Education: B.A., University of Minnesota, 1948; M.S., hospital administration, University of Minneapolis, 1950
VHA tenure: President and CEO, 1977-1980
Other positions: President, Henry Ford Hospital (now part of Henry Ford Health System) Detroit, 1971-1988; CEO, Abbott Northwestern Hospital, Minneapolis (now part of Allina Hospitals and Clinics), 1967-1971; CEO, Northwestern Hospital, Minneapolis, 1961-1967; CEO, Parkview Hospital, Fort Wayne, Ind., 1955-1961
First healthcare job: Assistant hospital administrator, Butterworth Hospital, Grand Rapids, Mich. (now Spectrum Health-Downtown Campus)
Personal: Born Aug. 12, 1926, in Stanley, Wis.Stanley Nelson's Management 101: You are whom you hire. "If you pick (good) people and delegate, you will have a winning organization," Nelson says.
Nelson, VHA's first volunteer president, had not only the ability to pick talented people; he also possessed the maturity to let them run things. "He was always available when I needed him, but he was quite willing to allow me to grow and take responsibility," says C. Thomas Smith, VHA's current president, who worked for Nelson at Henry Ford Hospital from 1971 to 1977.
Nelson created or turned around many healthcare organizations during his nearly 40-year career. But he is probably best known for his work at the helm of Henry Ford Hospital, which he guided from a troubled, inner-city hospital to a thriving metropolitan healthcare network.
When Nelson arrived in 1971, Henry Ford was suffering a host of problems. It was technically insolvent. It had lost affluent patients, who had abandoned inner-city Detroit in droves during the 1960s and 1970s. Its nursing staff had dwindled. "I couldn't understand how they were meeting the payroll," Nelson recalls.
Henry Ford had one big plus: a top-quality multispecialty group clinic, which became the key ingredient in the hospital's turnaround. In 1974, Henry Ford opened ambulatory centers in Dearborn and West Bloomfield, Mich., to lure suburban patients to its medical staff.
Those first ambulatory centers were the beginning of Henry Ford's push to become an integrated healthcare system. The system now provides 20% of the ambulatory care and 12% of acute care in southeast Michigan.
Then came another good idea. In 1979, Henry Ford launched Health Alliance, an early provider-owned, staff-model HMO. Henry Ford took over a fledgling plan of about 40,000 members from the United Auto Workers, which became Health Alliance, Nelson says. "We knew there was a market for one-stop shopping and we had an integrated multispecialty group and decentralized access points for delivery," Nelson says. "We made it a viable health plan."
Growth in Henry Ford's total revenue followed the changes Nelson made at Ford: $83 million in 1975, $251 million in 1980 and $498 million in 1985. In 2000, total revenue was about $2 billion.
In addition to Henry Ford, Nelson's management skills also guided VHA. During his presidency from 1977 to 1980, VHA grew from nothing more than an idea to an organization that suppliers respected.
"Stan had the prestige to bring people together because he was at Henry Ford and was a well-known person," recalls Allen Hicks, a VHA founder.
Nelson didn't rely on his reputation alone. Nelson gave VHA his time, office space and a full-time employee, Robert Kitzman, who became VHA's first employee. "Stan Nelson wanted to see this thing work," Kitzman says.
Education: B.A., University of Central Oklahoma, Edmond, 1957; M.S., hospital administration, Northwestern University, Evanston, Ill., 1959
VHA tenure: President and CEO, 1980-1988
Other positions: National director, McManis Consulting, 2000 to present; director, McManis Associates, 1996-2000; president, Arnwine Associates, 1989-present; president and CEO, Charleston (W.Va.) Area Medical Center, 1972-1981; director of hospitals, University of Colorado, 1961-1972; assistant director, 1959-1961
First healthcare job: X-ray technician, Mercy Health Center, Oklahoma City, 1951-1953
Personal: Born Oct. 2, 1932, in Ponca City, Okla.
Don Arnwine walked into Mercy Health Center in Oklahoma City in 1951 when he was 18 years old. He liked what he saw there so much that he's worked in healthcare ever since.
"I liked the atmosphere and the culture. At the time, it was really like a big family (where) very bright people had come together to do good and needed things for society," says Arnwine, who would become VHA's second chief executive.
He entered a two-year training program for X-ray technicians at Mercy. When he graduated from the program in 1953, Arnwine joined the Army, spending 10 months at Fort Hood, Texas, and two years in Germany in the Army Medical Corps. After returning to the U.S., Arnwine completed his undergraduate degree in 1957 and his master's degree in hospital administration in 1959. While the collegial atmosphere and opportunity to help people attracted Arnwine to the healthcare field, his career-long fascination with organizational dynamics has fueled a number of career decisions.
"I liked that a hospital was like a big clock-all the parts had to work together," Arnwine says.
Throughout his career, Arnwine has promoted the development of large healthcare organizations as a means to reduce costs and improve care. That certainly was the case at Charleston (W.Va.) Area Medical Center, where Arnwine became the system's first chief executive officer in 1972. He was recruited to the post because of his experience leading the University of Colorado's teaching hospitals from 1961 to 1972. Charleston Area Medical Center was created through the merger of five hospitals as part of a larger vision to build a branch of the University of West Virginia's medical school in Charleston, using the hospitals as sites for residency training. During Arnwine's tenure, staff from the medical center and university worked together to create a 110-person residency program as well as a program for 52 third- and fourth-year medical students, he says.
"He is people-oriented. He has an ability to bring people together and build consensus," says James Crews, who worked with Arnwine as chief operating officer of Charleston Area Medical Center. "He is very good at developing relationships."
Arnwine says West Virginia's physician-to-population ratio increased to 2.2 per 1,000 in 1992 from 1 per 1,000 in 1972, an increase he attributes largely to the medical education program in Charleston. Arnwine also spearheaded growth at VHA. Arnwine replaced Stanley Nelson as volunteer president in 1980, and became VHA's first paid president and CEO in January 1982.
"He was the one who was able to take a dream and put it into a structure and get it up and going," says Gordon Sprenger, a VHA founder and former board chairman. "He's a great strategist."
Under Arnwine's leadership, VHA grew to more than 850 members. The number of VHA employees grew from a handful to more than 3,000. VHA developed a regional structure and added a host of start-up, for-profit businesses organized under subsidiary VHA Enterprises.
But VHA may have grown too fast. Under pressure from the board, Arnwine resigned from VHA in 1988 after sizable losses at VHAE created friction between staffs at VHA and the for-profit unit, as well as disenchantment from alliance members.
In 1989, Arnwine launched his consulting career, which he continues to pursue today as national director of McManis Consulting and president of Arnwine Associates, both based in Irving, Texas.
Education: B.S., University of Massachusetts, 1965; M.P.A., Graduate School of Public Affairs, State University of New York, Albany, 1968; J.D., Suffolk University, Boston, 1973
VHA tenure: President and CEO, 1989-1991
Other positions: President and CEO, PacifiCare Health Systems, 2000; chairman, Premier, 1998-2000; chairman and CEO, Premier, 1996-1998; CEO, American Healthcare Systems, 1995; chairman and CEO, American Medical International, 1991-1995; president and CEO, St. Joseph's Health System, Orange, Calif., 1983-1989; president, Illinois Hospital Association, 1974-1983
First healthcare job: Planning analyst, New York State Health Department, Albany, 1965
Personal: Born Dec. 3, 1943, in New Bedford, Mass.
Robert O'Leary's management style: turn around an organization and then move on.
"If you look at his career, Rob is not one to leave a lot of grass under his feet," says Gordon Sprenger, a founder and former chairman of VHA and recently retired CEO of Allina Hospitals and Clinics, Minneapolis. O'Leary "is very much stimulated by challenges," Sprenger says.
That's what O'Leary undertook during his tenure as head of VHA from 1989 to 1991. VHA had been in turmoil for several years and without a permanent chief executive for a year. It also had been selling pieces of its financially strapped, for-profit subsidiary, VHA Enterprises.
During his tenure at VHA, O'Leary set the alliance back on course. He promoted a philosophy of customers-first among VHA employees. O'Leary also met face to face with as many members as possible. "The first year, I spent six days out of seven on a plane, just asking members to stick with us," he says.
The job of wooing members became even more important symbolically after Henry Ford Hospital, a founding member of VHA, withdrew from the alliance in early 1990.
O'Leary also sold VHA Enterprises' stake in Partners National Health Plan to Aetna. VHAE was set up in 1983 to invest in for-profit businesses in healthcare. O'Leary also began official liquidation of VHAE, downsized the management ranks, and launched a program of paying cash distributions to members based on participation in VHA programs.
Then he was off to American Medical International, a for-profit hospital chain. O'Leary was named chairman and CEO of American Medical Holdings, the Dallas-based parent company of AMI, in 1991.
O'Leary hadn't planned on leaving VHA so soon, but the job at AMI intrigued him. O'Leary says he learned about the AMI job from Jay Pritzker, a Chicago financier whom O'Leary had met while president of the Illinois Hospital Association.
Pritzker, whose family owned a stake in American Medical Holdings as a result of a 1989 leveraged buyout, persuaded O'Leary to take the job at AMI.
O'Leary stayed at AMI until early 1995 when National Medical Enterprises purchased the hospital chain in a deal valued at $3.3 billion. The merged organization became Tenet Health Corp. O'Leary netted about $10 million in cash, stock and other options.
His next move: American Healthcare Systems, San Diego, a national healthcare alliance, in March 1995. Within eight months, O'Leary had put together a three-way alliance merger among AHS, Premier Health Alliance, Westchester, Ill.; and SunHealth Alliance, Charlotte, N.C. The new organization was named Premier.
O'Leary stayed with San Diego-based Premier until June 2000. That's when he accepted the top job at PacifiCare Health Systems, a large Medicare HMO, quitting after just three months. O'Leary says he left because he concluded that PacifiCare needed a chief executive with an HMO background, which he didn't have.
Since early 2001, O'Leary has been working as an independent consultant based in Rancho Santa Fe, Calif.