Singin’ the Blues

Vermont’s Blue Cross and Blue Shield is ready for the changes ahead in health care

by Will Lindner

bcbsIn 1993, Barre native Don George joined Blue Cross and Blue Shield of Vermont. He was named president and CEO in 2009 and began to prepare for an era of major reform.

In conversation, Don George, the president and CEO of Blue Cross and Blue Shield of Vermont, reveals the traits of a middle infielder on a baseball team. He’s nimble, sharp, anticipatory. Fielding a question, he takes a calculated and purposeful route to the ball, fields it cleanly, and delivers his points like a well-executed throw to first. It’s obvious that not much gets by him.

George has had ample opportunity to hone these skills, because our health care system, and the structures that pay for it, are among the critical issues of our time. At 56, he has been immersed in health care and health-insurance matters virtually since he graduated from the University of Vermont in 1981. His first job was with then–Lt. Gov. Madeleine Kunin as a legislative assistant, largely following health care issues at the government and policy level. Afterward, one job led to another until 2009, when he was made president and chief executive officer of one of the cornerstones of health coverage in this state.

That was a tsunami of a year for health care as a social, economic, and political issue in the U.S. — the year when Congress passed the Affordable Care Act (ACA) amidst rancorous debate that has hardly quelled even as the ACA and its provisions have become, increasingly, a fact of life for many Americans. But in Vermont, that was just the beginning. In 2011 the Legislature passed, and Gov. Peter Shumlin signed, Act 48, which some have called a “road map” to universal coverage under Green Mountain Care, a still-conceptual system for providing insured care, with improved health outcomes, for all Vermonters.

Here, too, as in the nation, not just the principles of expanded health care parameters but the flawed state and federal websites meant to deliver these reconstructed plans, have elevated both the confusion and the dissent.

Amidst that unsettledness, Don George has steadily gone about readying his company for change and putting it in the best position, he believes, to flourish in the health care environment that lies ahead.

“In 2009, even before the ACA and Act 48 were passed, the way we began to prepare for an era of major reform was that we embraced it,” says George. “The way I characterized it was that we weren’t ‘open’ to health care reform; we weren’t ‘supportive’ of health care reform; we were going to be strong advocates for health care reform. We adopted an essentially reformist vision, one in which every Vermonter has coverage, and timely, effective, affordable care. We really feel it’s in the best interests of our customers to have a delivery system and payment reforms and further consumer safeguards for people.”

George is adamant that these are not merely his sentiments; the corporate culture at Blue Cross and Blue Shield of Vermont, he says, is one in which the customer’s experience in dealing with the company is of paramount importance.

“We created a training program for all our employees, called We CARE, to reinforce that,” George continues. “CARE is an acronym for Creating Authentic, Respectful Experiences. The people in our building really do feel passionately about their mission.”

While that may seem a rose-colored vision of the workplace atmosphere (BCBSVT employs some 350 staffers at its headquarters in Berlin and has a wellness and information center in South Burlington), the company must be doing something that inspires its employees. In April 2013, it was selected as a Best Place to Work in the Large Company category, in a statewide survey conducted by a consortium of business interests.

And this, George points out, came near the end of a four-year period during which the company reduced its administrative budget by 20 percent to hold down costs for its customers.

Carrie Cobb, administrative assistant at Pomerleau Real Estate, is one of the company’s fans. In October, attempting to comply on schedule with the state’s new health care mandate, she tried to navigate the Vermont Health Connect website to explore insurance options for Pomerleau. Her attempts were foiled when she encountered errors on the site.

“Our company was insured by Blue Cross and Blue Shield of Vermont,” Cobb says. “So I reached out to Derek Obray, my contact there, and he volunteered to come over and help me try to set things up. Even though Blue Cross was our insurer, he didn’t try to steer me one way or the other. Derek managed to get me through. He stayed in contact with me, making sure I got updates about the health care exchange. He was my security blanket.”

Maybe part of the reason George displays the disciplined traits of a middle infielder in conversation is that he actually was a middle infielder earlier in life. Baseball, he says, meant everything to him when he was growing up in Barre Town, where his parents, Donald and Alita, still live in the house of his childhood, seven miles from his hilltop office in Berlin.

After graduating from Spaulding High School in 1976 he went to a small college in Maine on a baseball scholarship, but transferred to the University of Vermont after one year, looking for a broader academic opportunity. He enrolled in the university’s school of business, but his interests led him to courses in history, constitutional law, and philosophy in the College of Arts and Sciences. He persuaded the university to allow him to take a double major in business and political science.

“My parents went to two different graduations,” he recalls, “on two consecutive days. I could have gone in the political direction under Lt. Gov. Kunin, but I can actually recall thinking and saying that there is something undeniably altruistic about people who work in health care, people who provide health care.”

Next came a position with the Vermont State Employees Association, where he took on research related to the union’s health-benefit plans. After two years he moved on to the Chittenden Bank, burrowing deeper into health care issues as manager of its employee compensation and benefits programs. He cemented that direction in 1986 with a job at the Medical Center Hospital of Vermont, predecessor to Fletcher Allen Health Care.

“That was the defining move in my career,” says George, not least because it brought him into close contact with Blue Cross and Blue Shield of Vermont. Through that association, MCHV launched the Vermont Health Partnership for the hospital’s employees, which George says was BCBSVT’s first functioning managed-care project.

“Shortly afterward,” he recalls, “there was an opportunity here at Blue Cross and Blue Shield to continue to develop that program, and to develop further programs around it. I was recruited by Blue Cross and Blue Shield in 1993 and I’ve been here ever since, in a variety of positions.”

George and his wife, Camille, live in Richmond. “I’d been commuting to the Medical Center, but then one day, instead of taking a left onto the interstate I took a right and came down to Blue Cross. Being from Barre Town, this is very familiar territory.”

The appeal of the Blues, George says, lay not only with the company’s well-ingrained position in Vermont’s health care sector, but also in its structure. Nationally, there are 38 BCBS “plans”; Vermont’s is an independent, not-for-profit company that serves only Vermonters.

“It has served every single market segment, irrespective of people’s health status,” says George. “It’s in the Medicomp, individual, small group, and large group, and it’s deeply involved in Vermont’s communities.”

George’s favorite manifestation of that community tie is the annual Blue Socks for Kids program. The company purchases 8,000 pairs of blue socks, at cost, from Cabot Hosiery Mills at Christmastime and delivers them to the state’s community action agencies, which distribute the socks to children in need.

With the intense focus and ever-shifting health care landscape these days, there’s not abundant leisure time in the George household.

“Camille and I are both pretty devoted exercise people,” says George, a former marathoner who hits the treadmill when he gets home, or the roads around Richmond on weekends. Camille, whom he met through friends when she was a senior at UVM while he, having graduated, was working in the Burlington area, was director of the developmental disabilities services division at the Vermont Agency of Human Services. Their sons, Andy, 23, and Ben, 21, are off to college.

Meanwhile, George is helping others navigate the health care shoals.

“I have worked with Don very closely around policy issues that are priorities for the Vermont Business Roundtable,” says VBR President Lisa Ventriss, where George sits on the board of directors. “He’s very smart, very analytical, and he has a very steady temperament; he’s able to bring that quality to the discussion and help people stay focused on issues rather than politics and emotions.

“On top of that,” Ventriss adds, “he’s a really funny guy. He can leverage that quality to keep us lighthearted when we otherwise might not be.”

Certainly the health care industry — not to mention its millions of customers and the thousands more, in Vermont, who will gain coverage as the system expands — is in the midst of a shakeup. George, for one, is not fazed.

“We’re a different company now than we were five years ago,” he says. “And we’re going to be a different company yet again five years from now. But you look at so many other industries; companies evolve or they get exited out. It’s all about change, it’s all about improvement, about doing a better job for the people you’re serving. I think health care ought to be like that, too.” •