Cleve Killingsworth Jr. Biography

1952—

Health care administrator

The rising cost of health care just might have met its match in Cleve Killingsworth Jr. As chief executive of the Detroit health maintenance organization Health Alliance Plan (HAP) and later as president and chief operating officer of Blue Cross and Blue Shield of Massachusetts, Killingsworth became noted for his innovative emphasis on containing costs through the streamlining of health care. "A lot of people think that more care is better care," Killingsworth told Terrence Oprea of Detroiter magazine. "The truth is that better care is better care." He backed up maxims like that with detailed initiatives that cut costs without reducing service. Jack Martin, Killingsworth's boss at Health Alliance Plan, described Killingsworth to John Strahinich of the Boston Herald as "a very bright person, and very principled. He's a geek with great people skills."

Cleve L. Killingsworth Jr. was born in Chicago on June 5, 1952, and grew up on the city's West Side. His father was a shop steward in a rawhide factory, his mother a social worker. Killingsworth was an intelligent child from the start, more interested in schoolbooks than in the conflicts that roiled Chicago's streets. "My sisters talked about the race thing, but I was always kind of ambivalent about it," Killingsworth was quoted in Cracking the Corporate Code. "Frankly, what happened in physics and math was more interesting and more true to me than what happened with societies."

Encountered Hostile Reception at
Planetarium

A pair of unpleasant social interactions, however, helped to refocus Killingsworth's intelligence on humans and their ways. One day when he was nine, he saw a group of sociology students from the nearby University of Chicago ride by his house in a bus, taking notes. "I was a specimen," Killingsworth recalled to Strahinich. "I was a native, a subject of their study." Resolving to be the researcher rather than the subject of research one day, Killingsworth began to excel in school. He haunted the famed Adler Planetarium on Chicago's lakefront, and one day he asked for help in building a telescope of his own from workers in the planetarium's machine shop. He encountered a wall of hostility, but he redoubled his efforts on his own, finished his telescope, and became a multiple science-fair award winner in high school.

In 1970 Killingsworth enrolled at DePaul University, a small school on Chicago's North Side. He was elected president of DePaul's black student union but lost his financial aid after leading a student sit-in. Still, Killingsworth's academic record was strong enough that he was able to transfer to the prestigious Massachusetts Institute of Technology, where he finished a degree in management in 1974. His adviser at M.I.T. suggested that he go into the public health field, telling him (as Killingsworth recalled to Strahinich) that hospitals were "large, complex institutions. And nobody knows how to run them."

Taking the advice to heart, Killingsworth went on for a master's degree in public health at Yale University. The early part of his career in health care administration saw him rapidly assuming new levels of responsibility in a series of positions: after landing his first job as associate administrator at the Hospital of the University of Pennsylvania, he moved on to the post of vice president of management resources for the Group Health Cooperative of Puget Sound in Washington state in the mid-1980s. A stint as president of the Genessee Valley Group Health Association in Rochester, New York, led to another post in that city, as senior vice president of health plan operations at the local office of the Blue Cross/Blue Shield group.

Sought Out Executive Positions

With a top executive mentor, William Van Faasen, shepherding his career, Killingsworth seemed to be slated to move up in the giant BC/BS hierarchy. Instead he sought out posts in which he could have more of a hands-on impact in coping with the rising cost of health care. In 1994 he became Ohio regional manager for another health-care giant, the Kaiser Foundation Health Plan health maintenance organization (HMO). In that post he was credited with reducing the organization's operating costs and improving services, turning the HMO into a top-rated competitor in the Cleveland area. Moving up to the post of president of Kaiser's mid-Atlantic states region, Killingsworth set his sights on a CEO position.

That opportunity came in 1998, when Killingsworth became CEO of the Detroit-based Health Alliance Plan (HAP). Under Killingsworth's leadership, HAP (a nonprofit affiliate of the Henry Ford Health System) added 40,000 members to its rolls, a large chunk of those coming when Killingsworth spearheaded HAP's acquisition of the rival SelectCare HMO. HAP's revenues rose from about $900 million to nearly $1.3 billion between 1998 and 2002.

On the expenses side of the ledger, Killingsworth began to attract attention for his cost-cutting philosophy, at first in Detroit—where the Big Three auto companies struggled with the crushing health-care bills incurred by their workforce of aging and retired assembly-line workers—but soon beyond Detroit as well. At HAP, he directed a company-wide team to find $34 million in savings over three years. "At the first meeting," Killingsworth recalled to Michael T. McCue of Managed Healthcare Executive, "I asked my team, 'Can anyone here tell me that with a budget of more than half a billion dollars, we can't find $34 million in misuse and overuse?'" Sure enough, near the end of its first year, Killingsworth's initiative had resulted in over $8.5 million in cost savings, with the bulk of the expenditure reductions coming in the areas of increased use of generic drugs, reduced length of hospital stays, and reduced usage of emergency rooms for non-life- or limb-threatening conditions.

Laid Out Health-Care Cost
Philosophy

Killingsworth expense-reduction moves were successful in part because they were guided by a consistent set of principles. Cost reduction, Killingsworth maintained, was not synonymous with budget-cutting or the reduction of services. As policymakers traded blame with industry figures and patients over rising costs, Killingsworth argued that pointing fingers was unhelpful. "If you try to find a culprit," he told Oprea, "we will end up together making very little progress." Politicians, health-care providers, and the public needed to become better informed, Killingsworth argued, and "we ought to make the investments that are needed to give physicians and other health providers the tools—principally information tools—that they need to be able to close the [health-care cost] gap. And then I think we should have a conversation with providers about accountability."

Killingsworth's innovations weren't aimed solely at improving HAP's bottom line. He started a $5-million grant program that helped Detroit-area providers implement cost-saving practices that had proven successful at HAP. All these new ideas stirred the Detroiter to ask, "Can the future of health care be sitting right in our backyard?" And these actions once again attracted the attention of Van Faasen, who hired Killingsworth as president and COO of Blue Cross and Blue Shield of Massachusetts in December of 2003. Killingsworth, Harvard Medical School professor Donald Berwick told Strahinich, "may be the best piece of news on the Massachusetts medical scene in a decade."

Immediately taking aim at waste within his new company, Killingsworth settled into life in New England with his wife and three children. Industry insiders named him as a probable successor to Van Faasen as the company's CEO. But Killingsworth had his eye on systemic change as well as personal success. For Killingsworth, the looming financial problems of health care in the United States brought to mind another epic struggle: the civil rights movement. "Both were driven by the general population's demand for an improvement," he observed to McCue. "As we saw in the 1960s, this is a mobilization at the grass-roots level, because people believe they have a right to high-quality care, and they know that goal is within reach."