Insights Blog



By QLK Team
on Oct 9, 2017
  • Spotlight
SPOTLIGHT: Interview with Dr. Patrick Conway, CEO of Blue Cross and Blue Shield of North Carolina

Patrick Conway, MD, recently became the CEO-elect of Blue Cross and Blue Shield of North Carolina ---a plan with 4 million members. Prior to this, he was the most senior non-political executive at CMS who had a say in every healthcare policy change during the Obama administration.

During his DC tenure, he served as the acting principal deputy administrator and chief medical officer, as the deputy administrator for innovation and quality, and as the director of the Center for Medicare and Medicare Innovation and the Center for Clinical Standards and Quality (CCSQ).

While there, Dr. Conway and his team focused on health system transformation by improving quality, affordability, access to care, and health outcomes, reducing health disparities and combatting healthcare fraud. He was one of the driving forces behind the national movement toward value-based care and tying healthcare payments to quality and innovation.

Concurrently, he served for 10 years as an attending physician at Children's National Medical Center, teaching residents and medical students. He credits this experience with providing him an invaluable perspective on policy, as well as the ability to bridge the gap between bureaucracy and real-world care.

Prior to joining CMS, Dr. Conway served as the director of hospital medicine at Cincinnati Children's Hospital Medical Center, where he was also the associate vice president for outcomes performance, the director of the Anderson Center Section on Rapid Evidence Adoption and an associate professor. In these roles, he led quality improvement and measurement, clinical operations, and research, with a focus on improving patient outcomes across the entire multi-billion-dollar health system.

Dr. Conway has also served as the executive director of the Federal Coordinating Council on Comparative Effectiveness Research, made up of senior federal officials tasked with developing a strategy and report to Congress and the president on priorities for $1.1 billion in Recovery Act CER funding. Dr. Conway spent two years as the chief medical officer for the Department of Health and Human Services, advising the organization's leaders on healthcare policy, care delivery and payment, program development, and evaluation of its programs and policies.

After graduating summa cum laude from Texas A&M University with a degree in genetics, Dr. Conway began his career as a private sector consultant for healthcare clients with McKinsey & Company. He then returned to school full-time to complete his MD at Baylor College of Medicine, which he earned with high honors. Having recognized a desire to work with children while serving as a camp counselor in his teens, Dr. Conway undertook a pediatric residency at Harvard's Boston Children's Hospital, where he met his wife, a pediatric intensive care nurse. Dr. Conway spent two years as a Robert Wood Johnson Clinical Scholar and then one year as a White House Fellow before joining the Department of Health and Human Services.

Over the course of his career, he has published more than 80 articles in professional journals, and has presented at hundreds of national and international meetings. He was elected to the National Academy of Sciences Institute of Medicine in 2014, one of the highest honors in the fields of health and medicine; was selected as a Master of Hospital Medicine in 2014 by the Society for Hospital Medicine; and has received the President's Distinguished Senior Executive Rank (2015) and HHS Secretary's Distinguished Service (2014) awards, representing the president's and secretary's highest distinctions for senior executive excellence.


Patrick Conway is one of those people whose likeability and capability are immediately evident. While I was Secretary of HHS, Patrick was a While House Fellow. In the ten years since, l have watched him emerge as one of America's foremost policy thinkers. I have no doubt that same combination of likeability and capability will make him one of America's most admired executives. -Governor Mike Leavitt, Former Secretary of HHS



What do you see as your greatest accomplishment at CMS?

We moved from zero percent of payments in alternative payment models to over 30% of Medicare payments in alternative payment models, where the provider is responsible for quality and total cost of care; this represents over 200,000 provider agreements and over $200 billion. We also improved patient safety, including achieving a reduction in harm of over 25%, representing over 125,000 lives saved, over three million injuries and infections avoided, and over $26 billion in cost savings. Lastly, our employee engagement and satisfaction scores for CMS moved from the bottom quintile to second among federal government agencies.

What will you miss most about working at CMS?

I will miss the people and the mission. It was an honor to serve in an organization that impact so many people across the country.

How did your role change at CMS during your tenure?

I started as chief medical officer, leading the Center for Clinical Standards and Quality, with responsibility for quality measurement and improvement, clinical standards and survey and certification of all providers, value-based purchasing programs and coverage decisions. I then led the CMS Innovation Center for over four years, with responsibility for new payment and service delivery models across the country, such as ACOs, bundled payment, primary care medical homes and state-based models. I served as the principal deputy administrator (the number-two role at CMS) and acting administrator of CMS, leading the whole agency, for the last few years of my tenure.

How will what you learned and did at CMS serve you in your new role?

I learned how to lead complex organizations and how to develop deep provider partnerships to achieve better health outcomes and lower costs. Government insurance programs are also a growing part of Blue Cross NC business and I have extensive experience in these programs.

What is your vision for your new company?

I want our company to be a model Blue Cross health insurance and health solutions company for the nation. We will drive better health outcomes higher quality, lower costs, and best-in-class service.

What do you think the most important facet of "Obamacare" is to retain?

Insurance access for all people.

Why was "Obamacare" such a lightning rod for the public?

Even though it represents less than 5% of the U.S. health insurance market in terms of people, it became a lightning rod for everything good and bad in the U.S. health system. It is a lesson in why bipartisan legislation for large social programs is important, as opposed to legislation from one party.