FAIR Health Board Access—Chair Exit Interview with Stephen A. Warnke, Esq.
In October 2009, Stephen A. Warnke, the founding Chair of the FAIR Health Board of Directors, was asked to steer a nascent, independent nonprofit entity created to bring greater transparency to the healthcare system. Under the mandate that governed its founding, FAIR Health was tasked with providing an independent database of claims information contributed by payors nationwide, a free website to educate consumers about the cost of care in their geographic areas and about insurance reimbursement, and data for research that could help to formulate or evaluate policy and support academic studies.
Under Mr. Warnke’s steadfast leadership, FAIR Health’s impact on the healthcare sector flourished beyond its founding mission. FAIR Health data have shaped myriad policies, statutes and research studies, and power the free consumer site that is used by hundreds of thousands across the country. Today, proving yet again the value of an independent source of empirically grounded healthcare data, FAIR Health is playing an especially timely role in supporting healthcare stakeholders as they seek to respond to the COVID-19 pandemic.
After a decade of extraordinary leadership, at the end of last year Mr. Warnke stepped down as Chair, although he will continue to serve one more year on the FAIR Health Board. In addition to his leadership of FAIR Health, Mr. Warnke also is an award-winning healthcare attorney and a partner at Ropes & Gray LLP in New York City, where he represents a wide range of healthcare providers and plans. To mark the end of his tenure, Mr. Warnke reflected on FAIR Health’s remarkable evolution and the critical role it is now playing as the healthcare sector confronts the COVID-19 pandemic.
FAIR Health: As the founding Chair of FAIR Health during its initial, formative decade, you steered a new, independent nonprofit through an ever-changing healthcare landscape. What personal or professional experiences best prepared you for your role as Chair of FAIR Health?
Stephen A. Warnke: My preparation for serving as Chair in the first decade of FAIR Health’s existence came from my experience representing complex nonprofit organizations as an outside counsel—helping them navigate the tension between their charitable missions and their need to be financially healthy and self-sustaining—and my experience in and around the healthcare landscape. It would be an exaggeration, however, to say that I was well prepared. I learned quite a bit on the job and was quick to tap the knowledge and experience of colleagues on the Board of Directors, all of whom gave generously of their time and experience and helped guide the organization to its current success.
FH: When FAIR Health was founded 10 years ago, the Affordable Care Act (ACA) was still being deliberated. And when FAIR Health’s founding was announced, you noted, “Its launch could not be better timed.” What was important about the timing of FAIR Health’s creation?
SAW: Healthcare remains one of the most hotly debated, polarizing issues in American politics. The passage of the ACA 10 years ago last month and its subsequent implementation have neither resolved that dispute nor reconciled the warring players—to the contrary. Today, we are even more polarized in our views as to how best to deliver quality healthcare to all Americans. FAIR Health, as a neutral repository of healthcare data available to all stakeholders, has been pivotal in informing the debate while maintaining its objectivity and neutrality.
FH: Of all of FAIR Health’s contributions to the healthcare sector, which makes you most proud?
SAW: Remembering the fraught litigation environment from which FAIR Health emerged, I am proudest of all of its technical accomplishments. When we started, coming from that place, it was far from clear that FAIR Health would establish its bona fides as soon as it did and become recognized as the go-to, unimpeachable source of benchmark data, used not only in FAIR Health’s core business of providing pricing benchmarks for insurers but also in generating datasets and data analytics that inform the larger policy debate. That FAIR Health has emerged 10 years after its founding with stakeholders—including government agencies, physicians and insurers—all confident that the data accurately reflect healthcare charges and trends in utilization and costs is a hugely satisfying outcome. And with the COVID-19 pandemic’s profoundly disruptive effect on all sectors of our economy—not to mention our daily lives—that broad-based confidence in our data and what it reveals is a social good of which we can all be proud. We have shown the efficacy of our data already, in a study issued in late March that estimated what the country is likely to spend on hospitalized COVID-19 patients before introduction of a vaccine. The fuel that powers FAIR Health’s engine is the real-time, constantly replenishing claims data that health insurers contribute every day to our database, creating a vast repository of raw information on where and how Americans receive care; that engine will serve us all well as we weather the COVID-19 storm and emerge, I hope, to a better world.
FH: FAIR Health’s Board of Directors boasts an impressive roster of members who represent a wide spectrum of healthcare stakeholders. What insights can you share about chairing a multi-stakeholder Board of a national, neutral and independent organization?
SAW: A fiduciary board’s most important tasks are to husband and preserve an organization’s assets and ensure its faithful adherence to its mission. The composition of FAIR Health’s founding Board and every subsequent election to the Board have been motivated by an insistence that members of the Board be willing to set aside their particular personal perspectives and promote FAIR Health’s mission. Fortunately, we have made good choices. The Board has been extraordinary. As Chair, my job largely was to ensure that the Board engage in a robust discussion and then come to consensus. While we have had the occasional disagreement, we have never not reached consensus and we have had fun.
FH: What are the most pressing issues that healthcare stakeholders will face in the coming years? What role will FAIR Health play in supporting stakeholders in navigating those challenges?
SAW: The healthcare system in the United States still faces the fundamental challenge of providing quality, affordable healthcare to all who need it. Although we have made progress in the last 10 years, too many Americans still remain uninsured or lack adequate insurance coverage. The devastation that unequal access to care wreaks on individuals, their families and our social fabric has always been clear, but it is even more so now, as we collectively face the COVID-19 outbreak, which can’t be solved unless adequate diagnosis and treatment (and, ultimately, vaccination) are available to all. Our outcomes, whether measured by infant mortality, life expectancy, obesity or other chronic diseases, are appalling when compared to other industrialized democracies and when considering the share of our GDP that we devote to the healthcare sector. Against that backdrop, I do not think I am saying anything original when I say that we still have a major task in front of us. I hope that FAIR Health will continue to inform that task with reliable, up-to-date, broadly disseminated data on cost and quality.
FH: How do you think FAIR Health will evolve in its second decade?
SAW: The stewards of FAIR Health have put the organization on a good path. I expect we will continue down that path while simultaneously ensuring that we remain true to our fundamental charitable purpose of promoting transparency in healthcare data.
FAIR Health Board interviews reflect the views of the Board member in his or her individual capacity and not necessarily those of FAIR Health.