In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is the story of Bruce Bodaken.
This profile was published in the December, 2012 issue of HealthLeaders magazine.
"All of us have a responsibility to be a part of the system and we need to make a way for those who can't afford to get care."
Bruce Bodaken, the long-time chair, CEO, and president of Blue Shield of California will retire at the end of 2012.
He acknowledges that he is walking away from his healthcare career just as a lot of exciting things are happening in the industry and at Blue Shield. Healthcare reform holds the promise of bringing accessible and affordable healthcare to millions, and Blue Shield is at the forefront of efforts to develop accountable care organizations and other interesting programs.
But Bodaken thinks 12 years is long enough for one CEO to lead a company. "When I took over I told the board that in my vision, for organizations to evolve and make sure they are at their very best requires continuous change," he says.
Bodaken's tenure has included his early support for universal coverage, as well as Blue Shield's 2011 announcement that it would voluntarily limit its income to 2% of revenue and redistribute anything over that amount to its members, providers, and the Blue Shield Foundation.
The Blue Shield that Bodaken is leaving is quite different from the struggling insurer he took over in 2000. That company had around one million members and made its payroll by pulling money out of its limited surplus funds. "It simply wasn't going to survive," he explains.
Today the insurer is a dominant player in the California market. Membership has tripled, its surplus has grown to billions of dollars, and the company is on solid financial ground.
When asked to name his biggest accomplishments Bodaken points to the company's journey toward helping to make sure everyone has access to affordable healthcare, including prevention and wellness services. "All of us have a responsibility to be a part of the system and we need to make a way for those who can't afford to get care," he states.
And he is pleased with the results the 2% pledge has produced so far. Over the years Blue Shield has been roundly criticized for its steep rate hikes and when the pledge was announced, it was greeted with a healthy dose of skepticism by just about everyone. But in 2011, the company paid out around $475 million, including $450 million to members, $20 million to help provider groups form accountable care organizations, and $5 million to the Blue Shield Foundation and community grants.
Bodaken says Blue Shield is trying to convince other companies to join the effort. The ultimate goal, he explains, is for Blue Shield to price its rates "so we don't give money back. We're getting closer to having lower rates and giving less back."
He is proud of the work Blue Shield has done to expand accountable care organizations across the state. It now has eight ACOs throughout California.
Healthcare wasn't part of Bruce Bodaken's career plans when he was working on a PhD in philosophy, but with few teaching job available he accepted a position with an HMO.
He discovered that his sense of social responsibility and interest in making a difference complemented HMO efforts to focus on wellness, prevention, and better care at lower cost. "In a funny way I was able to combine my education and the mission of the nonprofit organization."
He moved to Blue Shield in 1994 and says he once again found himself in an organization that was aligned with his own thinking about the access, delivery, and cost of healthcare.
"I have truly enjoyed and loved being in the business."
When he retires Bodaken says he hopes to get back to being a respectable tennis player. He also wants to teach at a local university and to do some board work. He will continue, in some capacity, to be part of the healthcare reform policy dialogue. "It's too important to me personally and too important to the country," he says.
He expects healthcare affordability to be a continuing challenge. "All of us involved in healthcare—hospitals, physicians, health plans, and pharma companies—need to get our administration costs down." Once that step is taken, he expects, over time, that healthcare will be affordable for the vast majority of Americans.
He notes that the government cannot afford to take the lead forever and that the industry needs to become self-sustaining at some point.
Bodaken says his Blue Shield legacy will be his work in healthcare reform and the risks he took to speak up for change in the industry. "I wasn't the darling of our industry when we first started down this path. But it is what needs to be done if we want to make transformative change."
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
