Ten years ago, CareFirst BlueCross BlueShield was under siege. The nonprofit health insurer launched more than seven decades earlier had been eyed suspiciously since 2003, when its leadership tried to convert it to a for-profit and sell it at the bargain basement price of $1.3 billion in a deal that was ultimately blocked by Maryland’s insurance commissioner. As a result, the CEO and a majority of the board were forced out, and the company had little credibility with Democratic lawmakers in Annapolis, not to mention a contentious relationship with medical providers.
Enter Chet Burrell, a former New York state health care administrator who had run Blue Cross plans in New York and Indiana as well as heading two medical technology companies. He knew government, he knew health care and he understood CareFirst’s mission wasn’t to turn a profit or even to sell more insurance policies. It was to improve the health of nearly 3.4 million people it served in Maryland, the District of Columbia and Northern Virginia. And he had some ideas about how to make coverage not only better but cheaper and more efficient.
What happened next? Not only did Mr. Burrell restore CareFirst’s credibility, his work allowed the company to withstand the extraordinary changes in health care policy on the national level, from the expansion of Medicaid coverage and the passage of the Affordable Care Act to the ongoing efforts to destroy the ACA. And on that subject, Mr. Burrell minces no words. The law known as Obamacare may have been flawed, but he still sees it as a “stunning achievement” that has done much good to expand health care coverage, only to have the current Congress and Trump administration “actively sabotage” it, he says.
“The ACA did a tremendous amount of good. It’s just a wrong interpretation to think otherwise when 30 million people get coverage who didn’t have it before,” Mr. Burrell says. “Had it not been sabotaged and undermined by the government, I think we’d have a vibrant market right now.”
It’s that kind of candor that has endeared the 70-year-old to Maryland’s political leaders, who have leaned heavily on him to help the state chart a course in health care. He measures success not just in finding ways to lower costs but in introducing ways to improve health and reduce hospital stays. A favorite yardstick? CareFirst has maintained its customer base, but because it’s put greater emphasis on primary care and follow-up treatment, it’s reduced the number of hospital visits each year from 125,000 to 85,000. That’s a win-win of better health outcomes and lower cost.
House Speaker MIchael E. Busch calls Mr. Burrell “well respected” in state government and the health care community, particularly considering the pressure he was under when he first came to the state in 2008. To restore CareFirst and then deal with such a fundamental shift in health care policy on the national level is what has been impressive. And then most recently, he’s been at the center of efforts to help stabilize Maryland’s individual insurance market despite the tumult coming out of Washington. The speaker’s only regret? That Mr. Burrell is retiring in June.
“He’s going to be very tough to replace,” Mr. Busch says. “He’s a straight shooter with everything. That’s why he has stature in Annapolis.”
Mr. Burrell is proud to report that CareFirst is financially sound. Even as a nonprofit, it needs to run a small surplus and maintain a reserve. He still sees the cost of health care as the biggest obstacle to his company’s mission: “How do you keep down the cost of care without reducing benefits?” Part of the answer has been to make sure people are taken care of better, that they eat right and exercise, that they are regularly screened for disease and that a doctor who knows you remains the best way to “quarterback your care.” He calls it patient-centered medical home care, and it’s a delivery model that now has broad support across the country. His next project in retirement? Working on strategic investment in health care technology companies and looking to find ways to use the human genome to provide personalized health care.
“It’s been gratifying,” he says. “I think we’ve done a lot but there’s an enormous amount still to do.”