Presbyterian's Jim Hinton

New Mexico Business Journal, Sept, 1996

The president's commitment to overall health is reflected in Presbyterian's new mission statement, as well as in the exercise trail which winds through the grounds of the corporate headquarters. An avid cyclist, he practices what he preaches. But he adds, "I'm certainly no Gary Johnson. Gary and I have done a couple of triathlons together, but we're only together at the start. He has already stopped sweating by the time I've finished."

Hinton comes from a family with a tradition of health care. One of his brothers is a radiologist in Texas, and the other is an Arizona psychologist. His mother was a volunteer hospital director. He received his undergraduate degree in economics from the University, of New Mexico and his masters in health care administration from Arizona State University.

Hinton's wife, Carol, who also holds a masters degree in health care administration and worked for several years at Presbyterian's health plan, Health Plus, now works at home raising the couple's two children, Rebecca, 9, and Robert, 6.

NMBJ: You have just completed your first year as president of Presbyterian Healthcare Services. How have you moved to put your personal stamp on the organization or change its direction?

Hinton: I guess the common theme I have been trying to push - although not in the interest of my personal stamp, but because I think it's the right thing for the organization to do - is to have a single-minded focus on the customer. I think the Achilles heel of health care organizations in the past has been that they too often assumed that they knew what was best for the customer without asking or surveying after services were rendered. So I would hope that is what I have brought in the last year, and I think our success with some very visible accounts in the state through the health plan and some other successes we have had are indicative that some of that is paying dividends for us.

NMBJ: Presbyterian recently went through a very spirited and public competition with Lovelace for the hearts and health care dollars of state of New Mexico employees. Who won?

Hinton: The state of New Mexico won because they are reducing their costs of providing care to their 19,000 employees and their dependents. Many of our doctors and hospitals were already providing care to state employees under Blue Cross. So the real difference here is that they come in through the Presbyterian Health Plan and Lovelace doors now instead of the Blue Cross door. From a delivery system standpoint it's not a huge increase in lives to our system, but it's a huge increase to the health plan.

NMBJ: How did the numbers finally shake out?

Hinton: It's not over yet, but it is our understanding that we got about 85 percent.

NMBJ: What do you attribute your company's growth to?

Hinton: Our growth comes because people want Presbyterian's services. Our delivery system is really the product that our health plan sells, and that is something that makes us unique in that we are not in the insurance business to be in the insurance business. We are in the insurance business to organize customers to use our delivery system. As a non-profit corporation, our shareholders are the community; and to the extent we have some expertise as business people that allows us to have more revenue than expense, that net income, which in a for-profit company would inure to the benefit of shareholders, is used to reinvest in programs and services.

NMBJ: As the incoming president of the New Mexico Hospital and Healthcare Systems Association, do you have an agenda planned for your term?

Hinton: The agenda will be driven by the board and the membership, so my role will be primarily to provide some leadership to that group's agenda, but there is no question that the Medicaid system in this state will be an area of primary concern for us. The timing of this discussion is interesting in that the governor has announced some changes in the state resulting in the resignation of one of the cabinet secretaries, and I think this signals for the first time in Governor Johnson's administration his seriousness about tackling some of these very difficult issues in the Medicaid program.

NMBJ: You feel that these are issues that the governor needed to deal with?

Hinton: Absolutely. I think there is clearly an opportunity to move Medicaid into more of a managed program, a managed care model, versus the very open-ended fee-for-service model that we have today that by different estimates is attributed with budget overruns of about a $100 million in this state. Just to use a very simple example, if you are covered under an HMO, you are subject to what is called a drug formulary, which is a list of drugs which the HMO approves for use by its members; and while there is an opportunity to go outside that formulary if a specific drug is required by a member, they try to manage within that group of drugs that physicians and pharmacists and others feel are effective. Today the state Medicaid has no formulary, and the estimates are that if that program were merely subjected to the same kind of pharmacy formulary that you are with your HMO, they would save somewhere around $5 million a year. So that is the kind of low hanging fruit that exist in the Medicaid program.