Persuasive benefit manager breaks through barriers

Published June 26, 2006

by JOANNE WOJCIK

jwojcik@BusinessInsurance.com

REDWOOD CITY, Calif.--Paul Hackleman doesn't like to take no for an answer.

When his mind is made up, he can break through bureaucratic barriers, persuade vendors to provide additional services for free and win union backing when negotiating benefit plan changes.

But even though he may get his way most of the time, he does it with such finesse that all parties involved believe they've gotten something, too.

"Paul's very collaborative. He wants to work with you, and that's how he approaches negotiations for the renewal and so forth," said Rick Salow, senior account executive in San Francisco at Aetna Inc., which has provided San Mateo County employees access to its Simple Steps wellness program for the past two years at no additional charge to the county.

"We've given it to the county because they've been a long-term partner," Mr. Salow explained. "Because of some of the limitations that Paul has, as far as unions and so forth, he can't make a lot of changes and there will be times when he asks, 'Are there additional things you can do for us based on what we're currently paying you?"'

Aetna is also giving the county access to its patient safety system, MedQuery, at no additional cost, Mr. Salow added. Through the program, Aetna converts member health data into information that treating physicians can use to improve care and patient safety.

Although it took Mr. Hackleman awhile, he eventually persuaded the Redwood City office of Kaiser Permanente Medical Group Inc. to work on a joint venture with the county in combating diabetes and heart disease.

"Paul is very persistent in his advocacy for his employees in terms of health," said Dr. Timothy Wong, assistant physician-in-chief at the medical group's Redwood City, Calif., office, who also heads the county's PHASE program. PHASE stands for "Prevent Heart Attacks and Strokes EveryDay" (see story, page 21).

The county provided a registered nurse to assist with teaching the classes and Kaiser provided educational materials, physical space for classes, administrative support and two pharmacist care managers who provided individual counseling to 100 program participants who were selected based on their medical histories.

It was the first time Kaiser's Redwood City office collaborated on a health promotion program with an employer, according to Dr. Wong.

"Paul doesn't take no for an answer when he knows the organization can assist," said Mary Welch, the county's director of employee and public services.

Although Ms. Welch is Mr. Hackleman's supervisor, she said they often work together as peers.

"How the process works is, he'll usually talk about something we should be doing and we'll write up a proposal on how it might work, and if it does cost money, we need to get approval from the manager's office or potentially the Board of Supervisors. And then we meet with the unions. But, it's not that difficult to do. Paul is a great writer. He's brilliant. He has a great mind. And he's strategic," Ms. Welch described.

Mr. Hackleman decided to take the initiative and start assessing the county's retiree medical obligations in advance of the county's required implementation of the Government Accounting Standards Board Statement 34 in 2007 and get the go-ahead to commission an actuarial analysis last year. Governmental entities with total annual revenues between $10 million and $100 million are required, after Dec. 15, 2007, to implement this accounting recognition for post-retirement health benefits.

"He managed the whole thing and got it done early, got it done well," said Ms. Welch, who added that the responsibility for such a report would normally rest with another county department.

Mr. Hackleman also spearheaded the county's involvement in the HEAR2T Program, which began as a study by Stanford University's Prevention Research Center (see story, page 21).

"He's been a tremendous support of the program. He even went to the board and got this program funded as an employee benefit," said Susan Vana, the nurse coordinator of the program. "A lot of employers don't understand the benefit of this kind of program. He attends the meetings that we have with Stanford."

Walter Zhovreboff, president of San Francisco-based First Home Inc., which administers the San Mateo County Employee Homebuyers Education and Assistance Program, said that he is amazed at how well Mr. Hackleman navigates the political bureaucracy of county government.

"I'm used to the political bureaucracy where you have to go through just levels and levels and levels to get approval," he said. "Paul sat down and within an hour, an hour and a half, said, 'I want it. Draw up a proposal. Let's take it to Mary and everyone else.' And within two months we had this thing off the ground."

"I believe Paul has a really great capacity to bring people in to trust him and for him to trust people. He just has this great capacity to go over these boundaries. I think that he's an intelligent individual who quickly evaluates the people that he's working with. And, in so doing, if he makes a decision that this is someone he wants to work with it, he goes all the way," Mr. Zhovreboff said.

"At the same time, he makes it clear up front that he expects a very professional and high level of service," he added.