CMS' Patrick Conway named CEO of BCBS of North Carolina

Table with chairs around it
Patrick Conway, M.D., will start his new role as president and CEO-elect of Blue Cross Blue Shield of North Carolina on Oct. 1.

Patrick Conway, M.D., one of the Centers for Medicare & Medicaid Services’ most senior officials, is taking his talents to the private sector.

Blue Cross and Blue Shield of North Carolina has named Conway as its next president and CEO, replacing Brad Wilson, who is set to retire. Conway will start his new role as president and CEO-elect on Oct. 1, with Wilson continuing to serve as CEO for an unspecified transition period.

“At this important time in healthcare and health insurance transformation, Dr. Conway brings a unique background and perspective to our company and state,” Wilson said in a statement.

“His unique experiences as a healthcare provider and as a leader of the world’s largest healthcare payer will help Blue Cross NC fulfill its mission to improve the health and well-being of our customers and communities,” added BCBSNC Board of Trustees Chair Frank Holding Jr.

Patrick Conway, M.D.

Conway, a practicing pediatric hospitalist, has worked for CMS since joining the agency as its chief medical officer in 2011. In his current role as director of the Center for Medicare and Medicaid Innovation (CMMI), he’s been one of the dominant forces toward transitioning the U.S. healthcare system toward value-based payments.

Having served in both the Trump and Obama administrations, Conway has stayed out of the political fray despite how the agency has shifted its stance on the Affordable Care Act following the change in power. Indeed, as he discussed CMMI’s bevy of value-based payment models at this year’s AHIP Institute & Expo, he noted that none of the GOP’s healthcare overhaul legislation “does anything to change the innovation center.”

For Conway’s part, he said noted that BCBSNC’s role in transforming the healthcare system “is a model that other plans aspire to and that I want to work with the Blue Cross NC team to further improve.”

BCBSNC has had its share of problems, however. In 2016, state regulators hit the insurer with a $3.6 million fine over issues with its technology platform that wreaked havoc on its enrollment and billing system.

The insurer has also struggled with heavy losses in its ACA exchange business, prompting it to consider pulling out of the marketplace for 2017. However, BCBSNC decided to stick it out, and was the sole ACA exchange insurer in most of North Carolina’s counties, according to the Kaiser Family Foundation.

BCBSNC plans to remain on the state’s exchange next year but has requested a 22.9% average rate increase.