One in a series of interviews with Modern Healthcare's Top 25 Women in Healthcare for 2015.
As the president and CEO of the Catholic Health Association since 2005, Sister Carol Keehan is arguably one of the most powerful healthcare executives in the country and played a significant role in getting the Affordable Care Act passed. Yet there was a time in her life as a hospital executive with a nursing background that she felt stymied in her efforts to help the poor obtain medical care, so she went back to school to get a master’s degree in finance.
“I thought I had a lot of really wonderful ideas, particularly for how we could take care of people who couldn’t afford care. And I would always get just literally nailed by the finance person,” she remembers. “They would say, ‘That would be a nice idea, but you couldn’t do it for these reasons.’ And most of the time, those reasons were, ‘It’s easier for me not to get involved.’ But that’s just not right.”
Armed with that degree and an understanding of the intricacies of Medicaid, cost-based reimbursement and the art of negotiating contracts with insurance companies, Keehan became an even more formidable force to be reckoned with. She’s been honored by many, including a Trustee award from the American Hospital Association and another from Pope Benedict XVI. And in 2010, Time magazine named her one of the 100 Most Influential People in the World.
Keehan says she sees more women following a similar path in healthcare these days. “More and more, you’re going to see women reclaiming leadership positions,” she says. “More women are going into business schools, and more women are getting a degree in finance in addition to a degree in nursing.”
Gender diversity in leadership is important, she says, and should simply be common sense. She notes that it was primarily sisters from religious orders who built some of the largest healthcare systems in the U.S.
“Whether it’s the Catholic Church or whether it’s healthcare, if you only use 50 percent of the talent you’ve got, that’s a problem,” she says. “If you only use men, you’ve got a problem. If you only use women, you’ve got a problem.”
She has faced her share of opposition over the years. She had a well-publicized battle over her support of the ACA with a number of U.S. bishops, who erroneously believed the law provided federal funding for abortion.
“You don’t hear the bishops saying, ‘Repeal the Affordable Care Act,’ ” Keehan says. “The bishops always wanted healthcare for everyone. They got some advice that I didn’t think was correct. I had spent as much time as anybody working with the people writing the bill at the House, in the Senate and in the White House. So I knew exactly what was in the bill. Two federal judges already ruled early on that there was no federal funding for abortion in the bill.”
Keehan sees her positions on the issues based on morality and theology more than politics. She has spoken frequently about “solidarity as the moral foundation for health reform.” And for her, that solidarity begins with economically disadvantaged people.
“Part of it is your worldview,” she explains. “Do you see yourself as someone who is out to get everything they can for themselves in the time they have? Is the impact of what I do measured by what it gets for me?”
That’s opposed to Keehan’s worldview, which she describes in this way: “We are a part of something much more wonderful. We’re a part of creation, we’re created by a loving God and the fullness and our greatest happiness will come when we imitate that loving God and appreciate the relationship we have with other people whether we know them or not.”
As a veteran world traveler—she’s on the board of Catholic Relief Services--she has seen the poorest of the poor in countries like Rwanda and Guatemala and has strong opinions on issues ranging from immigration and climate change to how world powers sometimes take advantage of developing countries.
“We have a responsibility to take care of ourselves and to take care of our families, and there is a priority you put to that,” Keehan says. “But when that priority gets so out of balance that you don’t care what happens to other people, you really diminish yourself.”
Those experiences in the bleakest parts of the world, she says, make her more determined to make a difference as a leader, and more committed to prayer.
“I think you pray better when you’ve seen that kind of suffering. You also think about the impact of things when you live in a consumer society,” she says. “You can always find a reason why you can’t do something, but it does push you to find reasons why you can do something.”
Keehan’s concerns for the poor in the U.S. are no less strong, and she says one of the traits needed for leadership is championing people whose voices are often drowned out in the nation’s capital by the cacophony of lobbyists and special-interest groups.
“I’ll often say to people in an audience that a $25 co-pay is not going to stop you or me from getting a mammogram. But it often is the difference for a single mother with two children. ‘Do I spent $25 for a mammogram, or for meals for the rest of the week till payday, or fill my child’s prescription?’ ”
Up until she took the role at CHA, Keehan not only worked in hospitals but actually lived in them all her adult life as a Daughter of Charity. Though hers is a special calling, she says she feels that everyone in healthcare has a calling.
“In healthcare, if you don’t feel you can make a real difference, you must have some spot in your soul that’s dead and you need to get it resurrected. You have an opportunity to make such a big difference in the lives of so many people.”