A federal judge issued long-awaited final judgment in the closely watched healthcare megamerger.
After an extended and atypical review, the federal judge tasked with signing off on CVS Health's nearly $70 billion Aetna acquisition has done so, granting final judgmentin favor of a deal the merging companies struck with five states and the U.S. Department of Justice.
Determining whether this settlement is in the public interest was "no small matter," U.S. District Judge Richard J. Leon wrote in his opinion Wednesday.
"Industry players, consumer groups, and state regulatory bodies have all raised concerns about CVS's acquisition of Aetna," Leon wrote. "The merger combines two healthcare giants. Its effects, for better or worse, will be felt by millions of consumers."
Despite the concerns raised by a wide range of outside parties, the record in this proceeding failed to undermine the parties' claim that the proposal is in the public interest, he wrote.
CVS and Aetna took the news in stride.
"CVS Health and Aetna have been one company since November 2018, and today’s action by the district court makes that 100% clear," the company said in a brief statement. "We remain focused on transforming the consumer health care experience in America."
There was no mention of the ruling on the Aetna website.
The DOJ conditionally approved the megamerger nearly 11 months ago, directing Aetna to sell its Medicare Part D business to WellCare Health Plans to satisfy antitrust concerns in that particular corner of the market.
Leon, however, made clear that his review shouldn't be seen as a rubber stamp. He invited non-parties to testify during a highly unusual hearing in June.
Facing criticism from system physicians, the CEO defended his leadership and successes.
Board members for Chattanooga, Tennessee–based Erlanger Health System held a special public meeting last week to discuss physicians' criticism of the organization's senior leadership.
The trustees decided not to vote during Thursday's meeting on the future of President and CEO Kevin M. Spiegel, FACHE, because one of the 11 members was absent and two were participating via phone call, as Elizabeth Fite reported for the Times Free Press. But they did hear from Spiegel and various stakeholders.
Spiegel highlighted a list of successes Erlanger has enjoyed with him in its top executive job, and he touted the system's current financial position as the strongest it's ever been, as the Times Free Press reported.
"We want to see Erlanger go to the next level, and I'm prepared to lead that, and I want to see everybody here join me," Spiegel added.
The current flare-up between Erlanger's senior leaders and physicians stemmed from the 11-member medical executive committee's vote of no-confidence in several executives, including Spiegel. The committee informed the board chair of that vote with a letter in May that Fite reported in June for the Times Free Press.
The paper's left-leaning opinions editor, Pam Sohn, wrote in a column Saturday calling on Erlanger's board to engage in a more substantive discussion about the physicians' concerns.
"Spiegel trades in vision and talk of expansions," Sohn wrote. "He steered the hospital on a $40 million building campaign for the first phase of a 'new' Children's Hospital. ... As smaller hospitals across the state closed after Tennessee didn't expand Medicaid, Spiegel's 'expansion' mindset benefited. Six years after his hire, Erlanger has become the nation's 10th largest public hospital and seen a 92% increase in net patient revenue, market share growth and improved bond ratings."
"After the no-confidence vote, Spiegel, who now makes $964,000 a year, attributed some of the concerns to that very growth and expansion, and that's certainly true," Sohn added. "But where was the necessary on-the-fly planning to make room for the onslaught of new patients? Where were the needed additional nurses?"
The meeting came shortly after Erlanger incated that its executive vice president and chief operating officer, Rob Brooks, had "separated from the organization."
The former acting CMS administrator says his focus now is on using all available tools, from public policy advocacy to venture capital, to solve big problems.
Andy Slavitt, MBA, has firsthand experience at the helm of the Centers for Medicare & Medicaid Services, having served as the agency's acting administrator for the second half of President Barack Obama's second term. But don't bother asking him about his successor's approach to the role.
Slavitt has plenty to say about the Trump administration, which he criticizes frequently and accuses of sabotaging the Affordable Care Act. When asked about the job performance of current CMS Administrator Seema Verma, however, he demurs.
Slavitt says he makes a point to avoid commenting on individual officials, with the exception of President Donald Trump himself.
"I think some of this is just the tradition of allowing your successor the breadth and the run room to succeed," Slavitt tells HealthLeaders. "I'm happy to talk about the issues."
Slavitt acknowledges that some of the Trump administration's healthcare policymaking may bring positive results. The efforts to increase transparency around drug pricing and the contracts hospitals negotiate with insurers, for example, could prove beneficial even if their impact falls short, he says.
"It's not entirely clear that making prices more transparent is going to bring down costs. It may bring up costs. And it's not entirely clear that it's readily interpretable by consumers," Slavitt says.
"All steps are helpful because there's no one silver bullet," he says. "But I'm going to say that I don't believe the administration is doing nearly enough to grasp the challenge that most Americans face when affording their healthcare."
His Advice for Presidential Hopefuls
Slavitt says the Democratic candidates campaigning for the White House in 2020 need to differentiate themselves from the Trump administration's approach to healthcare policy. The starkest contrast between those two options centers on preexisting conditions, he says.
"I think it's important to remember that the choice the country has to make today is not a choice between Medicare-for-All and some other form of universal coverage," he says. "It's between a party that is focused on indeed allowing everyone to have access to affordable healthcare and a party that wants to end preexisting condition protections and repeal the ACA, and I think that is a major contrast that is going to be at the heart of the 2020 election."
Republican politicians, including the president, have voiced support for protecting people with preexisting conditions. The rhetoric was especially prevalent on the campaign trail ahead of the 2018 midterm, as voters cited healthcare as their top concern. But the preexisting condition protections in the legislative proposals brought forward thus far by the GOP have generally been less generous than the ACA's protections, and the Trump administration has argued before a federal appeals court that the entire ACA is invalid.
Does that mean Republicans are disingenuous when they claim to support preexisting condition protections despite opposing the ACA?
"I think they read polls," Slavitt says.
"I think they recognize that they have to say they're not in favor of taking preexisting condition protections away. But I think the American public is probably smarter now than it ever was before about looking at votes, not quotes," he says. "And I think the Republicans have a very difficult case to make, given their position on the lawsuit to repeal the ACA, given all of the repeal votes they've taken without any valid replacement, without having a plan."
"I would say there are probably some Republicans who believe that people should be able to not be discriminated against for having a preexisting condition, but I have never seen it in any Republican policy yet—and I don't say that with any joy," he adds. "I wish that weren't the case."
His Problem-Solving Motivations
Slavitt, who has worked as a Goldman Sachs investment banker and a McKinsey & Co. strategy consultant, says he got his start in healthcare when his former college roommate died of a brain tumor in 1998. His widow and their kids moved in with Slavitt and his wife shortly after they married.
The following year, Slavitt founded a company focused on trying to help people who were underinsured or lacked health insurance altogether. That company, Health Allies, was acquired in 2003 by UnitedHealth Group, where Slavitt worked in a variety of leadership roles, including group executive vice president for Optum, until he took a job with the federal government to fix HealthCare.gov amid a sputtering rollout.
"I think what motivates me today is I ask myself the question, 'What could be different in this country 10 years from now, and what can we be working on today to get there?' " Slavitt says.
"When I left the Obama administration, I was 50 years old, and I decided that instead of looking through the lens of 'What do I want to do every day?' or 'How much money do I want to make?' or even 'What kind of issues do I enjoy being involved with?' I decided to ask the question, 'What could I help change? What problems could I help solve?' " he says.
Upon returning to the private sector in 2017, Slavitt led town halls, where he spoke with people about the problems they experience in the healthcare system. Then he embarked on a mission to solve those problems, to advance healthcare equality and affordability.
"To do that, we need to focus on policy. To do that, we need to focus on innovation. To do that, we need to focus on the ecosystem of people who provide care," he says. "It's not one of those things. Unfortunately, in our system, it's all three of those things."
Hence his tripart approach:
Influencing public policy: Slavitt is a founder and the board chair for the nonprofit policy foundation United States of Care, which aims to push for principles that will make healthcare affordable. The organization's founder's council includes some big industry players, including Haven CEO Atul Gawande, MD.
Funding promising innovation: Slavitt is a founder and general partner for the venture capital organization Town Hall Ventures, which he says exists to support innovators who wish to meet the healthcare needs of lower-income communities and underserved populations.
Shaping provider ecosystems: Slavitt is also working with AVIA and health system CEOs from across the country on the Medicaid Transformation Project, which aims to use digital tools and innovative care models to better serve vulnerable populations. The team has identified four "challenge areas": substance use disorder, women and infant care, and avoidable emergency department visits.
"We operate through several different platforms, but all really focus on the same end, which is how to do we get every American access to affordable healthcare that they can use to take care of their family," Slavitt says.
His Enjoyment and Aspirations
When asked whether he would like to return to a government job someday or perhaps run for public office, Slavitt says he feels like he's "sitting in the perfect place."
"I don't think I've ever really had political aspirations. I have deep, ambitious problem-solving aspirations," he says.
"What excites me is to be able to say, how do you take a problem like that, use all the tools in our tool chest, get innovators solving the problem, get policymakers to put out better policies, get health systems to change the way they practice, and bring a lot of attention to the problem and use that to deliver real results using everything, everything we have in this country and going all-out—kind of what I would call a 'shock-and-awe' approach to solving problems like maternal mortality," he says.
"But I don't kid myself. It's hard work. It requires a lot of involvement," he adds. "But among all of the other people, it requires somebody who will kick and scream and push all of the resources necessary to get these things done. That's what I'm enjoying doing."
Today's professionally grown marijuana plants are significantly stronger than the type grown two or more decades ago.
Surgeon General Vice Adm. Jerome M. Adams issued an advisory Thursday warning against marijuana use by pregnant women and youths.
Although the drug remains illegal under federal law, 33 states have legalized marijuana in some way, whether for recreational or strictly medicinal purposes. In those states, there has been a decrease among high school students in the perceived harms of pot, Adams said during a press conference.
"While the perceived harm of marijuana is decreasing ... the actual potential for harm is increasing," he said, adding that today's professionally grown marijuana plants can have three-times as much THC as the plants grown two decades ago.
"This ain't your mother's marijuana," Adams said.
Marijuana continues to be the most commonly used illegal drug, and frequent marijuana use among youths and young adults "appears to be associated with risks for opioid use, heavy alcohol use and major depressive episodes," according to a Health and Human Services announcement that cites the Substance Abuse and Mental Health Services Administration's 2018 National Survey on Drug Use and Health.
During the press conference, Adams and HHS Secretary Alex Azar praised President Donald Trump for donating one-quarter of his salary ($100,000) to support digital outreach efforts related to this advisory.
The mobile-friendly redesign will walk users through the enrollment process, letting them search for additional information on pricing, supplemental benefits, and more, according to officials.
The online tool Medicare beneficiaries use to compare their options has a new look, with added functionality that officials say will make it easier for consumers to make informed selections.
The Centers for Medicare & Medicaid Services launched the revamped Medicare Plan Finder on Tuesday, seven weeks ahead of open enrollment for 2020 coverage.
The idea, says CMS Administrator Seema Verma, flows from the Trump administration's eMedicare initiative to meet the needs and expectations of tech-savvy consumers, especially in light of the added flexibility the agency has granted to Medicare Advantage (MA) plans for coverage of supplemental benefits.
"The tool had not been updated in a decade, so you can imagine that there were a lot of opportunities to just make it more user-friendly: redesigning the experience with simple prompts, clean design, fonts, colors, all things that are easy on the eye," Verma tells HealthLeaders in an interview. "But more importantly, it provides more functionality for decision-making so that they can compare the plans on cost and quality and supplemental benefits."
The updated tool will allow beneficiaries to compare prices among original Medicare plans, Medicare prescription drug plans, MA plans, and Medicare supplemental insurance options (Medigap), according to a CMS announcement. The mobile-friendly update will let beneficiaries compare up to three drug or MA plans side by side, and it will allow users to import their list of medications so they can compare plans in light of their known needs, according to the announcement.
The update comes after the U.S. Government Accountability Office issued a report last month that said the existing Plan Finder "is difficult for beneficiaries to use and provides incomplete information." The tool required users to navigate multiple pages before they could see plan details, lacked prominent instructions, and included complex terminology, according to the GAO report.
The overhaul, which sought to streamline the tool's information and use easy-to-understand language, is part of the Trump administration's far-reaching efforts to empower beneficiaries as consumers, Verma says.
"When we talk about 'empowering,' it's giving patients the information and the tools that they need to make decisions that are going to work best for them and their families," she says. "So a lot of our initiatives—price transparency, quality transparency, making sure patients have access to their medical records—all of those are our efforts to empower patients."
The changes are also about responding to requests from a younger generation of beneficiaries and caregivers, Verma says.
"Our new generation is used to Amazon, they're used to apps. And I think they have those expectations of the Medicare program as well," she says.
One in four Medicare beneficiaries accessed the Plan Finder tool on mobile devices last year, a significant increase from the previous year, according to the CMS announcement.
Both the old and new Medicare Plan Finder tools will be available online through the end of September, as part of a phased rollout, according to the CMS announcement. This will give users an opportunity to familiarize themselves with the changes and offer feedback.
There's also a potential opportunity for innovators and entrepreneurs: the agency says it intends to release real-time Medicare plan data in an API format by the end of the year, so the private sector can devise more tools to help beneficiaries make their plan selections.
It's not just about what an executive has accomplished, says Yale New Haven Health's long-time leader. How the exec has treated people along the way matters, too.
Yale New Haven Health CEO Marna P. Borgstrom, MPH, says her senior leadership team has done a lot of work thinking through what leadership looks like.
Beyond having a curriculum vitae that checks off the right list of "experience" boxes, healthcare CEOs need to exhibit a set of traits. It's not just about what candidates have accomplished; it's also about how they accomplish those things, including how they treat people along the way, Borgstrom says.
"In our system, our leadership team defined five basic attributes for a successful healthcare leader," she says.
1. Lead with humility
Whenever she goes to the team with a new initiative or direction, Borgstrom says she speaks with confidence but tempers her message with an acknowledgement that some of her decisions over the years will inevitably be wrong. A leader must be able to cast a strong vision while remaining humble and introspective, correcting course and requesting help as needed, she says.
2. Drive alignment
"Figure out how to create a common vision among enough people so that you can bring teams together and really get meaningful work done as a team," Borgstrom says. "No one person, no matter how smart, gets it done alone."
3. Be courageous
"You have to be willing to go out on a limb, not always be the person who says only brilliant correct things," she says. "Be courageous, but if you balance that courage with humility, you'll probably do very well."
4. Support innovation
Get people comfortable enough to propose ideas that may not work, even if 80 of them are duds and only three stick to the wall, Borgstrom says. "If people get comfortable that there isn't one way to do things, you can get a lot more enthusiasm for what you're doing."
5. Collaborate meaningfully
Don't just pull a team together to advocate for your position as though you already know precisely what the end result should be, Borgstrom says. "Really engage people because the value of getting people who are really invested in getting something done and who work together to get something done generally deliver a better product."
The prominent executive is pushing beyond a letter he released last week and is now seeking to rally his peers around solving what he sees as a public health crisis.
Northwell Health President and CEO Michael J. Dowling isn't done pushing fellow leaders of healthcare provider organizations to take political action in the aftermath of deadly mass shootings.
Dowling addressed healthcare CEOs in a "call to action" published online last week by the Great Neck, New York–based nonprofit health system. Now he's published a full-page print version of that letter in Thursday's national edition of The New York Times, while reaching out directly to peers who could join him in a to-be-determined collective action plan to curb gun violence.
"To me, it's an obligation of people who are in leadership positions to take some action, speak out, and prepare their organizations to address this as a public health issue," Dowling tells HealthLeaders.
Wading into such a politically charged topic is sure to give some healthcare CEOs pause. Even if they keep their advocacy within all legal and ethical bounds, they could face rising distrust from community members who oppose further restrictions on firearms. But leaders have a responsibility to thread that needle for the sake of community health, Dowling says.
"I do anticipate that there'll be criticism about this, but then again, if you're in a leadership role, criticism is what you've got to deal with," he says.
Dowling argues that healthcare leaders have successfully spoken out about other public health crises, such as smoking and drug use. But they have largely failed to respond adequately as gun violence inflicts considerable harm—both physical and emotional—on the communities they serve, he says.
"It is easy to point fingers at members of Congress for their inaction, the vile rhetoric of some politicians who stoke the flames of hatred, the lax laws that provide far-too-easy access to firearms, or the NRA's intractable opposition to common sense legislation," Dowling wrote in the print version of his letter. "It is far more difficult to look in the mirror and see what we have or haven't done. All of us have allowed this crisis to grow. Sadly, as a nation, we have become numb to the bloodshed."
His letter proposes a four-part agenda for healthcare leaders to tackle together:
Put pressure on elected officials who "fail to support sensible gun legislation." He urged healthcare CEOs to increase their political activity but avoid "blatant partisanship." The online version of his letter links to OpenSecrets.org's repository of information on campaign contributions from gun rights interest groups to politicians.
Invest in mental health without stigmatizing. Most mass murderers aren't "psychotic or delusional," Dowling wrote. Rather, they're usually just disgruntled people who let their anger erupt into violence, which is why firearms sales to people at risk of harming themselves or others should be prohibited, he wrote.
Increase awareness and training. Individuals shouldn't be allowed to buy or access certain types of firearms "that serve no other purpose than to inflict mass casualties," he wrote. Healthcare leaders should support efforts to spot risk factors and better understand so-called "red flag" laws that empower officials to take guns away from people deemed to be a potential threat to themselves or others, he wrote.
Support universal background checks. In the same way that doctors shouldn't write prescriptions without knowing a patient's medical history to ensure the drug will do no harm, gun sellers shouldn't be allowed to complete a transaction without having a background check conducted on the buyer, Dowling wrote, adding that a majority of Americans support this idea.
The letter notes that the U.S. has nearly 40,000 firearms-related deaths each year and that several dozen people have died in mass shootings thus far in 2019, including 31 earlier this month in separate shootings in El Paso, Texas, and Dayton, Ohio.
Corporate Responsibility
The way for-profit companies think about their relationship with the communities in which they operate has been shifting for some time. The most recent evidence of that shift came earlier this week, when the influential Business Roundtable released a revised statement on the principles of corporate governance, responding to criticism over the so-called "primacy of shareholders."
The 181 CEOs who signed onto the new statement said they would run their business not just for the good of their shareholders but also for the good of customers, employees, suppliers, and communities. There's some similarity between that updated notion of corporate responsibility and the sort of advocacy work Dowling wants to see from his for-profit and nonprofit peers alike.
Every single organization has a social mission, and large organizations that have sway in a local community have a responsibility to the community's health, Dowling says.
"A healthy community helps and creates a healthy organization," he says.
One major factor that may be pushing more CEOs to take a public stance on politically sensitive issues—or at least giving them the cover to do so confidently—is the generational shift in the U.S. workforce. Although most Americans overall say CEOs shouldn't speak out, younger workers overwhelmingly support such action, as Fortune's Alan Murray reported, citing the magazine's own polling.
Dowling says he has received hundreds of letters, emails, and phone calls from members of Northwell Health's 70,000-person workforce expressing support in light of his original letter published online last week.
"The feedback has been absolutely universal in support," he says.
But Which Policies?
Even among healthcare professionals who agree it's appropriate to speak out on politically charged topics, there's sharp disagreement over which policies lawmakers should enact and whether those policies would infringe on the public's Second Amendment rights.
The group Doctors for Responsible Gun Ownership (DRGO) rejects the premise of Dowling's argument: "Firearms are not a public health issue," the DRGO website states, arguing that responsible gun ownership has been shown to benefit the public health by preventing violent crime.
Dennis Petrocelli, MD, a psychiatrist in Virginia, wrote a DRGO article that called Virginia's proposed red flag law "misguided" and perhaps "the single greatest threat to our constitutional freedoms ever introduced in the Commonwealth of Virginia." His concern is that the government might be able to take guns away without any real evidence of a threat.
While gun rights advocates may see Dowling as merely their latest political foe, Dowling contends that he's pushing for a cause that can peaceably coexist with the constitutional right to bear arms.
"You can have effective, reasonable legislative action around guns that still protects the essence of what many people believe to be the core of the Second Amendment," Dowling says. "It's not an either/or situation."
Others Speaking Out
Dowling isn't, of course, the only healthcare leader speaking out about gun violence.
On the same day last week that Northwell Health published Dowling's online call to action, Ascension published a similar letter from President and CEO Joseph R. Impicciche, JD, MHA, who referred to gun violence in American society as a "burgeoning public health crisis."
"Silence in the face of such tragedy and wrongdoing falls short of our mission to advocate for a compassionate and just society," Impicciche wrote, citing the health system's Catholic commitment to defend human dignity.
American Hospital Association 2019 Chairman Brian Gragnolati, who is president and CEO of Atlantic Health System in Morristown, New Jersey, said in a statement this month that hospitals and health systems "play a role in the larger conversation and are determined to use our collective voice to prevent more senseless tragedies."
More than three-quarters of large and 'jumbo' employers report using a Centers of Excellence strategy, according to an Optum survey.
The percentage of large employers using a Centers of Excellence (COE) strategy to contain healthcare costs and improve outcomes for their employees has risen dramatically in recent years.
While just 45% of employers reported using a COE strategy in 2016, that figure grew to 64% in 2017 and 78% in 2018, according to Optum's 10th annual Wellness in the Workplace survey results released Wednesday.
The uptick comes as an overwhelming majority of employers, 87%, say they are concerned about the costs associated with managing complex and chronic medical conditions, according to the report, which surveyed 435 employers with at least 3,000 employees.
The survey aligns with the trends other industry watchers have identified. A report released earlier this year by Willis Towers Watson also found a significant increase in the percentage of employers looking into COEs within a health plan.
The idea is for companies to encourage their workers to seek care at high-quality providers, as the nation's largest private employer, Walmart, has demonstrated.
In other words, as Bruce Japsen wrote for HealthLeaders earlier this year, employers are "increasingly becoming savvier purchasers of healthcare services and demanding quality choices of hospitals, doctors, and health systems to make sure care is done right the first time."
The physician executive has two decades of clinical experience and 15 years of work history in various leadership roles.
Woman's Hospital in Baton Rouge, Louisiana, announced Monday that a new top executive will take charge this fall.
Barbara Griffith, MD, who has been serving as chief medical officer and chief of business operations for Duke Regional Hospital in Durham, North Carolina, was selected to lead the large specialty hospital as its new CEO after a national search.
"We needed a unique professional who would embrace and further our mission," Donna Fraiche, chair of the Woman's Hospital Board of Directors, said in a statement.
"The Board is confident that Dr. Griffith is the right person to lead Woman's into an exciting future," Fraiche added. "Her expertise in healthcare delivery and strategy, balanced with the compassion and commitment of a physician, are the perfect combination to lead the organization's strategic direction."
Griffith has two decades of clinical work experience and more than 15 years of work history in various leadership roles, according to the announcement. She said it's an honor to be chosen for the job.
"The commitment to providing exceptional care to patients and their families at Woman's is truly inspiring," she said in the statement. "I look forward to joining the team and building on the foundation that has been laid before me."
Griffith will take the reins from interim CEO Robert Burgess, who stepped into the position following the retirement earlier this year of CEO Teri Fontenot, who had been CEO since 2019 and has been named CEO Emeritus.
"We are thankful to Teri for the incredible foundation she established at Woman's and to Robert for upholding our standards of excellence while we searched for our new leader," Fraiche said. "His guidance helps ensure a smooth transition into Dr. Griffith's tenure as CEO."
The revised statement of purpose was signed by 181 CEOs from the Business Roundtable, including several making waves in the healthcare sector.
For the past 22 years, the Business Roundtable's statement on principles of corporate governance has affirmed the notion that corporations exist primarily to serve their shareholders. Not any longer.
The association of CEOs released a superseding statement Monday that says corporations exist for the benefit of all stakeholders, including not only shareholders but customers, employees, suppliers, and communities as well. The statement was signed by 181 CEOs who say they will lead their companies in accordance with these principles.
The list of signatories includes several business executives who have been making waves in healthcare, including CVS Health President and CEO Larry Merlo, Walgreens Boots Alliance Executive Vice Chairman and CEO Stefano Pessina, Anthem President and CEO Gail Koziara Boudreaux, Cigna President and CEO David M. Cordani, Walmart President and CEO Doug McMillon, Apple CEO Tim Cook, and others.
Amazon Founder and CEO Jeff Bezos and JPMorgan Chase & Co. Chairman and CEO Jamie Dimon—who lead two of the three deep-pocketed firms backing Haven's efforts to remedy healthcare's "hungry tapeworm" effect on the U.S. economy—are also on the list.
"The American dream is alive, but fraying," Dimon said in a press release. "Major employers are investing in their workers and communities because they know it is the only way to be successful over the long term. These modernized principles reflect the business community's unwavering commitment to continue to push for an economy that serves all Americans."
The statement on the purpose of a corporation includes five commitments:
To deliver value to customers.
To invest in employees.
To deal fairly and ethically with suppliers.
To support the communities in which the business operates.
To generate long-term value for shareholders.
"This new statement better reflects the way corporations can and should operate today," added Johnson & Johnson Board Chairman and CEO Alex Gorsky, who is also chair of the Business Roundtable Corporate Governance Committee. "It affirms the essential role corporations can play in improving our society when CEOs are truly committed to meeting the needs of all stakeholders."
The revised statement defies a central tenet of Milton Friedman's teachings on business ethics, as Fortune's Alan Murray wrote in a detailed article for the September edition of the magazine, which went live online Monday. While the revised statement of principles may seem sudden to some, it has really been a long-running evolution, Murray wrote.
"I've covered business as a journalist for four decades and, over that time, have conducted hundreds of interviews with CEOs of the largest corporations in the U.S. and across the globe," he wrote. "In the past few years, it has become clear to me that something fundamental and profound has changed in the way they approach their jobs."