to increase the diversity of staff and clinical providers.”

To ensure that those goals are more than pipe dreams, her department is developing hiring and retention tools that address this particular challenge. “While we do have representation from African-American and Hispanic providers, we have to increase and enhance those numbers,” she says. “That includes a hyper-focus on medical

colleges and organizations that have large minority representation.”

On the education and retention side, bias awareness courses (“Unconscious Bias: We All Do It” is one example) are mandatory for all system employees. Racial equity training began with the system’s leaders, including senior executives and trustees. This education has cascaded to at least four hundred others in managerial roles. Diaz says that data shows that bias and stereotypes impede care—and that building awareness in this area achieves better outcomes for patients and the hospital overall.

Diaz approaches certain equity issues by leading problem-specific programs. She is cochair of an action team for First Year Cleveland, a comprehensive program that addresses high infant mortality rates among African-American families in the county. She’s also the local chapter president of the National Association of Hispanic Nurses, and mentors prospective healthcare workers through this and other organizations.

With eleven employee resource groups, including a Pride Alliance for LGBTQ employees, the DEI function was recently elevated to C-level status— outside the human resources umbrella, with a chief equity officer and health equity medical director.

“That is a huge system shift,” Diaz says. “As a team we will work with all departments and initiatives throughout the system to eliminate disparities and make equity a central organizing principle of everything MetroHealth does.” AHL

Building Momentum

After a year filled with approvals and acquisitions, Jazz Pharmaceuticals is ready for big things as it pursues new breakthroughs for patients with serious diseases

By Zachary Brown

azz Pharmaceuticals had a big year in 2021. The publicly traded company, founded in 2005 and known best for brands like Xyrem and Erwinaze, acquired GW Pharmaceuticals and won approval for an acute lymphoblastic leukemia drug known as Rylaze. Along the way, Jazz surpassed $3 billion in annual revenue for the first time. Leaders are looking to continue the momentum and have made public their intentions to

nearly

double that yearly revenue number by the end of 2025.

Daniel Epstein serves as Jazz’s corporate counsel for litigation. He has been with the company for more than six years and oversees a team of attorneys and paralegals. The group handles significant offensive and defensive litigation as well as smaller disputes, but in between those matters, the lawyers have opportunities

to counsel their business colleagues on possible areas of risk and other matters as they pursue important objectives. Epstein looks for opportunities to engage with the physician-facing teams and patient advocacy teams while giving leaders input on how to meet their goals.

“Dan’s leadership skills, collaborative style, and shared commitment to achieving the best results possible make him a valued partner in our work for Jazz,” says Heidi Hubbard, partner at Williams & Connolly LLP.

Chairman and CEO Bruce Cozadd highlighted many of those goals while participating in the virtual J.P. Morgan Healthcare Conference in early January 2022. In addition to his vision for growing revenue to $5 billion, Cozadd said he and his colleagues are aiming to get five or more novel products approved by 2030 as they expand both Jazz’s developmental pipeline and product portfolio. “We are building on our track record and our patient-centered approach. We laid out vision 2025 in order to give investors and employees a better sense of where we’re going,” Cozadd told BioSpace.

The acquisition of GW Pharmaceuticals, a key player in cannabinoid-based prescription medicines, deepened Jazz’s neuroscience portfolio and laid important groundwork Cozadd intends to build upon. “We are excited to welcome our GW colleagues to Jazz as we mark a transformative milestone in creating an innovative, high-growth, global biopharma leader in neuroscience with a worldwide commercial and operational footprint,” he said. The move announced on May 5, 2021, brought another high-growth opportunity to Jazz, as the cannabidiol oral treatment known as Epidiolex used to

treat childhood-onset epilepsy surpassed $500 million in annual sales.

Last year, the US Food and Drug Administration approved Xywav, a Jazz product used to treat narcolepsy. The company expects the drug to generate about $2 billion in yearly revenue. Additionally, the fastgrowing company has around two dozen compounds in different parts of the development cycle. As Cozadd told BioSpace, Jazz Pharmaceuticals has a Phase II study underway for JZP150, a therapeutic to treat posttraumatic stress disorder, and is also analyzing Nabiximols for advanced trials. The cannabis extract first developed by GW Pharmaceuticals and sold as an oral spray contains both THC and CBS and alleviates spasticity and related multiple sclerosis symptoms.

These measures will help Jazz solidify its status as a leading global biopharmaceutical company. Jazz has its headquarters in Dublin, Ireland, and serves patients in almost seventy-five countries. The medicines it develops, manufactures, and markets in neuroscience and oncology give hope to individuals with serious diseases who often have no other therapeutic option.

In 2022 and beyond, Jazz remains committed to pursuing new breakthroughs and delivering promising new products. As the year started, Cozadd posted a message on the company’s website saying the milestones reached in 2021 simply reinforce Jazz Pharmaceuticals’ “passion for developing innovative treatments that help improve the overall quality of life for patients around the world.” This year, he and his colleagues are looking to build upon all that’s come before. AHL

We are proud to work with creative and collaborative industry leaders.

We congratulate Dan Epstein of Jazz Pharmaceuticals for his recognition by American Healthcare Leader.

Named leading litigation firm for General Commercial Litigation

– Chambers USA, 2004-2021

Named “Litigation Department of the Year” for Products Liability

– The National Law Journal, 2017 & 2021

Named leading firm for Antitrust (Civil Litigation/Class Actions)

– The Legal 500, 2016-2021

The Reason

Some executives feel the importance of their work because they have experienced its impact firsthand. Shaped by their mission to help others or by their personal experiences with healthcare, many executives are drawn to the industry from a sense of empathy and a desire to make a difference for others.

112. Teresa Tonthat Texas Children’s Hospital

120. Jennifer Blythe CaroMont Health

128. Adam Yoffie Bristol Myers Squibb

128. Amy Farris Wolfe Aurobindo Pharma

134. Tanya Thomas Experian Health

Allen Kramer

Teresa Tonthat VP of IT and CISO Texas Children’s Hospital

Planning for Every Scenario

Teresa Tonthat works to ensure that the technology she oversees at Texas Children’s Hospital won’t cripple the system

By Billy Yost

Teresa Tonthat remembers her first day at Texas Children’s Hospital, where she’d been hired as the director of information security. It came after an oil and gas career that spanned sixteen years, took her to six of the seven continents, and grew an audit professional into an innovative leader in both audit, risk, and IT functions.

“I remember my first day at Texas Children’s while getting into an elevator and someone asking me to hold the lift,” Tonthat recalls. “It was a father and his young child who was in a wheelchair and had an oxygen tank. I was so taken aback. In seventeen years of corporate work, I’ve met with my customers, but they were never these types of stakeholders. It didn’t take me long to understand that the mission for healthcare, specifically for children and women, is just not comparable to anything else.”

Tonthat jokes that anywhere else, you can implement new IT solutions that enable business objectives all day long, but how many industries can say that whatever you’re focusing on, it’s inevitably going to help save children’s lives? “I knew I had made the right decision to come to healthcare,” she says.

An Investment Center

Since coming to Texas Children’s four years ago, Tonthat has risen quickly in her organization. She was promoted to assistant vice president of IT, and then to her current dual role: vice president of IT and chief information security officer.

That rise, Tonthat says, can be attributed to continuous mentorship from her leadership, building a strong resilient leadership team, and the strong culture at an organization that sees value in technology and cybersecurity.

“People might say that the word innovation doesn’t really go well with controls and rigorous governance processes, but somehow we make it happen,” she explains. “I feel a lot of that has to do with the executive leadership team really understanding that we are not a cost center. We are viewed as an investment center,

“ It didn’t take me long to understand that the mission for healthcare , specifically for children and women, is just not comparable to anything else.”

sought out for insights. We provide solutions instead of the organization coming to us with a solution that they want implemented. We always strive to do what’s right and strike a balance of risk versus reward.”

Tonthat has felt empowered by Chief Information and Innovation Officer Myra Davis, who has helped grow Tonthat’s role and bring her to the executive leadership team. “Myra is not only my boss but has been a great mentor to me since I’ve joined her leadership team,” she explains.

Biomedical engineering, historically part of the operations organization, was brought under Tonthat’s purview as part of a broader effort to innovate and modernize the way services are delivered to the organization. “We have about 46,000 medical devices that touch our patients, and almost 10,000 of those are connected for interoperability, so it makes sense to bring biomed engineering into IT,” the VP says. “Biomedical engineering has always been viewed as skilled technicians repairing devices, and my challenge is to find opportunities to modernize the great work our people do. We also need to have a seat at the table and bring innovative healthcare technology solutions to our clinical partners and physicians.”

Tonthat’s colleagues outside the hospital have been impressed by her efforts. “Teresa’s unique approach to building partnerships that benefit all involved will have a long-term impact on Texas Children’s Hospital and those they serve,” says Len Noble, executive sales director for the IT company Netsync. “Her collaborative approach ensures outcomes that provide both financial and operational value for her organization. We truly appreciate Teresa and are thankful for our partnership.”

Ahead of the Curve

The COVID-19 pandemic has been a challenge for everyone in healthcare, but Tonthat says that the foresight demonstrated by Texas Children’s helped

put them ahead of the curve. The organization’s telehealth and e-health effort was already in working order when the pandemic hit, it just needed to be ramped up exponentially.

In 2019, there were approximately one thousand telehealth appointments. From February 2020 to December 2021, there have been more than three hundred thousand telehealth appointments—a massive increase.

“I’m so proud of the cross-functional teams that were able to stand up command centers and help desk centers for our physicians, schedulers, and patient families,” Tonthat says. “Not everyone uses the same type of personal devices, and we were able to walk our patients through those potential frustrations or anxieties of using their technology.”

Tonthat also credits technology services partner ePlus, whose partnership and ahead-of-the-curve efforts helped make moving more than five thousand employees home to work a secure and efficient process. A staging room full of new laptops (outfitted with the extensive security requirements required) was stood up quickly.

“Knock on wood,” Tonthat says. “We didn’t have one incident during the surge to virtual working, but I can tell you that there has been a lot of attempts and scanning of our environment from bad actors.”

The issues that Texas Children’s has to solve are varied, and Tonthat has worked with ePlus on multiple fronts. “Meteorological disruption has been a constant in the southeast Texas region, which challenged the ePlus teams to collaborate, adapt, and innovate in near real-time with Teresa and her teams to support TCH’s mission,” says Lisa Neal, an ePlus senior account executive.

The Planning and People for Every Scenario

In October of 2020, a US Joint Cyber Security Advisory was issued alerting healthcare and public health sector institutions of a credible threat of ransomware and

Elevating patient care

Hospitals and healthcare organizations across the country rely on ePlus to optimize their IT investments and deliver better patient outcomes through state-of-the-art care.

Enabling healthcare to transform to a continuum of care for better patient experience, ePlus makes technology mean more for healthcare.

+ Big Data/Analytics

+ Cloud for Healthcare

+ Security

+ Telemedicine/Telehealth

+ Mobility

+ Staffing Solutions

+ Tailored Financing

other targeted attacks. The University of Vermont Medical Center was taken offline for nearly a month, while a dozen other hospitals were also knocked offline with countless other reporting breaches.

Texas Children’s was not one of those systems, but Tonthat says that’s not because they weren’t targeted. Just like organizations that do active shooter simulations, cyberattack simulations need to be taken seriously, she says, because patient lives are on the line.

“Every year, we get our leadership team and our front-line nursing colleagues together—over a hundred leaders—to simulate the hospital’s technology systems going dark,” Tonthat says. “There are so many things to consider that you just can’t imagine. I’m not sure if any healthcare organization has simulated downtime procedures for not having access to their electronic medical record system, business solutions, corporate email, or internet for more than a day.”

This proactive and ever-evolving approach is a reflection of the team that Tonthat has built, encompassing not just healthcare professionals, but a diverse swath of technology professionals.

“We have a diverse team of leaders, and I believe it’s important to keep having pioneering types of conversations with outside industries that allows us to really differentiate our service,” Tonthat explains. “Compared with other hospitals, I think our leadership development is also of the same caliber.”

Texas Children’s has employed the company GiANT to conduct leadership coaching and help unite diverse leaders in styles that are best suited for each and every individual.

“It’s been nothing but beneficial to help us become stronger leaders and is continued proof of the investment that this organization is making in its current and future leaders,” Tonthat says. “The executive team supports leadership development at all levels, because we know how instrumental it has been for us all.” AHL

“I’m not sure if any healthcare organization has simulated downtime procedures for not having access to their electronic medical record system, business solutions, corporate email, or internet for more than a day.”

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Using ALTO, Netsync is enabling patients to have access to entertainment and education services with the click of a button, enhancing the patient experience. Netsync is giving healthcare facilities the ability to grow into the future by providing technology to enhance both patient and providers’ ability to access information easily, and therefore achieve better patient outcomes.

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Part of the Solution

Jennifer Blythe grew up with a desire to help. As CaroMont Health’s corporate counsel for legal affairs, she’s fulfilling that passion at the intersection of health and law. By Zach Baliva

I t was a once-in-a-career type of deal. CaroMont Health, a regional health system in North Carolina, was growing and needed to find land for a second hospital. Jennifer Blythe, corporate counsel for legal affairs, knew she had the opportunity to impact her community by improving access to high-quality care. When CaroMont’s leaders identified Belmont Abbey College as a strong partner with shared values, Blythe stepped in and helped to negotiate a fifty-year ground lease for the future location of CaroMont Regional Medical Center-Belmont.

The signed long-term lease will help secure Gaston County’s future, and Blythe is proud of the work she contributed to finding a solution. “This is a landmark deal that CaroMont and our patients will rely on for the next five decades and it gives us a foundation we can build on,” she explains. Construction will begin right away, and the facility will house medical office buildings, physician offices, operating rooms, sixty-six inpatient beds, surgical capabilities, labor and delivery, and an emergency department. The new hospital is scheduled to open in 2023.

As it operates in a Certificate of Need state, CaroMont required plan approval from the North Carolina Department of Health and Human Services, which it received in March of 2020. The work of Blythe and the legal and operations team in negotiating the land lease set other critical developments in motion. Her colleagues at the flagship hospital are now able to

expand critical care through construction of a new patient tower that will make service delivery more efficient and solidify the center as the region’s central hub for advanced care.

Each floor in the four-story expansion will house twenty-six patient rooms and state-of-the-art nursing stations built for enhanced collaboration. The 146,000-square-foot tower is part of a $350 million total investment in system projects and improvements necessitated by growth of an aging population. CaroMont now experiences about 250,000 patient encounters per year. Treating those patients takes contributions from each of the system’s 4,300 employees, and Blythe is happy to play an important role by leveraging her legal expertise.

Using her skills in the service of others has been a lifelong personal and professional goal for Blythe. A North Carolina transplant from Indiana, as a child she wound through the court system as a ward of the state. As she and her sisters struggled to find an advocate, a seed was planted, and she later nurtured a growing interest in the law.

That interest took Blythe to University of South Carolina School of Law, where she assisted a health law professor and completed an internship at a large regional firm with a strong healthcare practice. The experiences, coupled with the complicated nature of healthcare, helped Blythe realize she could use her passion for advocacy to make a difference.

Jennifer Blythe

Corporate Counsel, Legal Affairs CaroMont Health

Dodie Huffman

“Patients have to navigate a maze to receive good care, and then they find a new maze when it comes time to pay for that care,” Blythe says. “I saw the opportunity to use a legal degree to be part of the solution.”

Blythe has grown alongside CaroMont over the last eight years. She’s part of a small-but-mighty team of three lawyers who take calls from nursing stations and solve problems for clinicians. On any given day, she might be negotiating a major real estate deal, navigating records issues, dealing with employment matters, or advising operations departments about patient privacy.

Now, she’s helping leaders, executives, and administrators navigate skills shortages as they prepare to staff a growing independent health system. In today’s challenging environment, that can require some delicate behind-the-scenes legal work. When CaroMont wasn’t receiving enough clinicians for its hospital and other care settings, Blythe had to approach their exclusive staffing vendor and negotiate to open the contract to other third-party providers so the system could continue to treat patients instead of closing beds or diverting them to other hospitals.

The strategy works because Blythe has spent the time to make true partners out of CaroMont’s

vendors. “Transparency is key in all business relationships,” she says. “If we’re in a bind, I explain the truth lawyer-to-lawyer and ask them to help me find a creative way to get what we need.”

CaroMont is an independent system battling a nursing shortage, navigating COVID-19, and experiencing rapid growth. It’s dedicated employees like Blythe working together that make it all possible. But she prefers to give the credit to her colleagues who are on the front lines of care each and every day. “Moving this health system forward is a team effort, but there are people here who sacrifice a lot to improve and save lives each and every day,” she says. “They are the real heroes whose work I support.” AHL

“Moving this health system forward is a team effort, but there are people here who sacrifice a lot to improve and save lives each and every day.”

Congratulations to Jennifer Blythe and CaroMont Health for their well-deserved recognition in American Healthcare Leader ! Parker Poe ’s Health Care Industry Team is proud of the longstanding relationship it has cultivated with CaroMont Health. We look forward to working closely with Jennifer and the CaroMont Team in the years to come.

Committed to Assisting Others

Throughout his life, Adam Yoffie has been driven by a desire to help others. At Bristol Myers Squibb, he’s using his legal skills to accomplish that goal.

By Zachary Brown

“T zedek, tzedek tirdof.”

“Justice, justice thou shalt pursue” (Deuteronomy 16:20). As the son of a rabbi, Adam Yoffie has let this passage guide his career, first as a federal criminal healthcare prosecutor with the Department of Justice and now as senior counsel for litigation and government investigations at Bristol Myers Squibb (BMS).

Yoffie first developed an interest in the intersection of healthcare and social justice when he interned for an HIV/ AIDS organization in Atlanta. He spearheaded testing and counseling efforts

and performed community outreach in an impoverished population that had long been underserved by the medical community. His passion for fighting healthcare inequality then led him to Cape Town, South Africa, and later to Israel, where he spent a year working for a professor at the Hebrew University Hadassah Braun School of Public Health and partnered with the Jerusalem Open House on health education events for the LGBT community.

When he returned to the United States, Yoffie spent a year working in the US Senate. Watching lawyers tackle a mix

of challenging legal and policy issues reinforced his desire to go to law school.

After graduating from Yale Law School and clerking for two federal judges, Yoffie joined a Washington, DC, law firm where he worked on internal investigations, government enforcement actions, and civil litigation matters in the pharmaceutical industry.

Continuing his healthcare industry investigations and enforcement work, Yoffie next served as a trial attorney in the US Department of Justice’s criminal division, where, as part of the Miami and Philadelphia Medicare Fraud Strike

Forces, he prosecuted healthcare professionals, durable medical equipment company owners, money launderers, and other individuals taking advantage of vulnerable patients. As part of a multiagency team, he partnered with federal agents from the FBI, HHS-OIG, and DEA.

Although Yoffie was thriving in his career and loving his work, in March 2020, a personal tragedy set him on a new path: after an intense yearlong battle, his mother lost her life to gallbladder cancer, her third cancer diagnosis. Her experience sparked an interest in oncology, and Yoffie joined BMS. A leading biopharmaceutical company, BMS works to discover, develop, and deliver innovative medicines that help patients prevail over serious diseases, including cancer.

In this role, Yoffie investigates allegations of employee misconduct and/or of company impropriety and responds to domestic and international government inquiries. “We always seek to do what’s right in order to ensure we can get to the heart of the matter,” he says.

Although no two investigations are the same, he works with a team of lawyers and investigators to identify potential witnesses within and outside of BMS, conduct interviews, review documents, and consult with internal subject matter experts. “There may be a perfectly rational explanation for what transpired, but we won’t know unless we familiarize ourselves with the facts,” Yoffie says.

The COVID pandemic has allowed for virtual interviewing, which has enabled Yoffie to work simultaneously on investigations on multiple continents. He may start early in the morning with a meeting in Europe, move to Latin America in the afternoon, and then conclude at night in Asia where it is already the next morning.

Adam Yoffie Senior Counsel, Litigation & Government Investigations Bristol Myers

Yoffie explains that when conducting investigations outside of the United States, it is crucial to be aware of local laws that dictate what steps the investigation team can take. There may be nuances to attorney-client privilege, as well as limitations on cross-border data transfers and the use of personally identifiable information. “We work very closely with BMS legal and compliance personnel in the local markets to ensure we not only understand our legal

Squibb

obligations but also respect relevant cultural practices,” Yoffie says.

According to Yoffie, investigations and post-investigation remediation efforts are most successful when the team collaborates with a broad cross-section of the company—from scientists to sales personnel—to gain insights into the inner workings of local markets and identify any root causes that may have led to a concern in the first place.

open line of communication with the government, and be prepared to explain complicated concepts in a concise and coherent fashion to government enforcement authorities.

“Adam’s experiences in private practice and as a former DOJ healthcare prosecutor provide him with great insight in managing investigations and responding to government inquiries,” says Karl H. Buch, partner and cohead of global investigations for DLA Piper. “He is smart, insightful, and a pleasure to partner with.”

His role at BMS enables Yoffie to play a part in contributing to the company’s mission of developing life-changing medicines. The key to conducting internal investigations, according to Yoffie, is to hold people accountable while treating everyone he encounters with dignity. “We’re investigating individuals who may or may not have done something wrong,” he says, “and we must be fair, just, and respectful in our communications with them.”

When responding to external inquiries from the government, Yoffie relies on his experience at the DOJ to communicate effectively with government officials at the local, state, and federal levels. Yoffie explains that it is vital to identify potential civil and/or criminal legal liability for the company, be mindful of external deadlines, keep an

Outside of his day-to-day responsibilities, Yoffie is a member of the law department’s pro bono committee. On BMS’ day of service, he recently worked with colleagues to conduct anti-human trafficking research. Yoffie also cochairs the Philadelphia Bar Association’s healthcare committee, which recently hosted events about immigration challenges in the healthcare system and clinical trials in a post-COVID world.

As the federal government and state attorneys general devote additional resources to investigating pharmaceutical companies, Yoffie’s work becomes ever more critical to upholding BMS’s commitment to honesty, integrity, ethics, and compliance. AHL

“We’re investigating individuals who may or may not have done something wrong, and we must be fair, just, and respectful in our communications with them.”

We are proud to recognize the incredible contributions of Adam Yoffie in his groundbreaking work at Bristol Myers Squibb.

Reaching Lofty Goals

Amy Farris Wolfe has enjoyed a rapid rise to the role of general counsel at Aurobindo Pharma—but she’s too busy to slow down and celebrate

By Billy Yost

Amy Farris Wolfe General Counsel

Aurobindo Pharma

Carmen Fascia

The overarching goal for any in-house counsel is usually to become the head of legal. The general counsel position is one many in-house lawyers work toward for the bulk of their career, gradually proving over time that they’re up to the challenge. Amy Farris Wolfe made it there before she was old enough to legally run for president.

It’s fitting for the daughter of a lawyer who served as deputy general counsel for Verizon (her uncle was also the First Assistant Prosecutor for the Morris County Prosecutor’s office in New Jersey). Farris Wolfe says she’s known her whole life that she wanted to be a lawyer.

The thirty-year-old general counsel of Aurobindo Pharma USA Inc.—the US arm of India-based Aurobindo Pharma Limited, a pharmaceutical manufacturing company—has had an eventful year. She got married in 2021, including a reception at the Barnes Foundation in Philadelphia, where the tall ceilings and state-of-the-art air filtration system designed for art preservation were ideal for a small get-together in the COVID era. Her legal team helped close three massive deals, two the day before 2022 and one the Monday after New Year’s Day. And to top it off, Farris Wolfe was named general counsel in January 2022.

“I really haven’t had time to fully come to terms with it,” she says. “Our previous GC moved on to a new role, and it was so unexpected that I don’t think I’ve really had the chance to think about what this all means yet with respect to my future. I try to maintain lofty goals, but this really wasn’t on my horizon for the near future.”

Farris Wolfe came to Aurobindo in February 2020, just a month before the COVID-19 pandemic began. Almost

immediately, she helped launch the first product of her career: Hemady (dexamethasone) with Aurobindo’s branded subsidiary Acrotech Biopharma LLC. With the supply chain in disarray across every industry, Farris Wolfe says, there was the challenge of helping patients adjust to a new medication when continuity with any medication was uncertain.

“You were also asking people to transition to something new at a time where almost any communication they were receiving was about COVID,” she says. “It was an eye-opening experience, and while it was difficult, the whole process was still fascinating, and we prevailed.”

Farris Wolfe has been heavily invested in transactional work as well. The lawyer helped Aurobindo divest its US subsidiary Natrol, a nutritional supplement company, to an affiliate of New Mountain Capital for $550 million. She’s also instrumental in the acquisition and in-licensing of new products.

“These deals have helped us diversify our asset portfolio,” Farris Wolfe says. “Aurobindo is always looking to increase its global footprint, so we’re very dedicated to continuing to do what we can to employ vertical integration and get creative development-wise with how we can bring affordable and quality products to patients.”

That creativity in research and development is essential for Aurobindo’s generics companies, whose goal is to reduce the cost of drugs for its patients. “You’re trying to mitigate and cut as much fat as you can to make sure costs aren’t getting passed on to customers,” she explains. “That means working to streamline processes and working with all of the business units as much as we can to drive peak efficiency.”

“Aurobindo is always looking to increase its global footprint, so we’re very dedicated to continuing to do what we can to employ vertical integration and get creative development-wise with how we can bring affordable and quality products to patients .”

It’s clear why Farris Wolfe hasn’t had time to reflect on the achievement of being named general counsel at the age of thirty: there’s too much going on in too many different business lines for her to be doing any victory laps just yet.

For those looking to emulate her, Farris Wolfe urges new lawyers to get big firm experience as early as possible. “I realize that’s easier said than done,” she says. “But big firms are essentially boot camps for lawyers and provide a sense of urgency and work product that is unmatched. I can guarantee you that your business stakeholders will really appreciate that sense of urgency when you go in-house.”

Furthermore, Farris Wolfe says, litigation provides the chance to be exposed to a wide variety of subject matter. The lawyer built out experience in the toxic tort group at Duane Morris, which eventually led into complex litigation and then transactional licensing work.

“If you decide to go in-house, you need to do everything you can to learn about

the product portfolio and truly understand what your business does, or else you won’t be able to serve your client,” she says. “If you don’t truly understand the business, you can’t help the client achieve their goals and you won’t be able to thoroughly understand how to calculate risk.”

Currently, Farris Wolfe says, her main concern is helping Aurobindo achieve its goals. “The company is heading in a really great direction, and I’m so happy to be along for the ride,” she says. AHL

KLDiscovery congratulates Amy Farris Wolfe for this well-deserved recognition as Aurobindo’s general counsel. We are proud to be a long-standing partner of Aurobindo, providing e-discovery, forensic, and specialized data solutions. Through our proprietary software, Nebula, KLDiscovery delivers technology-enabled discovery solutions to help law firms and corporations solve complex data challenges.

Experienced data consultants design and execute solutions for the most complex data challenges.

“If you decide to go in-house, you need to do everything you can to learn about the product portfolio and truly understand what your business does, or else you won’t be able to serve your client.”

Our Business Begins With You ® .

Every day, we put our clients first.

Ulmer is pleased to recognize the accomplishments of Amy Farris Wolfe and Aurobindo . Our Life Sciences Practice Group offers customized, high-value legal services to the pharmaceutical and medical device industries. We are proud to partner with our clients, like Aurobindo, providing innovative legal solutions to help them achieve their business goals.

A Data-Driven Experience

Tanya Thomas embraces the power of data as she seeks to transform the experience of Experian Health’s customers and employees

By Natalie Kochanov

Tanya Thomas Director of Customer & Employee Experience Experian Health

Courtesy of Experian

anya Thomas knows how to fill a gap. Throughout her career, she has accepted roles requiring her to perform a function that didn’t always exist before she got there. “I am absolutely energized by opportunities like that,” she says. “I love problem-solving, so any time I’m faced with a pain point, I see it as a runway for innovation and creativity.”

These days, Thomas finds her runways at Experian Health, the healthcare business unit of credit reporting agency Experian. As director of customer and employee experience, she has ownership of insights, communications, and engagement activities as they relate to Experian Health’s clients and employees. She relies on her collaborative skills, industry expertise, and knowledge of data to enhance the experience of people interacting with the company—whether from the inside or the outside—and to support the mission of Experian Health as a whole.

Thomas started working at luxury department store Nordstrom when she turned eighteen, and she interned in the entertainment department of the Walt Disney Company while studying communications at Chapman University. Both Disney and Nordstrom, she discovered, went above and beyond for their customers. “I didn’t realize customer experience was an actual career trajectory at the time, but I was naturally going down that path by gravitating toward brands with highly differentiated experiences,” she says.

A few years out of college, Thomas joined the sales operations team at ifm, an industrial automation

technology company. The role opened her eyes to the ways in which customer relationship managements systems and other technologies can impact a brand’s customers and the quality of its day-to-day interactions. Thomas carried those insights with her to fintech startup Happy Money, which recruited her to help develop its customer-facing vision and teams.

“I got to build out every customer-facing component from the ground up,” she explains. “My fascination and obsession with the technology behind the scenes really took off there as well because I had to start from scratch, with no prior experience evaluating things like call center technology, telephony technology, or live chat capabilities.”

In 2016, Thomas followed one of her mentors to Experian Consumer Services. The business had created a position—customer experience architect—specifically to suit her skill set, and she thrived in the role. “We created a customer care strategy team that I coled with the vice president of customer care,” she explains. “We put an infrastructure in place to evaluate all of the top call drivers—seeking to understand all of things that were causing the most friction for consumers—so we could then systematically tackle those issues and work toward better efficiencies.”

All the while, Thomas continued to hone her understanding of technology and data, along with their applications in a customer experience context. That understanding paved the way for her transfer to the healthcare business in 2017. “Experian Health has a

or process improvement, being as data-driven as possible takes the subjective element out of it.”

“ One of the biggest lessons I’ve learned in my career is that if you’re trying to drive transformation or change

compelling mission statement, and that is to use datadriven insight to connect and simplify healthcare for all. I am very passionate about and motivated by that mission, and I have the opportunity to make sure it’s front and center in all of our employee activities and communications,” she says.

Indeed, Thomas keeps Experian Health’s mission at the heart of her work across communications, insights, and engagement. She created a center of excellence to facilitate efficient communication, and she maintains various strategic advisory boards, focus groups, and other client and employee communities from which to gather data.

the ebb and flow of the experience we’re delivering, and use that data for process improvement.”

Internally, Thomas conducts regular surveys to gauge how employees are feeling about their jobs. She then partners with human resources on engagement activities in response to the survey data as well as more qualitative data generated by committees of employees representing diverse sectors of the business.

Through one such activity—the “prioritizing purpose” challenge—Thomas and the leadership team have encouraged employees to give themselves the time and space they need amid the ongoing COVID19 pandemic. “We’ve got this massive challenge going on across our entire employee base, to recognize and address the fact that employees have found it really hard to prioritize their personal well-being when we’re all so focused on taking care of our clients on the front line,” she says.

Thomas has leveraged her status as a communications leader to reassure clients and employees alike throughout the pandemic. She brings a collaborative perspective to the issues at hand—and she always has the data to back it up. “One of the biggest lessons I’ve learned in my career is that if you’re trying to drive transformation or change or process improvement, being as data-driven as possible takes the subjective element out of it,” she says.

For instance, Thomas has partnered with vendor Alida to develop and deploy the Experian Health Innovation Studio, a digital community of Experian Health clients who offer ongoing feedback for innovation. These clients can use this platform to discuss industry trends they’re facing and weigh in on product road maps and future directions for the business.

She also obtains client feedback through the “voice of the customer” survey program. “We collect quantitative data through surveys at critical points in the client journey,” she explains. “We use these to capture key performance metrics, so we can report, map, and measure

Thomas’s colleagues outside Experian admire her approach. “Tanya and the team at Experian Health are incredibly collaborative, data-minded, and always lead with empathy to provide truly memorable customer and employee experiences,” says Ross Wainwright, CEO at Alida.

Given the cross-functional nature of her role at Experian Health, Thomas believes strongly in fostering collaboration within the business. She also understands that a company is nothing without its customers and the passionate employees that serve them. “I love that my role has expanded beyond just the customer experience to capture both customers and employees because there are so many natural dependencies between those two worlds,” she says. “I hope my role will continue to develop with both of those worlds in mind moving forward.” AHL

“I love problem-solving, so any time I’m faced with a pain point, I see it as a runway for innovation and creativity.”

The Business

Healthcare is a constantly evolving industry that demands executives to plan ahead. Often, this means business leaders need to address department- or companywide issues to remain focused on driving innovation and devising strategies to maintain a high level of care.

140. Diane Psaras VITAS Healthcare

144. Rich Isola KPMG

148. Maeve O’Meara Castlight

154. Gregory Pardo Fresenius Medical Care North America

160. Tracy Williams Penn State Health

166. Roger Sharma Emanate Health

When They Need Us

Diane Psaras on how VITAS Healthcare leverages company culture and communication to enable employees to work better and safer

By Maggie Lynch

As the executive vice president and chief human resources officer at VITAS Healthcare, Diane Psaras is charged with leading the end-of-life care provider from a people perspective. While that task may seem difficult, Psaras says it’s doable because of the culture, values, and passion the organization’s foundation was built upon, as well as consistent communication from the very top.

“We are a forty-two-year-old company,” Psaras says. “Our values have been in place since the inception of our company, when our founders identified a need for folks to be taken care of when they are most vulnerable and need us most.”

Psaras explains that the company’s culture runs so deep that when speaking with anyone who is part of

the organization, they’ll recite a value that coincides with the action they are taking. She describes the four values as: “We take care of each other; patients and families come first; I will do my best today and even better tomorrow; and I am proud to make a difference.”

“[These four values] have been the underpinning and our bedrock for years,” Psaras says.

The company’s values enable its culture to be what Psaras describes as “people-first,” which, from her position as CHRO, allow her to implement coinciding initiatives and help her to lead. “It’s really about making sure we are always thinking about our people as we make decisions,” she explains. “We make sure they always have what they need. We’re not perfect, but we’re continuously improving our relationship with our employees.”

Diane Psaras EVP and CHRO VITAS Healthcare

Courtesy of VITAS Healthcare

Of course, the COVID-19 pandemic complicated the ability to connect with employees, but it made that initiative more imperative. “The pandemic was humbling for everyone; none of us have been there before,” Psaras notes. “Our focus was clearly on our people, on several fronts.”

The VITAS leadership team came together daily, then weekly, to discuss how to best support the company as it went through the unprecedented time. Psaras says these meetings still happen, and leadership has remained heavily engaged. Through these consistent forums, the leadership team “was aligned and standing tall,” Psaras contends, which has enabled it to be proactive.

Beyond caring for potentially infected employees, Psaras says the team took preventative measures by providing “constant communication directly from the top” and sending out weekly updates about specific hygiene practices and safety protocols.

“We made sure that we had leadership standing tall, role modeling the confidence that together, as a VITAS

team, we would get through this,” Psaras says. “In addition, we continued to focus on continuous improvement of systems, tools, and processes to really support our employees while communicating constantly to ensure we kept employees informed and supported.”

One of those processes was moving all HR systems to the Oracle Cloud, implemented with the help of advisory firm KPMG. This new tool enables VITAS to run and deliver HR functions seamlessly and is especially useful to the company’s remote caregivers, who can now access timecards on mobile and complete trainings online.

VITAS’ third-party partners have been impressed with Psaras’s leadership in deploying these new HR systems to improve the employee experience. “Diane easily guides the project team as she weaves the VITAS culture and values into every aspect of a large-scale HR technology deployment,” says Rich Isola, principal with KPMG (p.144).

VITAS also worked to ensure employees had everything they needed to be safe, including PPE and time off to allow them to take care of themselves and their loved

“First and foremost, we recognize that the experience for a person in their dying days can only be as good as our team members who care for them. If employees feel good, they’re going to convey that, and they’re going to give the best care possible.”

ones. “We made multiple investments to make sure that we took good care of our employees when they needed us most,” Psaras says.

She also notes that the company implemented a number of measures to establish ongoing stability for its employees. VITAS launched free Teladoc services for employees and their families if they needed medical attention. Furthermore, there were no salary freezes, and the company went forward with its normal salary increases.

“We even bumped up our budget for merit increases,” Psaras adds. “We paid out bonuses for those who were eligible, and we still focused on things like leadership development and implementing employee selfevaluations to allow them to provide their own feedback. We really tried to stay focused on, ‘[This pandemic is happening, but] that’s not going to impede our ability to focus on you and your development.’

“We also launched the VITAS Employee Promise,” she continues, “which focuses on providing our employees with an environment they are proud to work in and the opportunity to make a difference and reach their aspirations.”

She explains that this initiative “is committing to our employees that every leader is going to provide them with the ability to leverage and really live out their purpose. Because folks who are in healthcare are in healthcare for a reason and are passionate about it.”

VITAS also initiated the VITAS Difference, which reminds employees of the difference they make in the work they do and the positive impact they make on their colleagues, patients and families, and their community. “[VITAS employees] are relied on by each patient and their caregiver during their patient visits, and they are the one person who can relieve an exhausted caregiver for that hour of the day,” Psaras says.

“First and foremost, we recognize that the experience for a person in their dying days can only be as good as our team members who care for them,” she adds. “If employees feel good, they’re going to convey that, and

they’re going to give the best care possible. And they want to do that, because that’s why they do what they do.

“We also spent time with our leaders in all regions discussing our VITAS Promise and the VITAS Difference. In those discussions, I saw the light bulbs go off and the energy was amazing,” Psaras continues. “You never know how your team will respond during business challenges when you are focused just on people, but those reactions were awesome and gave me confidence that these conversations would really resonate across the organization.”

Those discussions also let Psaras introduce the VITAS Difference recognition program initiative, which gives employees the opportunity to recognize each other. The project has been a great success, Psaras notes. “In a matter of three days, we had fifteen hundred recognitions,” she says.

“VITAS offers employees a purpose; we offer them an environment to live out their passion to take care of others,” Psaras says. “VITAS has a culture and environment that gives them possibilities for growth and learning, whether it be upward mobility, lateral mobility, or the opportunity to contribute with an enterprisewide initiative. We commit to having a presence, being approachable and visible, and being there when they need us.” AHL

A culture of caring is at the heart of healthcare, KPMG is proud to have partnered with VITAS Healthcare to modernize its HR systems. Diane Psaras and her team have embraced innovation to deliver HR services to their employees. Healthcare organizations face new disruptive challenges every day and the modern HR function links everything, including culture, back to the employee experience. KPMG is a leader in designing consumer-grade employee experiences centered around moments that matter. Connect with KPMG today to learn how you can digitally transform your HR operations with KPMG Powered HR and Oracle Cloud.

Putting People First

At KPMG, Rich Isola applies the latest tech innovations to change the way that healthcare providers and other clients interact with their most critical resource: people By Zach

Baliva

Rich Isola can sum up his career philosophy with one simple phrase: “I live to make my clients the heroes.” All companies and consultants pledge to serve their clients well, but for Isola, it goes beyond lip service. He’s passionate about accomplishing business transformations and reaching financial goals without sacrificing customer service or relationships along the way. That principle guided him early in his career and later led him to KPMG, where he helps clients in healthcare and other fields leverage cloud-based technology to enhance their delivery of HR services.

Isola was originally interested in finance, and upon graduating from college, he interviewed with leading

financial services firms. While most executives grilled him about nuanced securities codes or complex financial strategies, few talked about their goals for actually helping clients.

He noticed a difference at Hewitt Associates; there, he found like-minded leaders who made customer service their top priority. He joined the organization and spent seven years working to customize HR solutions for clients in nonprofit healthcare, public funds, and other areas.

After honing his skills for nearly a decade, Isola moved to Oracle Corporation as a practice director, where he had a front-row seat to the tech revolution of the late

Rich Isola Principal KPMG

Zee Wendell

“Using the latest technology is critical to the employee experience. These are the things you have to do if you want your people to stay and grow with you , and if you do them, you have a clear advantage in the marketplace.”

1990s and early 2000s. In that era, Oracle was launching robust database and e-business tools while providing hosting, consulting, and training to help clients leverage data and become more effective. As the company started taking HR applications online, Isola helped his clients access their systems and data remotely, through the internet, for the first time.

Fast-paced innovation continued to change the industry, and Isola joined a small start-up called Taleo Corporation to focus on providing talent acquisition and management HR services entirely through cloud technology. In 2015, he transitioned to KPMG to further deliver HR technology to clients through an all-cloud solution.

As a partner and practice leader, Isola gives his clients the ability to “understand and deploy the latest and greatest technologies” across their entire organizations. Those clients include healthcare providers and payers along with premier retail, transportation services, consumer product, and high-tech companies.

Isola and his team work to enhance HR delivery through digital transformation, and over the last two years have showcased what they can do in the healthcare space and beyond. “Digital transformation was once an aspirational goal that had to compete with other priorities, but the COVID-19 pandemic has made it an urgent business imperative,” Isola says.

KPMG’s dedicated expert teams have partnered with their clients to build customized solutions that support every moment in the employee experience. Cloud-based features let employees take time off, schedule shifts, access benefits, and complete other tasks faster and easier than ever before. This helps hospitals, health systems, organizations, and businesses attract and retain frontline workers and other associates facing COVID-related burnout.

When it comes to healthcare, Isola is particularly interested in breaking down silos. “We often meet our clients when various functions aren’t collaborating as well as they could be, and our solutions erode these

barriers to streamline everything in a way that benefits employees, managers, and leaders,” he says.

Today, as Isola’s teams help clients move all HR technology to the cloud to replace outdated on-premise systems, he’s thinking about the intersection of finance and profitability with healthcare. The switch to cloud brings constant innovation and support and limits both cost and manpower associated with ongoing upgrades and maintenance.

In early 2020, KPMG deployed a comprehensive HR technology transformation for VITAS Healthcare, a palliative care provider with locations and services in fourteen states. The organization employs about ten thousand professionals who travel the nation to provide care for more than eighteen thousand patients each day.

Many of these care providers are on the road and not often in the office or in front of a desktop computer. KPMG’s cloud-based solution builds flexibility and mobility into all the software its teams deploy. Thus, the client’s employees can now check payroll, submit expense reports, enter time cards, and perform all other HR functions on smartphones, tablets, and other handheld devices.

Isola and KPMG are also introducing the latest innovations to help train remote, hybrid, and in-office employees. Chatbots, videos, and other tools deliver all the information HR teams need to communicate to their associates without the need for lengthy in-person visits or on-site training sessions.

“Using the latest technology is critical to the employee experience,” Isola says. “These are the things you have to do if you want your people to stay and grow with you, and if you do them, you have a clear advantage in the marketplace.”

As quickly as things are changing in healthcare and other industries, Isola is excited about the future. He’s watching for new innovations he can help deploy for new and existing clients alike. “There are technological advancements every day,” he says. “And when we build these things into our solutions, we help take our clients to new heights.” AHL

A Rise to the Top

Maeve O’Meara joined Castlight because she believed the digital pioneer could improve life for millions of Americans. Now as CEO, she’s carrying out her vision for the company by harnessing the power of data and technology.

By Zach Baliva Portraits by Winni Wintermeyer

Maeve O’Meara decided she wanted to be part of Castlight Health when she spotted a macrotrend. An economics major with an MBA from Stanford and experience at Bain & Company, she’s trained to see widespread shifts before anyone else—and she noticed something interesting happening in healthcare payments. The Affordable Care Act and an emphasis on cost and quality were combining with other factors to move financial responsibility from the insurer to the patient.

O’Meara, who was once a premed student, was fresh out of business school and looking for a new-and-exciting company that could drive change in healthcare. That’s when she found Castlight, a pioneering company founded by visionary leaders Giovanni Colella of RelayHealth and Todd Park of athenahealth (who would later serve as a technology advisor for President Obama and chief technology officer of the United States).

Maeve O’Meara CEO Castlight Health

They started their company, Castlight Health, to apply data and technology to provide new levels of transparency regarding healthcare cost and quality. “Castlight was unique in that it was the only company in the industry tackling the right problem at the right moment,” O’Meara says. “Consumer-driven healthcare was becoming more of a trend as people were exposed to high deductible health plans, but those consumers lacked the tools they needed to make informed decisions.”

O’Meara joined the start-up in 2010 as a product manager in its pre-revenue phase. She then grew with the company, holding eight different positions before she became Castlight’s CEO in July 2019.

There were many significant milestones along the way. The Wall Street Journal named Castlight the top venture-backed company in America in 2011. In 2014, Castlight was the first digital health company to invest in machine learning and artificial intelligence to build a personalized customer experience that helps employees understand and use their plan benefits.

When O’Meara started, Castlight had no product and no revenue. Now, the public company with nearly six hundred employees serves millions of users. Its annual revenues are around $150 million. Moving through the growing company and working on strategy, business development, and the user experience kept her close to

“ We are guiding people to the right care , and that’s important because navigation influences costs and outcomes.”

employees and customers alike. It also prepared her to serve as CEO.

In fact, O’Meara was so prepared that she was able to introduce big strategic changes on day one. She pioneered the addition of a team of “care guides” to Castlight’s digital navigation solution. That move to add a service element to its tech platform helped Castlight cement its status as the market leader in navigation. “We are guiding people to the right care, and that’s important because navigation influences costs and improves outcomes,” O’Meara says.

Under O’Meara’s leadership, Castlight found new purpose and energy—and then the coronavirus pandemic hit just six months later. The company typically sells to VPs of benefits, and those leaders were the ones leading employer responses to their populations in crisis. Castlight’s teams quickly shifted to ensure they could support customers and help them navigate uncertain times.

Before there was a national database, O’Meara and her dedicated “Castlighters” volunteered to build the COVID19 Test Site Finder, which went live to the general public in early April 2020. They then partnered with Boston Children’s Hospital and the CDC to create a national COVID-19 vaccine inventory management platform for vaccine distributors and the public-facing COVID-19 VaccineFinder site, which later became Vaccines.gov.

Leaders at Castlight anticipate that the pandemic will have lasting results. “COVID has increased the adoption of digital solutions and awareness of how important navigation is,” O’Meara says, adding that deferred care will soon create an “avalanche of costs” and impact population health. Those factors—which disproportionately impact poorer communities and people of color—motivate her to ensure that all plan participants can find effective physicians and specialists who deliver the right care.

The investments O’Meara has made as CEO are paying off. In January 2022, more than 80 percent of Castlight’s new customers were purchasing the company’s navigation platform and Care Guides service. For customers that are already using them, employers are experiencing a 30 percent increase in member engagement. Today, 40 percent of new bookings come straight from health plan clients.

Castlight already had rich data sets based on more than ten years of claims data and member insights. Now, its Care Guides use the same technology and data insights to help members with highly personalized care to schedule appointments, answer questions, coordinate care, dispute incorrect bills, and act as personal health advocates. O’Meara also announced a go-tomarket strategy to expand offerings from the selfinsured commercial market to health plans.

This all led to Castlight’s best sales quarter in company history. O’Meara is finding success in a challenging time. She’s one of the few health tech CEOs who’s risen through the ranks of her own company, and others are taking notice. As a result of her leadership, performance, and passion for the business, at least eight former Castlighters—including O’Meara’s first boss—have returned to the company to help her execute her bold and exciting new vision to transform healthcare. AHL

“Castlight was unique in that it was the only company in the industry tackling the right problem at the right moment.”

Serving the Patient

While working to make Fresenius Medical Care North America an employer of choice, Gregory Pardo puts patients first by ensuring that the company has the best staff possible

By Zach Baliva

Gregory Pardo VP of HR Fresenius Medical Care North America

Krista Patton

Gregory Pardo likes a challenge. “Anyone can thrive in an easy position,” he says. “I want to be where I’m most needed and where I can add the most value.” That’s the philosophy that led him to join Fresenius Medical Care North America after developing his talent acquisition and human resources leadership skills in consulting and hospitality at companies like Impellam Group and Marriott International.

Fresenius Medical Care is a German company that provides dialysis treatment and other renal services to about 350,000 patients through a large network of outpatient care centers. Its North American division, based just outside of Boston, generates about 70 percent of the company’s total global revenue, and the US products business has a 40 percent market share in the renal care space.

The fast-growing, vertically integrated global company has $17 billion in revenue and 125,000 employees. Pardo has spent the past five years building a talent acquisition center of excellence capable of recruiting, hiring, and onboarding 24,000 new employees per year.

Talent and employment matters are in Pardo’s DNA. His dad was an HR executive at NYU Medical Center, his mom was in benefits administration, and his uncle was a labor lawyer. While at Marriott, Pardo created a general manager and executive operations search practice and improved global recruiting processes. And while strong leadership and a strong workforce are important in hospitality, both are especially critical in his new industry. “Everything a patient experiences starts with a human interaction. If you don’t have a great staff that’s aligned to your healthcare organization’s mission, you have nothing,” Pardo says.

When Pardo came to Fresenius Medical Care in 2016, he joined a company with a great HR foundation that prioritized speed. He’s worked with leaders and department heads to emphasize quality, cultural fit, and retention instead. “We were formerly managing only with intuition and emotion, but now we’ve layered on data and analytics to help us drive results and find employees who will call Fresenius home,” he explains. Online surveys, assessments, and predictive analytics built into the interviewing cycle empower recruiters to make targeted and quality hires.

“Everything a patient experiences starts with a human interaction. If you don’t have a great staff that’s aligned to your healthcare organization’s mission, you have nothing .”

These efforts have led to measurable results. In Pardo’s first four years, his team dramatically reduced time-tooffer and improved candidate satisfaction by 15 percent. Additionally, they saw ninety-day turnover drop from 23 percent to 12 percent during the same span.

Pardo also set out to raise the company’s profile. “We’re one of the biggest companies in the world, but only a few people recognize the Fresenius brand,” he says. “I wanted to change that for our employees and candidates.” His team worked with colleagues in the marketing and communications department to launch a research-based marketing campaign designed to reposition Fresenius as a destination employer and provider.

Before embarking on the journey, Pardo had to get key leaders on board. “It can be hard to win hearts and minds in healthcare because there are great leaders in this industry who have done things one standard way for a very long time,” he says. “But if we don’t change, we’ll be left behind.” Pardo overcame the existing inertia by casting a clear vision for how a more standardized, uniform, rigorous, and disciplined way of recruiting could transform the organization and contribute to the bottom line. He persevered and won approval to proceed.

They kicked off the process with a series of external focus groups with patients and prospective clients to learn how those important groups viewed Fresenius. Next, they had similar meetings and brainstorming sessions with internal stakeholders before distilling findings into plans for a brand-new career site and social media redesign.

It was a far-reaching effort; Pardo says HR completed 1,300 employee surveys and interviewed more than 13 executives in a process that lasted nearly an

entire year. Candidates now understand that they’re not job seekers but “purpose seekers” and achievers who partner with Fresenius in providing great care. The campaign won HRO Today ’s NA Healthcare Employment Brand of the Year award in 2019.

Although Pardo has enjoyed some early wins, he knows he’s still facing significant challenges. Costs are going up, the population is aging, and providers are facing COVID fatigue and burnout. “There’s an increased demand and increased costs but less labor to get the work done,” he says.

At the same time, Fresenius is committed to delivering the best care at the best cost with the best staff. That mission helps Pardo navigate a demanding era in a volatile industry. “I think about our patients a lot,” he says. “And that keeps me anchored and helps me prioritize my time, my teams, and my budgets. We are here to serve the patient.”

In just five years, the organization has seen vast improvements. Fresenius has a new employer value proposition, a new hiring portal, and new energy. HR is leveraging data to attract committed employees while reducing turnover and improving satisfaction. With these changes in place, Pardo and his team of 215 associates have made Fresenius into an employer of choice in healthcare. AHL

Congratulations to Greg Pardo for his outstanding HR leadership at Fresenius Medical Care NA. First Advantage is proud to enable Fresenius to hire smarter and onboard faster with our robust healthcare talent screening solutions. Learn more at fadv.com/healthcare.

“I think about our patients a lot. And that keeps me anchored and helps me prioritize my time, my teams, and my budgets. We are here to serve the patient.”

to Greg Pardo and Fresenius Medical Care.

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An Eye for Efficiency

At Penn State Health, Tracy Williams uses her finance and organizational skills to manage rapid growth and streamline systems

By Peter Fabris

Doing more with less may be a business cliché, but it barely begins to cover the test that teams at Penn State Health have faced recently. Begun as a single hospital affiliated with Pennsylvania State University, the system formed in 2014, creating a multihospital system that has been on an acquisition path over the past several years. It now includes four medical centers and two medical groups in central Pennsylvania. An additional hospital is opening in the fall of 2022, employing some 16,800 people, with further expansion in the works.

Supporting rapid growth amid the industry-wide imperative to cut costs has challenged Tracy Williams, vice president of finance, far beyond what’s typical for her role. For instance, an analysis indicated that Penn State Health would have needed to add approximately forty-four full-time, back-office employees per hospital without an aggressive standardization and automation program. Instead, the back-office head count—including finance, human resources, and supply chain specialists—per location has remained flat as a result of the system investing in technology.

Like all of her peers, Williams and her team have scrambled to make do with limited resources. “We had to figure out a way to be more efficient by default,” she says. “It’s not like there was a highly organized strategic effort to improve efficiency.”

The Impact of Standardization

A switch to standardized reports has been crucial to Penn State Health’s productivity gains in finance. “We now present a piece of information one way instead of multiple ways,” Williams says. For example, metrics such as financial performance of individual business units or labor distribution statistics appear just once on a standard report for all users. In the past, that information appeared in different places within reports customized for various users.

“We have trained users to come to a single source as opposed to creating a source for each user’s interpretation,” Williams says, noting that when these changes were first implemented there was some resistance. “But when we show how much work effort is saved, typically they come on board. People just don’t like change initially.”

Medical System Consolidation

Williams is now in the midst of an ambitious plan to convert sixteen separate electronic medical records (EMR) platforms to a single system within the next five years. Implementation has begun at one site and will slowly roll out to all Penn State Health facilities. The work can be arduous for IT personnel and requires significant financial and labor investments, including engaging the consulting firm Grant Thornton on the project.

Switching EMR and revenue cycle platforms will challenge users, Williams acknowledges. “The transition can be painful for physicians,” she says. “If they are working in both a clinic and a hospital at different locations, they may have to use two EMR systems in the interim.”

That can be clunky and confusing at times. Despite any frustrations they may have, however, providers support the effort—in fact, they will drive its success. They realized that the need for doctors to circulate through multiple care sites makes a standardized system a requirement for efficiency and quality of data, Williams says.

The efforts Williams has made on behalf of Penn State Health stand out to her colleagues. “Tracy is such an innovative force in healthcare,” say Principal Christopher Baratta and Partner Michael Sorelle of Grant Thornton. “During her time at Penn State Health she has overseen growth and promoted efficiency and excellence. It has been a pleasure to work with her throughout the years.”

Boosting Reimbursement Rates

In addition to simplifying record keeping, standardization will improve the bottom line by better aligning patient care with insurance reimbursement standards. “Reimbursement rates could improve because we will be more likely to hit our quality targets through consistency and data integrity aligned with standardization,” Williams explains.

A new decision support tool with standardized data sets will make a big difference. Previously, expenses associated with patient care were recorded differently at each location. In effect, each location had its own way of compiling statistics such as cost per patient for varying treatments.

“Our goal in the near term is to have more reliable direct data on cost per patient,” Williams says. “Then we can start a conversation with a providers and vendors related to standard products and care practices. Let’s say their patient population is staying in the hospital six days longer for a condition than average. We can say to them, ‘What can we do to help you discharge these patients on time?’”

Migrating to a single EMR system will also enable multiple providers to better coordinate care for each

Tracy Williams VP of Finance Penn State Health

Darrell E. Peterson

“ We want patients to have a seamless experience that will be easier to achieve when using a single system.”

patient. “We want patients to have a seamless experience that will be easier to achieve when using a single system,” she explains.

A Holistic View

Indeed, to reap the benefits of consolidating multiple organizations under one brand, Penn State Health has to become a well-coordinated whole. For example, there are opportunities to improve the way labor is deployed across sites.

“We are doing more to contain costs in real time instead of by hindsight,” Williams says. “In the future, we are going to be able to compare daily indicators marrying them to industry benchmarking.”

Viewing the system as a whole rather than piecemeal, Penn State Health can move personnel from site to site as needed to better match supply with demand. This applies to technicians, physicians, and other professionals. “It’s a more holistic approach to managing people, which is 60 percent of your P&L,” Williams says.

All this work to standardize reports, consolidate systems, and improve efficiency is going to be even more critical over the next few years as Penn State Health continues to grow. “We’ve got a new hospital scheduled to open in October 2022,” Williams says. “And there are more practices hoping to align with Penn State Health.”

The remainder of the decade will likely continue to challenge Williams and other organizational leaders. As healthcare transforms, departments that support clinical work must be agile enough to adjust to new regulatory environments.

“Things seem to change so fast that right after you adapt, you are already behind,” Williams says. She’s ready to keep adapting even faster. AHL

“Things seem to change so fast that right after you adapt, you are already behind.”

Up for the Challenge

Roger Sharma’s success as president and CFO at Emanate Health has landed him a position as interim CEO By Will Grant

In December 2021, longtime Emanate Health CEO

Robert Curry announced his retirement in April 2022. Curry, who has served in the role since 2008, is credited with growing a struggling nonprofit health system through mergers and acquisitions along with the establishment of several specialty practices throughout its health system based in California’s San Gabriel Valley. These include a comprehensive stroke center at Queen of the Valley Hospital, a heart center at Inter-Community Hospital, and a center for robotic surgery at Foothill Presbyterian and Queen of the Valley hospitals.

The continued expansion and evolution of Emanate Health will be in the capable hands of current President and CFO Roger Sharma, who took on the CEO on April 2, 2022. In Sharma’s nearly eleven years with Emanate, he has been repeatedly recognized for the strategic planning and dedication he has demonstrated for his community.

In 2019, Sharma was named to Becker’s Hospital Review “100 Hospital and Health System CFOs to Know”—one of only two CFOs who were highlighted in Los Angeles County.

“Roger’s outstanding leadership to transform Citrus Valley Health Partners to Emanate Health has been recognized on a national level for the past four consecutive years in Becker’s,” Curry said in a 2019 press release. “What’s more, Roger’s expertise goes far beyond financial stewardship as he also leads our patient care experience at Emanate Health, ensuring that our patients receive exceptional healthcare in the San Gabriel Valley.”

During his tenure as CFO, Sharma led Emanate to be recognized as one of the top one-hundred financially performing hospitals as recognized by ratings institutions Moody’s and Standard & Poor’s. More locally, Sharma has been repeatedly lauded for his dedication to his community and patients.

The health system has also earned its fair share of accolades. Emanate Health was named the highestrated health system in the country and number

nineteen on Glassdoor’s 2021 “Best Places to Work” list. That designation is all the more meaningful because the designation is purely based on anonymous feedback from internal employees.

While taking on additional CEO duties, Sharma will likely be overseeing work on a new 60,000 square-foot Emergency Department expansion at Queen of the Valley Hospital as well as a new intensive care unit. The work will follow Emanate’s groundbreaking on a twofloor, state-of-the-art cancer center at the same hospital, which is slated to open by December 2022.

Sharma has been instrumental both in the department expansions and the talent buildout at Emanate Health. The president and CFO has placed significant emphasis on finding the right people at a health system that acts as the largest nonprofit health provider in the state. Sharma is known to spend significant time with his own team, not micromanaging but instead focusing on their well-being. Sharma believes that leadership isn’t demonstrated by title, but by example.

Sharma has also been heavily involved with the St. Gabriel Valley Economic Partnership. The organization’s stated mission is to “advance the economic vitality and quality of life of the San Gabriel Valley” in California. The CFO says that helping enable business in the community will make the San Gabriel Valley a bastion of talent, leadership, and economic growth.

In light of the significant praise for Emanate’s outgoing CEO, Sharma may feel he has big shoes to fill. But the new CEO’s own commitment to his community is matched with a track record of significant growth. Sharma is surely up to the challenge. AHL

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The Impact

Executives know there is an increasing need to help individuals manage their own health anywhere and anytime.

To do that, healthcare leaders are developing products and services and offering resources catered to different communities’ needs—all aimed at motivating them to stay engaged with their health and empowering them to be their best, at home or at work.

170. Amy Whitaker Bon Secours Mercy Health

174. Michelle Garrison GetixHealth

180. Amy Crawford North Kansas City Hospital

184. Karena Weikel Priority Health

Purchasing Power

At Bon Secours Mercy Health, Amy Whitaker is working to launch a new group purchasing organization that will benefit providers, patients, and communities by improving care and reducing costs

By Zach Baliva

Bon Secours Mercy Health (BSMH) is the fifth-largest Catholic health system in the United States and the biggest nonprofit private healthcare provider in Ireland. In the US, its three thousand providers serve patients in hospitals, clinics, labs, and imaging centers across seven states. The system generates about $10 billion in annual operating revenue.

Amy Whitaker, a veteran nurse with a decade of experience in floor work and another decade in management, is helping BSMH leverage its influence to address the increasing cost of healthcare in the United States and beyond.

“We realized that because of our size, we could do something new to drive change across the industry,” Whitaker says. “The ultimate outcome is a new standard of care for patients, reduced risks, lower costs, and improved quality.”

In early 2021, BSMH laid out its plan to create a new group purchasing organization known as Advantus Health Partners (AHP), with Whitaker at the helm as vice president of supply chain clinical integration. AHP will help BSMH and others reduce budgets and increase efficiencies by uncovering opportunities for cost-saving through purchasing. The new group will also

Amy Whitaker VP of Supply Chain Clinical Integration Bon Secours Mercy Health

Kylie Cooper

provide advanced expertise in inventory management, distribution and logistics, and clinical integration.

As AHP launches, the entity will focus on serving BSMH, but Whitaker says she’s looking forward to collaborating with health systems, institutions, physician clinics, and other partners. “Our long-term goal is to negotiate contracts that will benefit our members as we maximize supply chain savings and find new ways to help organizations control costs in a difficult environment,” she explains.

The job is a natural fit for Whitaker, who started her leadership journey as a nurse manager at Mary Washington Healthcare. The experience helped her get a fuller picture of what happens in any large health system. “When I got into management, I saw how budgets and supplies and schedules impact patient care, and I started looking at care delivery in a whole new way that goes beyond patient outcomes,” she says. Suddenly, Whitaker wanted to learn more about how business and financial decisions affect nurses, physicians, patients, and whole communities.

That desire set Whitaker on a new path. She made her goals known and became a clinical resource coordinator, then a resource utilization manager, and ultimately a director of supply chain solutions. In those roles, Whitaker set out to develop and lead value analysis and clinical transformation teams. Her teams now include clinicians who review projects and

help make informed decisions regarding the supplies purchased for hospitals, labs, and other healthcare facilities.

“I act as the translator to bridge the gaps between the administrators and the care providers who actually use the supplies,” she says. “Having an experienced nurse leading the team drives better

“I act as the translator to bridge the gaps between the administrators and the care providers who actually use the supplies. Having an experienced nurse leading the team drives better outcomes, and we keep the patient at the center of every decision we make.”

outcomes, and we keep the patient at the center of every decision we make.”

In the uncertain world of healthcare, speed, accuracy, and consistency are key. Whitaker has worked tirelessly to limit suppliers and reduce unnecessary options. “We don’t need twenty suppliers for spine products if we can get what we need from five,” she explains. Thousands of products exist, and those choosing which products to order should understand every nuance of their clinical use.

As she’s progressed in her career, Whitaker has led a number of important initiatives. She collaborated with other leaders to drive a consistent supply chain strategy across the entire organization, created short- and long-term goals, and was instrumental in evaluating existing and potential products, devices, equipment, and services.

Whitaker was already leading value analysis and contracting teams at Bon Secours when a merger created Bon Secours Mercy Health in 2018. As the organization doubled in size, she created a new value analysis program and developed the necessary processes and protocols to review new product requests, create new contract categories, and support utilization and standardization projects.

While many similar teams focus solely on decision-making, Whitaker takes it one step further by coordinating implementation from start to finish through three critical teams that report back to her. First, a clinical transformation

committee develops and prioritizes new use cases before suggesting changes. Second, clinical resource program teams embedded in medical facilities provide training and information to drive changes forward. Lastly, surgical navigators manage and update physician preference cards and find new ways to reduce waste or increase standardization.

A hands-on leadership style has helped Whitaker develop a reputation for building strong teams and effecting change. She has experience in launching new endeavors, leading multimillion-dollar projects, and implementing effective processes—all while keeping patient care at the center of every decision. These are the qualities she’s drawing upon to lead AHP through its start-up phase.

Whitaker can’t remember a time when she didn’t want to become a nurse. As an RN, she worked in general nursing, in the NICU, and in pediatric units. Her most rewarding moments include being with patients in their time of most severe need, or being recognized and thanked by a patient’s loved one out in the community. Although she sometimes misses direct patient interaction, she also knows her work in supply chain and group purchasing is making a real impact.

“Most of us got into healthcare to help others and drive outcomes,” she says. “And when we can improve efficiency and lower costs, we are making sure every patient receives the best care we can possibly provide.” AHL

Perfecting the Playbook

Michelle Garrison tackles dual roles at GetixHealth with the aid of a strong framework she’s created

By Billy Yost

Michelle Garrison CFO and CHRO GetixHealth Grady Carter

Michelle Garrison hesitated to make the leap when she accepted the role of chief finance officer (CFO) for GetixHealth in 2015. The company had been a client of Garrison’s, and she was worried that she might feel stifled by what seemed like a maintenance role. That apprehension, however, turned out to be unfounded.

“Our CEO told me that this was not a place where I was going to get bored,” Garrison remembers. “I can tell you that he absolutely made good on that promise.”

Within Garrison’s first six months on the job, GetixHealth underwent six acquisitions. The company went from one location with about two hundred employees to fifteen locations (including a substantial branch in India) and more than seventeen hundred employees. Garrison would go on to occupy a dual purview, becoming the company’s chief human resources officer (CHRO) as well as CFO.

After working on thirteen total acquisitions, supporting the creation of more than a dozen new sites, and building an entirely new HR skill set, Garrison is anything but bored. She’s currently helping GetixHealth unite culturally as

one company while also finding new and innovative ways for the finance team to push the business forward.

An Entrepreneur’s Heart Garrison brings a unique perspective to her role. A graduate of Georgia Tech (she earned an electrical engineering degree), Garrison owned and operated her own electrical construction company for twelve years. “I was working for a construction company and decided there were opportunities for me to start my own, so I did,” she says. “I had to operate as my own CFO and just learn on the fly.”

During that time, Garrison recognized just how important a trusted advisor could be—mostly because she didn’t have one. And it wasn’t until she decided to move on that she realized what she wanted her own future to look like.

“As I was working on an exit strategy, I hired a consultant who I wish had been there with me the entire time,” she says. “It got me thinking about how many other entrepreneurs out there could use a person with financial expertise to help move them forward. I decided my mission going forward would be to help other entrepreneurs succeed.”

“When I look at this business, I see it as a beautiful Cadillac, best in class—but if we don’t take care of our engine, our human capital asset, then we won’t be able to move forward . Our people make the difference.”

Garrison earned a master’s degree in accounting and financial management and found an ideal role at Strategic CFO, a company that works with midmarket businesses and entrepreneurs to provide interim financial support. GetixHealth was one of her clients, and the rest is history.

Check the Playbook

While Garrison welcomed the acquisitionforward focus at GetixHealth, it wasn’t a process she had been through before. So she did what she always does: build a playbook.

CREATING THE NCAF

“Once I had a couple M&As under my belt, I started creating a playbook and refining it every time we went through something new,” Garrison says. “I think it’s my electrical engineering background coming out, because it requires critical thinking, process creation, and being very methodical about activities I’m doing repetitively. I’m big on playbooks.”

She’s applied the same methodology to her CHRO role. In an effort to promote more engagement between managers and employees, managers are required to meet one-on-one with employees at least once a month to build connections.

When Michelle Garrison’s son Chase was diagnosed with a right coronary anomaly (a congenital heart defect), she barely understood what the doctors were telling her, and had no idea where to turn for support.

That led to Garrison creating the National Coronary Anomalies Foundation (NCAF), a nonprofit that was established to increase awareness of coronary artery anomalies and to foster a community where patients, their families, and physicians share experiences and knowledge about this condition to help prevent sudden cardiac death. Along with offering information and forums, the NCAF helps out with costs for patients traveling to receive treatment.

The NCAF is participating in a grant awarded by the Patient-Centered Outcomes Research Institute for its efforts, and Garrison says she’s grateful that she’s been able to create an organization that can help provide answers for fearful patients and parents. Her son Chase underwent successful surgery and is currently studying at Morehouse College in Atlanta, Georgia.

“We want to provide a framework for our managers to engage, and to make sure we know the kinds of directions our employees want to evolve [in]. When I look at this business, I see it as a beautiful Cadillac, best in class—but if we don’t take care of our engine, our human capital asset, then we won’t be able to move forward. Our people make the difference.”

Of course, Garrison has built a playbook for this process as well.

Future Forward

On the financial side, Garrison partners with the chief technology officer and the operations team, who are utilizing bots and AI to continue to find new ways to serve the company’s clients. To address the always relevant “propensity to pay” concept, the GetixHealth team is using machine learning to create algorithms

around patient payment behavior. A score is created utilizing a wealth of information, and GetixHealth then knows the priority in which it should seek to collect payments.

“It’s allowed us to prioritize our efforts and not have to continue to add more bodies to our call centers,” Garrison explains. “It adds value by helping us focus on what matters most at the time, and the model is learning all the time.”

As Garrison continues to find new ways to help enable her company’s business, she’s also looking out for the next generation of leaders. Garrison serves on the diversity, equity, and inclusion board for the CFO Leadership Council.

“I just want to see more people given the chance to rise to the occasion,” she says. “I was given the opportunity to grow, and want to see others have that same opportunity.” AHL

“Once I had a couple of M&As under my belt, I started creating a playbook and refining it every time we went through something new.”

First Impressions, Last Impressions, and Everything in Between

Amy Crawford’s passion for improving patient experience is clear at North Kansas City Hospital

By Billy Yost

It was her second day at North Kansas City Hospital that was pivotal in helping Amy Crawford, vice president of revenue cycle, understand the kind of culture she was entering. After nearly twelve years at a pediatric hospital, Crawford was already missing her former colleagues. She wasn’t sure if moving from the environment of serving children and parents to a more traditional hospital system would be the right fit.

“I remember standing at a coffee cart just trying to figure out what I wanted,” Crawford recalls. “The person next to me made a recommendation, and before I’d figured out what happened, she’d paid for it and moved on. That simple little gesture meant the world to me and reassured me that while the culture might look different in adult care, the thoughtfulness and things I valued most were a part of this organization.”

Crawford has made it her mission to do everything in her power to make that culture a regular part of patient interaction. It’s a clear passion point for the VP, which is illustrated in the multitude of ways she and her team are helping make the hospital as welcoming, navigable, and, importantly to Crawford, predictable as possible.

“All of us are very motivated to create more predictability in the patient experience as much as we can,” she explains. “Especially in this pandemic environment, I think a little more predictability is what we all need right now.”

Crawford says it’s all about first and last impressions. Whether a patient is walking through the front door, entering the emergency room, or visiting a doctor’s office, every person should be greeted, made to feel safe, and made to feel welcome.

Amy Crawford VP of Revenue Cycle North Kansas City Hospital

“It’s all of these little things,” Crawford explains. “We should be holding doors for you. If you’re lost, we should walk you to your destination instead of pointing you down a long hallway. We should make the check-in and wait times as brief as possible, because ultimately, we know patients don’t necessarily want to be here if they don’t have to be.”

vendors to gather patient information prior to their visits.

“This allows our staff to focus on other tasks and really help engage the patient,” Crawford says. “It provides further efficiencies while also relieving some of that waiting room tension.”

For more heavily trafficked outpatient areas, the hospital team has created check-in kiosks so patients don’t need to wait in line to notify staff that they have arrived for their appointments.

With a large portion of the revenue cycle team working from home, Crawford says they’ve had to be more proactive and intentional about how they conduct call reviews and customer service training. They’ve developed a scorecard to ensure consistent scripting, improve the patient experience, and, again, ensure predictability when people need it most.

The overall patient phone experience is a particular area of focus in the upcoming year for Crawford and a small team of her colleagues charged with customer service optimization. They’ll be conducting an in-depth review on how long patients are waiting on hold, how long it takes for their messages to be returned, and what patients are encountering in terms of pain points when it comes to the task of contacting one’s healthcare provider across the health system.

She rattles off a full-scale offensive of initiatives her team is tackling to improve the patient experience, from first to last impression. To relieve some of the patient anxiety of “broadcasting all of your demographic information to a waiting room full of people,” as Crawford sums it up, registration and financial clearance teams have partnered with

On the back end, Crawford says that if a patient payment process ends poorly, it can negatively color what was otherwise a very positive outcome or experience with the provider. “With that in mind, we’re looking to build a more consumer-friendly payment portal that supports whatever a patient’s financial situation might be,” she says. “You want your last impression to be as strong as your first, and that means making sure the billing and payment processes are as painless as possible.”

Crawford’s positivity is contagious. She says that she has benefited from many strong mentors throughout her

“You want your last impression to be as strong as your first, and that means making sure the billing and payment processes are as painless as possible.”

career who have given her a chance to truly develop, and she’s now intent on doing the same for others.

She is especially passionate about building confidence in new leaders and setting them up for long term success. “Furthering the professional development of others is my favorite part of this job,” the VP says. “I get to see those ‘lightbulb moments’ in someone’s eyes and see them acknowledge themselves doing a great job at something new.”

It’s clear that Crawford’s focus on others is part of what makes her an important business partner and ambassador of culture at North Kansas City Hospital. The VP says that creating improvement starts with consulting those who work on the front lines of care.

“Whatever we’re doing, whatever changes we want to make here, it’s always with the direct input of our staff and our patients to make sure we’re hitting the mark,” Crawford says. “They know the things that need to change and often the best way to accomplish them, so it’s imperative that we keep them front and center as we continue on our journey.” AHL

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CarePayment truly enjoys partnering with healthcare professionals and providers, like Amy Crawford and the North Kansas City Hospital. Our 0.00 percent patient financing plans enable more patients to get the care they need and protect the financial health of providers. So they can focus on what they do best—caring for our communities.

MedData is a proud partner of North Kansas City Hospital and its award-winning healthcare services. With forty years of experience, MedData’s suite of revenue cycle management services simplifies complex account resolution while maximizing payer discovery, revenue recovery, and patient satisfaction for more than 1,500 facilities across the country.

Leading the Way to Affordable Healthcare

Karena Weikel

SVP of Advanced Analytics and Chief Actuary Priority Health

Tatiana Goloborodko

arena Weikel has loved math for as long as she can remember. But when her high school guidance counselor suggested she become a math teacher, she couldn’t envision it for her career.

“I had a speech problem where I had trouble saying words with the letter ‘r’ in them,” Weikel explains. “So saying ‘four’ was a problem for me, and as math teacher, I would be saying that a lot. I didn’t think I had any future working in mathematics even though that was my passion.”

After seeing a speech pathologist in college, Weikel began to reevaluate her options. Instead of math education, however, she found her way to actuarial science. Some twenty years later, she is senior vice president of advanced analytics and chief actuary at Priority Health, a Michigan-based health plan. As has been the case throughout her career, she takes pride in applying mathematics and technology to meet the needs of the business, while also seeking to address the affordability of healthcare for Priority Health members.

Weikel graduated from Bloomsburg University with degrees in mathematics and secondary education before entering the workforce as an actuarial support analyst in a healthcare setting. “I love bringing together mathematics and technology for a business purpose,

and healthcare has been a natural fit for me. I have seen the need throughout our country and how critical health insurance is, so that’s where I focus on making a difference,” she says.

Weikel studied for actuarial exams in her free time but made sure to prioritize her job and family. “I never wanted to be at a point where I looked back and felt like I had missed an opportunity to be the kind of mom I wanted to be to my two boys,” she says. “I’ve always had such support from my husband, my children, and my friends and family. They’ve all helped me conquer any difficulties I encountered as a woman in this profession.”

Weikel also connected with female role models to ask for advice on navigating work and motherhood—and proved herself to be more than up for the challenge. “I advanced very quickly in my career to become a leader, and I think it had to do with my teaching degree. I love to share my knowledge so others can grow and change our world in healthcare,” she says.

In addition to knowledge, Weikel is passionate about affordable healthcare. Together, those passions have driven her work as an actuary and a leader for the past two decades, during which time she has strived to innovate and transform healthcare from within. She has pushed

“My passion each day is looking for ways to make healthcare more affordable. I believe in making data more actionable and a value-driven approach to analytics. I won’t let myself get comfortable or stop growing .”

Karena!

Healthcare Leader

Talix is a SaaS health information technology company serving payers and healthcare providers

Talix is a SaaS health information technology company serving payers and healthcare providers.

The Talix Platform uses purpose-built natural language processing (NLP) and machine learning (ML) techniques to power workflow applications that help healthcare organizations shift to value-based care. Talix’s cloud-hosted applications read structured and unstructured patient data to extract accurate reimbursement codes, identify gaps in care, and analyze population health trends. These solutions drive customer revenue and reduce administrative costs.

talix.com

for greater proactivity as well as the incorporation of technology, data, and analytics—a toolkit that supplies her with the hard facts needed to make tough calls and solve problems.

Along the way, Weikel has gained experience leading teams of analysts, actuaries, economists, data scientists, coders, underwriters, and healthcare knowledge experts. She focuses on building relationships with her team members by getting to know them, both professionally and personally. “Relationships are key,” she explains. “You need to be honest, authentic, and trusting to bring out those relationships. It really bonds people together when you’re able to open up to one another.” She also shares her experiences in transformational work, where one key to success is providing a transparent vision.

Weikel dedicates herself to helping her teams reach their full potential. She hopes that her passion inspires them to achieve their own ambitions, which they discuss during frequent one-on-ones. “It’s about really hearing what somebody says,” Weikel says of those conversations. “Listening to their ideas and aspirations, learning what makes them happy, and then setting them up for success.”

Weikel also connects with her team by having individual rounding and

small team listening tours. She believes that her relationships with her teams and others throughout the industry have led to her career success. “I’ve been truly honored by working with such great people throughout my career,” she says.

Weikel’s courage in sharing her experience matches the fierceness of her belief in effecting change. By bringing metrics to the forefront, she has moved one step closer to aligning healthcare providers and payers around the common goal of reducing member costs while maintaining the highest quality of care. She believes that providers and payers must collaborate, innovate, and build strong relationships so that members and patients can have the best health outcomes. It’s been her mission since day one, and she remains as committed to it as ever.

“My passion each day is looking for ways to make healthcare more affordable. I believe in making data more actionable and a value-driven approach to analytics. I won’t let myself get comfortable or stop growing,” says Weikel, adding, “I will remain inquisitive and commit myself to being a lifelong learner so one day our overall healthcare affordability problem will be solved.” AHL

We are proud to join American

in recognizing her career and passion for leadership.

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