Hartford Business Journal

10 Hartford Business Journal • October 5, 2020 • www.HartfordBusiness.com By Matt Pilon mpilon@HartfordBusiness.com J ill Hummel, Connecticut president and general man- ager for Anthem Blue Cross and Blue Shield since 2013, has left a distinct imprint on the state's healthcare sector. Known by industry insiders as a tough negotiator, willing innova- tor and well-connected relationship builder, Hummel has been on the frontlines of the uphill battle of pushing health care away from fee for service and toward value-based plan designs that reward lower costs and good patient outcomes. She's kept Anthem committed to the state's Affordable Care Act insur- ance exchange, Access Health CT, continuing to offer Anthem plans there as Congressional Republicans have dealt various blows to the fed- eral healthcare program. Hummel has done all that while maintaining Anthem's dominant statewide market share position, though competing carriers have man- aged to nibble away at some of the insurer's membership counts during her tenure, according to state data. Her seven-year run as president sailed by and now Hummel, who re- tired with little fanfare on Oct. 2, is sailing off, literally, in a boat she and her husband — newly retired Ship- man & Goodwin partner Zachary Hummel — recently bought after selling their house and giving away many of their possessions. The couple will be living in less than 500 square feet of space as they sail south when the weather here gets too cold. In a recent interview with HBJ, Hummel, who spent her final two months on the job telecommuting from her new floating home, docked in an area marina, discussed her tenure and accomplishments at An- them, which has not yet named her successor, and the evolving dynam- ics of relationships between insur- ers and care providers. In many respects, Hummel said her core task at Anthem was being a care- taker for an already strong operation. "I always like to remind people that I did not come into a fixer-upper situ- ation," Hummel said. "I inherited a re- ally strong asset and all I've really tried to do is build on that asset, … to hand it off to the next leaders so they can build on it." Connecti- cut healthcare industry officials interviewed for this story, includ- ing hospital higher-ups, ben- efit brokers and state officials, say Anthem has ben- efited from Hum- mel's accessibil- ity, willingness to spend time exploring new partnerships, and reputation for keeping her word. Friendly professional relation- ships, however, don't mean there aren't high-stakes disputes. Hum- mel has been perfectly willing to square off with the likes of Hartford HealthCare and Yale New Haven Health, the two largest Connecticut health systems, during contract negotiations, some of which led to prolonged and contentious disputes. The most notable took place in 2017, when Anthem and Hartford HealthCare were unable to come to terms until seven weeks after their prior contract had expired. A probe by state lawmakers drew media cov- erage, and ultimately led to beefed up consumer protections for any future payer-provider stalemates. "She can be a very tough negotia- tor and she knows her business," said Dr. John Murphy, CEO of Nuvance Health (formerly Western Connecticut Health Network), which counts Anthem as its largest payer. Contract disputes have become more common, thanks to hospital consolidation and other factors, but Hummel prefers not to dwell on them. "They may get the most press, but at the end of the day, our relation- ships with our providers go so far beyond that," she said. "It's less about the negotiations, it's more about what you do as partners dur- ing the contract period." Dr. Steven Schutzer, medical direc- tor of the Connecticut Joint Replace- ment Institute (CJRI) at Trinity Health of New England in Hartford, said Hummel was more willing than others to put in extra time and effort to pursue value-based contracts, which are seen as an alternative to the dominant and costly fee-for-ser- vice payment model in health care. Anthem signed on to one type of value-based contract, known as a bundled payment plan, with CJRI just over a year ago. Despite a service discount and high quality metrics, Schutzer couldn't convince other carri- ers, which didn't want to steer their members to- ward an exclusive provider, to bite. "To no one's surprise, it was Jill who was re- lentless in getting this over the goal line," Schutzer said. "It comes down to relation- ships, even in this dicey business, and that's the ingredient that's not going to be easy [for Anthem] to replace." Call anytime As COVID-19 battered Fairfield County this past spring, Nuvance Health's Murphy needed an urgent favor, so he called Hummel's cell, a number she shared readily with many in Connecticut's healthcare world. Doctors at Nuvance, which has seven hospitals in western Connecti- cut and New York, had been working around the clock treating corona- virus patients, and some staff had been sent home to quarantine after potential exposure. Murphy wanted to call in a team of physicians from Nuvance's New York hospitals to spell the local doctors for a few weeks. However, Nuvance was worried it would run into reimbursement problems because those doctors had not gone through the formal approval process to be a part of local insurer networks. The credentialing process can take weeks, and Murphy didn't have that much time to solve his staffing problem. "She said we'll credential them, we'll figure this out," Murphy re- called in a recent interview. Hummel told Murphy it was Moving On Anthem's tough negotiator, willing innovator Hummel sails into retirement Jill Hummel, who ran Anthem's Connecticut market for the past seven years, has retired. She's pictured here participating at a Sept. 18 volunteering event for the Connecticut Food Bank. Connecticut Joint Replacement Institute's Dr. Steven Schutzer worked closely with Jill Hummel on a novel value-based contract. PHOTO | HBJ FILE PHOTO | CONTRIBUTED

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