Year: 2021

A Different Kind of Gig

For roughly two decades, Richard Swift hop scotched the country on a series of interim assignments during which he shared his considerable expertise with several different health plans. As fruitful as this niche has been for Swift, he has traded his ‘interim’ tag for something permanent at Health New England — the role of president and CEO — and at a very unique and challenging time, for him and the company.

Richard Swift says he applied for the position of interim chief financial officer at Health New England with the expectation that this assignment would be like all the other longer-term interim gigs that had dominated his résumé for the previous few decades.

To say that things haven’t turned out as he originally thought would be a huge understatement.

For starters, while he interviewed for the position at Health New England’s offices in Monarch Place in downtown Springfield and had the opportunity to meet many of those in the finance team before starting, once he was awarded the job, he wouldn’t set foot in those offices for close to six months, and only then for short, very infrequent stops.

His arrival coincided almost exactly with that of COVID, which would put him in a working environment unlike anything he was used to.

“I’m told I was the first person they remotely onboarded,” he said, adding that several days before his scheduled start date the company had begun “experimenting” with employees working remotely, experiments that went very well. “They said, ‘I guess we’ll just send you a laptop.’ They sent me a computer, the IT folks hooked me up … the first time I came into the office was in August.”

While that was a huge adjustment for him, there was an even bigger one to come later.

Indeed, he would soon lose the word ‘interim’ from his business card — only he never actually had any in the CFO role, to the best of his recollection — not only from that title, but from the one he would be given roughly a year ago — president and CEO, succeeding Marion McGowan, who would become executive vice president and chief operating officer at Baystate Health, which owns Health New England.

After roughly 20 years of taking on year-long assignments as president of Medwise Partners and flying home every weekend from wherever he was stationed to his home in Arizona, he was planting roots; he even bought one of the Classical High Condominiums. When asked why, and why at Health New England, he said, “this was the right opportunity at the right place at the right time.”

It’s certainly been a whirlwind 18 months for Swift, whose tenure has, indeed, been dominated by the pandemic in every way imaginable, from its impact on Health New England and all health plans, to how and where the 380 employees at the company get work done, to the company’s work within the community and how it has changed in some ways but not in any of the ones that matter.

In a wide-ranging interview from his office at Monarch — he’s been there for several months now, usually without much company — Swift talked about all of the above. And in so doing, he provided some keen insight into what it’s been like to manage during a period unlike anything that a business manager has seen before.

“One size is not going to fit all. And for the 360 of our 380 employees who have been remote for the past year and a half, it’s been an almost seamless process. So given the fact that it’s been successful, it makes it hard to say ‘you have to come back, because it hasn’t been successful and that’s the only way to make it work.’”

“We need to be sensitive to our diverse workforce and their diverse and different needs,” he said, while summing up the challenge of leading at this time. “As a leader, I need to be sensitive to these varying needs, and I need to make sure the organization is sensitive to them. One of the things this experience has taught me is the need to be adaptable — both personally, for myself, and the organization and everyone within it — and accessible.”

As for the pandemic and health plans like Health New England, he said COVID and the changes resulting from it have brought challenges in many shapes and sizes, including to the bottom line. Indeed, while 2020 saw insurers facing far fewer claims than would be considered normal, and most eventually issuing rebates to members, 2021 has seen a surge in claims, with many health plans posting losses in the second quarter.

Swift said Health New England posted losses in that quarter as well (specific numbers were not available), but it has been able to avoid layoffs and cutbacks while actually increasing its involvement in the community, financially and otherwise (more on that later).

As for where and how people work, Swift said the pandemic gave him a first-hand look at how effective employees can be when working from their home office or dining-room table.

And he is using that experience as he goes about setting policy for the company. Above all else, he said he’s learned that managers must be practical and flexible in such matters.

“One size is not going to fit all,” he noted. “And for the 360 of our 380 employees who have been remote for the past year and a half, it’s been an almost seamless process. So given the fact that it’s been successful, it makes it hard to say ‘you have to come back, because it hasn’t been successful and that’s the only way to make it work.’”

Assignment Desk

As he talked about his lengthy tenure as a consultant to a number of different health plans and life as an ‘interim,’ Swift said he thoroughly enjoyed what he considered a ‘niche,’ and a successful one at that.

“For me, it was fun to parachute in somewhere and learn new people, new things, and new places; I liked to travel — it was fun to go back and forth,” he told BusinessWest, adding that his various gigs took him to all corners of the country and for assignments — usually as CFO but also CEO and COO — that varied with the health plan in question.

“Sometimes they were eight months long, sometimes they were for a couple of years,” he explained. “In some cases, people left suddenly; in other cases, it wasn’t suddenly, but they realized that they didn’t necessarily have the successor they thought they had, or they knew they didn’t have one and were going into a search process.

“Sometimes they were successful, strong health plans that just needed some expertise, and some of them were turn-arounds,” he went on. “What I brought to the table was that experience of running that business.”

Health New England was looking to tap into that experience early in 2020 when its CFO announced his retirement and a search for a successor had commenced. As noted earlier, Health New England was going to be another one of those interim assignments.

“When I looked at what was going on here, and at the opportunities that Baystate has with Health New England and that Health New England has with Baystate, I realized that there is so much that we can do together in the Western Massachusetts market.”

But things didn’t go according to script, starting with day one — or actually, even before day one.

Indeed, Swift was scheduled to start in April of 2020. COVID, as we all know, made its arrival in the 413 in mid-March, abruptly changing the landscape for the company and its new CFO (he quickly lost the interim tag), who wouldn’t have to get on a plane to take on his latest assignment.

He recalls that leadership at the company was going to use March 13, 2020, a Friday, as an experiment to see how effectively people worked remotely. That experiment went so well, and COVID invaded so suddenly, that workers never came back. In his case, he never arrived.

“I remember that conversation about ‘we’ll just send you a computer and you’ll work remotely,’ and how stunned I was at the time,” he recalled. “Because in 20 years of interim work, I pretty much got on a plane every week and flew out to my client. I was in my office in whatever city it was, on site. So the notion of doing all this remotely … it took me a while to wrap my head around it.”

While making these adjustments, Swift would soon have to make some others as well.

Indeed, in June, as McGowan was assuming some duties at Baystate while still serving as president and CEO at Health New England, Swift picked up some additional responsibilities for the company. And in October of last year, as McGowan moved to Baystate full time, he was asked to become CEO — again, without the ‘interim’ before the title.

When asked what he saw in Health New England that made him accept a permanent position — he had declined a few offers of that type in the past — he said it was a combination of things, including the team that was in place at Health New England and the opportunities he saw to partner with Baystate in meaningful ways.

“When I looked at what was going on here, and at the opportunities that Baystate has with Health New England and that Health New England has with Baystate, I realized that there is so much that we can do together in the Western Massachusetts market,” he said. “And I was really excited by those possibilities.”

By the Numbers

Looking back on his first 18 months with the company — and ahead to what might come next — Swift said this has obviously been a different and very challenging time for Health New England, and all health plans.

And the pandemic is just one reason why, albeit a big reason. At first, it contributed to a steep decline in claims because people were not visiting the doctor or seeking help even if they needed it. And then, it prompted a huge surge as people went back to the doctor and the emergency room, often with conditions made more serious by not seeking care through most of 2020. Meanwhile, treating COVID itself has often required lengthy and very expensive hospital stays.

“We’re certainly seeing more members having more claims and more services, and more-costly services than we did in 2019,” he said, adding that all this certainly contributed to the company’s second-quarter losses.

Richard Swift

“COVID has brought a tremendous level of uncertainty. So all of us who put plans and benefits and rates in place for 2021 did that in the summer of 2020 in the middle of COVID, trying to understand what that would look like, and we’re doing it now for 2022, and we don’t know what next month is going to look like, let alone six months from now.”

But mostly, the pandemic has created uncertainty and even greater difficulty forecasting into the future, which creates problems for health plans, Swift noted.

“We set rates well in advance based on what we think our costs are going to be, and we don’t really have a chance to revisit those until the next year,” he explained. “And we obviously don’t know what the services are going to be or what new technologies are going to emerge.”

Elaborating, he said that telehealth technology certainly came of age during COVID, and Health New England, like many health plans, had previously created a telehealth benefit for members.

“In all of 2019, we had something like 850 or 900 total claims for telehealth visits; over the past year, it has averaged almost 30,000 per month,” he noted, citing this as just one example of how quickly and profoundly the landscape can change and health plans can be impacted by those changes.

Vaccines are another example, he said, adding that health plans couldn’t anticipate a two-dose vaccine when they set rates for 2021 last year, and they couldn’t have anticipated a booster, or third shot, as they set rates for next year.

“COVID has brought a tremendous level of uncertainty,” Swift went on. “So all of us who put plans and benefits and rates in place for 2021 did that in the summer of 2020 in the middle of COVID, trying to understand what that would look like, and we’re doing it now for 2022, and we don’t know what next month is going to look like, let alone six months from now.”

As noted earlier, the surge in claims and other factors have generated losses for some health plans in recent quarters and prompted layoffs and cutbacks as well.

Health New England has been able to avoid such cuts, he said, adding that, in the meantime, it has been able to maintain and, in many ways, increase its financial support to the community and its business community, something Swift takes great pride in.
“Even with everything going on with COVID, we’ve continued, and increased, the community support in terms of activities, foundations, grants, and actually providing PPE and hand sanitizer to people who didn’t have the wherewithal and the ability to get it themselves,” he said. “A lot of companies have turned inward, and many of them have laid people off; we made a conscious decision not to lay people off if we could at all avoid it, and fortunately, we have been able to avoid that.”

Elaborating, he said the company adjusted some of its sponsorship activity to accommodate what it would call “COVID mini grants,” roughly $300,000 worth of them that were awarded to community organizations that needed support to address their COVID-related needs.

In addition, the company created Where Health Matters grants, multi-year grants totaling $50,000 to $150,000 awarded to organizations to help offset the effects of COVID on their operations.

Giving the Forecast

Moving forward, Swift said the company would continue its pattern of flexibility and responsiveness to changing conditions as a fall shrouded by uncertainty approaches.

As he talked with BusinessWest, he noted that he was one of very few employees in the building that day, and things would probably remain that way for the foreseeable future. Employees were slated to return, in a hybrid format, by this time, he went on, but there is now more of a wait-and-see approach than a definitive schedule.

Meanwhile, Health New England has joined a growing number of businesses, especially in the broad healthcare realm, that have made vaccination a requirement for employment, a step taken in the interest of maintaining the safety of employees and customers alike.

“One of the things we’ve said concerning our coming back to the office is that we don’t know what we don’t know,” he said. “The only thing we know for sure is that things are going to change.”

And with those sentiments, he summed up both the short term and what could be called the post-pandemic world — whenever that arrives. When it does, said Swift, noting that, in some respects, it is already here, it won’t look like the pre-pandemic world.

And that goes for everything from how and where employees work to how people will access healthcare.

With regard to the latter, telehealth will almost certainly continue to increase in popularity, he said, adding that while the numbers have fluctuated as the pandemic has waned and surged, the technology has gained a broad level of acceptance.

“I do think you’ll see a lot more movement to leverage the technology that’s out there and technology that’s being developed for care without having to traditionally go back and see your doctor in the office on their schedule,” he explained.

As for the office setting and what it will look like, Swift said things simply won’t go back to the way they were in 2019. Companies have learned that employees can work effectively in remote settings, and thus it only makes good business sense to allow them to continue doing so, either in a fully remote fashion or in a hybrid format now being tried by many area businesses of all sizes.

“We have some departments that, by and large, were partially remote before and will be partially, or maybe completely remote in the future,” he explained. “The work they’re doing is such that it’s fine remotely, and they’ll stay that way.

“We have not come out with any edicts that people have to be here on ‘x’ amount of days,” he went on. “Because we know that one size does not fit all and there are certain departments and functions that have very different needs than others; we came to the conclusion that an edict was as arbitrary as pre-COVID, Monday through Friday, 8 to 5, in some respects.”

And there’s a competitive aspect to creating flexibility with working conditions, he said, adding that Health New England can now hire talented individuals from outside the 413 and even outside the state because they have the ability to work remotely.

As for business strategy and long-term planning, Swift said COVID has certainly made such exercises more difficult. But companies still have to plan, he noted, adding that there must be layers of flexibility built into such plans.

“I think that COVID requires us to plan even further ahead, but be more nimble with those plans,” he explained. “Our original date for returning to the office was Sept. 1; with what’s happened over the past several weeks, we’ve pushed that back. But in the spring, we threw out that date of Sept. 1 as the one we were targeting, again with the caveat that everything is subject to change.”

Bottom Line

Swift told BusinessWest that, a few weeks back, his sister called him asking for recommendations on restaurants in Detroit, which she would soon be visiting.

He was able to help her, because that was one of the places he parachuted into while doing his consulting work.

That life has ended, at least temporarily, with a permanent assignment, one that is a far cry from what he thought he was originally signing up for back in March of 2020.

He was, by most accounts, the first Health New England employee to be onboarded remotely, but he certainly wasn’t the last. His first 18 months have been a learning experience on myriad levels, and in all ways it is still ongoing.

George O’Brien can be reached at [email protected]