Kevin Mahoney, CEO of Philadelphia-based University of Pennsylvania Health System, is setting the record straight regarding his thoughts on the topic of health system and health insurer relationships.
In February, Mr. Mahoney told the Philadelphia Business Journal that the University of Pennsylvania Health System has steered clear of the trend of health systems acting as insurance companies. Instead, the health system prefers to work with them, like its partnership with Independence Blue Cross in population health.
"I advocate for the patient and beat insurance companies into the ground to make sure our patients are getting the very best care," he told the publication.
Now, Mr. Mahoney wants to make one thing clear: he does not hate insurance companies.
"Working with insurance companies is a good thing," Mr. Mahoney told Becker's. "I'm just against a CEO having responsibility for both patient care and paying for that patient care, because I think it creates an ethical dilemma."
The role of a CEO should be providing the best patient experience, advocacy, and care quality to a patient.
"I want the new Alzheimer's drug covered," Mr. Mahoney said. "My patient needs that coverage. I understand that. The insurance company may say we're not covering this. My job is to advocate, to explain, to push hard to get that coverage approved."
In a perfect world, Mr. Mahoney said the relationship between a health system and health insurer would be where the insurance company is protecting their subscriber and access to healthcare.
"They need to take care of an ecosystem where they're watching out for their subscriber and I'm watching out for my patient," he said. "If we both do that, we'll end up in the right place. It doesn't exist right now, but I'm hopeful."