Coreen Dicus-Johnson brings diverse health care perspective as CEO of Network Health

Coreen Dicus-Johnson began her career working for a health insurance company and later worked for a health care system.

She has negotiated contracts with each, having sat on both sides of the table.

For that reason, she brings a unique perspective to her job as chief executive officer of Network Health.

She understands hospitals' and doctors’ complaints about insurance companies and insurance companies’ complaints about hospitals and doctors.

That perspective in all likelihood will be useful in running a health insurance company owned by two health systems — Ascension Wisconsin and Froedtert Health.

“I’ve been on every single side of health care. I now can bring it all together,” Dicus-Johnson said. “That’s why they put me in this role, because they understand that I know both sides.”

Network Health, with 136,000 people in its health plans and revenue of $798 million in 2017, is a fair-sized player in the state’s health-insurance market. But the company, based in Menasha, has lost money overall for the past five years.

Dicus-Johnson, who previously was an executive at the former Wheaton Franciscan Healthcare, was hired as chief executive of Network Health in October 2016 to stem its losses.

So far, she’s made progress.

Network Health posted a much smaller loss in 2017 than in the prior year, Dicus-Johnson said. It expects to make additional headway this year and to break even next year.

“This is a long game,” she said.

Network Health also hopes to build a larger presence in southeastern Wisconsin — a market that Dicus-Johnson knows well.

The health insurer focused mainly on the Fox Valley until Froedtert Health bought half of the company in November 2014 for $107.8 million.

In southeastern Wisconsin, Network Health competes with two of the nation's largest health insurers — UnitedHealthcare, part of UnitedHealth Group, and Anthem Blue Cross and Blue Shield in Wisconsin, part of Anthem.

If anyone can make Network Health a success in this market, it is Dicus-Johnson, said Tom Gazzana, who worked with her at the former Blue Cross Blue Shield United of Wisconsin.

“Coreen knows this market,” he said. “She grew up in this market.”

Gazzana, who started Children’s Community Health Plan, negotiated contracts with Dicus-Johnson when she worked for Wheaton Franciscan.

It apparently wasn’t a cakewalk.

“She is incredibly tenacious,” he said. “She is incredibly bright.”

Since becoming chief executive, Dicus-Johnson has put in place a three-year plan that has included bringing in executives and other staff, such as actuaries, with needed expertise instead of relying on outside consultants.

“We have to be nimble,” Dicus-Johnson said, “and we are now because we have the right talent in the room.”

Network Health’s interests also align with those of Froedtert Health and Ascension Wisconsin. The health systems not only own the health insurer but also make up a large part of its network.

“We are all part of the same team,” Dicus-Johnson said. “We at the plan are part of the integrated delivery system.”

Working together to improve quality and slow the rise in health care costs could help Network Health compete with much larger competitors, and, in turn, bring more patients to Ascension Wisconsin and Froedtert Health.

The chance to help the health systems become more efficient, Dicus-Johnson said, is one of the reasons she took the job.

“When I was on the provider side, I saw so many things we could do better and differently in collaboration with the payers,” she said, “and I worked really hard to build strong relationships with them.”

The goal is to build “a different mousetrap, if you will,” she said, to control costs and provide more integrated and better care.

One of her first moves was beginning to build the information systems and processes to do that. Another was hiring Rita Hanson, the former chief medical officer of Wheaton Franciscan.

Hanson initially was a reluctant recruit.

“My experience working with payers generally speaking, was not a positive one,” Hanson said.

Hanson said she took the job only because of Discus-Johnson.

“I remember getting up in my first day and thinking, ‘Why am I doing this?’” Hanson said.

Hanson originally was hired to be chief medical officer for a few months until Network Health could hire someone to fill the job long-term. By then, she had laid out her plans for working more closely with the health systems and physicians and was asked to stay.

One of Hanson's main tasks has been working with health systems to develop the information systems needed to track the care patients are getting.

“If you don’t have good data, everyone spends all their time arguing about the data,” said Hanson, who now is medical director for clinical integration.

Patients, particularly those covered by Medicare Advantage plans, often get care from multiple doctors and multiple health systems for different medical conditions.

Tracking the care of patients or capturing an entire episode of care, Hanson said, is more difficult than people realize.

She and others have been meeting once or twice a month, typically in person, with their counterparts at health systems to design the information systems needed to do that.

“We have key players on our team and the key players on their team sitting down and talking through this at an unprecedented level of detail,” Hanson said.

Hanson talks about “bolstering the basics” — getting accurate data and determining which physician has the responsibility for overseeing a patient’s care.

“Anything else we do can be layered over that,” Hanson said.

For now, Network Health is focused on primary care, particularly lessening the fragmentation of care and improving the coordination of care. Three years from now, the health insurer can focus more complex care, such as oncology and orthopedics.

“It’s an iterative process,” Dicus-Johnson said

Network Health has a financial incentive to put in the time and hard work partly because of its strong presence in the Medicare Advantage market, with 66,000 people enrolled in its plans.

People covered by Medicare Advantage are less likely to change health plans. But Network Health also has less “churn” in its commercial market than many insurers, Dicus-Johnson said.

That said, Network Health did lose some customers when ThedaCare no longer was included in its network.

But Network Health already has seen growth from becoming one of the health insurers available through the state Department of Employee Trust Funds. It now insures 21,000 employees of the state, the University of Wisconsin System and municipalities from Kenosha to Green Bay.

“We stand to grow substantially in that line of our business,” Dicus-Johnson said.

Jim Mueller, chief executive of Mueller QAAS, an insurance broker, said Dicus-Johnson knows health insurance, health systems, brokers and employers and has put a talented team in place.

“I’m very bullish on Coreen Dicus-Johnson,” said Mueller, who worked with her during her brief stint at the former Frank F. Haack & Associates.

Network Health’s presence in southeastern Wisconsin gives employers and patients another insurance option. And for her part, Dicus-Johson has more than a little confidence about Network Health’s prospects.

“We are doing great things together,” she said. “And we are going to do even better things together.”