Finding an executive who can juggle a hospital's constant challenges often leads trustees to scour for a candidate with firsthand knowledge of hospital or health system operations.
Often, but not always. On occasion, search committees look beyond a well-defined pool of candidates from nearly identical organizations and hire from the ranks of insurers, academia, physicians-or another industry altogether.
On Oct. 18, Sandra Van Trease, 43, joined a reportedly small cadre of healthcare executives who have made the jump from one seg- ment of the healthcare industry to another, bringing with them an outsider's perspective to an intertwined, though sometimes adversarial, business. Van Trease, for-merly president and chief executive officer at insurer Unicare, a WellPoint Health Networks' subsidiary, is now group president at BJC HealthCare in St. Louis, where she oversees eight hospitals.
The American College of Healthcare Executives has no data on how many or how often executives cross over between sectors in the industry. "It's not that common," Tom Giella said of executives moving from insurer to provider or vice versa. Giella is healthcare-services practice leader for Korn/Ferry International, a global executive-search company. "It's more the exception than the rule," he said. Amanda Fox, a partner with the international executive-search company Spencer Stuart, echoed Giella's assessment. "It's not that common, but it does happen," said Fox, who specializes in managed-care recruiting.
"It doesn't raise as many eyebrows as you might think," Giella added. That's because healthcare's complexity has pushed companies to put a premium on executives who excel, regardless of the industry, or to seek out those with specific know-how, such as saving a financially troubled company or negotiating contracts.
And the hospital-to-insurer leap isn't that great, he said, "because they're almost hand-in-glove. They really need to know each other's business pretty well."
Fox said insurers moved first to hire expertise by recruiting doctors or health system executives. Now it's providers that are seeking executives who are experts in critical areas, such as network selection and reimbursement contracts. Both sectors realize ignorance is costly, she said.
So why isn't there more cross-training in healthcare leadership? For one, volunteer hospital or health system trustees and directors may find it difficult to gauge the future success of a candidate who lacks a track record from a similar organization, said Gail Vergara, also a partner at Spencer Stuart. "They are hesitant to take a leap of faith," she said, particularly if other candidates can point to accomplishments in a hospital or health system.
Beth O'Brien, president and CEO of Birmingham, Ala.-based Baptist Health System, argues that more executives ought to work for both insurers and providers to cultivate common ground between the two sectors. O'Brien left San Francisco-based Catholic Healthcare West, which operates 42 hospitals in three states, to join insurer Cigna Corp. in 2002 before her December 2003 appointment at Baptist.
"I wouldn't have traded that experience for anything," said O'Brien, who ventured into insurance for an education. "I learned that I did not know a whole lot" about how insurers operate or weigh decisions, she explained. O'Brien discovered insurers have a wealth of clinical resources that providers could put to better use. The experience left her with a better understanding of how insurers design benefits and a lingering curiosity about how insurers and hospitals could better work together.
Van Trease said her familiarity with how employers evaluate healthcare benefits will help BJC tailor its services to be consumer-friendly. Increasingly, that means providing patients and employers with understandable, useful information on providers' cost and quality, she said.