Sarah Iselin, who helped implement Massachusetts’ 2006 health reform law that became the template for the Affordable Care Act, has been appointed the new head of the state’s largest insurer.
Blue Cross Blue Shield of Massachusetts announced the move on Tuesday, saying Iselin will be the first female chief executive in the company’s history. Iselin, currently the chief operating officer of Blue Shield of California, will join the company in December and take over the CEO role in January. She will replace Andrew Dreyfus, who announced in January his intention to retire by the end of the year.
“Sarah is a gifted leader who’s smart, strategic, and passionate about improving health care,” said Dreyfus, in a release. “She knows our company, our culture and our values, and I look forward to working closely with her on an effective transition over the next few months.”
Iselin comes into the role at a turbulent time in health care. Hospitals have increasingly consolidated and, buffeted by years of COVID upheaval, are demanding higher reimbursements. Meanwhile, many in the state have complained that health care is increasingly unaffordable. She will oversee the insurer’s 2.9 million members and more than $8 billion in annual revenue, amid grumblings from some in the hospital sector over insurer earnings. Last week, Blue Cross announced it would give $13 million in rebates back to customers.
In an interview, Iselin said providers in every market were struggling as they emerged from COVID, but it was the mission of insurers to ensure affordable access to health care.
“Having now worked in several other markets, I’ve gotten to see other competitive dynamics — how other plans think about some of the big strategic questions, how best to engage consumers to create that optimal experience, how best to partner with providers,” she said. “And having worked as a regulator, I’m really able to step into lots of different people’s shoes, and will bring that back to Massachusetts.”
Iselin has a lengthy resume in Massachusetts health care, but she initially went to school to study photography. Growing up in Washington, D.C., with parents who worked in the nuclear arms control community, her response was to go to art school, she said.
She moved to Boston after earning her bachelor’s degree from the School of the Art Institute of Chicago and got an entry-level job at the Visiting Nurse Association. While there, she fell in love with health care.
She went on to be director of health care finance for the Massachusetts Hospital Association, where she first worked with Dreyfus. They both then moved to Blue Cross Blue Shield of Massachusetts Foundation and then to Blue Cross Blue Shield of Massachusetts, where she worked as chief of staff for Health Care Services.
Dreyfus, she said, has been a profound influence and mentor throughout her career.
“I count myself lucky to be one of many, many leaders in this community and nationally that he has also mentored,” she said.
Iselin also served as commissioner of the state Division of Health Care Finance and Policy, where she helped implement the 2006 Massachusetts health care reform law. She returned to BCBSMA in 2010, as president of the insurer’s charitable arm, and was then appointed senior vice president of strategy, policy, and community partnerships for the insurer, according to her LinkedIn page.
Iselin left Blue Cross in 2014 to oversee the fixes to the state’s health insurance marketplace, the Health Connector, amid technical and performance glitches that plagued the system as it transitioned from a state-based market to one in compliance with the Affordable Care Act. She went on to work for Optum, which the state also hired to help with Connector fixes.
In 2016, she joined Florida Blue in senior leadership roles and became chief operating officer at Blue Shield of California in 2021, a nonprofit Blue plan with 4.7 million members and $23 billion in annual revenue.
“Sarah is the right person to lead our organization into the future,” said BCBSMA board chair Dorothy Puhy, in a statement. “She’s a seasoned and innovative health care executive who combines a deep understanding of our industry and the Blues system, a passion for making health care simpler and more affordable, and a familiarity with our company and the unique role it plays in Massachusetts health care.”
Iselin will oversee Blue Cross’s required entry into the subsidized ConnectorCare market starting in 2024. Whether that would mark an opening to also move into the Medicaid market for the first time was unclear. Iselin said she wouldn’t start in the role until December and that the company was always looking at every market opportunity through the normal course of business.
She said the company would examine growth opportunities overall, though BCBSMA will remain focused on Massachusetts.
Jon Hurst, president of the Retailers Association of Massachusetts, worked with Iselin during her time as commissioner for the Division of Health Care Finance and Policy and said she was helpful to small businesses as she worked to implement Romneycare.
Many in the health care sector applauded Iselin’s appointment, including Lora Pellegrini, chief executive of the Massachusetts Association of Health Plans, who called her a “thoughtful and compassionate leader.”
Amy Rosenthal, executive director of Health Care for All, which advocates for improved health care access, said, “At a time when Massachusetts continues to face nagging and significant health care affordability, access, and equity challenges, she is a strong leader to guide BCBS and build on the important, collaborative successes of the company and its partners.”