Q&A: Kaiser Permanente CEO Halvorson on Retirement

Cheryl Clark, for HealthLeaders Media , October 5, 2012

HLM: I mentioned that a lot of hospitals resent Kaiser. Talk about that and how you've been able to forge relationships with providers in those communities?

GH: I always feel a little bad for hospitals that are totally bound to a fee-for-service world. I've done that...and I know that hospital world very well. It's hard to be a fee-for service hospital. You have to wait for something bad to happen to someone to get them into your hospital, and then you make more money when the worst things happen. There's a perversity there that makes being in that world challenging.

And I think some of the hospitals are jealous. I don't have a sense that it's a nasty energy, but I think some hospitals are jealous of the fact that we can figure out how to cut broken bones by a third, and not lose revenue from all those patients...

We get the money up front and then we have savings, and we can divert the savings to other uses without losing revenue stream. I think other hospitals are jealous of that...people wish they had our model.

HLM: Regardless of whether the President is re-elected, what challenges do you see for the implementation of healthcare reform?

GH: I think it's going to be really important to get the exchanges right. They will define the insurance market going forward, and if they're done well, there will be consumer choice and people will be able to go to the exchanges with a broader array of choices, with good data about quality and service. If they're done badly, they can end up being just narrow channels with dueling actuaries rather than dueling healthcare systems.

HLM: Who will be your successor?

GH: We have some extremely highly qualified internal candidates. I've given our board a rich array of people to choose from and we have some exceptional people. In addition to that, it's the best job in healthcare, a vertically integrated healthcare system. And there are going to be some people outside who will say, "Oh boy, I would love to have that job."

HLM: What kind of fishing and boating do you like?

GH: I love to fly fish. I do it for trout, small mouth bass and panfish. I love every kind of boat. I have canoes, kayaks, wind boards, motorboats and a sail boat. The sailboat is a 26-foot MacGregor.

Segments of this interview were edited for brevity.

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