Mary Brainerd became CEO of HealthPartners, an integrated hospital and health plan system based in Bloomington, Minn., in 2002. Under her tenure, the nation's largest consumer-governed, not-for-profit integrated delivery network has grown to more than $5.5 billion in revenue, employing 22,500 people, including 1,700 physicians, to serve its 1.5 million medical and dental plan members. Just before taking the top job, Brainerd was diagnosed with breast cancer. Her conversation with Modern Healthcare reporter Bob Herman started there. This is an edited transcript.
Modern Healthcare: What was it like to be a patient with cancer while also being so involved with the healthcare system professionally?
Mary Brainerd: It's one of those things that you can never be prepared for, but I can still remember the shock of hearing the word cancer and knowing it was applied to you. Our kids were younger then, and you immediately get concerned about the people around you and what's next. I was so lucky my cancer was caught early and was really very treatable, but it was really the fear and anxiety that was the very most difficult part of that diagnosis.
A lot of people still see cancer as a death sentence more often than is clearly the case today. It was a really good reminder of the mind-body connection and how much chronic illnesses or any kind of illness is emotional in nature.
What I really learned that affected me the most was how much you need to understand, how much information you want to have available, how important your team is, and the fact that they know each other and everyone has the same game plan for your care. That coordinated-care, team-based approach and consistent game plan for how we're going to tackle the challenge of care and treatment together all were really clear priorities for me.
MH: The president has called for a moonshot to cure cancer. How can America's healthcare system try to achieve such a lofty goal?
Brainerd: For many kinds of cancers, new treatments and new effective approaches to care are being developed all the time. We worked with public television here in Minneapolis to profile some of the people who have been our patients who are longtime survivors living with cancer.
The future of cancer is better treatment and management so it becomes much more like a chronic illness, much more like living with diabetes or heart disease.
MH: Why did you tread outside your Minnesota stomping grounds to form a joint venture with UnityPoint Health to sell Medicare Advantage plans in Iowa and Illinois?
Brainerd: This comes from our roots. A health plan can be most effective if it has strong connections with the delivery systems. So we try to work closely with delivery systems, not only our own, but across our marketplace. UnityPoint was looking at the future and saying: We want to be much more closely tied to the financing system to be able to accept some financial risk and to step up to do care coordination. We had a similar world view about the opportunity to bring Medicare Advantage into the Iowa marketplace.
MH: What advice would you give to hospitals that are looking to start their own insurance arm?
Brainerd: There is a clear appetite. (But) being a health plan is a lot more complicated now than it was five years ago. It's not for the faint of heart. You really need to know what you're doing. Sometimes people still feel that health plans handle the transactions of healthcare and enrolling and paying claims and doing some reports. Anyone who's worked with a state-based exchange, anyone who's working with Medicare Advantage, anyone who's figuring out how to work with their state Medicaid program, any health plan in those roles knows it's a very complicated environment.
Don't think you can turn into or develop a health plan on a dime. It's a cultural evolution as well and a delivery system. That doesn't happen overnight. Being able to perform at scale as a competent health plan is a very challenging body of work.