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November 27, 2006

Closing thoughts: an interview with Jon Kingsdale, Commonwealth Health Insurance Connector Authority

Welcome to the health-care fishbowl

When Jon Kingsdale was tapped to head the Commonwealth Health Insurance Connector Authority last July, he had already established himself as a seasoned, forward-looking and outspoken marketing and development expert. Gov. Mitt Romney appointed him as executive director of the Connector, an independent authority that serves as the clearing house linking individuals and small businesses with health insurance products. Kingsdale left a high-level private-sector job at Tufts Health Plan to take a three-year contract to manage an agency that four months ago existed only on paper. Since then, according to observers, he has been building his staff – and consensus – from scratch.

WBJ: Why did you choose to take your current job?

Kingsdale: I quickly decided that I simply could not turn down this once-in-a-lifetime opportunity. I’ve been training for this job ever since 1975 when I first became interested in health care financing and policy as a cub reporter in Washington, D.C. Since then, I’ve been working on the challenge of how to make this wonderful stuff – health care – more affordable. My new job is all about designing health plans, staffing a board of directors to make some tough health policy judgments, and designing and then the pricing and marketing health insurance plans. The last 20 years at Tufts Health Plan – developing strategy and directing public affairs and product development – are all directly relevant to the challenges of making health policy and selling health insurance in Massachusetts.

WBJ: Your expertise has been in planning and business development for a non-profit plan. What is the biggest difference between your old environment and the public sector?

Kingsdale: The biggest difference is working in a fishbowl. In a private, commercial enterprise, you’re generally trying to call attention to new products, new ideas, and your company’s success. In this job, there is no escaping public attention. It started with the first meeting of the Connector’s board of directors, the morning of my third day on the job, when we ran out of guest seating for 200 very interested on-lookers. I was accustomed to presenting in front of a private corporate board, but now find myself planning a start-up enterprise in front of reporters, potential business partners and even competitors. In the five months since the Connector started, we have had 11 board meetings – over 40 hours in public – not to mention several active committees, which also meet in public.

WBJ: What has the initial employer reaction been to the new law?

Kingsdale: I make a point of getting out to speak to a lot of audiences and individuals who will be touched by health reform, including employers. They have all been wonderfully supportive. The idea that everyone needs to contribute resonates with them. We don’t just let sick people die in the street – that’s part of a social compact. I think most employers understand that everyone has to share the costs of this compact.

Where I do sense some frustration beginning to build is about how to exercise that responsibility. Employers and their agents are hungry for information on what they need to do, when and how. Given how tight the deadlines are to implement this wide-ranging and complex reform, their sense of urgency is completely understandable. I share it. But making the myriad decisions and implementing them, let alone communicating them to thousands of brokers, tens of thousands of employers, and millions of their employees takes longer than any of us would like.

WBJ: As someone who has worked for a health care insurer, what do you think is the most important aspect of an insurance plan? An example: Premiums that can support payment for the medical care that’s being promised.

Kingsdale: It’s a package. You cannot focus on just one element, such as monthly premiums, without also asking what protection those insurance premiums buy you. However, if I have to name the single most important aspect of buying health insurance through the Connector, it will be that consumers enjoy a clear, well-informed choice of the health plan features that they judge to be most important. This is no simple thing, when health plans are so complex. We need to understand where do they value choice – premiums, benefits, cost-sharing, networks of hospitals, etc. – and how to best inform buyers on the choices they do value. We also need to earn their trust that we’ve taken good care of those other features – exclusions, out-of-pocket maximums, service standards – that they don’t want to worry about.

WBJ: What do you hope to learn from leading the Insurance Connector?

Kingsdale: How to sustain and build on the tremendous goodwill, across the politician spectrum and across so many interests and perspectives, that made this reform happen.

This interview was conducted and edited for length by

WBJ Editor Christina P. O’Neill.

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