Blue Cross of Idaho CEO shares personal inspiration

“I can’t really tell you about our patients, or members, but let me talk about Medicare patients,” said Charlene Maher as she walked across the lit-up stage.

“Ruth, at 47 years old, found out she’s going to be a grandmother for the first time. At the same time Ruth found out she has Huntington’s chorea. By the time Ruth was 55 she was in a nursing home. She couldn’t talk; she couldn’t walk; she would spend her days strapped in a wheelchair, and her evening strapped in a bed. We had to help the family.”

The story didn’t end there.

“How about the executive who is in Manhattan, and they say, ‘You don’t need to have a mammogram,’” Maher says, speaking from experience. “‘You know we’re moving to three years on this policy; you have no family history.’ Come here to Idaho, the doctor says, ‘Let’s do a baseline.’ Cancer.”

Health care challenges and opportunities

Maher felt she would not be speaking at the June Boise Metro Chamber CEO Speaker Series if it hadn’t been for Saint Alphonsus testing her for cancer. And Ruth was a member of Maher’s family. The main purpose of the Chamber CEO Speaker Series is for members of the community to hear and learn from the top CEOs in Idaho who are having an impact on business, Tom Mortell, board chairman and partner at Hawley Troxell, said in his opening remarks.

During her presentation (held virtually and in-person) at the Boise Centre, Maher, the CEO of Blue Cross of Idaho, took the opportunity to highlight challenges in the health care industry, and what she and Blue Cross of Idaho are doing to address those problems:

Ranked 50th in the nation, Idaho has a shortage of primary care physicians, particularly in rural areas. Health care graduates are discouraged from practicing in those rural areas because they are not confident in the ability to pay off the typical $250,000 to $300,000 in debt accrued during their education.

To help, Blue Cross of Idaho has met with College of Idaho, Idaho College of Osteopathic Medicine and other higher education institutions to establish continuing scholarships totaling millions of dollars through several 501(C)(3)s.

2020 in the health care industry

Looking back at 2020, Maher remembered:

• Members did not pay for approved COVID-19 testing and treatment; Blue Cross of Idaho covered $77 million
• Telehealth was expanded through efforts with legislators
• Premiums for fully insured groups (including small businesses) were reduced by $11 million
• Representatives served on the Governor’s Economic Recovery Council, and consulted with other stakeholders
• A mobile vaccine van was purchased to get COVID-19 vaccines to rural communities

Today, Blue Cross of Idaho has also:

• Helped Camp Rainbow Gold build a medical center
• Supported the creation of the YMCA Thrive Center
• Launched Blue Cross of Idaho RX plan
• Created a payment integrity department to address fraud and confusion in billing — recouping almost $40 million

“Everybody’s talking (about) diversity, equity, inclusion; inclusion means you go to the people and you help them, and you learn what they need and you meet them in the middle,” Maher said. “It’s not expecting these children with autism to come to you, it’s expecting you to give them the tools so they can meet you halfway, and then you go the other half.”

Future health care plans

Maher shared some goals as well, crediting the Blue Cross of Idaho team for its relentlessness, and commitment:

“We believe that over the next five years, the total cost of care — the premiums, deductibles, your coinsurance, your copay — should be 20% to 50% lower,” Maher said. “This is not a business for us. This is personal.”

A recently formed team of scientists can now tell within 95% of accuracy — not the 2% of greatest costs — but what future needs will look like. This can help through partnering with primary care physicians or specialists “to make sure that (patients) never advance to that crisis moment.”

“That is how we can change health care,” Maher said. “We have to give (doctors) the tools, the resources, the analytics, to help them, because no one should get between a primary care physician and their patient.”

Maher’s history

Maher, who began her career as a registered nurse, draws on over 30 years of experience in the health insurance industry, and more years in other subsets of health care. Prior to being named president and CEO of Blue Cross of Idaho, she was the chief marketing officer and senior vice president for commercial sales at EmblemHealth in New York, and spent 15 years with WellPoint Inc., where she became vice president and general manager for individual services for 14 Blue Cross Blue Shield states, Mortell said in the introduction. Maher is also a former Boise Metro Chamber president.

Maher was inspired by her mother, who always wanted to be a nurse but could not pursue that education “because she was female.”

Blue Cross of California was where Maher started gaining experience in the administrative side of health care, and she made it a point to work in every role available.

“The reason is, and I say this all the time to my people, number 10 on the job description said ‘other duties as assigned.’ I love that line, because that meant I was not stuck in that four-by-four cube doing the same production work every single day. I could take on any opportunity I wanted.”

When it came time to interview with Blue Cross of Idaho, Maher recalls the passion of the board of directors, and, instead of tying goals back to Wall Street and financials, they asked if Maher could innovate and change the health care ecosystem for Idaho “if we empower you.”

“What (is) different about Idaho is people want to know who you are, and they want to know why you’re here and they want to know what you’re going to do when you’re here, but more importantly they want to know how they can help you,” Maher said. “Did I say I’ve been in 20 states, and lived in 10? Idaho is different.”