NUHW calls for Kaiser board member’s resignation

February 18th, 2014

Christine Cassel’s conflict of interest undermines the integrity of the National Quality Forum

EMERYVILLE — The National Union of Healthcare Workers calls on Dr. Christine Cassel, the CEO of the National Quality Forum, to resign from Kaiser Permanente’s Board of Directors.

A February 12 ProPublica story revealed that Cassel is encumbered by significant conflicts of interest. Cassel is the CEO of the National Quality Forum, whose recommendations are adopted by thousands of hospitals across the nation, while serving on the boards of two corporations with a stake in NQF’s policies and recommendations.

Kaiser pays Cassel about $200,000 a year — more than $1.5 million since 2003 — to serve on its board. In addition, Cassel received $235,000 in compensation and stock last year for serving on the board of Premier Inc., which provides purchasing and performance improvement consulting for thousands of hospitals and nursing facilities. All of this comes on top of Cassel’s approximately $500,000 salary as CEO of the National Quality Forum, which conducts reviews of hospital procedures to determine best practices, many of which become standard practice in medical centers throughout the country.

“The National Quality Forum plays a huge role in our hospitals by defining the ‘best practices’ that our caregivers use,” said Sal Rosselli, president of the National Union of Healthcare Workers (NUHW), whose members include 5,000 Kaiser employees throughout California. “Healthcare workers and patients have a right to know whether NQF’s top officials are getting hundreds of thousands of dollars a year from giant HMOs like Kaiser, and whether this money is corrupting their decision-making process.”

National ethics experts criticized these ethical breaches. Harvard School of Medicine professor Eric Campbell told ProPublica that Cassel would have to recuse herself from nearly every issue that came before her. Tufts University professor Sheldon Krimsky called Cassel’s conflicts “absolutely egregious.” Both said the cleanest way to eliminate these conflicts would be for Casell to resign from the Kaiser and Premier boards.

“All of this is about relationships,” said Lisa McGiffert, director of the Consumers Union Safe Patient Project, and Cassel’s relationship with Kaiser “means that Kaiser might weigh in with her on these hospital measures” that are reviewed by the National Quality Forum.

The National Quality Forum has refused requests from ProPublica and NUHW to provide copies of the conflict-of-interest statement Cassel signed at the time of her hiring.

It is the second conflict-of-interest scandal to engulf the National Quality Forum in as many months. In January, the U.S. Department of Justice settled a $40 million whistleblower lawsuit involving an NQF expert adviser who reportedly received millions of dollars in kickbacks for shepherding a drug company’s product through NQF’s Safe Practices Committee, which he co-chaired. In the wake of that investigation, U.S. Senator Charles Grassley (Iowa) sent a letter to Cassel, raising serious questions about NQF’s policies and leadership.

“This case calls into question NQF’s due diligence and its obligation to prevent conflicts of interest,” Senator Grassley wrote.

Considering the extent of these conflicts and their potential to taint the recommendations of the National Quality Forum, the National Union of Healthcare Workers calls for the resignation of Christina Cassel from the Kaiser Permanente Board of Directors.