Preserving a legacy to endure long after retirement
Ralph Muller, former UPHS CEO, and Beth Johnston Muller, former executive director of the Clinical Practices at the University of Pennsylvania, have endowed three Penn Medicine positions over the last year, extending excellence in leadership far into the organization’s future.
Ralph Muller and Beth Johnston Muller, both emeritus leaders of the University of Pennsylvania Health System (UPHS), collaborated with talented colleagues throughout their careers to position Penn Medicine among the top academic health systems in the nation. Now, even in retirement, they’ve remained dedicated to the health system and the people whose lives they’ve changed through tireless advocacy for excellent patient care. And they’ve chosen to write a new chapter of their Penn Medicine legacies through philanthropy.
Muller and Johnston have endowed three administrative positions over the past year, with a total of $7 million supporting the future successes of Penn Medicine’s mission. Regina Cunningham, PhD, RN, FAAN is now recognized as the Ralph and Beth Johnston Muller CEO of the Hospital of the University of Pennsylvania. The title of Ralph and Beth Johnston Muller Chief Financial Officer (CFO) of the University of Pennsylvania Health System is held by Julia Puchtler, through a gift which also honors Keith Kasper, UPHS chief administrative officer (CAO) and former CFO. Kevin Volpp, MD, PhD, is the inaugural Ralph and Beth Johnston Muller Center for Health Incentives and Behavioral Economics (CHIBE) Director.
“We wanted to honor these outstanding individuals as well as their key roles in shaping Penn Medicine,” Muller explained. “These positions have a big effect when they’re performed exceptionally well, as they are by the people we’re honoring.”
The couple’s philanthropy is rare in that their gifts create administrative position endowments, which are generally reserved for academic roles.
“These gifts strengthen roles that are essential to everything we do at Penn Medicine,” said Kevin B. Mahoney, CEO of the University of Pennsylvania Health System. “Regina, Kevin, Julia, and Keith lead work that reaches every patient we serve, and the endowments provide additional resources to build on their momentum, pursue new opportunities, and mentor the leaders who will follow them."
The couple is part of a trend of giving back to Penn Medicine when nearing or after retirement, following in the footsteps of Penn faculty such as Ralph Brinster, V'60, GR'64, the Richard King Mellon Professor of Reproductive Physiology at Penn’s School of Veterinary Medicine, whose family has committed over $5 million to create the Elaine Redding Brinster Prize in Science or Medicine and the Ralph L. Brinster Symposium. Louis Henry Edmunds, Jr., MD, HOM'73, PAR’86, emeritus chief of the Division of Cardiothoracic Surgery at Penn Medicine and former Julian Johnson Professor of Cardiothoracic Surgery, and Martha Mel Stumberg Edmunds, PhD, G'86, GR'93, PAR’86, created the Edmunds Family Faculty Fellowship Fund with a gift of $2 million.
“Over the course of a long career at Penn Medicine, you come to see that its greatest strength lies in its people,” said Jonathan A. Epstein, MD, dean of the Perelman School of Medicine and executive vice president of the University of Pennsylvania for the Health System. “When leaders choose to give back through philanthropy, as Ralph and Beth have done, it reflects a deep pride in that culture and a belief in sustaining its future.”
Muller and Johnston’s endowments provide flexible funds to advance leadership training, support innovation, and maintain organizational stability as administrative roles evolve. They also highlight the role of mentorship in maintaining the excellence in care for which Penn Medicine is renowned.
“We hope these endowments will be a signal to the larger organization that administrative leadership roles are critical to the success of the whole organization,” said Johnston.
Honoring—and empowering—leadership and excellence
Johnston and Muller’s legacies were forged in a challenging health care marketplace. Muller was UPHS CEO from 2003 to 2019, and Johnston began her career at Penn Medicine in 1996. Among their achievements, both played transformative roles in the health system’s financial operations in support of Penn Medicine’s clinical, research, and educational excellence. Muller introduced greater financial rigor, and Johnston, as an executive director of the Clinical Practices of the University of Pennsylvania (CPUP) from 2004 to 2020, developed an innovative funds flow model to ensure alignment between the faculty practice plan and Penn hospitals, which subsequently became a national model for academic medicine.
“It was the privilege of a lifetime to take a complex institution and set it on course to not only serve Philadelphia, but influence medicine worldwide,” Muller said.
Muller mentored 23 hospital CEOs throughout his career, and his dedication to identifying talented staff led to national recognition for UPHS as a top employer, including as a top employer for women. Under Johnston’s leadership, CPUP gained financial stability and climbed from the 18th percentile in surveys of patient satisfaction to the 98th percentile, helping Penn Medicine hospitals consistently rank among the nation’s best.
“Great mentors within the health system and great partners, whether they were people in Penn Medicine Academy, the finance team, or hospital CEOs, were all critical in the results we were able to achieve within CPUP,” Johnston recalled. “That kind of mentoring and teamwork are also very consistent amongst the people we are choosing to honor, so there's a common thread there.”
Puchtler joined Penn in 2015 as the vice president of finance, operations, and budget, and subsequently served as the HUP CFO. She played a key role in planning the acclaimed Clifton Center for Medical Breakthroughs and was honored as Philadelphia Business Journal CFO of the year in 2023. After succeeding Kasper as UPHS CFO in 2024, Puchtler now also bears the endowed title of the Ralph and Beth Johnston Muller CFO of UPHS. Under her guidance, Penn Medicine welcomed Doylestown Health into UPHS, marking the health system’s seventh acute-care hospital. Further expansion of patient care capacity at Penn Medicine Montgomeryville, the Roberts Proton Therapy Center at Penn Presbyterian Medical Center, and a cancer center and an outpatient imaging facility at the Penn Medicine Princeton Medical Center campus is slated for the near future.
“We’re living in uncertain times, which can be challenging as a financial leader,” she said. “This endowment can help us cultivate great financial talent to weather the challenges ahead.”
The couple’s recent philanthropy supporting Puchtler’s CFO office drives home an important point about the power of health care finances, Kasper added. The gifts “emphasize that the educational and research sides of Penn Medicine are hugely successful, but not by themselves,” Kasper said. “They elevate foundational administrative roles, because if we don’t have the dollars and cents to support the organization, then research or teaching won’t get done.”
Ultimately, Muller and Johnston want the endowments to nurture the next generation of health care leaders and ensure their readiness to take the reins of new opportunities.
For Regina Cunningham, the need to support emerging leaders in their growth is clear from her own experience. A decade ago, the idea of becoming the CEO of HUP was something she was initially uncertain about, when then-CEO Garry Scheib was planning his retirement and approached her about considering the CEO role. At that point, Cunningham had quickly risen from her first position as associate chief nursing officer of cancer services at the Abramson Cancer Center and was chief nursing officer at HUP and senior vice president and chief nursing executive for the health system. HUP, a large institute with 1,132 beds, serves some of the region’s most vulnerable patients and those requiring the most complex and advanced treatments, and its CEO must be proficient in guiding high-performing health care teams in consistently achieving exceptional patient outcomes and operational efficiency.
Muller ultimately chose her to become the HUP CEO and oversee the expansion of HUP’s campus through the addition of the Clifton Center for Medical Breakthroughs, an expanded Penn Medicine Radnor facility, the Interventional Support Center, and HUP’s Cedar Avenue Campus. Now, nine years into the job, she’s excited by the possibilities the endowment will open for developing leadership and shaping the future of health care.
When considering how these new resources from the Ralph and Beth Johnston Muller CEO endowment can grow HUP’s capacity to provide complex care, she asks questions like, “How can we innovate to develop the most effective care models for the future? How can we equip tomorrow’s health care leaders to meet the evolving challenges that lie ahead?”
“These are the things that really intrigue me in terms of developing innovations and leveraging the kinds of technology that will differentiate health care organizations in the future,” she said.
The third endowment likewise recognizes an outstanding leader, while cultivating the future of research on how behavioral science and well-designed incentives can encourage healthy behavior and disease prevention. Volpp joined the Penn faculty in 2001 and is the Mark V. Pauly President’s Distinguished Professor at the Perelman School of Medicine and The Wharton School. Having trained as an MD at the Perelman School of Medicine and a PhD student at Wharton, he has a deep appreciation for the role strong mentors and leaders at Penn played in his development. He’s excited to forge new ground with programs to improve health while helping to cultivate new leaders.
“Every project we work on has a real chance to develop approaches that can help people live healthier lives,” said Volpp of the research initiatives at CHIBE. “The endowment offers unrestricted funds to help us accelerate the pace of innovation and catalyze new research.”
The couple have endowed these positions because they want their honorees to replicate their successes, and, as Muller put it, “develop the next generation of Julias, Reginas, Kevins, and Keiths.” To do that, succession planning is imperative to preserve institutional memory while advancing the standards of excellence cultivated during their tenures.
“We built something we’re very proud of, and we built it to last,” said Muller. “We’re proud of the leaders we developed, and we want to keep that tradition of great leaders going, because great leaders work well with great doctors, great nurses, and great staff to take care of our patients.”
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