Regence BlueCross BlueShield Loses Another Key Executive

Meanwhile, the search for chief medical officer of Regence’s four-state region is still ongoing, following the abrupt departure of Dr. Ralph Prows in late March

June 13, 2012 -- Another leading executive has abruptly left Regence BlueCross BlueShield. Dr. Michael Kaufman, who had been its medical director in Utah, is no longer with the company. No reason was given for his sudden departure.



Earlier, Dr. Ralph Prows, chief medical officer for the parent company of Regence’s four-state region of Oregon, Idaho, Utah and Washington – known as Cambia Health Solutions – also left for unknown reasons.

Neither Prows nor Kaufman could be reached for comment. However, The Lund Report learned from an inside source that Kaufman’s departure occurred several days after he applied for Prows position, as chief medical officer.

While that search continues, Dr. Csaba Mera, medical director for Regence’s Oregon health plan, is vyying for that position and has been named acting chief medical officer. Both Mera and Kaufman joined Regence at approximately the same time, last October.

According to Scott Burton, spokesperson for Regence, "we continue to recruit applicants for our open positions including our chief medical officer, in which Dr. Csaba Mera is currently serving in interim capacity. Per our personnel policy, we do not discuss potential candidates for any open positions or employees who are no longer with the company."

Earlier, Mera had been medical director at ODS Health Plans in Portland and joined Regence after having 23 years of clinician experience as a board certified pediatrician and 15 years in medical leadership. He also served as a consultant to health care organizations and Fortune 500 organizations including Time Warner, Dow Chemical, Xerox, AT&T and American Airlines.

Kaufman, meanwhile, had executive level experience in medical group practice, health plan administration and health law, also was a consultant on healthcare reform, cost management and delivery system care coordination. A graduate of Columbia College, Kaufman received his Juris Doctor degree from Harvard Law School and a Doctor of Medicine from Yale. He completed his pediatric residency at Pittsburgh Children’s Hospital and a health policy fellowship at RAND, according to an earlier press release by Regence.

Before leaving Regence, Prows led Regence’s medical strategy since September 2010, maintaining the company’s medical policies and standards while providing oversight to all clinical operations. In September 2004, he joined Regence BlueCross BlueShield of Oregon as its medical director.

Prows also serves on the board of the Oregon Health Quality Corporation where he had been its president and is also a committee member of the Oregon Health Care Leadership Council, and an advisory board member and volunteer physician for the North by Northeast Community Health Center in Portland, an organization that provides free healthcare services within the community.

After his abrupt departure on March 31, Jared Short, president of Regence, sent an internal memorandum obtained by The Lund Report, indicating that Prows “left the company to pursue other options.”

When Prows was promoted to chief medical officer, John Stellmon, senior vice president of healthcare services said in a press release, “We are pleased Dr. Prows has accepted this new position. I believe his clinical background and medical management expertise will prove invaluable in assisting our entire organization as we continue to strengthen existing – and implement new – programs Regence-wide that focus on reducing medical costs for our members in this ever-changing healthcare environment.”

Before joining Regence in 2004, Prows had more than 25 years experience as a practicing physician and healthcare executive. He was the chief executive officer of the Corvallis Clinic, the largest private multi-specialty clinic in the mid-Willamette Valley. In addition, he served as chairman and president of the Northwest Physicians Association in Linn and Benton Counties.

Prows earned his medical degree from Tulane University School of Medicine and completed his residency in internal medicine at Oschner Foundation Hospital in New Orleans. He is board certified by the American Board of Internal Medicine and has current state medical licenses in Massachusetts and Oregon.

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Comments

A huge loss for Cambia Health Solutions. Dr. Michael Kaufman has unbelievable experience and brings real credibility to the Company. Really understood the business and was a pleasure to work with. Head and shoulders above Jared Short. This Company seems like its losing all its good people on top of its membership.

Dear Anon123: Inside-baseball opinion is that Regence - er, Cambia - is not interested in focusing on their core business, which is a Blue healthcare services contractor. Mark Ganz has said that he isn't "interested in just paying claims", and has stated his vision to "transform healthcare" year ago. The relentless move into ancilliary lines, social media, narrow networks and member engagement tools is not random - they are intentionally moving away from the health insurance game. The name change is just the latest one symbol. The devastating loss in membership, which would be of concern to any other company, becomes understable when viewed through the lens of a company that doesn't value the core business, and intends to exit the market at some point, anyway. Then, Ganz can point to the membership losses to justify leaving the business. The real question is who is going to buy their Shield. Anthem? Peter Witting

I work for Regence in Salt Lake City. Last Friday Dr. Csaba Mera came here from the Portland Cambia office and personally met with Dr. Kaufman, accompanied by the head of our HR department. The next thing we saw was Kaufman being escorted out of the building. Then we were told nothing other than to say nothing about Kaufman's departure. Dr. Kaufman was uniformly highly respected and liked by everyone who works at the Regence Utah health plan. Everyone in Utah was totally unaware of this move and we are all devastated and we continue to work in total fear of what Ganz-Short-Mera will do next. What is the objective? First Prows is terminated and now Kaufman. Our membership is crumbling and Cambia is firing the last few credible people who have any real interest in healthcare and growing the health insurance business. Working here feels like I am working in the Soviet Union circa 1960... Meanwhile, Ganz and pals are making millions and taking millions from the non-profit health insurance side of the company and putting it into high risk for-profit start-up companies. What is wrong with this picture?