Policymaker Profile: Secretary Polanowicz

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By Emily Armstrong  

For many years, John Polanowicz led a helicopter assault unit on overseas missions as a company commander in the United States military.  Now the West Point graduate and Stanford business school alum will bring his leadership experience and healthcare expertise to his new role as Secretary of the Executive Office of Health and Human Services (EOHHS).  Appointed by Governor Deval Patrick in January 2013, Secretary Polanowicz will oversee 15 different departments and divisions, including the Department of Public Health, the Department of Elder Affairs, the Board of Registration in Medicine, the Department of Children & Families, the Department of Veterans’ Services and the Commonwealth’s Medicaid Program, MassHealth. Further, as a member of Governor Patrick’s cabinet, Secretary Polanowicz will offer advice and policy guidance regarding how Massachusetts can maintain its global reputation for excellence in healthcare while also maximizing efficiency and controlling costs.

On behalf of the Boston Bar Association’s Health Law Reporter I had a chance to speak with Secretary Polanowicz about his interesting background and vision for healthcare in the Commonwealth.

Question

You have a really interesting background.  Can you tell our readers how a graduate from West Point and officer in the military embarks on a career in health care?

Answer

It is actually a little bit of a different path to health care. When I left the military I had just given up my company command in Panama.  I was a company commander for the Blackhawks.  At that point in time, there were a lot of firms that recruited junior military officers, and several of us ended up working at pharmaceutical firms as pharmaceutical representatives.  I had the opportunity to work for a company called Stryker Endoscopy which was a quasi start-up out in Sunnyvale, California.  Stryker had just developed a new technology – a three chip camera that was used for minimally invasive surgery – which was just starting to take off (which dates how long ago that was).  At first I worked in operations, and then, because the company was so small, the CEO asked if I could also act as the CIO because I had some computer background from West Point and everyone was doing a little of everything.  After a few years, I decided to pursue a business degree at Stanford, where I met a number of physicians.  I became good friends with some of my physician-classmates so I decided to start taking some health care classes with them.

Allen Tobin, who was one of the original proponents of managed care and worked as a consultant with a health care company with expertise in operations improvements, similar to McKinsey or Bain but health care specific, offered me a position with his group.  I ended up working with that company after I graduated from Stanford.  I did health care consulting for a couple of years.  As a health care consultant, I worked with a number of academic medical centers, primarily doing operations work but also some strategic planning.  My last client was the University of Massachusetts.  When I got to UMass, I was ready to get off of the consulting bandwagon because I had two very small children.  At that time UMass asked me to put together an internal consulting group.  I built a small group of nurses, management engineers, and finance folks to do operations improvement and quality improvement on the UMass quality operations.  Eventually the UMass system merged with the Memorial System.  After I worked at UMass, I took a position as the CEO of Marlborough Hospital, which is a part of the UMass system, for approximately eight years.  I came to Boston to be the president of St. Elizabeth’s Hospital, which is the flagship for the Steward System in Massachusetts.  In January of this year I received a call from the Governor’s Office which asked me to come and work as his Secretary of EOHHS.

Question

Prior to receiving that call in January, had you worked with Governor Patrick before?

Answer

When Governor Patrick first ran for office, I was the CEO out in Marlborough.  Congressman Jim McGovern called and asked me if I would give Mr. Patrick a tour of the hospital.  At the time the congressman explained that Mr. Patrick was planning on running for governor, and that Congressman McGovern planned on endorsing him.  The congressman further explained that Mr. Patrick was making an effort to meet lots of folks in the industry.  I gave Mr. Patrick a tour.  Later, I received a call from the Governor’s campaign who stated that Mr. Patrick was putting together his platform committees and wanted me to serve as co-chair for the health care committee.  At that point, Judy Ann Bigby and Don Berwick were also committed to chairing the committee, and, frankly speaking, as a relative youngish CEO from a small community hospital I signed up right away to work with them and Mr. Patrick, who I already knew, and I appreciated his approach and ideals.  The Governor and I stayed in touch over the subsequent years.

Question

You have served in a variety of types of hospitals, from the University of Massachusetts, to a small community hospital, to a for-profit system.  How do those varying experiences assist you in your current role?

Answer

My past work at a large academic medical center that has a medical school associated with it, a small community hospital with a pluralistic medical staff, and a smaller academic medical center on the for-profit side, helps me as we are going through reforms and health care regulations to have a perspective on how things my office decides here impact hospitals of various sizes and types.  I know where the leaders are coming from in most of these organizations, whether it is a small community hospital or academic medical center, I have had those same types of issues when in the other positions I have served in.

Question

Your career started in public service and then took a turn to the private sector before you returned to public service again.  What do you see as the benefits and challenges of leaving the private sector?

Answer

One of the reasons why the opportunity to work in this position was really attractive to me is that I think what the public sector is doing is so important.  Certainly there are times when public employees are vilified, but I can tell you from working in the public sector, even for a short period of time, the dedication of public sector employees and how hard people are working on behalf of the entire Commonwealth should really be commended. People are not taking these jobs in public health to get rich and famous.

For me, it is important to help make whatever it is that we are doing here in the secretariat a little bit better.  If at the end of my role here as the Secretary I can look back and feel like we made things better, in a number of different areas, whether it involves access to services, protection for our children in foster families, or the coverage we are providing for the disabled – if we have made things better for those people it will absolutely be worth coming back and helping out.

Question

With the passage of the Accountable Care Act you are in a critical position at a fascinating time for health care.  What do you anticipate are changes that may come through or receive some direction from your office?

Speaker

It’s that old Chinese proverb “may you live in interesting times” and we certainly are.  Within the secretariat there are a number of areas we are trying to focus on within the time that I am here.  We need to get the Affordable Care Act right.  As the rules are promulgated at the federal level, we have a lot of work to do in the Commonwealth.  As people know Chapter 58 served as a blue print for the Affordable Care Act, but there is still a lot of work for us to be in compliance with the federal requirements.

We are spending a lot of time taking a look at the requirements of the ACA and evaluating what the impact will be on the state.  With a population with about 98 percent covered, we are in a very different position than a lot of other states and we need to make sure that we do not have unintended consequences from the federal legislation that is coming down.  Everything that is happening, we are looking at it from our lens, which is a large scale coverage model for the population, and we need to look at how that is being implemented here.  As a result, we asked for time to transition because we believe that our rating factors worked very efficiently and we need to make the necessary adjustments, as opposed to just having it be a light switched make that change immediately.

Question

For our readers who are primarily health law attorneys representing hospitals and other providers, is there any particular message or issue that you want those folks to know about from this office?

Answer

We are trying to be effective communicators and be as transparent as we can with respect to the work that is going on in this office.  We have a lot of people who have been doing health care and health care-related services here in the office for some time, but we also know that we have an incredible bounty of individuals here in the Commonwealth with depths of knowledge that we should be leveraging.  As a result, when we reach out to boards and commissions, or conduct studies, we are making an effort to ask outside experts to become involved.  It is in our collective best interest to get the best solution we can for the entire Commonwealth.

Question

What are your goals while in this office?

Answer

Certainly, as we already discussed, the Affordable Care Act is too important and too big for us not to get it right.  I would say there are two other things. One is around program integrity across the entire secretariat.  Program integrity is critical for our MassHealth population, or our Department of Transitional Assistance, as well as other departments that provide access to benefits – whatever those benefits might be.  Program integrity includes ensuring that everyone who is eligible for benefits – whatever those benefits might be – has access to those benefits.  In the alternative, it also means preventing those who are not eligible for receiving benefits from accessing those benefits.

Then finally I think that the last area of focus is addressing the Department of Public Health.  The first task is finding the next leader of the Department of Public Health.   Also, we need to find ways for the Department of Health to keep performing the great work that it does while also working more consistently with the secretariat.  We need to address the issues of silos within the Department of Health.  The focus of the new Department of Health leader should be how the department can work together with constituents and customers, while at the same time ensuring the public health and public safety.

Question

So you have been in this role for three months now. Have there been any big or small surprises?

Answer

Nearly every day I hear some story that feeds the soul somehow.  We often hear about work that’s been accomplished by our staff in one of the different agencies or commissions, or the really heartwarming stories that come up at our listening sessions.  We heard one the other day at a DTA listening session about a young single mom, with four kids, who uses the transitional assistant benefits to help feed her kids while she is studying to get her college equivalence degree.  At the end of the day those are the kinds of things that keep you coming back, because you know that what you are are doing is right.  That does not mean we cannot always strive to do better and be more efficient, whether it is from the Commonwealth’s perspective or from the viewpoint of a not-for-profit or for-profit hospital system, but it is really nice to hear those stories about how your staff is making a positive impact in people’s lives.

Emily Armstrong is an Associate General Counsel in the Office of the General Counsel at Beth Israel Deaconess Medical Center (“BIDMC”).  Prior to joining BIDMC, Emily worked at the Massachusetts Office of the Attorney General in the Consumer Protection Division investigating and prosecuting violations of the Massachusetts False Claims Act and Consumer Protection Law.  Emily started her legal career as a litigation associate at Goulston & Storrs, after graduating from Boston College Law School.