DOCTORAL DECREES: Chart-topping reviews and a payments scrap with North Carolina's biggest insurer have raised Mission Health Chief Executive Officer Ronald A. Paulus' national profile.

AuthorMildenberg, David
PositionCover story

Asheville's bragging rights extend beyond beautiful scenery and hoppy beer: Its dominant hospital system, Mission Health, has been rated among the 15 best nationally for five of the last six years, according to annual research of clinical outcomes and efficiency by IBM Corp.'s Truven Health Analytics. Chief Executive Officer Ronald Paulus has led Mission since 2010, having previously worked as an executive vice president of Geisinger Health System, a Danville, Pa.-based not-for-profit business modeled after the Mayo Clinic. Before his hospital-management career, Paulus co-founded a health care data mining company later acquired by Charlotte--based Premier Inc. Holding both MBA and medical degrees from the University of Pennsylvania, Paul us was at the center of Mission's dispute over reimbursement rates with Blue Cross and Blue Shield of North Carolina last year. The companies reached an agreement, but not before Paulus labeled the state s dominant, insurer "unethical" and "unconscionable. "Modern Healthcare magazine last year ranked Paulus 13th on its list of the 50 most influential US. physician executives. His comments were lightly edited for brevity and clarity.

MISSION REPEATEDLY RANKS HIGH FOR SERVICE QUALITY AND OUTCOMES. WHAT ARE THE KEY REASONS?

First, we just have a terrific team. I've never been around a better group of nurses, physicians, leaders and more. Second, we have made it an absolute top priority. When I arrived, we developed something we call our BIG(GER) Aim: to get each person to their desired outcome, first without harm, also without waste and always with an exceptional experience for every patient, family and team member. It guides everything that we do. Accordingly, we have provided the tools, resources, focus and measurement to ensure that success.

WHAT IS MISSION'S MOST PRESSING CHALLENGE?

Managing in an environment where we are paid less than the actual cost of providing care for more than 70% of our patients. That's a nearly impossible task for any business, whether a restaurant, hardware store, law firm or otherwise. In fact, I can't imagine any other type of organization even trying to do so. When you add to that some commercial payers being unwilling to cover the cost of inflation for the care provided to their very own members, it creates a truly extraordinary challenge.

WHAT DID MISSION LEARN FROM ITS DISPUTE WITH BLUE CROSS?

We learned BCBS's position on covering the inflationary costs of the care...

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