North Carolina

The CEO of UNC Health Care and dean of its medical school is stepping down

William Roper, who held top posts with the Bush and Reagan administrations before turning UNC Health Care into the largest hospital system in the Triangle, will be stepping down, the Chapel Hill health care organization said Thursday.

As CEO of UNC Health Care and dean of UNC's Medical School for the past 14 years, Roper oversaw UNC's expansion to a 13-hospital network that doubled its revenue to nearly $5 billion in just six years.

But what would have been the most far-reaching achievement of Roper's UNC career — a planned partnership between UNC Health Care and Charlotte's Atrium Health — fell apart when Atrium pulled out after nearly a year of negotiations.

The partnership would have created one of the nation's largest networks, employing 90,000 people, with 60 hospitals in three states. Roper and the proposed deal were criticized by public officials concerned that the much larger Charlotte organization would control the state-owned health care system and UNC's prestigious medical school in Chapel Hill.

Just weeks after the deal fell through in March, the 69-year-old executive vowed to stay on with UNC, saying in an interview with The News & Observer that to quit at that point, "would send the wrong message: that Roper, in a fit of pique, took his ball and went home."

On Thursday, Roper offered a different message, saying that his time served is "a gracious plenty," and emphasized his timing had nothing to do with the Atrium deal falling through.

"It's time," Roper said in an interview. "I surely wasn't forced out."

He will step down from his position, which pays a base salary of $837,700, effective May 2019, giving UNC leaders a year to find his replacement. Then he'll take a year-long sabbatical before returning to the UNC medical school in 2020 as a professor of pediatrics, his specialty by training.

"I don't want to fritter it away," Roper said of the coming year. "I want to work on consequential things that matter."

'Transformative leader'

Roper does multiple duty as medical school dean, health system CEO, vice chancellor of medical affairs and guest lecturer for medical students. His current CEO position is the longest he's ever held in a varied career that has included being special assistant to the president for health policy, administrator of the nation's Medicare system and deputy assistant to the president for domestic policy under President Ronald Reagan, as well as director for the Centers for Disease Control and Prevention under President George H.W. Bush.

He also logged a stint as a health insurance executive before becoming dean of UNC's School of Public Health in 1997, which consistently ranked among the nation's top public health programs under Roper's guidance. He is highly sought after for his political acumen and academic credentials, and has been named by Modern Healthcare magazine on its 100 Most Influential People in Healthcare list six times, most recently last year.

Roper also sits on two corporate boards: DaVita, the kidney dialysis center company, which paid him nearly $340,000 last year in cash and stock; and Express Scripts, the pharmacy benefits management organization which paid him $315,000 last year in cash and stock.

"He's probably the most important health care leader in North Carolina in the last 20 years," said Bill Pully, the past president of the N.C. Hospital Association. "He's a transformative leader."

A. Dale Jenkins, the chairman of UNC Health Care's board of trustees, described Roper as "giant in terms of ideas and being able to bring those ideas to reality."

Jenkins said Roper can be demanding and sometimes impatient, with a sense of urgency about the need to continue adapting and evolving. Roper, for instance, insisted on the need to amass a huge patient base in order to comprehensively manage population health care, rather than just respond to illnesses and emergencies.

"He has the ability to see the future," said Jenkins, the CEO of Medical Mutual, an insurance company that covers physicians. "He's a bit impatient that the day-to-day activities aren't keeping up with what needs to be accomplished."

Looking to the future

Roper has denied that he's an empire builder or, in his words, a "day trader in hospitals," but he has never been shy about stressing the need for hospital systems to keep getting larger if they want to survive the changes sweeping through the nation's health care system.

"Dr. Roper and his team did what most aggressive leaders do," said Bill Atkinson, the former CEO of WakeMed Health & Hospitals in Raleigh. "They go for the maximum market share with the belief that what they have to offer is good or better than anyone around."

It was those concerns about the need for critical mass to survive in a business environment of lower reimbursements to hospitals, that drove Roper to try to form a partnership with the state's biggest hospital chain, Atrium. Roper said Thursday he had had these conversations with other hospital chains and the answer often had been: This is a promising idea but we're just not ready yet.

Atrium was ready and wanted to make UNC part of its organization. The two sides spent months discussing options that would give the much smaller UNC fair representation on the board without giving UNC a majority. In the end, public officials, including the statewide university system's Board of Governors, balked at ceding control of a major state asset.

If the Atrium deal had succeeded, Roper would have become executive chairman of the joint operating committee board, with his term ending in late 2019. With that now off the table, and with a contract requirement that he give a one-year advance notice of his plan to step down, Roper said the timing was right for Thursday's announcement.

He said he would consult with the board to set priorities for the coming year.

"The logical thing is to look out into the future and anticipate where health care is headed," Roper said.

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