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An accountable leader

June 27, 2013
by H. Steven Moffic, MD
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In all my recent blogs on leaders that we can learn from and model on, none have been from our own field, healthcare in the USA. One reason is that we can learn skills which can be generalized from leaders in other fields and other countries. Another reason is that this publication honors and awards administrators in behavioral healthcare.

However, there is one leader who seems to be very significant, yet very unknown. In fact, I only found out about him in the business publication Fortune ("Can UnitedHealth Really Fix The System," May 20, 2013, by Shawn Tully). He is Stephen J. Hemsley, the CEO of UnitedHealth group, and an accountant by training. On second thought, maybe that's not so surprising, given the increasing influence of business on health and behavioral health.

Now, one reason for staying out of the limelight might be that the prior CEO of UnitedHealth, a physician, became notorious for obtaining very ethically questionable, but very lucrative, stock options. Another reason may be the continuing public controversy about the merits of for-profit managed care. And, business-wise, there may be a tendency to avoid any situations that might endanger trade secrets. For instance, it is still not clear and transparent what criteria is used to define "medical necessity" for treatment authorization in various managed care companies.

Perhaps most importantly, with this article and interview of Mr. Hemsley, we may have better sense about where our for-profit health insurers are heading, so important with their ever-increasing role in healthcare reform. Moreover, UnitedHealth Group is the giant in the field, covering over 40 million people in one way or another. From a business standpoint, it has certainly been successful, with annualized returns of about 25% over 28 years. That makes it the third most successful publicly traded company over that span. I say that with some personal regret, as early in my involvement and leadership of not-for-profit managed care (see my book The Ethical Way: Challenges & Solutions for Managed Behavioral Healthcare, Jossey-Bass, 1997), I made a decision not to invest with such for-profit companies or receive a percentage of savings from my own system. I felt that ethically speaking, that could be too much of a complicated influence on my own leadership.

Given United's success story, what is Mr. Hemsley thinking about the future? Perhaps some of his comments from the article will provide a picture.

"America wants more for less, more care for less money, and we're in the best position to make that happen."

"We're in the most sensitive area of human endeavor, and we were not respectful of the importance of our role."

"We had lots of EQ but not nearly enough EQ."

"The journey never ends in trying to find the right balance between the analytical and the emotional."

Of course, these comments could be intentionally misleading, or just to get some positive PR for his company. Yet, if his communicated strategy and vision is real, and his company continues to dominate the market, this is what the rest of us should be paying attention to:

-lowering costs while increasing quality through better data collection and availability

-providing pay-for-performance bonuses and incentives to caregivers and hospitals

-emphasizing wellness and preventive programs

-within UnitedHealth itself, providing more bonding experiences and fun for employees




We can't deny with the fact that, we should learn some basic leadership skills from different leaders. In order to improve our personal leadership attitude, we used to follow different leadership ingredients. Leadership is what, we can't develop in our personality overnight. We need to put our efforts to improve our leadership style. Thanks for such wonderful article.


H. Steven Moffic

H. Steven Moffic

H. Steven Moffic, M.D. retired from the clinical practice of psychiatry and his tenured...

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