Ep. 95: The Power of Perseverance

with Diane Holder
Episode hosted by: Ceci Connolly

December 28, 2022

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Diane Holder
President and CEO, UPMC Health Plan

Diane Holder is Executive Vice President, UPMC; President, UPMC Insurance Services Division; and President and Chief Executive Officer, UPMC Health Plan. UPMC is one of the nation’s leading integrated delivery systems and through its health plans and affiliates provides health care coverage and benefits management for more than 4 million men, women, and children in Pennsylvania.

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You have as much failure built into most of your steps as you do success.

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Ceci Connolly: [00:00:00] Hello everyone. We are so excited to bring to the Her Story audience today. Diane Holder. She is the c e O of U P M C Health Plan, but honestly, that title does not do justice to her really impressive portfolio of companies that she oversees. And so I am so excited to say hello Diane and.

Diane Holder: Hi, Cici. It’s great to be here with.

Ceci Connolly: Thank you Diane, and I know that our listeners want to jump right into your career path because it is so inspiring. And maybe we could start, Diane, with a little bit of your background and journey, and in particular was healthcare. What you always set your sites.

Diane Holder: I went to college as a journalism major. I was the editor of my high school newspaper and [00:01:00] I was very excited about the opportunity to communicate and I was Later. As I got into my undergraduate degree, I took an introductory psychology course and I became fascinated. I became a psychology bug and I wanted to learn more and more, and I eventually ended up Doing my degree in psychology, I ended up doing my graduate work. I was in Ann Arbor when I was, I, as I got my undergraduate degree in Ann Arbor. And that was one of those times in the world when things were pretty active a lot of social movement, a lot of issues with the women’s movement. Civil rights were really kind of coming into their own. And so although I was interested in psychology, I was also interested in the context of how it is we become who we are. And as I began to apply more and more thinking about this, I decided what I really wanted to learn more about [00:02:00] is people in their environment. And I ended up doing a graduate degree in social work. Worked a lot in looking at communities. I then went on to New York City and studied, did additional graduate work. And part of what I found when I left Ann Arbor, which was a sort of hotbed for social reform. I at that time went to New York City, which felt like the entire world in psychology and social was focusing on mental health. And I then went on in my formal training when I got to Pittsburgh, I went to the School of Public Health and I looked at, I actually was in the doctoral program in psychiatric epidemiology. And what was interesting to me was, how do you think about what I think now we call the social determinants of health, quite honestly. and way back when. . One of the earliest papers that, that I participated, cause I was working in a research setting, was the biopsychosocial environment and [00:03:00] how it influences life and what it is that we look at to try to impact people’s lives. So my academic journey when I went to the University of Pittsburgh and worked really for many years. In psychiatry, that was really my home in Pittsburgh early on, was in the Department of Psychiatry and eventually running the psychiatric behavioral health system that we had as part of U P M C for many years. So that was very exciting to me.

Ceci Connolly: I’m already hearing so many of the important themes and threads that I am certainly familiar with as a CEO now of U P M C, but. We get all the way there. Let’s just help our audience understand how you kind of transitioned from really much more of the clinical to administration and then and leadership. What was that transformation like?

Diane Holder: So I was always very interested in How you would create programs. And so when I was in my role at Western Psychiatric [00:04:00] Institute and Clinic, which was where I came when I left New York . It was a lot of work in terms of trying to figure out how do you help people, how do you help their families? I was particularly interested in kids in adolescents and one thing very quickly led to another. In those days, it was one of those things like, Mikey will do it, here, do you want to look at this program? What do you think we should, oh, she’ll do. And I think that was one of the things that, that happened to me. I happened to come into the organization at a time of tremendous change. There was a lot of merger acquisition happening. There was a lot of expansion happening in the clinical and delivery environment. There were lots of changes in the health reimbursement environ. And part of what started to happen is I got more and more involved in building programs. I ended up taking on various responsibilities, which ultimately put me on the team when U P M C decided whether or not they should try to [00:05:00] start an insurance company. And at the time I didn’t know very much about insurance companies. Nothing in fact. But what I did at that point, I was at the stage in my career where I was really running a lot of the clinical behavioral programs. And so when everybody else was busy talking about how are you thinking about health insurance in the traditional sense I raised my hand and I said, well, I’d like to think about how. A business plan for how we’re gonna address all the behavioral health needs of our patients slash becoming members. And because nobody knew very much about insurance, they said, oh, that’s a good idea. Write a business plan, . So what started to happen was really, I started to really apply many of the things I think that we. Did in those days in chronic care management, in early intervention prevention. And so I felt pretty comfortable in the space of how do you develop care delivery models and payment models. I didn’t know [00:06:00] very much about financing insurance and that I had to learn at the bedside. I had some good mentors, some good teachers, and that was helpful.

Ceci Connolly: I wanna get to the theme of mentorship in a moment, but let me ask through all of those early. Years. Did you often find yourself as a woman in the minority? Were you sometimes the only woman at the table or was yours kind of a different experience coming up?

Diane Holder: I would say that my first two significant mentors were women. . They were the first was really more sort of a mentor to learn how to function in a clinical environment. And the second very important mentor I had was also a woman who was herself very interested in developing programs and services. When I got to the point where, Became the c e o of the behavioral [00:07:00] health hospital. I started reporting to my then boss that I had for a long time, and he was the first non woman I worked for in any period of time. So, I was happy to have the opportunity and I have to tell you one of the things that was very interesting to me and I learned something from the process. I’d known him for several years in the broader context, but when I started reporting to him, he said to me in our very first meeting okay, so what I really feel strongly about is that I need to be your mentor. And it was intentional. and it was direct. And I really did find that was very important, that it was intentional and direct and it opened the door to have different kinds of conversations, which I thought were important.

Ceci Connolly: That is super interesting and I dare say in all the her story interviews we’ve been doing, I think it might be a little bit [00:08:00] unusual, maybe a little bit of the exception. So I’m curious then with. A couple of very important women mentors earlier in your life, and then this man who set that as one of his priorities and goals. What did it do for you, the fact that you knew that from day one, and how was he helping you rise?

Diane Holder: So I think part of what is, part of that story is that there was a history here of People taking people on in a formal way. He himself had been mentored and supported by really probably the guy who was originally the architect of the U P M C system. And so, and he became really I think supported and helped to then become what turned out to be. System, c e o for, pushing 40 years in his role. And so what I thought was important [00:09:00] was to take that opportunity and to use it in a way that would allow me to really have a sounding board and to be able to. Get help when I needed it. There’s this line between mentorship and advocacy we talk about all the time, right? Like, how do you mentor and how do you advocate? And it feels to me that I was mentored and it took a long time before I felt like there was also a function of. . And in truth, I think that comes, I mean, I don’t think all of us stand up one day and mentor and advocate. I mean, we learn the people, we learn what their skills are. We learn what we feel is important to promote. Right? And to help and assist. I think if I was going back to a question on advocacy versus mentorship, I would go back to my two women mentors who I felt were not only mentors, but [00:10:00] advocate.

Ceci Connolly: So do you favor one? Approach over the other, or do they both kind of contribute to success?

Diane Holder: I think they’re both important, but I also think that they’re developmental. I don’t, I mean, I think if I look at myself, I feel like I, I am an, I’m a mentor for many people that work with me. When it turns into mentoring and advocacy, it’s a subset. Of people that I feel that I’m in a position to help and that I want to help in certain directions.

Ceci Connolly: Got it. . And so, but this all sounds, so smooth sailing, which I’m certain it was not. And before we even get up to your current seat, E o position. There had to have been bumps and hurdles along the way. What can you share about how you navigated some early challenges, especially if [00:11:00] it was from, we’re always interested in the kind of the female leadership journey. I don’t know if that played into any of your early lessons, but not all smooth. I.

Diane Holder: Well, I think the hardest thing, quite honestly, when I was younger and building a career and my husband was building a career and we had, at that time we had the first of our three, we had the first two of our three kids. That was a constant juggle. And I always, when I think about the con combination of things that people have to do that to me was really challenging. How do you. , how do you think about responsibilities and things you have to do? Quite honestly, I I remember nine 11 and standing in my office running a hospital and knowing I had a little kid at school and knowing that I had to invoke my family support. because my husband was out of town. I don’t have any relatives in Pittsburgh and so my family support is [00:12:00] my best friend who would have to go to school to get my child because I couldn’t leave the hospital. , and it was one of those moments that stays in my mind where you have to think about all these various things. Now, I’m not saying that I put my job over my child, per se, but I’m just saying that, it’s kind of one of those extreme examples where you feel like you’re constantly trying to juggle and figure out what you need to do. And I think it’s hard. I mean, . I think it’s harder for women. I think it’s harder, it’s still harder for women. . And I think one of the things that has been important in the course of my career is finding ways to figure out that balance.

Ceci Connolly: . . And as you’ve moved up into more senior leadership positions, how do you try to assist and advise other women particularly in that balancing piece since you yourself have been through it?

Diane Holder: Well, I think part of what I have grown to have greater appreciation [00:13:00] for is the. Need to be very vocal and intentional. I didn’t grow up in a time, my early career days. You really couldn’t talk about it out loud. I didn’t even keep pictures of my family in my office because I didn’t want people to think that I was focused on my family. Quite honestly, we didn’t talk about it

Ceci Connolly: I bet the men had photos of their

Diane Holder: Well, it’s like one of those things where I actually I don’t even remember. It was just one of those experiences where it felt to me like home was home and work was work and there was a pretty hard wall. And when, if I couldn’t do so, I never said it was because I had to go pick up my kids. All right. Never said it was X, Y, or z. I don’t think that’s true anymore. I think people are much more capable of the whole evolution of life balance. I mean, nobody talked about life [00:14:00] balance. I mean, it just wasn’t a concept that I recall anyway. And so the opportunity to. Work a lot but try to figure out how you build those systems of support became really important. And I think what I do today, I hope, and what I’ve tried to do as somebody running programs is to recognize that you can. , you can do a lot of things. It’s just really helpful if people can actually give you a little break now and then, or have some concept of some support systems you might need in the process. And I have been very happy to be able to recruit a lot of women and have a lot of women historically on my leadership team and today still have a lot of women on my leadership team. Many.

Ceci Connolly: Yeah, I think that’s really notable. For sure. So at her story we often like to pose a couple of specific questions and one that I’m super [00:15:00] interested in, cuz. I don’t know the answer here, but would you describe yourself as an accidental or an intentional?

Diane Holder: Oh, I think I’m pretty intentional. I think that. Personally, I think you have to be, I mean, I think that if I look at my career, it’s not like I woke up at 10 and said, I’m gonna go into healthcare. And so every single step I took was a track to get there. That wasn’t how my career went. It was a little bit serendipitous at times. It was a little window of opportunity. It was, hard work but you know. Good fortune in many ways too. And so when, but when I think about what it. What is needed to do work and to create different programs and methods. I think you have to really think about it. I remember a time that I was in the psychiatric behavioral world, and, but we have a very large health system and that certainly isn’t the, the main stay. Right. [00:16:00] And I was. Kind of mid-career would I kind of leave that and come in and do more of the traditional health delivery system work. And this was before we got into insurance. And know, it was interesting, the person asking me was somebody who most people cured a lot of favor with, et cetera. And I went home and I thought about it. I said, Nope, that’s not really what I wanna do. That’s not the leader. Role I want I wanna do something that feels more, that resonates with me. And so I do think that you get sometimes these choice points and that’s when I think you do have to know what you really like and why you wanna get up in the morning.

Ceci Connolly: So you said yes to c e o of a very large, very complex company. Maybe just describe a tiny bit of it for our her story listeners and viewers, and then I want to know what made you say yes to that one.

Diane Holder: Well, it wasn’t [00:17:00] very big when I said yes. So quite honestly, , I think it was. So I started one of our companies. I started our behavioral health company from scratch and that we just. Built the company. And so that was easy because it was a side job. That group became, that’s a very successful company at this point. Still. It’s a great labor of love on some level. The other, the decision to take on the CEO of the other traditional health insurance companies of U P M C was in 2000. and we were relatively small pretty startup phase still. U P M C was looking for leadership shifts and changes and for a variety of reasons, they asked me to step in and try to help the company stabilize, grow, reorganize, et cetera. So that was the task at hand. And so I think at that point we. . [00:18:00] I don’t know how big we were. Not very. , but we were able to grow and one of the things that’s been exciting is the ability to grow these companies. And and that’s been a laborer also of love, which I will now hit I think 20 years next year, having grown these companies from. Tiny to will be about 14 billion across the companies in the insurance side this coming year. So, spent a lot of growth. It’s been a lot of change. And so saying yes to that was not so much about, about, oh my gosh, this is such a big job. It was a big job, but this is such a different job. And do I really want to leave a lot of what I know? and try to do something that I really don’t know very well, and so that felt to me like the risk.

Ceci Connolly: Okay. Okay. And so, another question at her story they’ll [00:19:00] ask, is there a characteristic that gives you your edge? Sue turn, a friend of ours, she and I like to refer to it as, what’s your superpower?

Diane Holder: It’s my superpower. I think that maybe perseverance. . I think that one of the things. has been very clear to me is that very few things that are very complicated, are very easy, and so that you have as much failure built in to most of your steps as you do success. And you just have to keep turning them around and saying, well, I went right and maybe I should have gone li little more left. And how do I keep finding that. And it’s easy, I think, sometimes to get a little bit overwhelmed by how many things there are and how many balls there are in the air. So I would say that. Along with the other things you need figure some of that [00:20:00] out. You really do have to persevere and just keep pushing that envelope. And it’s like one of those never give up unless you don’t see any other choice . So maybe that’s kind of it.

Ceci Connolly: I think it’s a terrific one, and I think it’s especially appropriate in healthcare today. It’s something you and I have certainly discussed. I mean, it just seems to get more and more challenging and complex by, by the week and the month. I’d love to close given your incredible career and achievements. and I love the perseverance piece that really resonates for our her story audience in particular. Diane, maybe a little bit of advice, especially for the women that are coming up through the ranks night right now, and hope to someday maybe sit where you sit.

Diane Holder: So I think I would say that. , follow your curiosity. Follow what excites you, follow what’s interesting. You’ll find in [00:21:00] any of those situations that there’s a ton of work and, there’s always stuff in a job people don’t love. But if you don’t love most of it that it’s not really usually a good choice and you aren’t gonna bring your best to the table. And so if you’re fortunate early on, early enough, Find the things that really do matter to you. What’s the why in your life and what’s the why in your job? And so to me that’s really important. I think the how is much easier so for people to figure out, but I think if it’s not following a why it, it often is not something you can keep pursuing and persist because it just doesn’t matter enough.

Ceci Connolly: Right, right. Is excellent advice. I am so grateful to Diane Holder for joining us on her story and all of her years of really just service in healthcare. Diane, thank you for spending the time with us.

Diane Holder: So my pleasure. Have a great [00:22:00] day.

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