Becker's Hospital Review

Register Today! Becker's Hospital Review CIO and CEO Strategy Roundtables - Nov. 4 and 5, 2014 - Chicago 61 6. Atul Gawande Atul Gawande, MD, PhD, is a practicing endo- crine surgeon, journalist and professor at both the Harvard School of Public Health and Harvard Medical School. In 2012, Dr. Gawande wrote a provoca- tive piece for The New Yorker suggesting that medi- cine should become more like The Cheesecake Factory — more standardized with better quality and a small amount of room for customization and innovation. The standardization of medicine or the assertion that for most conditions there should be a clear set of guidelines — or even algorithms — that guide care is criticized by some physicians because the theory undermines the autonomy of the physician as well as undercuts physicians' in- telligence. His critics have referred to his concepts as the "commoditization" of healthcare and argue such an approach would be detrimental to the cor- nerstone of healthcare; the autonomous physician. 7. Charles Grassley Sen. Charles Grassley (R-Iowa) helped create the Physician Payment Sunshine Act, included in the final version of the PPACA. Much to the cha- grin of many physicians and healthcare companies, the act requires that any "payment or other transfer of value" of $10 or more to physicians and teach- ing hospitals must be reported to the United States Department of Health and Human services. He is often disliked by Republicans for siding with the President Obama on several issues. Supporters consider the act to elucidate poten- tial conflicts of interest and lower health costs; however, physicians are not only threatened by the new enforced transparency, but are also strug- gling to find a balance between that transparency and what some consider cumbersome paperwork under the Act. The Sunshine Act has also caused many surgeons to rethink their industry relation- ships now that device and other related compa- nies will be reporting gifts and meals in addition to speaking and consulting fees. 8. David Green David Green is CEO of the Oklahoma-based craft store Hobby Lobby. Mr. Green recently won a Supreme Court case, Sebelius v. Hobby Lobby, asserting that closely held businesses, such as Hobby Lobby, that hold religious objections to certain forms of birth control, can deny contra- ceptive coverage for their employees under federal law. The 5-4 decision is the result of David Green and his company taking on the PPACA, which as written requires that employers include a set of preventive services in their employees' healthcare plans if they offer healthcare benefits including FDA-approved contraceptives. "In a decision of startling breadth, the Court holds that commercial enterprises including corpora- tions, along with partnerships and sole proprietor- ships, can opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs," Supreme Court Justice Ruth Bad- er Ginsberg wrote in her 35-page dissent. She also declared that the Court had "ventured into a mine- field" with its decision to side with Hobby Lobby. 9. Stephen Hemsley Stephen Hemsley is CEO of UnitedHealth and is listed as one of the top ten highest-paid CEOs in the United States. Mr. Hemsley is known for being wary of UnitedHealth's participation in the new market exchanges that resulted from the PPACA and is entering into them slowly if at all. UnitedHealth is also known for being a cost leader among payers, making the company more challenging for providers to work with. Most recently, according to company officials, Unit- edHealth plans to cut up to 700 Massachusetts physicians from its physician network for seniors enrolled in its private Medicare plan as a way to control costs. Featured on Sick for Profit, a media outlet aimed at exposing the CEOs of the largest health insur- ance companies, Mr. Hemsley is berated for his high salary and stock options. 10. Mary Kay Henry Mary Kay Henry represents healthcare workers through her work as international president of the Service Employees International Union. She is the first female to lead the union. She and SEIU have been leaders in organizing healthcare unions. During her work with SEIU, she has been lauded in her efforts regarding the organization's use of card check agreements, non-traditional collec- tive bargaining agreements, comprehensive cam- paigns and system-wide healthcare organizing strategies. In a recent column for USA Today, Ms. Henry part- nered with Lee Saunders, president of the Ameri- can Federation of State, County and Municipal Employees, to warn against "[opening] the door to a multitude of religious objections that could upend basic workplace rights," if upreme Court of the United States ruled in favor of Hobby Lobby in Burwell v. Hobby Lobby. After SCOTUS ruled in favor of Hobby Lobby, Ms. Henry joined Cecile Richards, president of Planned Parenthood, in ac- cusing the five conservative Supreme Court justices who ruled in favor of Hobby Lobby of devaluing working American women and giving corpora- tions a "free pass to discriminate against anyone in the name of religion." 11. Karen Ignagni Karen Ignagni is president and CEO of America's Health Insurance Plans. She has long been the voice of health insurance plans, representing pay- ers in healthcare, long-term care, dental and dis- ability benefits to more than 200 million Ameri- cans. She is widely regarded by the payer industry and well respected even if not liked by other pro- vider organizations. Ms. Ignagni tends to fluctuate in her support of the PPACA. She has spoken out against various aspects of the PPACA, such as the law's excise tax on health insurance providers and the need for lower-tier health plans in the PPACA. She has voiced recently that her main concern with the PPACA lies more in the balance of healthy to sick people, not how many people are signing up for their age. 12. Sandeep Jauhar Sandeep Jauhar, MD, is a practicing cardiologist, the director of the Heart Failure Program at the Long Island (New York) Jewish Medical Center and a regular writer for The New York Times. In April of 2014, Dr. Jauhar wrote an impas- sioned op-ed entitled "Nurses are not Doctors." Al- though the title speaks for itself, Dr. Jauhar discusses his problem with promoting nurse practitioners as a "cost-effective way to meet [the need for primary care physicians]," because it "[underestimates] the clinical importance of physicians' expertise." Angela Golden and Kenneth Miller, the co-pres- idents of American Association of Nurse Practi- tioners, a professional membership organization, took issue with Dr. Jauhar's op-ed and respond- ed that his concerns were "unfounded" and that decades of "third-party research have shown that nurse-practitioner outcomes are equivalent to those of physicians." 13. David Koch David Koch, controversial conservative, co-owner and executive vice president of Koch Industries, a Wichita, Kan.-based firm that has its hand in oil refining, pipelines, commodities trading and paper pulp, is widely known for his Libertarian outlook. His views can be generalized into strong support for a free-market and a reduction in big government. He is also known for his financial support of the Tea Party movement. Mr. Koch formerly led a charge against the PPACA. Despite his opposition to the law, he is a major philan- thropist and throws his support behind several healthcare and medical causes. Mr. Koch is on the board of trustees at the Hospi- tal for Special Surgery in New York City, to which he gave $25 million in 2009. David Koch also re- cently gave $100 million to New York Presbyterian Hospital in New York City to create an ambula- tory center. The donation is the largest in the hos- pital's history. Mr. Koch is scrutinized by many liberals for his generous contributions. Senate Majority Leader, Harry Reid (D-Nev.), recently attacked David Koch and his brother Charles in the media accusing Sen- ate Republicans of being "addicted to Koch" and calling the Koch brothers "un-American." 14. Marty Makary Marty Makary, MD, is an associate professor of surgery at Baltimore-based Johns Hopkins and the surgical director at Johns Hopkins Pancreas Multidisciplinary Cancer Clinic. Dr. Makary wrote a highly controversial book titled "Unac- countable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care" about physician-led efforts to increase transparency and improve quality in healthcare. As a researcher and health reform advocate, he is best known for his work on medical quality and patient safety. He heavily voices his support of minimally invasive surgery because of its low cost and substantially lower risk of serious complica- tions.

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