Craig Kovacevich, Waiver Operations and Community Health Plans

Feb 17, 2017, 16:09 PM by KirstiAnn Clifford
Craig Kovacevich
Craig Kovacevich serves as UTMB’s associate vice president of Waiver Operations and Community Health Plans. He is also the executive director for UTMB HealthCare Systems, a Texas 501(c)3 corporation.

In his roles, Kovacevich directs the daily operations of UTMB HealthCare Systems’ corporate office and provides executive leadership within the department of Waiver Operations. He is part of the management team responsible for directing daily operations oft he 1115 Medicaid Waiver—including regional learning collaboratives and local planning and project implementation within the 16 counties UTMB oversees as the anchor institution for Region 2.

Prior to joining UTMB in 2010, Kovacevich was the vice president of marketing for Moody Insurance Group, Inc. He is a Galveston native and holds a bachelor’s and master’s degree in communications from the University of Houston.
What does Best Care mean to you and how do you contribute?
When UTMB initially launched the “Best Care” initiative, I struggled to fully comprehend how the work I do related to the 1115 Healthcare Transformation Waiver contributed to it. However, after learning more about the initiative, it quickly became apparent that I have the ability to impact Best Care in a very meaningful and tangible way. UTMB is both a performing provider and regional anchor under the waiver, and as such, the Delivery System Reform Incentive Payment (DSRIP) projects that my office oversees have a direct relationship to many of the key domains of quality and accountability under the Best Care initiative. Our organization currently has 29 active DSRIP projects, and each one has components that focus on positively impacting patient safety, improving efficiency, reducing 30-day readmissions and even touching mortality through projects like our palliative care efforts. Additionally, one of the main tenants of the waiver is to increase access to care and create an environment where continuity of care becomes reality. This supports Best Care by maintaining and improving UTMB’s commitment to patient-centered care.

What are the biggest challenges you face as AVP for Waiver Operations and Community Health Plans?
This question is very timely given the ongoing negotiations between Texas Health and Human Services Commission (HHSC) and Centers for Medicare and Medicaid Services (CMS). Currently, the waiver is in a transition period as the state and federal governments decide the next steps, which could include a longer term extension or possible redesign of the current program. This uncertainty poses certain barriers in planning for sustainability of existing projects, as well as challenges me to proactively strategize about the future of not only UTMB’s health care transformation efforts, but those of our regional partners in the 16-counties UTMB oversees as anchor.

I have always believed that challenges provide opportunity, so I look at this period of uncertainty as a chance to reassess and improve our efforts to meet the overarching goals of the waiver. I am confident that negotiations will be fruitful and we will have the framework to continue the great work being done in our region and across the great state of Texas.

In addition to my role overseeing the waiver office, I also have responsibility for the health plans that UTMB and UTMB HealthCare Systems (UTMB HCS) administers for both senior supplemental coverage and employer-sponsored benefits. Given the uncertainty of how and when the federal government will address anticipated changes to the Affordable Care Act, I find myself continuously challenged to be prepared to ensure we administer plans that meet various regulations, are financially viable for the organization, affordable for the members and have coverage options that allow UTMB providers to deliver high-quality services at the right time and in the most appropriate setting.

What was your first job?
While completing my master’s degree, I taught at Burnet Elementary School in Galveston. What started as a short-term assignment at the beginning of the academic year, quickly evolved into nearly a year-long position. This job was instrumental in helping me learn the true meeting of “patience.” Being responsible for helping 20-plus second-grade students learn, explore, and, most importantly, have fun doing so, was one of the best experiences of my life.

What do you like to do outside of work?
My wife, Marjorie, and I have had the awesome privilege to travel broadly, both nationally and internationally. Travel provides opportunities to make lifelong memories and is an escape from the ordinary for us and our two sons, Matthew (14) and Grayson (6). As cliché as it sounds, travel helps me find myself and appreciate alternative perspectives on life.

If you could have only one meal for the rest of your life, what would it be and why?
That’s really hard especially when all the food seems to call my name when I step into the kitchen or open the refrigerator. But, if forced to narrow it down, I’d have to say hot and sour soup, sesame chicken, and shrimp fried rice from Hop Lee Rice House in New York City’s Chinatown. It just doesn’t get any better than this!

What’s something you always wanted to do but have not done yet?
After watching my wife cross the finish line at this year’s Aramco Houston Half Marathon and celebrating our son’s three straight Junior Olympic invitations for distance running, I am setting a personal goal to run the half marathon with both of them in 2018. I know this will not be an easy task but I will certainly have the two best coaches ever!

If you could travel anywhere in the world, where would you go and why?
I look forward to traveling with my wife to Cuba someday. Her mother was born and lived near Havana until her family fled in 1959 when Fidel Castro took over the government. My mother-in-law always dreamed of returning to visit her beloved island nation with her husband, children and grandchildren after his reign, but passed away before she had the opportunity. Making the journey to Cuba would be very special because it would celebrate a legacy so important to my wife and our entire family.