Hartford Business Journal

23 HARTFORDBUSINESS.COM | OCTOBER 18, 2021 POWER 25 HEALTHCARE James Shmerling James Shmerling, who arrived at Connecticut Children's Medical Center in late 2015, has spent the last year-plus trying to manage his hospital through the pandemic. And it hasn't al- ways been easy. Earlier this year, CCMC became the first Connecticut hospital to sue its insurance com- pany, Continental Casualty Co. and its parent CNA Financial, for failing to pay business interruption claims relat- ed to the COVID-19 pandemic. That put CCMC at the center of a national legal controversy over wheth- er business interruption insurance covers pandemic-related lawsuits. Courts, for the most part, have said no. Despite the challenges posed by the pandemic, CCMC has continued to innovate. For example, in late 2020 it announced a new collaboration with Hartford HealthCare to streamline care for children and families from birth to young adulthood. With the new collaboration, Con- necticut Children's will be the pediatric partner of choice for Hartford Health- Care and patients will be ensured access to care as they transition to adulthood. Connecticut Children's has also launched an innovation center to foster its own clinicians' commercial ideas and to collaborate with industry to pilot new healthcare technologies toward clinical trials. In September, the hospital announced it would be leading a five-year, $30 million federal "cradle-to-career" pipeline program that will help children in North Hartford improve academic outcomes and long-term developmental trajectories. Shmerling and his team are also working to manage a surge in children showing up in the hospital's emer- gency department seeking urgent behavioral health care, according to the Hartford Courant The Nashville native is well-known in the industry, having held manage- ment roles at children's hospitals in five states since 1979. He also chaired the board of the national Chil- dren's Hospital Association in 2014. Sonja LaBarbera and Lynn Ricci Connecticut's two long-term care hospitals — the Hospital for Special Care in New Britain and Wallingford's Gaylord Specialty Healthcare — play a crucial role in providing care and rehabilitation for elderly and seriously injured or ill patients. At the respective helms of HFSC and Gaylord are CEOs Lynn Ricci and Sonja LaBarbera. Combined, Gaylord and HFSC — which have a different mix of patients and payers — serve tens of thou- sands of inpatients and outpatients each year. LaBarbera has overseen a major renovation of Gaylord's Wallingford campus. Last fall it launched a new research center aimed at developing new discoveries in rehab medicine. The new Milne Institute for Health- care Innovation employs Gaylord ex- perts in brain and spinal cord injuries, complex strokes, amputations and pulmonary diseases to innovate on technology and treatment to help care for patients recovering from illness and injury. Gaylord has also played a role in helping COVID-19 long-haulers — people who got the disease and have suffered long-term effects — rehab from their illness. It is also receiving some national at- tention this year, being featured in the Public Broadcasting series "Travels & Traditions with Burt Wolf," for its innovation and long history. Ricci has played a key role in building HFSC's autism inpatient program, which in early Oct. 2020 cut the ribbon on a $13-million facility expansion built with the help of state funding. She's also pushed back against state legislative proposals over the past decade seeking to levy property taxes on nonprofit hospitals. In June 2020, Hospital for Special Care and Bloom Energy commis- sioned a 600-kilowatt fuel cell instal- lation on the hospital's New Britain campus that will help reduce energy costs by more than $130,000 annu- ally. Eric Galvin & Roberta Wachtelhausen Roberta Wachtelhausen is the pres- ident of expanding WellSpark Health, a Farmington provider of corporate wellness programs that announced plans earlier this year to grow its headquarters and add 287 jobs over the next seven years. "We're hiring like crazy because we're growing like crazy," Wachtel- hausen told HBJ last November. The company's offerings — which focus on several areas, including health coaching and disease preven- tion, particularly related to chronic diseases like diabetes and hyperten- sion — have seen growing demand as employers put an emphasis on keeping their workers healthy. WellSpark is an affiliate of health insurer Connecti- Care, which has been led by Pres- ident Eric Galvin since 2017. ConnectiCare, a subsidiary of New York-based EmblemHealth, has been a stalwart presence in the state-run Access Health CT Obamacare insur- ance exchange, when giants like Aetna, Cigna and UnitedHealthcare have ignored the marketplace. Galvin, who was formerly chief fi- nancial officer, succeeded seven-year chief executive Eric Wise in 2017. Since Galvin's appointment as pres- ident, ConnectiCare has tightened its bond with the Connecticut Business & Industry Association (CBIA), launch- ing a type of self-insured health plan, known as a "level-funded" plan, in the lobbying group's insurance exchange. During the pandemic, Galvin acted quickly to ensure his company could manage and expand telemedicine coverage. He also mobilized resourc- es to make sure that ConnectiCare's 700 employees could quickly shift to remote work. The insurer also opened its fifth ConnectiCare center in Shel- ton, which helps members better un- derstand and use their health plans, and make informed decisions about doctors, coverage and staying well. In May, the insurer, which was originally founded by a group of local doctors, marked its 40th year in busi- ness. Susan Halpin One of the most contentious issues at the state Capitol in recent years has been an effort by some Dem- ocratic lawmakers and advocates to create a public health insurance option for small employers and others with the hopes of driving down the cost of health care. It's been blocked on every occa- sion, in part by the state's powerful insurance industry. Directing the Connecticut lob- bying interests of Cigna, Aetna and a handful of other major com- mercial health carriers operat- ing in the state is the Connecticut Association of Health Plans (CAHP), managed by Executive Director Su- san Halpin, who is also a lobbyist with Hartford law firm Robinson+Cole. As major employers, health insurers wield significant power in the halls of the state Capitol and they've been able to fend off a public option by tout- ing the number of people they employ in the state and their overall economic impact. Most recently insurers have taken criticism for requesting double-digit rate increases for 2022, including an average 12.9% prorated increase on small group plans. The Connecticut Insurance Department pared back those rate requests. Halpin defended her members this way: "As high cost drugs come to market, treatments like gene ther- apy develop, reimbursement rates to doctors and hospitals rise, new legislative mandates are passed, additional taxes and assessments are imposed, and utilization of services goes up, so too will the cost of cover- age," Halpin said in a statement to the CTNewsJunkie. "The unpredictability of COVID adds an additional layer of complexity." Dr. Andrew Agwunobi Andrew Agwunobi was so well-liked as CEO of UConn Health, the state's flagship university decided to give him a second job. A big one. Earlier this year, Agwunobi was named interim president of the Uni- versity of Connecticut, following the sudden departure of former school head Thomas Katsouleas. And it may not be a bad thing to have a health- care CEO lead a major university in the middle of a pandemic. Agwunobi is already making his mark as the school has implemented a vaccine requirement this semester for both students and faculty. Agwunobi is a pediatrician by training, but his patient for the past six years has been a $1.2-billion hos- pital and medical and dental school that consistently produces significant budget deficits, largely driven by "unsustainable" increases in pension and healthcare costs. Earlier this year Agwunobi asked state lawmakers for a 174 million, three-year bailout. Agwunobi, who previously held hospital system leadership roles in Washington and Georgia, has spent much time in recent years respond- ing to legislators' demands to find a suitable path forward for the clinical operations of UConn Health, through an envisioned acquisition of or co-in- vestment in John Dempsey Hospital and UConn's medical group. UConn Health, which pursued an ultimately unsuccessful merger with Hartford HealthCare in 2009, received several confidential proposals in 2018, but Agwunobi and his board decided not to pursue them. The continued losses come despite James Shmerling Lynn Ricci Eric Galvin Sonja LaBarbera Roberta Wachtelhausen Susan Halpin Dr. Andrew Agwunobi

• Cover