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Insurance Exec Comes Home At a Time of Rapid Change

Greene Has Hartford Roots

Ruth K. Greene listens to a question during an interview in Lebanon recently. She is vice president and chief financial officer at Blue Cross and Blue Shield of Vermont. (Valley News - Geoff Hansen)

Ruth K. Greene listens to a question during an interview in Lebanon recently. She is vice president and chief financial officer at Blue Cross and Blue Shield of Vermont. (Valley News - Geoff Hansen) Purchase photo reprints »

Hartford — Last fall, Ruth Greene left the insurance company in Maine where she’d worked for 26 years to take a job in Vermont, where the prospects for her industry are far from certain.

Greene, 51, a 1979 Hartford High School graduate, is the chief financial officer of Blue Cross and Blue Shield of Vermont. Her new employer is the state’s oldest and largest health insurer, providing coverage for about 180,000 Vermonters.

But times are changing. This October, Vermont will being open enrollment through its health insurance exchange, which is like a virtual shopping mall in which individuals and businesses may buy health insurance. The state is also pushing toward a single-payer system by 2017, and Greene and her colleagues are going to be busy figuring out the role they will play in these efforts.

Prior to Blue Cross, Greene worked at Unum Corp., which offers disability, life and voluntary insurance products, and where she held a number of financially oriented positions. She now lives in Montpelier.

In a recent interview with the Valley News, Greene said she wanted to come back to her home state and be a part of figuring out the future of health care and how to get more people covered. Below is an edited transcript of that conversation:

Valley News: It’s an interesting time to be coming to Vermont in this particular industry. What have the past couple months been like for you?

Ruth Greene: I have a lot of, some ancillary knowledge of the health benefits industry, so now the first few months have been getting up to speed on all the more direct benefits packages, pricing and rating. A lot of it has been worrying about the exchanges.

I had done some strategic reviews at Unam having to do with the coming of the health exchanges, but this is the real thing. ...

VN: What Vermont was doing in terms of reforming the health care system, did that play a big role in your decision (to join Blue Cross) or was it primarily personal?

RG: I think it was a combination of both. One was personal because I wanted to be in Vermont. But also, the idea that health care, the provision of health care to people in a lot of ways is a big challenge for most societies and the way that Vermont was tackling that head on in a progressive way was very exciting to me. I feel like I have something to offer.

VN: What struck you about what you know about the exchange so far? It just got federal approval ... Has anything stood out for you in the way it’s going to affect the coverage people are offered?

RG: One thing that’s interesting, the way the Vermont exchange is set up, if you’re going to buy health insurance, you have to do it through the exchange. If you’re in another state and they have an exchange, you can either buy through the exchange or they can still go directly to Anthem, Blue Cross or United Health Care. You can do either-or. In Vermont, all health care will be offered through the exchange. So that’s one challenge. We have to help all small employers and individuals, anybody who wants to buy health insurance — we have to play a role in helping them understand how to buy on the exchange. ...

Blue Cross Blue Shield of Vermont, one of the things that attracted me to the company is they really focus on what we call member experience. Part of our concern with the exchange, we want people who currently have health care coverage to get into the exchange and have a good experience and continue to buy and value their health care coverage. Just getting through a transition like that is pretty important to us as a company because we like to think we offer really good-quality products to small employers and individuals.

VN: What kinds of questions remain to be worked out as you understand it from now until it begins rolling out in October?

RG: The Vermont exchange has been approved ... but Vermont still needs to build the website and the infrastructure to bring people on to the system. And then companies like Blue Cross Blue Shield of Vermont and other insurance companies still have to go through the process of getting their products onto the systems, and that’s all going to happen over the next nine months ...

VN: The exchange, as the state has envisioned it, is kind of like a springboard to single payer. Which is really interesting for a company like yours. You’re having to adjust your business for the exchange and then presumably in four years, if Vermont goes to single payer, what happens to Blue Cross Blue Shield then?

RG: As you can imagine, in the decision-making process of taking a position at a company that has this kind of challenge ahead, I really don’t know where that single payer will end up in the end. People who need health care and are buying health care will still need the wellness support and some of the support of getting the services provided. Financially, it could turn the entire who pays who upside down. Quite frankly, I was excited about being a part of figuring that out.

VN: Even if it means that, it eliminates the company you’re working for?

RG: That question has come up and even the employees at the company ask that question. We say we’re going to work through it and Blue Cross Blue Shield Vermont has such a strong connection with our members. Being able to provide good service. We’re really confident that we’ll play a role in figuring out how to get affordable health care to Vermonters. The details will be worked out over the course of the next few years.

VN: Did the single payer question give you any pause before committing to a job?

RG: It was something I had to investigate. In some ways, it speaks to your earlier questions about how much did I know about exchanges. I had already done some research in my previous role just as part of my strategic planning jobs but, I looked into it, I read some of the Vermont statutes that came out of the last couple of legislatures, I could understand what this road map looks like. I’m at a place in my career where I want to be part of something that’s significant, and if it meant I had to take a turn somewhere in my career down the road, I’m prepared to take another turn.

VN: What remaining concerns or questions do you have, not only as the state rolls out the exchange, but as they study the viability of single payer?

RG: I think, just a practical concern, I really respect Vermont for wanting to change things and do things differently, but I think there is only so much you can do at once. Just getting the exchange up and running is a big deal. Whether or not you can do that and also invest in the other activities that require movement toward the single payer, it’s a difficult hill to climb.

VN: What role does the private marketplace have in helping the state do that? It’s kind of contrary to the interests of the industry to help the state at all.

RG: I think that’s what makes Vermont so unique. You have a lot of individuals who, I think, can step back from that conundrum and say, ultimately, we want to get affordable health care available to all Vermonters, how do we do that? And yeah, there is a near-term challenge to try and balance the interests of all the people who have jobs wrapped up in all of the above. Working through that, what’s so unique about Vermont, people are prepared to kind of put their thinking hats on and figure that out instead of run for the hills and take their money.

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.