Since 2010, six former employees of the Georgia Department of Community Health have gone to work for health insurance giant UnitedHealthcare after leaving the...

Since 2010, six former employees of the Georgia Department of Community Health have gone to work for health insurance giant UnitedHealthcare after leaving the state agency, GHN has learned.

The exodus began in April 2010, when the agency’s commissioner, Dr. Rhonda Medows, left to join the Minnesota-based company. She had been Community Health commissioner since late 2005.

Among the latest is the former inspector general of the agency, Robert Finlayson, who recently left for United, a major contractor of the state.

UnitedHealthcare is the insurer covering almost 90 percent of the members in the State Health Benefit Plan, which covers more than 660,000 schoolteachers, school personnel, state employees, retirees and dependents.

The state said it paid the company $114.6 million for that work in 2011.

Community Health oversees the state employees plan, as well as Georgia’s Medicaid program.

State law does not forbid contractors to hire state employees. And other corporations have hired former state employees, including health insurers employing former Community Health workers. But the number involved with United over a two-year period, along with the high level of the positions they formerly held with the state, appears unusual.

UnitedHealthcare, responding to questions from GHN, issued a statement on its hiring practices:

“UnitedHealthcare hires the best-qualified employees we can to help achieve our goals of helping people live healthier lives and making the health care system work better for everybody, so our 2,000 employees in Georgia have broad experience in the private, public and non-profit sectors.”

The company, while emphasizing its large workforce in the state, declined to respond to a question about the number of DCH employees hired in the past two years.

Community Health also did not confirm the number or names of former employees hired by United. “The Georgia Department of Community Health does not track where former employees go to work once they leave DCH,’’ the agency said in a statement.


The record of rivals

Health insurers Aetna, Blue Cross and Blue Shield of Georgia, and WellCare, when asked by GHN about their own practices, each said this week that they have not hired any Community Health employees over the same time period.

Cigna declined to address the question, saying, “Cigna’s policy is that we do not provide information regarding individual employees beyond confirming a title and period of employment. “

Amerigroup, which has a managed care contract for Georgia Medicaid and PeachCare, said this week that it had hired two people from Community Health in the past two years. “Both associates were hired into non-executive capacities,’’ the company said. “In addition, Amerigroup’s recruiting practices are non-discriminatory, and for any position we hire the best person based on their qualifications and relevant experience regardless of any other factors.’’

Kaiser Permanente said it hired two people last year from Community Health –- a person from Public Health and an elder-care nurse –- but that neither was involved with the State Health Benefit Plan.

Centene Corp., parent company of Peach State Health Plan, a state contractor, could not be reached for comment.

UnitedHealthcare’s contract for the State Health Benefit Plan ends Dec. 31, 2013, and work has already begun on the upcoming bid process, the Community Health statement said. The intent is to award a contract next spring.

The state’s Medicaid program, with its proposed restructuring on hold, may have a contract bidding process begin in the next two years as well.

Asked whether the presence of former agency employees would help United in a possible bid to again land the state employees contract, Community Health said, “DCH follows strict ethical and procedural guidelines for procurements. Contracts are awarded based on merit and strict procurement and ethical policies. All potential vendors are on equal footing when bidding.’’

The agency emphasized that it “has a detailed ethics policy regarding employee and potential vendor interaction, particularly during a procurement period.’’

“For instance, once a [request for proposals] is released, the only employee who can speak on behalf of DCH to potential vendors is our procurement officer.’’


A question of appearances

Mila Kofman, a former Maine state insurance superintendent and now a professor at Georgetown University Health Policy Institute, said it makes good business sense for a health insurer to hire a state official who is familiar with Medicaid, as the government program moves more into managed care in many states.

Kofman also said it’s not uncommon for state insurance regulators to leave for a job with a private insurance company. But she added, “It doesn’t always mean it’s the best public policy.’’

After hearing a description of the Georgia hiring situation, Kofman said, “It’s an unusual situation because you’ve had a high number of state officials going to work for one company.’’ Further review of this could help assure the public that nothing wrong or inappropriate occurred during this process, she said.

William Perry, executive director of Common Cause Georgia, a government watchdog group, said the former state employees could give the insurer an advantage in bidding with their ‘‘insider knowledge and insider connections.’’

“It adds to the erosion of public trust,’’ Perry said, when government becomes ‘‘the breeding ground’’ for private industry employment.

Russ Toal, a former Community Health commissioner and now a health policy expert at Georgia Southern University, declined to comment on the UnitedHealthcare hiring. But he said it’s not surprising that employees leave state positions.

“In a demanding and growing field like health care, there is serious competition for talent, but the state really has a limited ability to compete with the private sector for that talent,’’ Toal said, citing, among other factors, lower salaries than in the private sector, no pay raises, little career advancement, and constant budget cuts.

“There is a lack of respect from all too many and rising benefit costs to state employees,’’ he added. “It is an environment that encourages folks to leave.’’


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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