Greater Harrisburg's Community Magazine

A Lifetime in Healthcare: A Q&A with Phil Guarneschelli, the retiring president of UPMC in Central Pa.

Phil Guarneschelli

Let’s call it a career.

This month, President Phil Guarneschelli retires after nearly 38 years with UPMC of Central Pa. and its predecessors, as Lou Baverso assumes the reins of the rapidly growing, regional healthcare provider.

We decided to use this occasion to ask Guarneschelli a few questions, both reflecting back on his long career and offering a glimpse of what comes next.

TheBurg: Please introduce yourself to our readers with some background information. For instance, where did you grow up, and how did you get into the healthcare field?

Guarneschelli: I’ve spent my whole career in healthcare and with various entities of UPMC now, Pinnacle before. I grew up in Harrisburg; I spent my childhood in the suburbs of Harrisburg. My whole family, we all are literally a mile apart on Linglestown Road. So, we’ve all stayed local, which is strange, and we’re all in healthcare, which is probably even stranger.

My dad influenced my decision on healthcare at the time. He was chairman of the Blue Cross board. His advice was: do what you love and it’ll all come. And don’t worry about what your pay is initially—pick something you like. I always liked helping people—that was my M.O. So, my parents thought that would be a good route for me to go.

I got my first job with the Capital Health System, or it might have been the Harrisburg Health Foundation at the time. I was in the planning department. I went in as a facilities-type planner. It was when we were starting to expand the primary care network 38 years ago. So, I started there and then I really enjoyed it and moved through the progression. I think it was 13 promotions up to now being the CEO.

TheBurg: Please highlight a few milestones of your career.

Guarneschelli: At one time, John Cramer was the CEO of Capital Health System and was responsible for forming Pinnacle. That was when we merged with Polyclinic Medical Center and later on with Community General Osteopathic. Prior to that, we were basically Harrisburg Hospital and Seidle Memorial Hospital. John created Pinnacle and assigned me basically the project of bringing two rivals together. At the time, Polyclinic was a 500-bed acute care hospital literally 2.8 miles down the street, and there was fierce competition between us. So, we had to form the Pinnacle Health System, bringing those two entities together. That was definitely a milestone of my career. It was a humungous project, probably one of the largest projects in Harrisburg at the time.

My second biggest milestone wasn’t that long ago, and it was when I got the assignment from our board to merge with UPMC. We had gone through several attempted mergers that we were not successful. The first one was with WellSpan, and that did not work out for various reasons. The second one was with Hershey Medical Center. We took that right up to the end when we were challenged, and we ultimately lost the challenge to merge, because of the competition. Then our board, after many iterations of planning, decided that we would search for a partner, and the partner that we landed on was UPMC. As you know, UPMC has a health plan, a very large, well-run health system. We felt we would do best with them.

My role was to integrate the two systems over the next five years. So, that was 2017, and we are today on the milestone of our fifth year of coming together. I believe we accomplished it. I would give it “A’s.” The management team is incredible at both places. We worked very well with Pittsburgh and UPMC, and our team here did a stellar job at bringing the two organizations together. So, those are my two milestones.

TheBurg: During your long career, the healthcare landscape has changed significantly in central PA. Could you describe some of those changes?

Guarneschelli: For the longest time, to win in healthcare, you had to differentiate yourself. We differentiated ourselves on quality. If you run a high-quality organization, financials will follow, everything will follow. Scale became very important. What you saw happening in this area was a lot of mergers and acquisitions. It was basically growing, but growing with thought, not just growing for growth’s sake.

At that time, there were five or six hospitals for sale. At the same time that we were merging with UPMC, we were acquiring five hospitals. And history will show that we ended up meeting the commitment of the York community by building a new hospital, which has been an absolute home run success. Prior to our growth and expansion, we built the West Shore Hospital. Prior to that, we had no inpatient presence on the west shore. So, we built the West Shore Hospital, which subsequently has grown in size because of its success. We added onto that a year ago. Through the acquisition of the CHS hospitals, we got Carlisle, which, at the time, was a sleepy, little hospital running at 30 beds. Today, it’s a 100-bed hospital, thriving, and a really nice success story.

In the Lancaster market, we bought two hospitals. We bought the Heart of Lancaster, which was in Lititz, and we bought the downtown hospital, which was the old St. Joe’s. We knew we’d have to consolidate, so we made the decision to close the downtown hospital and consolidated everything at Lititz. You can see the markets that we’re in. It’s truly a central Pennsylvania footprint.

So, that change has been a lot of mergers and acquisitions, a lot of scale building and really developed into, I’d say, three competitive health systems in the area. This community, let’s face it, is blessed with incredible health care. I don’t know many communities that you can say there are three health systems, the quality, the size of the three that we have here in central Pennsylvania.


TheBurg: Could you touch more upon the Pinnacle/UPMC merger, specifically why it happened and how it’s going?

Guarneschelli: In choosing a partner, it was very well thought out. UPMC happened to be in the growing mode, and we knew that, and we knew it was a very well run organization. They were very quality-focused and quality-driven, as well. And we felt their culture was the closest to ours. We wanted the health plan component, and we got all that from them. We felt this was the right choice, and it turned out to be that it was the right choice.

Bringing a large health system into an even larger health system is very difficult to do. Everybody worked very hard. We had the normal issues—you know, “Oh, we’re being taken over by UPMC.” All those things occurred, but, because we had so much experience at doing this prior, we went through that stuff relatively well. We let people grieve. We let people do what they need to do and, now, you just don’t hear it anymore. It’s just—we’re UPMC, that’s what we are. We’re happy to be UPMC, and we’re happy to spread the UPMC differentiation in the market, which is very high quality, life-changing medicine, on the cutting edge of things and really what the community needs and will need going forward.

TheBurg: Looking ahead, how do you see healthcare changing for our area over the next five or 10 years?

Guarneschelli: I personally believe that you’ll see a slow change in technology. So, we all learned from the COVID pandemic that there are other ways to deliver medicine that are probably more efficient, and the outcomes are just as good. So, during the pandemic, we ramped up from having about 10 physicians doing telemedicine to having over 600 physicians doing telemedicine, from maybe 50 visits a week to thousands of visits a week. From that, we learned that, first, it can be done, and, second, it can be done in a quality way that we will only deliver quality care, and the outcomes are great. So, we want to continue that change. The younger population today works from the iPhones and their iPads, and they want convenience. So, I see healthcare really going through a revolution of more technology.

The second thing is the workforce. It is a very competitive workforce. It will continue to be a very competitive workforce. These are highly skilled people, highly skilled physicians, highly skilled nursing, clinical and administrative staff, and they will have options.

So, these are the biggest changes you’re going to see—more technology introduced into healthcare, and you’re going to see a movement again more towards around the patient, the whole circle of continual care around the patient and not around us. The patient is the driver. They want convenience. They come to an appointment when they want to, not us dictating when they come to an appointment, not us dictating where they go. So, it’s a real patient-focused approach.

TheBurg: What’s next for you? What are your personal plans upon retirement?

Guarneschelli: I promised my family and myself that I would retire in decent health, so we could have some fun and do some things. I always had in my head (age) 62. So, I decided months ago that I was going to meet that commitment. You kind of miss the kids’ football games, you miss the cheerleading, because, in this job, you’re 100% with it. But now I’m going to make it up with the grandkids, and I’m going to do a lot of family-oriented activities. I’m still going to do something. I can’t just sit still. So, I will look for something that is rewarding for me to do. I’ll continue to work with the foundation and continue to promote UMPC in Central Pa. I think it is the best, not just because I’m here, but it really is incredible healthcare. And I believe that a community deserves state-of-the-art, A-grade healthcare, and you’re getting that here.

So, bluntly answering the question, up until Christmas, I’m just going to relax. I’m going to do the honey-do list that I have been waiting to do for many years. So, I’ll work on some of those things. And then I’m going to look for something to do that is fun and rewarding. I don’t know what that is yet. I do know that I’m staying here in the community that I’ve lived in my whole life.

This interview was edited for length.

For more information on UPMC in Central Pa., visit

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