This month’s Women in Comp featured executive is Melissa Campesi, CEO and Chairman of the Board of Louisiana Commerce and Trade Association Self-Insurer’s Fund (LCTA). Campesi sat down with Louisiana Comp Blog to discuss her impressive and varied career, plus her unique blend of rural and urban sensibilities and LCTA’s new plan to convert from an SIF to a standard carrier.
Comp Blog: Tell us about your background and life growing up.
Campesi: I grew up in Abbeville, Louisiana, south of Lafayette. My Dad was a rice farmer. I was one of seven children and I went to school at USL, now UL, and became a nurse. Since I had a brother in medical school in New Orleans at the time, I decided to go there; [that fact] was the only reason my Dad let me leave.
Comp Blog: How did you start your nursing career?
Campesi: I started at Tulane Hospital when it was in its first years and stayed there for thirty years. During that experience I took a trip through the range of opportunities and advancements offered there.
Comp Blog: Can you elaborate on the progression of those advancements at Tulane Hospital?
Campesi: Within the first year they promoted me to manager of a nursing unit. I then moved on to supervise the whole hospital on off-shifts. These management positions led me to decide to pursue an MBA. As a nurse, we were always dealing with shortages and fighting for salaries, and I found that I couldn’t compete or have conversations with the CFO because I didn’t have that financial background. So, against the direction of my Director of Nursing, I went and earned an MBA at the University of New Orleans instead of a Master’s in Nursing. I finished my MBA in 1989.
Comp Blog: Did that decision pay off?
Campesi: Definitely. I became the Director of Operations and Finance in the Nursing Department. In this position, I was responsible for the nursing budget, which is the largest salary budget in a hospital.
I worked well with that CFO and he eventually brought me over to the corporate office of HCA [Hospital Corporation of America], which had purchased Tulane in 1995. I worked at that corporate office for two years, which was a great experience, negotiating contracts with him for eighteen hospitals in the state. Financial analysis took over more and more of my job responsibilities and I went back to Tulane as COO, was Chief Nursing Officer for a while, and then at the time of Katrina I was helping to run the practice of 300 physicians there.
Comp Blog: What transitioned after Katrina?
Campesi: After Katrina I married Ross Campesi, the founder of LCTA, and I thought I was going to White Castle [where Ross Campesi lives] to play with grandkids in sugarcane fields. I had no plans to come into work! But, he asked me to come help. We got married in 2006 and I continued to work part-time at Tulane until 2009. Then I came over here full-time and assisted him.
Comp Blog: So what was your starting role at LCTA?
Campesi: At first, I was doing mostly the financial management part, which I already had a lot of experience with; that was an easy transfer from the hospital. However, transitioning from a hospital to an insurance company, there were some really key shifts that I had to make. Understands claims was easier than the other departments because you’re essentially managing patient care there, and I feel that [my clinical background] is one of the things that I really bring to the company as a complement to my financial knowledge for claims handling. Loss control and underwriting were more difficult to learn, but I just went through step by step.
Comp Blog: Could you describe further how your clinical background helps you and LCTA in day to day operations?
Campesi: I understand quality outcomes, I understand how to get people back to work, and how those options play out. Troy Prevot, our Administrator, also has a clinical background, so the two of us can get together, especially for catastrophic claims, and talk about the treatment, always through the adjuster though. I’ve well learned that you’ve got to let people who know how to do their job do that job, but I like to give some additional perspective on certain cases.
Comp Blog: So what led you to the CEO position at LCTA?
Campesi: Ross retired two years ago at 87 years old and the Board appointed me Chairman and CEO. I knew that I was not an insurance expert. One of the things I learned from Ross is that, to be successful and fill in those gaps, you need to hire the right people.
The first thing that I did after being appointed was to look for an Administrator for the Fund that I believed in and that had great experience – that led me to Troy Prevot. Then, I stayed in an executive level, looking at governance and financial aspects, while Troy took over relationships with the service company, day to day operations, relationships with agents and marketing.
Tim Reier was the Underwriting Manager at the time. A few months after Troy and I joined, he was promoted to COO of the service company. Between the three of us we cover all of the bases: underwriting, claims, agency relations, insurance, clinical, and financial management.
Comp Blog: Did you ever think you were going to be involved with workers’ comp or insurance during your first career at Tulane Hospital?
Campesi: It’s been an interesting ride and something I never thought I would do. I graduated from high school in 1972 and my mom told me that you had two choices: you could be a schoolteacher or a nurse.
Comp Blog: Did you always know that you’d go beyond conventional nursing when you got started?
Campesi: No, I really didn’t. When I got started my goal was to be a clinical nurse specialist in pediatrics, mainly because, at the time, nurses specializing and having a truly clinical path was very new. I always loved children so I thought it would be a good path for me. However, once I got started, I realized that taking care of children in a nursing context sometimes involves causing them pain and I had a hard time with that. Actually, the first person that put me in a management role had to convince me, since I was set on the clinical side. She explained to me that in management, you take care of your nurses so that they can provide the best care to patients. I also saw that I could potentially change processes for the better that would affect far more patients than I could serve as a nurse without management duties.
Comp Blog: Many times it is a mentorship like that which pushes successful women into leadership roles. Did you feel that you were a leader growing up as well?
Campesi: Yes, I found myself in those positions a lot. I had been on Student Council and yearbook editor in high school, those kinds of things. I always knew I had leadership ability and the organizational skills for that.
Also, when you’re the oldest girl of seven, you’re in a leadership role basically on day one. By the time I was eleven years old, I was taking care of my infant brother and I was learning cooking and housework very young when my mother went back to work.
Comp Blog: Seven kids is pretty rare these days. What else can you share about that experience growing up?
Campesi: We had a lot of fun, it was like having a whole neighborhood in one house, especially since we lived in a rural area and essentially didn’t have neighbors. And of course with all of us there were responsibilities when my Mom went back to work, but I don’t think any of that hurts. I don’t think most children get that these days. I absolutely believe that my work ethic comes from home, my sense of confidence as well.
I can remember being very young and my Dad was working on the engine for his combine one summer. I was standing next to him at a toolbox looking for a seven sixteenths wrench. I didn’t know what a fraction was – I was probably five or six year old max! He was in there holding something that he couldn’t get out and so he told me, “You can do it. Don’t tell me ‘you can’t,’ there’s no such thing.” I guess I heard that from him enough that I believed it. I also think rural life teaches you self-sufficiency. You’re pretty isolated, so you can’t just run to town every time you need something, you learn to solve problems and make substitutions.
Comp Blog: So where is LCTA heading?
Campesi: We’ve changed the logo and image, and in the Spring of 2014, we started getting out on the ground and changing the company’s image with agents, because it was known as Ross Campesi’s company. Now it’s moving in a new direction with different leadership. We hosted cocktail parties in some of the bigger municipalities where I told people the story about my clinical background and qualifications and explained how LCTA is moving workers’ comp forward.
We’ve also made some operational changes and have a strategic plan in place to convert LCTA from a self-insured fund to a standard carrier, which is a huge project.
Comp Blog: What’s the timeline on that conversion?
Campesi: Our hope is that we can make the move official in the first quarter of 2016. It’s a lot of work, but I’ve been enjoying the project-oriented aspect of it. I’ve also enjoyed being able to mentor younger managers here and watch how people from different departments, with different strengths, are able to reach solutions. The more diverse your team, the better results you get.
Comp Blog: Zooming out a bit, what’s your perspective on Louisiana’s workers’ comp system overall?
Campesi: I think that we’ve made good progress in recent years. In the comparative data, our costs are higher than other states, and though you’d think that would be a deterrent to business, it appears that investment in the state is still good; the low price of natural gas is probably trumping the higher cost of workers’ comp.
The biggest thing that I think we need to work on is reducing medical costs and length of disability. There are things we can do about that. Though the advent of the Medical Treatment Guidelines was a great first step, but our fee schedule is way too old. Thankfully, there is significant work being done on that right now in the OWC.
Comp Blog: Coming from your vast experience working in a hospital, what do you think about the inpatient/outpatient disparities from that old 90s data?
Campesi: Coming from the hospital side, I think I have some perspective on it. When Ross brought me in to help originally, he joked and said, ‘I couldn’t beat those hospitals that keep charging us too much money, so I married the enemy!’ And I used to reply, ‘Yeah, I couldn’t get insurance companies to pay us the right way, so I married you!’
For hospitals though, workers’ comp is the last – the last – payer that is using a percent of fee schedule for outpatient charges. I would say that the inpatient is limited right now, that per diem is very low. It needs to be worked on both sides.
Comp Blog: So what’s a typical day for you?
Campesi: It’s easier to think about a typical week. We have management meetings on Tuesdays and we all confer about where we are on big projects and how moves have been made.
As for a typical day, I usually meet with Troy and Tim in the morning to see what’s going on and then I like to get around the building to the different departments. I like to stay in touch, follow up with project’s that individuals are working on and might need guidance on, and I make sure that I keep a list for myself. When I walk around I always ask if someone is waiting on me for anything to make sure I haven’t forgotten and we’re moving forward. I would call myself hands-on, but I like to ask questions rather than dictate.
Comp Blog: Do you have any hobbies that you’re passionate about?
Campesi: My favorite thing to do is to play with Ross’s great-grandkids. He has seven great-grandkids and they are such a joy to be around. I’ve never had children of my own, so to spoil them is such a blessing.
Ross has always had cattle along the Mississippi levee, so now I manage a cattle operation as well! That’s another thing I never thought I’d be doing! I guess that’s a passion for my time at home.
Comp Blog: So finally, what are your thoughts about being an executive as a woman and the challenges there?
Campesi: It’s a difficult decision for a woman, particularly for a woman that has a family and children. I didn’t marry until I was 52 years old, and I never had children, so to continue to pursue a career through Tulane and HCA and eventually to come here – I never really had to consider anyone else. If you’ve chosen to have a family as a woman, those career choices have so many other considerations. It’s not an issue of right and wrong, but if you’re a wife and mother it’s a much larger commitment to try and be an executive and also maintain your family.
Comp Blog: Any advice for young women looking to make it?
Campesi: Women need to have confidence. Women are capable of anything and we can do whatever we want. Women should never let any supposed barriers of a male-dominated field stop them, because those doors are open now. When I got out of high school in the early 70s, those doors were closed. Anything you choose to do, know that it will be work and that you’ll give a part of yourself. I also think that all people have to be flexible and willing to start instead of searching everywhere for that “perfect job.” You can’t sit and wait.
Editor’s Note: Melissa Campesi was also recently named one of Baton Rouge Business Report‘s 2015 “Influential Women in Business.” Read that profile here.