Facilitator to help forge M Health Fairview’s future, despite ‘turbulent water’

The future of health care training, research and patient care at the University of Minnesota is too important to allow it to get lost in past disputes over the academic health program.

That was the message Friday from former UnitedHealth Group executive Lois Quam, who was named in April by Minnesota Attorney General Keith Ellison as "strategic facilitator" to help negotiate a proposed partnership among the U, Fairview Health Services and Duluth-based Essentia Health.

“I recognize that there has been turbulent water under this bridge,” Quam told the U Board of Regents on Friday. “We can’t undo that. But there is too much at stake to dwell on past disputes.

“And while these disagreements are real and some are longstanding, they certainly aren’t the most difficult or entrenched issues that I have dealt with.

“Agreements can and will be reached,” she continued. “There is far more that unites than divides.”

The partnership between the U and Fairview, which jointly operates hospitals and clinics under the brand M Health Fairview, is scheduled to end late next year. And the U has proposed Fairview merge with Essentia to create an “all-Minnesota” health system as a way forward. So far Fairview has balked, saying it doesn’t want to lose its autonomy while suggesting a “strategic partnership” is possible.

Quam worked at Eden Prairie-based UnitedHealth Group from 1989 through 2007 and was credited with leading the company’s ascendance as the largest private health insurer for Medicare beneficiaries. It was driven in part by a critical marketing agreement that Quam helped secure with AARP, the influential lobbying and education group for seniors.

In 1989, Gov. Rudy Perpich appointed Quam to lead a commission that produced recommendations leading to the state’s MinnesotaCare health insurance program, which provides coverage for uninsured working families with modest incomes. In the 1990s, she was senior adviser to a health reform task force convened by then-First Lady Hillary Clinton.

Over the years, Quam has held leadership positions at groups focused on clean energy, environmental causes and public health, including CEO of the Nature Conservancy in 2014-2016. In the past 12 months, she briefly served as chief executive at nonprofit health insurer Blue Shield of California.

Her résumé, and her general acknowledgment of past problems, was applauded Friday by U Regent Mary Turner.

“That has been a concern of mine, that too much water has passed under the bridge — that it’s irresolvable,” said Turner, a past president of the Minnesota Nurses Association. “So I’m comforted by your words and your experience.”

Tensions between the U and Fairview have ebbed and flowed ever since the Minneapolis-based health system acquired the university’s teaching hospital in Minneapolis in a financial bailout in 1997.

The relationship has vacillated from optimism in 2018 for a new joint clinical enterprise called M Health Fairview to friction since 2022 over proposals to merge Fairview with Sanford Health or Essentia Health.

The partnership between the U and Fairview is important because it provides key funding for the U’s Medical School, plus support for research, training and patient care services at the university.

A proposal floated in January by U President Rebecca Cunningham to combine Fairview and Duluth-based Essentia into a statewide nonprofit health system has been opposed by Fairview and questioned by some university physicians.

Quam said she’s been charged with overseeing discussions among the three organizations to create “a mutual path forward to support building and maintaining strong health care services across Minnesota.”

“I understand that there is urgency to provide clarity and confidence to all involved,” she said.

Gregg Goldman, the U’s executive vice president for finance and operations, told regents the university trains about 1,000 physicians each year in residency and fellowship programs, as well as 265 medical students annually.

The U and Fairview’s affiliation agreement is set to expire at the end of 2026. The partnership generates about $100 million for the university each year

The Minnesota Star Tribune reported in March that Fairview and the standalone organization University of Minnesota Physicians have been in arbitration to settle a variety of financial disputes, some of which touch on a large clinic and surgery center they jointly operate on the U’s East Bank campus. Neither side has released details.

Fairview leaders were upset over being given short notice in January about the U’s proposal for a new statewide nonprofit that would merge the health system’s assets with Essentia Health.

Similarly, U officials balked over Fairview’s plan to merge with South Dakota-based Sanford Health, which included a 2022 episode where the school accused Fairview of mismanagement and Fairview accused the U of hoarding M Health Fairview profits.

Quam didn’t specifically reference the disputes Friday, while stressing the importance of finding common ground.

She praised the U, Fairview and Essentia Health as venerable institutions with significant contributions to the state’s health care history, wryly noting, “Essentia is the youngest, having been founded as St. Mary’s Hospital in Duluth in 1883.”

Growing up in the southwest Minnesota city of Marshall, Quam told the regents, she learned the importance of access to health care while watching her father’s work as a Lutheran pastor in the community.

It became clear how the cost of care could be as damaging to families as illness itself, she said. Surviving tough diagnoses often required traveling for advanced care at the University of Minnesota or Mayo Clinic in Rochester.

Next week, Quam plans to attend an honors event at her former high school in Marshall and spend time with a school board member she’s come to know in recent years: a woman whose daughter needed life-saving treatment at the U’s Medical Center when she was just 1 day old.

“There, as a fragile infant born with a rare, poorly understood genetic condition, Emma and her parents met the University of Minnesota doctors who would save her,” Quam said. “Now a junior in college, Emma, like so many other talented rural Minnesotans, is poised to be a Minnesota leader building a future that benefits all of us. All because of the care she received here.”