The quiet departure of Arthur Leibowitz, M.D., as AetnaUSHealthcare's chief medical officer continues the company's efforts to refocus itself as more customer-centered and physician-friendly.
And that's the reason Leibowitz says he decided to leave after 13 years with the company.
In a move that slipped under most observers' radar, Leibowitz left the Blue Bell, Pa.-based insurer Oct. 6. He says he wasn't happy. But, he adds, more importantly, his departure allows the company to continue to refocus and remake itself.
"The company is going in a different direction," Leibowitz said in an interview with Modern Physician days after his resignation. "The clear direction for the company is to establish itself as a healthcare business and move on from its past."
Aetna has agreed to sell the majority of its nonhealthcare business to a Dutch-based firm.
While Liebowitz says the decision to go was his, it's also true that Leibowitz was seen as part of the old guard, associated with a time when former CEO Richard Huber ruled the company, a period that many physicians would like to forget.
"Whatever was done at least had the appearance in the medical arena to be sanctioned by him," says Paul Shanor, executive director of the Medical Association of Georgia, one of the company's strongest critics in recent months. "He got the blame whether he approved it or not. No question he was painted with the same broad brush."
Leibowitz says he approached top Aetna executives several months ago and suggested that the new president of AetnaUSHealthcare ought to be a physician.
He also told them he wanted to move on. He wasn't happy with his new role in the company, and he wanted the company to be able to start with a fresh leadership team. Leibowitz was one of only a couple high profile people who kept their jobs after the board of directors ousted Huber and hired William Donaldson as the new CEO. The president of AetnaUSHealthcare resigned, as well as USHealthcare's founder.
But unlike those departures, there was no press swarm surrounding Leibowitz: The company issued no press release on his resignation. There were no Page One stories the next day in major newspapers. His departure seemed to have no immediate impact on the company's stock price, which has slowly begun to recover since February.
Aetna officials declined to comment on Leibowitz's resignation, saying only that they respect him and wish him well. They named Jay Krakovitz, M.D., as interim chief medical officer. Krakovitz has been the company's medical director for the mid-Atlantic region. The company plans to conduct a nationwide search for a new CMO but hasn't set a timeline.
Leibowitz hasn't made any decisions on what he plans to do next, saying he has several options and wants to take some time to consider them.
He was chief medical officer with USHealthcare for 10 years and continued in that position after Aetna purchased it three years ago. He held on to that position throughout the past year despite numerous high-level changes, including the hiring of Donaldson.
Leibowitz, it seemed, was walking the trail to a customer service-centered path with his new boss. He was at Donaldson's side during the new CEO's first public comments to physicians in May. Donaldson, Leibowitz and a contingent of other Aetna executives attended the Connecticut State Medical Society's annual meeting, announced plans to essentially eliminate the all-products clause and a desire to decrease the animosity between Aetna and physicians.
It was an about-face for the nation's largest insurer and a defining mentality change for its top brass -- including, say some, Leibowitz.
As recently as a couple years ago, Leibowitz's perspective on the physician-health plan relationship mirrored the industry's: Physicians will have to learn to accept managed care and lower reimbursements. Their frustrations were simply the price of affordable healthcare, the justification went.
But in the last 10 months he had been singing a new tune. In an August interview, Leibowitz talked of improving relationships with physicians and acknowledged that the company had slipped in its responsibility to maintain those relationships.
"In an earlier time, in the old USHealthcare and old Aetna, we had much more ability to pay attention, close attentio . . . It's fair to criticize and say we got away from that. We've been rebuilding that for the last 1 1/2 years. Even if 99% of the time we do it right, it's still a lot of times we don't. It takes only a minute to hurt the relationship."
"We need the opportunity to find solutions," he says.
MAG's Shanor says it's not important whether it was Leibowitz's or the company's decision to leave. "The culture of Aetna has got to change . . . Whether it was his idea as he suggested or the company's, what he said is correct," Shanor says. "He needed to leave."
Leibowitz says his association with Huber and former AetnaUSHealthcare President Michael Cardillo were not the reasons for his departure. Donaldson asked him to reconsider, Leibowitz says. Initially he planned to leave several months ago but agreed to stay through the transition to the new president of the healthcare unit. Leibowitz stayed until John Rowe, M.D., filled the position in September.
Long before Leibowitz said he wanted to leave, Aetna changed how regional medical directors would report to the company. Regional medical directors no longer report to the CMO but instead to regional business managers. Ultimately, the regional medical directors report to Rowe. Aetna has given no indication that it plans to change the new reporting structure when it hires a new CMO.