The Harvard Pilgrim lessons
TWO WEEKS ago, the Massachusetts Supreme Judicial Court officially released Harvard Pilgrim Health Care from any further oversight by state government relative to the organization's past financial troubles. Given the health plan's success in recent years, this is hardly a surprise, but it still feels like a bit of a miracle to those of us who worked through the temporary receivership and rehabilitation during the first six months of 2000.
Six years ago, it was hard to tell what the final chapter would be. No health organization had ever been ordered by the Massachusetts courts into a temporary receivership, and the media speculation about the plan's future included possible bailouts, dissolution, or a sale. Membership was sliding and many hospitals around New England worried about how the possible downfall of a major health insurance plan would affect their own bottom lines.
The good news, since then, is this: Harvard Pilgrim has not only worked itself back from the brink of financial disaster but gone on to become the highest-rated health plan in the country for the past two years. It has won back a big piece of the membership that was lost during that period, and won several awards as both a health plan and as an employer. In short, the temporary receivership and the plan of rehabilitation worked, and there are lessons to be learned from this experience that can be incorporated into other policy debates.
Number one, people come first. One of our proudest accomplishments was that during the time of the receivership, not one Harvard Pilgrim customer in Massachusetts was denied care. What was a financial crisis for company executives and a political crisis for state officials never became a personal healthcare crisis for the health plan's members. Surgeries were performed, cuts were stitched, and babies were delivered without interruption. And when all was said and done, every provider was paid in full.
Second, the best decisions are driven by facts. There were a lot of opinions at the time of what should be done to rescue Harvard Pilgrim. The overwhelming preference was to restore the company to health as a non-profit. Because of the company's dire financial condition, every option had to be on the table, including an outright sale. There was no amount of convincing or cajoling that was going to allow Harvard Pilgrim to retain its place as a locally owned and controlled non-profit health plan. In the end, it was performance. If the numbers didn't add up, the outcome would have been different.
Third, all involved left their agendas at the door. Everyone with a stake in the outcome was at the table as we worked to find a solution -- government, health experts, businesses, insurers, providers, consumers, advocates. But this was no time for partisan politics or ideological pursuits. In the end, a Democratic attorney general and a Republican CEO had to come together to find a solution that best served the public interest. That may seem a strangely quaint notion in today's highly charged political atmosphere, but we showed it can happen. The lesson here, for issues large and small, is that if people are willing to work together toward the right result, things can get done.
Fourth, we held ourselves accountable. We did our best to make the process transparent by holding regular news conferences and reporting financial figures as soon as possible. We were also honest with each other. Discussions between public officials and company executives early on laid the groundwork for the trust that was necessary later to allow the management team to execute on its turnaround plan.
Finally, there are some things about Massachusetts that are special -- and worth saving. Our healthcare institutions and the people who work for them are clearly at the top of anyone's list.
The Harvard Pilgrim financial crisis was a wake-up call for all of us. The crisis may have passed for Harvard Pilgrim, but the work to fix what ails our healthcare system continues. As we go about that work, we should do so in the manner and spirit of that extraordinary and challenging time.
Charles D. Baker, a Republican cabinet secretary for two governors, is president and chief executive officer of Harvard Pilgrim Health Care and Thomas F. Reilly is attorney general of Massachusetts and a Democratic candidate for governor. 
