Position, Politics and Potential Rank in Healthcare’s ‘Most Influential’ List

September 18, 2012 - Even with a few months to go before the end of the year, there is little doubt that the biggest event in healthcare in 2012 was the Supreme Court’s verdict that upheld the Affordable Care Act in June.

“It’s irrefutable that this was the watershed moment this year,” said Jason Beans, CEO of Chicago-based Rising Medical Solutions. “It changes everything going forward.”

Modern Healthcare recently acknowledged the event by naming Supreme Court Chief Justice John Roberts the most influential person in healthcare for 2012. After casting the deciding vote to uphold the landmark health reform law, Roberts topped the magazine’s annual list of the “100 Most Influential People in Health Care,” displacing insurance industry executives, physicians, hospital and health care system leaders, lawmakers and other government officials.

Modern Healthcare’s editor even noted that it “broke tradition” by putting Roberts in the top spot-- Roberts’ name wasn’t even included on the readers’ ballot, but his action “gave the go-ahead for…key provisions of the law” such as the individual health insurance mandate and the accountable care organization program to be implemented. And those provisions, and others, will “reach into every corner of the $2.7 trillion healthcare industry.”

“That’s influence,” wrote David Burba, the magazine’s editor.

Roberts will almost certainly cede the top spot next year, given the unique circumstances of this year, but many believe the Patient Protection and Affordable Care Act (PPACA) will continue to affect who is considered influential in healthcare in the future.

“I think we are entering the ‘proof is in the pudding’ stage of PPACA implementation and that there won’t be one or two people who are influential, but rather we’ll see greater visibility accorded to those running successful ACOs that are successful at containing costs while maintaining decent quality of care,” said Jessie Gruman, PhD, president of the Center for Advancing Health.

Will clinicians be more influential in the future, given the leadership role that many expect them to play in moving the accountable care organization (ACO) trend forward? Beans said that it’s possible, but in that case it will depend on their roles as leaders of business practices than because they are clinicians.

There were 25 physicians and four nurses on the “100 Most Influential People in Health Care” list this year, and some of the highest ranking clinicians are already involved in working with health reform implementation, in some form or fashion.

For example, the most influential clinician on the 2012 list is John Kitzhaber, MD, an emergency medicine physician. He is currently serving his third term as governor of Oregon and is director emeritus for the Center for Evidence-based Policy at Oregon Health and Science University. He has already taken on health reform in his state; earlier this year, he shepherded a Medicaid reform plan for Oregon’s Medicaid recipients. The Centers for Medicare and Medicaid Services (CMS) recently announced it would provide a $1.9 billion grant over five years to fund part of the program.

The highest ranking nurse on the 2012 list is Marilyn Tavenner, the current acting CMS administrator. In her role, she will be responsible for implementing many aspects of the Affordable Care Act.

Based on the Modern Healthcare list, insurance company executives were very influential in 2012. The magazine noted that half of the top 12 slots were occupied by individuals who are executives or leaders of insurance companies. They may continue to exert influence in the future, as well. In fact, a number of the people at the top of the list were from companies that are most likely to be “directly affected by Roberts’ influence,” according to Modern Healthcare. For example, Aetna’s chairman, president and CEO, Mark Bertolini, was listed in the second spot, notably for Aetna’s acquisition of Coventry Health Care and for creating its own version of an accountable care organization.

Who will be influencing the country’s healthcare in the future? Craig Garner, a healthcare consultant and attorney in Santa Monica, Calif., said he hopes that people who are considered influential in the future are the ones who are also setting a good example with their personal health.

“We learn by example,” he said. “I would ask, ‘How many on the list have been hospital patients?’ and ‘How many truly take pride in their health and are actively trying to be proactive about their own health?’”

Garner also expects that patients themselves could have a greater influence on healthcare in the future, because their attitudes will have an impact on the success of many initiatives, including provisions of the ACA.

“They’re the ones who can make or break what is going to happen,” he said.