ROI Influencers: Health Care 2020 (Industry heroes, A to Z)

Vince Alonge; Howard Cutler; Dave Gambino; Valerie Harr; Suzanne Kunis; and Siobhan Matsagas
Vice president enterprise operations; VP health care delivery; VP transformation; Director of community health; VP mental health; Director of mandate and payment integrity
Horizon BCBSNJ

When the state’s largest insurer is called on to pivot amid changing rules and regulations around coverage, claims and payments ­— you can bet it takes an army of folks to get it done. Horizon has just that. Here are just some of the top leaders in the company who worked around the clock to ensure patients got the care they needed, and providers got the payments they depend on. How successful was this group and this organization in meeting that need during a once-in-a-century crisis? Ask yourself this: Did you read about any issues involving insurance?

A look at six leaders at Horizon who did their best work behind the scenes — true unsung heroes:

Howard Cutler was instrumental in getting advance payments to physicians, allowing providers to keep their business going at a time they were desperately needed. Dave Gambino deserves credit for helping to expand Horizon’s telehealth capability during COVID, helping to institute changes that allowed telehealth be the top way doctors delivered care, especially in the early days.

Changing in coding relating to reimbursements usually takes months — that’s how it works when you process 60 million claims a year. When Horizon decided to waive copays for telehealth, Vince Alonge and Siobhan Matsagas worked to change the system in days.

And then there were the behavioral health issues. Suzanne Kunis started building capacity in January, predicting the pandemic would be a great disrupter for members in recovery from substance use disorders who would be unable to attend in-person therapy/support groups or obtain medication-assisted therapy — not to mention the wave of people newly diagnosed with anxiety or depression, including first responders and frontline medical workers. Kunis led a team that brought new providers to the network.

Valerie Harr, meanwhile, leads the team responsible for Horizon Neighbors in Health, the company’s comprehensive Social Determinants of Health program — an issue of importance the pandemic has only elevated. Under Harr’s leadership, Horizon has partnered with various groups who are ensuring those who often are left behind are not left out during the pandemic.

Cathleen Bennett
New Jersey Hospital Association

Hospitals obviously were at the center of COVID-19 care. Bennett and the NJHA are helping them navigate this once-in-a-century pandemic.

Jeffrey Brenner; Kathleen Stillo
Senior vice president, clinical redesign; Chief operating officer, clinical redesign

There was a time when the state feared the virus would be so great that it would fill four field hospitals. That didn’t happen. But Brenner and Stillo helped prepare for this situation.

Andrew Brooks
Infinity BiologiX

The company, which spun off from Rutgers University, created the “saliva test” that could increase mass testing.

Kevin Conlin
Executive chairman
Horizon Blue Cross Blue Shield of New Jersey

Conlin put patient care ahead of cost at every turn, authorizing multimillion-dollar spends on PPE, which were donated to the state, a $2 million gift to the Pandemic Relief Fund and the elimination of copays for telehealth, which enabled a boom in service with a reduced reimbursement for Horizon.

Michellene Davis
Executive vice president
RWJBarnabas Health

She is a health equity innovation strategist, one who literally wrote a book — “Changing Missions, Changing Lives” — on how the pandemic is showing the need to address the systematic discrepancies in health care.

Robert Falcone
Chief medical officer and principal investigator
Amici Clinical Research

The Raritan-based facility is one of the leading outlets for human testing of COVID-19 vaccines.

Ken Frazier
Chair and CEO

His company is one of many doing groundbreaking COVID-19 research. And Frazier, who headed Gov. Phil Murphy’s Restart and Recovery Commission, has the governor’s ear, too.

Alex Gorsky
Chair and CEO
Johnson & Johnson

J&J may not get to the finish line first, but you can bet the New Brunswick-based global health care power will be one of the leaders in the COVID-19 vaccine market.

Bob Hariri
Founder, chairman and CEO

The personable Hariri heads the Warren-based company that’s ahead of the curve on therapeutics as it is searching for cell- and gene-based solutions.

Allen Karp
Executive vice president, health care and transformation
Horizon BCBSNJ

When health systems and providers got walloped by COVID — operationally and financially — Karp was the person at Horizon who worked with them.

Jeff LeBenger
Summit Health Group/CityMD

In a time when treatment and testing are as important as ever, LeBenger’s addition of CityMD added another level of access for New Jerseyans.

Don Liss
Chief medical officer
Horizon BCBSNJ

Using a mandate of “Do what’s best for our members and providers,” Liss led an internal team of senior officials tasked with one goal: Ensure members’ medical needs came before of financial concerns.

Paul Marden

The state’s second-largest insurer was a leader in the moves to make testing and telehealth more affordable and with greater access to all. 

Mike Munoz
Market president
AmeriHealth New Jersey

When COVID-19 hit, AmeriHealth New Jersey members were well covered. Several years ago, the insurer began preparations for a remote-work situation. Because of it, the transition was seamless. 

David Perlin
Chief scientific officer
HMH Center for Discovery and Innovation

Perlin led the team that created the first privately developed COVID-19 test early on in the pandemic. At the time, it doubled the state’s total testing capacity.

Steve Rusckowski
Quest Diagnostics

The Secaucus-based company stepped up in the early days of the pandemic, enabling the country to dramatically increase the number of tests. Because of Quest, the country was able to catch up on testing needs quickly.

Gary St. Hilaire
Horizon BCBSNJ

St. Hilaire started as CEO three weeks after the company transitioned to work from home and the state was reporting more than 3,000 new cases a day. Two months in, he forcefully planted Horizon’s flag after the murder of George Floyd, saying “it cannot be allowed to simply pass as yet another instance in which intolerance and injustice provoke more words than actions,” and then issued a powerful commitment to addressing health care disparities.

Monika Vnuk
VP, worldwide business development

Vnuk was one of the business development leaders that led the way on the deal with BioNTech, which is producing a vaccine that the U.S. has a deal to purchase as many as 600 million doses of.

(Read the rest of the list.)