Remarkable Leadership: Meet Cindy Hundorfean, Chief Living Health Development Officer

• By:  Catherine Clements
• Posted:  June 30, 2023
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2023 is a big milestone for Allegheny Health Network (AHN), marking the 10th anniversary of the western Pennsylvania-based health system. What was a five-hospital network in 2013 has grown into a 14-hospital, $4+ billion health system today. At the helm of that growth and development was innovative leader, Cindy Hundorfean.

“Over the past few years, we’ve proven the success of a blended health model that is part of our larger Living Health strategy. When you think about all the changes and improvements we’ve made at AHN as a result of becoming part of the Highmark Health family, the list is endless. We’ve proven that we are better together,” says Hundorfean.

I sat down with Cindy to reflect on her lessons learned as AHN’s president and CEO and explore her new role as chief Living Health development officer for Highmark Health.

Allegheny Health Network at the 10-year mark

Catherine Clements: For seven years, you served as AHN’s president and CEO. What accomplishments are you most proud of?

Cindy Hundorfean: Several things come to mind — we built a strong operational foundation for AHN through a relentless team that was focused on “getting health care right.” The leadership team worked tirelessly to turn the system around financially and to show the community that they could receive first-class care throughout AHN.

One of the things I’m most proud of is putting physicians and nurses into leadership positions across the network. Clinicians make decisions that are based on putting the patient first — a big differentiator for achieving our mission to create a remarkable health experience. This also gives clinicians a voice, so decisions are made with them — not forced upon them.

Our response to COVID-19 is one of the personal highlights of my career. I’m immensely proud of our caregivers, who worked 24/7 to care for our patients and each other. They are true heroes.

I certainly don’t want to leave out the establishment of the Enterprise Equitable Health Institute in 2021, led by Dr. Margaret Larkins-Pettigrew and her talented team. They’re doing some incredible work to advance equity, inclusion and belonging in our workforce and improve health equity and quality of care for our communities.

Catherine Clements: What was it like leading a hospital system during the pandemic?

Cindy Hundorfean: To see everyone come together, across the entire organization, including all the outside organizations that we asked to help, was something that none of us have ever experienced. David Holmberg was on board from the very beginning. I still remember him saying, “I'll do anything and everything that you want me to do.” He was amazing throughout it all.

AHN and Highmark Health worked together to accomplish things that neither could have accomplished on its own like the mass vaccination events, and the COVID test-kit assembly. We worked with our community allies like the Pittsburgh Pirates, Dick’s Sporting Goods, MSA Safety, the Erie Insurance Arena, and many others, throughout 2020 and 2021, and they helped us respond to the needs of our patients and caregivers. We even went out to local churches, barbershops and bars for community-based vaccine clinics.

Investing in caregivers and the community

Catherine Clements: Over your tenure, you’ve led an immense ($1.8 billion) capital expansion. What does that growth mean for the community?

Cindy Hundorfean: It means that we listened to the people we serve. We had a goal from the very beginning to provide care close to home and to expand the reach, breadth and depth of our clinical programs. It was also crucial that we provided better access to our high-growth, high-need programs such as cancer, women, and orthopedics. We had to provide faster, more convenient emergency access. We did this by renovating and expanding many of our hospital’s emergency departments and by partnering with Emerus, to build four neighborhood hospitals. Building the neighborhood hospitals was something that hadn’t been done in Pennsylvania. This has been incredibly successful. For many patients, this is a more appropriate place of care and people rave about their experience.

I’m very proud of how we expanded access, both in person and virtually. Our goal was to move care to the community, and that’s what we did.

Catherine Clements: What does this expansion mean for people working at AHN?

Cindy Hundorfean: As leaders, we must give our caregivers the tools and resources they need to succeed, and they need to feel listened to and supported. By building new emergency departments, surgical suites, and modernizing our facilities, it’s allowed our caregivers to perform their jobs more effectively and efficiently. Investments in our footprint are ultimately an investment in our patients and caregivers.

Taking care of our caregivers is our most important job. Burnout is real and there are no easy answers. But we are paying attention and asking our caregivers how we can help them. Our clinician wellness program is drawing attention nationally, including its rigorous focus on measuring performance. AHN conducts regular wellness surveys for all our clinicians to help track progress and continuously meet their needs.

At AHN, we employed a multi-pronged approach to address the nursing shortage: better starting pay, more flexible shifts and building our own travel nursing staff. Through a program we call “Reimagining Nursing,” we’ve identified ways to liberate nurses so they can focus on working at the top of their license, meaning doing what they were trained to do. We’re also tapping into remote nursing opportunities and reducing the administrative burden through our Digital Nursing program. Another highlight I want to share is our “blended care model” to re-introduce licensed practical nurses (LPNs) back into acute care. This includes collaborating with regional academic partners to reduce a student’s financial burden of education for a commitment of employment after graduation.

Catherine Clements: You’ve brought leading-edge technologies, key academic/clinical partnerships and other innovative solutions to market during your time at AHN. Can you share some of the top milestones?

Cindy Hundorfean: Same-day appointments would be high on my list. As of now, we’ve scheduled nearly 1.9 million same-day appointments since we started, and we’re averaging 1,333 per day. This is incredible.

In June 2022, we also launched self-scheduling for primary and specialty services. This approach breaks down barriers to care and empowers patients to access health on their own terms. In fact, about 80% of self-schedule appointments are new AHN patients.

We also repurposed our AHN Suburban Hospital into an innovation hub. Led by Dr. Jeffrey Cohen, part of the space is occupied by AlphaLab Health, a life science center focused on advancing medical technologies and making early-stage investments. It was the result of a collaboration between Allegheny Health Network (AHN) and Innovation Works. It gave new life to a hospital that had been closed for many years.

Teaming up to deliver on Living Health

Catherine Clements: You’ve certainly made your mark at AHN. Now, I want to talk about what’s next in your role as chief Living Health development officer for Highmark Health. What attracted you to this position?

Cindy Hundorfean: I wanted to have an integral part in shaping and influencing the Living Health strategy. Living Health means uniting payers, providers, tech innovators, and community organizations to build a health ecosystem that works better for everyone. The prospect of building upon what we’ve learned as a blended health organization and working with other delivery systems to create a simpler, more personalized, and proactive health experience for individuals and clinicians is very exciting.

The knowledge that I’ve gained over the last several years working in both the provider and payer worlds puts me in a unique position to help our partners transform their model and approach — and to also expand our national reach through active connections with other health care thought leaders.

Catherine Clements: Let's dive into what our organization calls blended health. How is this approach different from other ways that payers and providers work together?

Cindy Hundorfean: In the future, a provider system’s ability to collaborate effectively with its payer partners will be linked to sustainability and financial solvency. Our blended approach means that we’re acting as one organization, charting the course and solving problems together. We have shared goals and infrastructure, including incentives and support that enable a greater focus on experience and outcomes.

In our case, what we're blending is also a differentiator. We're leveraging the experience and resources of one of the nation's largest Blue Cross Blue Shield licensees, the clinical expertise of high-quality providers, and also a lot of community-based knowledge and relationships.

Highmark Health has a purposeful growth and partnership strategy. From tech disruptors like Google Cloud and League to pharmacy collaborations like Evio and CivicaScript, to simplifying the payment experience with Cedar, we’re redesigning the coverage and care experience.

As an enterprise, we’re also collaborating with community-based organizations to move care upstream, and that includes addressing social determinants of health in a serious way.

Catherine Clements: What excites you most about Living Health and what we plan to achieve in the immediate future?

Cindy Hundorfean: All the work that has been done already to deliver on Living Health or is being built and will be rolled out soon is incredible. I’m really excited about the solutions our leaders have brought to market like the My Highmark digital member portal and the Medically Tailored Meals pilot program to name a few.

We’re doing a lot to improve population health, streamline prior authorizations, increase days in the home, expand access to behavioral health, strengthen our clinically integrated network and expand virtual health options. We have some exciting initiatives rolling out later this year and early next — so stay tuned for more in this space.

Shifting from volume to value

Catherine Clements: Many organizations and thought leaders talk about transforming health care in the U.S. What are the biggest challenges that the ‘transformers” face, and where do you see the most promise for achieving meaningful change over the next three to five years?

Cindy Hundorfean: Let’s start with the goal. As Dr. Bruce Meyer said in an interview with the Pittsburgh Business Times, “[we need] to build the type of health care system that not only delivers healthier people, but also at a lower financial burden.” Health care costs continue to spiral out of control. We need to create a sustainable economic model that works for both health care providers and payers.

The biggest challenge continues to be the “fee for service” mentality that many health care organizations and clinicians still have. “The more I do, the more I get paid.” Compensation systems haven’t changed to reward clinicians for providing the right care, and systems are still trying to fill up their hospital beds. That’s going away fast, and the systems that don’t pivot to providing great care at a reduced cost will not be successful in the future.

Catherine Clements: What are the benefits of shifting to value-based care, and how can health organizations get there?

Cindy Hundorfean: Payers and providers must work together with common, aligned goals. Together, they can be powerful allies by trading ideas that will strengthen the customer experience and outcomes. If done well, it will result in reduced cost for payers, providers and ultimately our customers.

You’ll need to build trust, transparency, the ability to share information bidirectionally and perhaps update your governance structures. It will be critical to define a common vision and agree on the risk tolerance.

One of the biggest rewards of successful payer-provider collaborations is the potential to reduce denials. Both health care systems and payers have significant infrastructures in place to deny and fight for authorizations. The patients are caught in the middle, and it causes delays and adds cost.

I see success as having exactly the right patient in a bed, one that is acutely ill, and all other patients are cared for in other settings like the home, community or virtually. We are way ahead of many provider systems in this regard. They will agree with the statements above, but they don’t know how to get there.

Catherine Clements: What sets Highmark Health’s approach to value-based care apart?

Cindy Hundorfean: The difference in our approach to reinvent coverage and care is that the payer and provider designed it together. Many will say that they do this too, but not to the extent that we do. The advantage to Highmark Health’s approach is that we’re not afraid to fail, or to change course when needed. We are very agile.

Catherine Clements: What advice do you have to other health leaders driving transformational change?

Cindy Hundorfean: Build a well-defined, inclusive strategy for your organization and gain alignment from your leaders. Embrace value-based care and virtual care. Prepare to be disrupted. Constantly look at other health care organizations to find best practices. Learn from each other. Care for all your employees like they are members of your family — this will inspire them to take the journey with you.