Bob Greczyn, the top executive of Blue Cross and Blue Shield of North Carolina for more than a decade, plans to retire next year.
The state's largest health insurer on Monday promoted Chief Operating Officer J. Bradley Wilson to president. The move, which the Blue Cross board approved over the weekend, puts him in line to succeed Greczyn.
Greczyn, 58, will remain CEO for now. He indicated he will step down in 2010 after running the Chapel Hill-based nonprofit for 11 years.
Wilson, 56, is a well-connected Tar Heel native and lawyer who joined Blue Cross in 1995 after serving as general counsel for former Gov. Jim Hunt. Wilson, who holds degrees from Appalachian State, Wake Forest and Duke universities, is on the UNC system board of governors.
At Blue Cross, he will help run an insurance company with more than 3.7 million members and 4,800 employees. He begins his work as medical costs continue to surge and health-care reform promises to transform the industry.
Wilson also will face critics who say that Blue Cross holds too much power in the state's health insurance market, charges too much for its services and pays its executives too much money.
"The fact that we are a lightning rod doesn't mean we deserve all the lightning that we get," Wilson said. "We do lots of good things for this state. No individual or company is perfect, and we'll work hard in those areas we need to improve."
Blue Cross Chairman Jeff Houpt said a key factor in choosing Wilson was his commitment "to improving the lives of North Carolinians." Wilson was one of several candidates, and board members have been working on a succession plan for more than a year.
"Clearly the organization isn't looking for someone who will take the company in a markedly different direction," said Adam Searing, a frequent critic of Blue Cross as director of the N.C. Health Access Coalition, an arm of the N.C. Justice Center in Raleigh. "I think it will stay the course of acting more like a for-profit while reaping the benefits of being a nonprofit."
Wilson played a key role in Blue Cross' failed attempts to convert to for-profit status in 1998 and 2003, Searing said.
Wilson said trying such a move again "is not on the agenda."
But Wilson will play an important part as Blue Cross officials lobby North Carolina's congressional lawmakers who are considering ways to reform the health system. Blue Cross is especially concerned that potential legislation doesn't significantly raise costs for its members, Wilson said.
"We're engaged, and we're being a positive and productive partner for our members of Congress," he added.
Another challenge will be Blue Cross' large contract with the health plan that covers 667,000 state employees, teachers and retirees. Blue Cross has come under scrutiny for its expenses related to administering claims for the plan, which is struggling with rising costs. The Blue Cross contract runs through 2013, but a rebidding process is scheduled to start in 2011.
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