🔒Anthem’s tough negotiator, willing innovator Hummel sails into retirement

Jill Hummel, Connecticut president and general manager for Anthem Blue Cross and Blue Shield since 2013, has left a distinct imprint on the state’s healthcare sector.

Known by industry insiders as a tough negotiator, willing innovator and well-connected relationship builder, Hummel has been on the frontlines of the uphill battle of pushing health care away from fee for service and toward value-based plan designs that reward lower costs and good patient outcomes. She’s kept Anthem committed to the state’s Affordable Care Act insurance exchange, Access Health CT, continuing to offer Anthem plans there as Congressional Republicans have dealt various blows to the federal healthcare program.

Hummel has done all that while maintaining Anthem’s dominant statewide market share position. Despite shedding some customers in her first five years as president, according to state data, Anthem says recent wins have pushed its Connecticut membership counts above 2013 levels, reaching nearly 1.3 million.

Her seven-year run as president sailed by and now Hummel, who retired with little fanfare on Oct. 2, is sailing off, literally, in a boat she and her husband — newly retired Shipman & Goodwin partner Zachary Hummel — recently bought after selling their house and giving away many of their possessions.

The couple will be living in less than 500 square feet of space as they sail south when the weather here gets too cold.

In a recent interview with HBJ, Hummel, who spent her final two months on the job telecommuting from her new floating home, docked in an area marina, discussed her tenure and accomplishments at Anthem, which has not yet named her successor, and the evolving dynamics of relationships between insurers and care providers.

In many respects, Hummel said her core task at Anthem was being a caretaker for an already strong operation.

“I always like to remind people that I did not come into a fixer-upper situation,” Hummel said. “I inherited a really strong asset and all I’ve really tried to do is build on that asset, … to hand it off to the next leaders so they can build on it.”

Connecticut healthcare industry officials interviewed for this story, including hospital higher-ups, benefit brokers and state officials, say Anthem has benefited from Hummel’s accessibility, willingness to spend time exploring new partnerships, and reputation for keeping her word.

Friendly professional relationships, however, don’t mean there aren’t high-stakes disputes. Hummel has been perfectly willing to square off with the likes of Hartford HealthCare and Yale New Haven Health, the two largest Connecticut health systems, during contract negotiations, some of which led to prolonged and contentious disputes.

The most notable took place in 2017, when Anthem and Hartford HealthCare were unable to come to terms until seven weeks after their prior contract had expired. A probe by state lawmakers drew media coverage, and ultimately led to beefed up consumer protections for any future payer-provider stalemates.

“She can be a very tough negotiator and she knows her business,” said Dr. John Murphy, CEO of Nuvance Health (formerly Western Connecticut Health Network), which counts Anthem as its largest payer.

Contract disputes have become more common, thanks to hospital consolidation and other factors, but Hummel prefers not to dwell on them.

“They may get the most press, but at the end of the day, our relationships with our providers go so far beyond that,” she said. “It’s less about the negotiations, it’s more about what you do as partners during the contract period.”

Dr. Steven Schutzer, medical director of the Connecticut Joint Replacement Institute (CJRI) at Trinity Health of New England in Hartford, said Hummel was more willing than others to put in extra time and effort to pursue value-based contracts, which are seen as an alternative to the dominant and costly fee-for-service payment model in health care.

Anthem signed on to one type of value-based contract, known as a bundled payment plan, with CJRI just over a year ago. Despite a service discount and high quality metrics, Schutzer couldn’t convince other carriers, which didn’t want to steer their members toward an exclusive provider, to bite.

“To no one’s surprise, it was Jill who was relentless in getting this over the goal line,” Schutzer said. “It comes down to relationships, even in this dicey business, and that’s the ingredient that’s not going to be easy [for Anthem] to replace.”

Call anytime

As COVID-19 battered Fairfield County this past spring, Nuvance Health’s Murphy needed an urgent favor, so he called Hummel’s cell, a number she shared readily with many in Connecticut’s healthcare world.

Doctors at Nuvance, which has seven hospitals in western Connecticut and New York, had been working around the clock treating coronavirus patients, and some staff had been sent home to quarantine after potential exposure. Murphy wanted to call in a team of physicians from Nuvance’s New York hospitals to spell the local doctors for a few weeks.

However, Nuvance was worried it would run into reimbursement problems because those doctors had not gone through the formal approval process to be a part of local insurer networks. The credentialing process can take weeks, and Murphy didn’t have that much time to solve his staffing problem.

“She said we’ll credential them, we’ll figure this out,” Murphy recalled in a recent interview.

Hummel told Murphy it was crucial the situation not lead to patients receiving inflated surprise out-of-network bills, and after they hung up, she directed her staff to alert the Connecticut Association of Health Plans, which then briefed its other member carriers about Nuvance’s situation. Murphy was able to bring in his doctors quickly.

“That phone call reminded me of the old days where a handshake was all you needed to secure a transaction,” Murphy said. “She was as good as her word and we didn’t have to sweat out a month-long contract process.”

Hummel said she prided herself on being accessible for such calls.

“Most hospital presidents or the leaders of most large physician groups will tell you that I might be that one health plan president whose cell phone number they have,” she said. “And not only do they have it — they’ve used it.”

Expanding government business

State Comptroller Kevin Lembo oversees a state employee and retiree health plan that includes more than 200,000 lives.

That puts him in a position to make some demands.

“It’s a big book of business and [insurers] want it,” Lembo said.

Lembo wanted the state to have access to and ownership of its plan’s claims data, and he wanted the state, not just the insurer administering the plan, to negotiate reimbursement terms with hospitals and other providers. So he put the state employee health plan contract out to bid last year. Insurers were taken aback.

“The heads blew off some folks,” Lembo said. “Some of it was their technological capabilities, but more often than not the response was ‘we don’t do that. We don’t let our customers negotiate their own deals.’ ”

Anthem was an exception, and its willingness to be flexible about the new demands won it the entire contract, which in the past had been split among several insurers.

“Jill, I think, figured out that the old way of doing business never lasts and that they need to change with the needs of customers,” Lembo said.

Hummel further solidified Anthem’s relationship with state government by maintaining the insurer’s participation in the Access Health CT exchange.

Anthem — along with Farmington-based ConnectiCare — has offered plans on the exchange every year since it first launched in 2013, while other insurers, including UnitedHealthcare, dropped out.

Lembo said that’s an example of an insurer putting its money where its mouth is.

“I think it’s easy to talk ‘community support,’ right? But here’s a situation where the need is great and the challenges are likewise great, and you get to see who’s really committed,” Lembo said.

Correction: A previous version of this story has been changed to reflect Anthem's statement that it has grown its customer counts during Hummel's tenure. While the company lost members between 2013 and 2018, according to the latest available data from the Connecticut Insurance Department, Anthem says its current membership counts are higher, thanks to several big customer contracts, including one with the State of Connecticut.