Tuesday, June 18, 2024

Pillars of North Carolina: Bob Greczyn’s pivotal role in N.C. health care

After leading an HMO’s rapid growth, the East Carolina University grad helped expand Blue Cross’ dominance in N.C. health insurance. 

Few people have had a bigger impact on North Carolina’s health insurance industry in recent decades than Robert Greczyn (pronounced Grech-en). He helped start companies, served as CEO of the state’s biggest insurer and is a longtime director at the largest hospital system in eastern North Carolina.

Born and raised in Hightstown, New Jersey, Greczyn moved to Greenville in 1969 to pursue a psychology degree at East Carolina University. He earned a graduate degree in public health from UNC Chapel Hill in 1981, which he says was a way to honor his mother’s legacy as a nurse. She died while he was in college.

In 1979, a community health group in Anson County hired Greczyn to start a medical clinic and recruit doctors and dentists to the rural area. In 1984, he became associate director of an HMO startup based in Cary. A larger HMO, Principal Health Care, then recruited him to lead its business in Delaware, where he spent four years.

By 1990, he came back to the Triangle as CEO of Carolina Physicians Health Plan. During his tenure, the physician-owned company grew from 30,000 members to nearly 300,000. Revenue increased from $30 million to $360 million, attracting a buyout in 1996 from larger insurer Healthsource, which was then acquired a year later by Cigna.

In 1998, he joined Blue Cross Blue Shield of North Carolina, where he became president in 1999 and CEO in 2000. The company had lost a combined $180 million in the previous five years. Over the next decade, annual revenue more than tripled to $5.2 billion and membership nearly doubled to 3.7 million. 

After retiring in 2010, he partnered with his oldest son, Will Greczyn, to purchase six Mellow Mushroom restaurants in North Carolina. He also owns a stake in Fortnight Brewing, which has pubs in Cary and Wake Forest.

Greczyn, 71, is vice chair of the ECU Health Board, which was created this year through a combination of the former Vidant Health and East Carolina’s medical school. 

Greczyn and his wife, Kristen, have been married for 27 years and live in Cary. He flies single-engine planes, races sports cars and enjoys their home on Smith Mountain Lake in Bedford County, Virginia.

Blue Cross Blue Shield of North Carolina grew rapidly during Greczyn’s CEO tenure. He’s shown with former board chair Dr. Jeff Houpt.

Comments are edited for length and clarity.

My favorite job was Blue Cross. I was given the opportunity to change it, to make it better, to work with an incredible group of leaders and colleagues — to create something special. You don’t get many opportunities in your life to do something truly special. 

When I got to Blue Cross, the company was not particularly healthy. After losing money on operations after a number of years and not, in my view, doing everything they could to be as customer friendly as an insurance company could be, we set about changing that. During my tenure, we became the fastest-growing Blue Cross in the U.S. We competed hard and we tried to take good care of our members and communities. I think today, they are doing exactly that. 

We set up a program for our employees, called Blue University. We set up classrooms in one of our buildings and professors came to us from schools. We paid for our employees to go to college. About 13% to 14% of the company was in school, on their time, and when they graduated, we gave them a sabbatical for the hard work. I’m pretty proud of that.

In 2001, BCBS bought Partners National Health Plans, which was owned by [Winston-Salem-based Novant Health.] It was the largest HMO in the state. I don’t think anyone expected Blue Cross to make that acquisition, but I absolutely wanted to make that acquisition. It has paid off well not from just a member size standpoint, but one of the things that Partners was really good at was the early stages of Medicare managed-care. We built a lot of our expertise in Medicare managed-care based on that acquisition, which was a very positive thing.

Obamacare passed within two months of me retiring. While it gets a lot of mixed reviews, I personally think it was a good thing and a good step. I think the more difficult thing about Obamacare was that it was never intended to be a finished product. It was always intended to be something that kept developing and changing and getting better over the years. Because of the political environment and Congress changing, a lot of the things that should have happened never did. It’s still very valuable, but it’s not what it could have been.

My biggest disappointment, and I hope it gets resolved this year, is approving Medicaid expansion in this state. We’ve not done that for years. That has left a lot of people on the sidelines that could have been helped. The quotes I’ve seen say half a million people in North Carolina would benefit from Medicaid expansion. And every rural hospital would benefit from Medicaid expansion. My hope is that the current legislature will approve Medicaid expansion in the near future.

Greczyn’s post-corporate career mixes charity work, including assisting on volunteer building programs, and racing sports cars.

In eastern North Carolina, the payer mix is very heavily skewed to Medicare and Medicaid, with a much smaller percentage that is commercial insurance, which tells you the potential of Medicaid expansion.

Hospital consolidation can work. I think in eastern North Carolina with ECU Health, my view of the world is that it has worked. It’s because we don’t do what some others do, which is essentially, do an affiliation agreement with a hospital. But they’re not really all in. They’re not putting capital dollars there.

All of the ECU Health facilities are part of the system.
Part of that means we have a financial obligation to help make them successful. We have to make capital improvements because
we are all in.

When I had the opportunity to join ECU Health (formerly Vidant) in 2012, I’d never had any opportunities to be involved on that side of the health care system. I started out early in my career building a community health center in rural North Carolina. But I’ve never been involved with a hospital. 

I’ve thoroughly enjoyed seeing the world from the other side of the coin. I bring my skill set to the table. The involvement is not just with the medical center in Greenville, although that is the largest. There are eight additional hospitals in a 29-county area that are part of ECU Health.

My favorite book, which I’ve carried around with me forever, is “Change Is Good, You Go First.” Everyone says they love change; nobody loves change. Change is a constant. You can stand in the way; you will get run over. 

I race cars and fly planes because I think it helps keep your mind sharp. I think it’s really important to maintain your health and keep your reflexes as sharp as they can be.



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