Ricardo Rivera-Cardona entered the EXEC program eager to create new initiatives in healthcare for Puerto Rico. Mr. Rivera-Cardona is the Executive Director of the Puerto Rico Health Insurance Administration. In this role he manages the Government Health Plan (GHP) which serves 45% of Puerto Rico’s population with a 2.8 billion dollar budget. When he assumed the role in 2013, Rivera-Cardona had inherited a system in crisis. The agency had a projected deficit of 200 million dollars. In the last three years, Rivera-Cardona has streamlined the system, working to eliminate inefficiencies, and the organization is currently projecting a 60 million dollar surplus by the end of this fiscal year.
Since enrolling into the EXEC program, Mr. Rivera-Cardona has completed several courses which have been extremely useful in his effort to navigate challenges within the Puerto Rican healthcare system. One course, Issues and Approaches to Healthcare, has proven particularly informative. “The class provided a historical context for understanding how the US system works and the challenges and the political issues surrounding it,” Rivera-Cardona explains. “That gave me additional tools to do my job. In Puerto Rico, people are caught up in the moment, and they don’t step back to understand history, and that class taught me how to value history and to use history as a foundation in order to build a future.”
When Rivera-Cardona’s graduates from the EXEC program in 2017, he plans on moving back into the private sector. He knows that the skills he has acquired throughout his professional and academic career will help him transition smoothly into his next role. Mr. Rivera-Cardona sees opportunity to effect change in the future of healthcare. His experience eliminating the inefficiencies in organizations is a strength that he hopes to employ in his next role. “My life has been getting into challenges and then trying to turn them around, and that’s what excites me about healthcare.”
When Gina Villani was thirteen years old, her cousin died from leukemia. Villani was stunned by the disease and the swift and devastating impact it had on her family. This experience ignited her interest in medicine and drove her to pursue a career as a physician. There were no doctors in her family and no model of how to navigate the medical school applications and entrance exams. Villani’s parents were skeptical of her career choice, which only made her more resolute. “Because we didn’t have anyone in healthcare in the family and no one had ever been to medical school, we didn’t know the process,” Villani says. She applied to medical schools for four years in a row, and undeterred, kept retaking her MCATs. On her fourth attempt, she got a perfect score and was admitted to the State University of New York (SUNY) at Stony Brook.
After medical school, Villani completed a residency in internal medicine at SUNY Syracuse and North Shore University Hospital. She did post-doctoral work in Hematology and Oncology at New York University Medical Center and Bellevue Hospital, and she worked at Montefiore in the Bronx during the height of the HIV epidemic, treating patients with HIV-related cancers. At North Shore, Villani treated patients without insurance, which sparked her interest in working with underserved populations. At North Shore, she also became a member of the Gynecological Oncology Group, studying the effectiveness of new drugs and drug combinations used to treat gynecological cancers. “It takes a lot to get people to understand what a clinical trial is,” she remarks. “It was a big accomplishment, being able to work with patients to help them understand the value of participating in clinical research.”
As much as she valued working in a clinical setting and treating patients, Villani was eager to expand her career options. “I really like clinical medicine, but ultimately, I felt discouraged. I knew that I couldn’t keep doing it five and six days a week. I was really frustrated with the healthcare system overall.” Villani began to research her career options and decided to go back to school. She enrolled in Columbia’s EXEC program. “The program completely changed my career path,” she says, “I started to learn about the bigger picture, how the healthcare system works. It made me see that there were so many opportunities and alternatives to clinical medicine.” She also learned valuable management skills at Columbia. “I had always been a staff physician at a hospital, so management was sort of the enemy,” she jokes. She describes the relationship between the administration and the clinicians in her experience as two groups who didn’t understand each other’s roles and didn’t speak the same language. “Learning about management widened my view of the whole healthcare system.”
After getting her MPH, Villani served as the Vice President of Health and Quality of Life for the National Urban League. There she worked on a pilot program in partnership with the Morehouse School of Medicine. The program, first implemented at the Urban League in Elyria, Ohio, paired African-American men from the community with health coaches. The coaches provided physical screenings, nutrition and fitness education to help instruct the men on ways to control diabetes and hypertension. The program was such a success that it has since been instituted in various Urban League sites around the country.
In February of 2012, Villani was named CEO of the Ralph Lauren Cancer Center. The center was founded as a community-based facility focused on cancer prevention, diagnosis and treatment. This month marks the ten year anniversary of the center, and it continues to provide a space to treat underserved populations. Villani is proud to note that the center has expanded what is considered underserved, “It’s not just racial and ethnic minorities—it’s LGBT and the mentally-ill and other marginalized populations. We want to provide cancer prevention and treatment for those populations because they suffer disparities as well, so we’ve broadened who we are serving.” She explains that the center is not a place for large-scale clinical trials or experimental drugs. “The center’s goal is to stand as a model of how to provide cancer care in the community for underinsured, uninsured, disenfranchised people, and do it in a way that is financially responsible.” Because Medicaid pays so little for cancer care, underserved individuals don’t have access to quality care.
Arthur A. Gianelli, MA, MBA, MPH
Arthur A. Gianelli, MA, MBA, MPH, is President of Mount Sinai St. Luke’s, part of the Mount Sinai Health System. He is also a Special Advisor to the President and CEO of the Mount Sinai Health System for Medicaid Strategy. He has served in both positions since February of 2014. For the previous eight years, Mr. Gianelli was the President and Chief Executive Officer of NuHealth (the Nassau Health Care Corporation), a publicly run healthcare delivery system that provides high-quality care to Nassau County's most vulnerable populations and trains hundreds of medical professionals annually. Prior to joining NuHealth, Mr. Gianelli held senior executive positions over a 10-year period for two Long Island municipalities. He was Deputy County Executive for Budget and Finance for Nassau County, and Director of Operations for the Town of North Hempstead. He has served or currently serves on the Board of Directors of the Long Island Association, Island Harvest, and Regional Policy Board 2 of the American Hospital Association. He also served on the Executive Committees of Healthfirst and America’s Essential Hospitals (formerly the National Association of Public Hospitals and Health Systems). Mr. Gianelli earned a bachelor’s degree in History from St. John's University, a Master of Arts in Political Science from Brown University, a Master in Business Administration from Dowling College, and a Master in Public Health from the Mailman School at Columbia University. Mr. Gianelli has taught health care and hospital management to graduate students at Hofstra University, Dowling College, St. Joseph's College, and Columbia University.