From business leaders to politicians, those in power know that it is work to get to the top and a struggle to stay there. Challenges from opponents can present themselves at any time and then there’s always the next test, the next task, the next obstacle.

Cincy’s 11th annual Power 100 list recognizes those people who hold and use the most clout to benefit the region.

1 John Boehner & Mitch McConnell
Speaker of the U.S. House of Representatives and new Senate Majority Leader

Boehner (R-West Chester) returned for his third term as Speaker. With Kentucky’s McConnell, it’s the first time in half a century, two friends from the same region and party have had this much clout in Washington.

2 A.G. Lafley 
Procter & Gamble Co. chairman and CEO

In his second go-round as CEO, Lafley has committed to shedding about 100 of Procter’s lesser-performing brands and reshaping the company for sustained growth. Lafley, 67, also has to pick his successor. It’s already led to some of the not-so-heir apparents departing the executive suite. Whatever the outcome, Lafley’s tenure will leave a lasting impact on the company and the region.

3 Robert Castellini 
chairman, Castellini Co., and CEO of the Cincinnati Reds

He hasn’t delivered a promised championship, but the Reds and Cincinnati will be center stage for this year’s Major League All-Star Game, baseball’s mid-season extravaganza. Castellini, who built a produce distribution empire before leading the Reds ownership group, was one of the prime movers behind the Banks redevelopment and will receive the Association for Corporate Growth’s Lifetime Achievement Award in May.

4 John Barrett
chairman, president and CEO, Western & Southern Financial Group

Critics may not always agree with his approach, but they can’t question his commitment to his hometown. Barrett’s been one of the region’s biggest supporters for economic development, education, health care and the arts since becoming CEO. He has plans for a high-end hotel in the Anna Louise Inn after the purchase of the home for troubled women is completed.

5 John Cranley 
mayor of Cincinnati

With the streetcar under construction over his opposition and his choice for city manager in place, the Mayor has focused on getting the city’s financial house in order. At year-end, he struck a deal with city unions to stabilize the city’s pension system, a storm cloud over city finances. He’s also sent out feelers about shared services with Hamilton County and has established a task force on immigration.

7 Michael Connelly
president and CEO, Mercy Health

As head of the former Catholic Health Partners, Connelly has combined five religious and several community hospitals into one of Ohio’s largest health systems with nearly 30,000 employees and assets of more than $6 billion. The parent of Cincinnati’s five Mercy Health hospitals and related facilities is building a $71 million corporate headquarters in Bond Hill that will employ 1,000 when completed in mid-2016.

6 W. Rodney McMullen 
chairman and CEO, Kroger Co.

A year after succeeding David Dillon as CEO, McMullen this year succeeded him as chairman of the nation’s largest supermarket chain. Like Dillon, McMullen, who started as a Kroger grocery clerk in college, doesn’t seek the limelight. But he was recently ranked by CNN as one of the nation’s best CEOs. Kroger’s stock rose more than 60 percent last year, one of the best performers on the S&P 500. He also was an architect of Kroger’s “Customer 1st” strategy which has fueled 10 years’ of sales growth and has initiated Kroger’s experiment with online grocery shopping to counter Amazon.

8 Greg Hartmann 
new president of Hamilton County Commission

The mild-mannered Republican, who cast the deciding vote excluding Music Hall from the “icon tax” last fall, is now the first among equals on the three-member board of commissioners as the county deals with tighter budgets and demands for more services. Despite a failed bid for Ohio secretary of state in 2006, he won’t rule out another bid for statewide office.

9 Tom Williams
president and partner, North American Properties Inc.

Williams, a member of one of Cincinnati’s most influential families, has transformed North American Properties from a local real estate developer into a multi-regional real estate firm. He chairs the Regional Economic Development Initiative (REDI), is vice president/treasurer of the Cincinnati Reds, and co-chair of the business group pushing for a new Brent Spence Bridge.

10 Carl Lindner III & Craig Lindner
co-presidents and CEOs, American Financial Group

Much more low-key than their late billionaire father, Carl Lindner, Jr., the brothers Lindner, who’ve co-led AFG for more than a decade, continue to focus on community, religious and political activities. Among them: The Lindner Center for Hope for treatment of disorders, addictions and mental illness.

12 Kevin Kabat 
CEO and vice chairman, Fifth Third Bancorp

As leader of the region’s largest locally based bank and the nation’s 20th largest overall, Kabat is stepping up his local visibility by leading both the United Way of Greater Cincinnati’s 100th anniversary community campaign and co-chairing with Tom Cody Cincinnati Children’s Hospital Medical Center’s Change the Outcome Campaign.

14 Kathy Merchant 
outgoing president and CEO of the Greater Cincinnati Foundation

She’s retiring at mid-year after leading one of the nation’s largest community foundations for 18 years and leaves a lasting impact. She has directed the investment of more than $700 million into the community and she is a thought leader on the role of community foundations.

11 Michael Fisher
president and CEO, Cincinnati Children’s Hospital Medical Center

As President and CEO since January 2010, Fisher has been a champion for reducing infant-mortality rates. He launched an employee-giving campaign that raised $1 million in its first year and initiated the hospital’s largest-ever fundraising effort, the Change the Outcome Campaign, which expects to raise $250 million by 2018 to improve local children’s health and further the hospital’s research efforts.

13 Santa Ono 
president, University of Cincinnati

A renaissance man, Ono is a teacher, research biologist, university administrator and omnipresence on social media. Inside Higher Ed named Ono the nation’s most notable college president for 2015. With more than 41,000 Twitter followers and growing national visibility, this adopted Bearcat is the university’s biggest booster.

15 Mike Brown
president and principal owner of the Cincinnati Bengals

Frustration, thy name is the Cincinnati Bengals. After qualifying for the NFL playoffs for the fourth-consecutive year, the Bengals in January failed to advance, again. The team hasn’t won a playoff game since 1991, leaving many fans increasingly restive. Brown admits to disappointment, but observers say the conservative owner isn’t likely to make drastic changes in the team’s makeup or approach.

16 Bill Butler 
chairman and founder, Corporex Corp.

Although he’s stepping away from active real estate development, Butler continues to have an impact on Northern Kentucky through a number of charitable endeavors, most notably the creation of Life Learning Center, Inc., a Covington nonprofit that provides education and care to help at-risk individuals reach their potential.

19 John Dubis
president and CEO, St. Elizabeth Healthcare

The leader of Northern Kentucky’s largest health care system and its largest employer with more than 7,400, Dubis has been in the forefront of the ongoing changes in the nation’s health care system, breaking ground on the hospital’s Heart and Vascular Institute, announcing affiliation with the Mayo Clinic Care Network in 2012, and forming a unique partnership with TriHealth in 2013 to offer better patient service and lower costs.

17 Kay Geiger 
regional president, PNC Bank

One of the most visible female executives in town, Geiger is two years removed from chairing the Cincinnati USA Regional Chamber and she’s active on a number of community boards, including the chamber, 3CDC, United Way, Cincinnati Children’s Foundation, the Cincinnati Business Committee and Regional Economic Development Initiative (REDI).

18 Richard P. (Rick) Lofgren 
president and CEO, UC Health

In his first year as head of the region’s only academic health system, Lofgren has emphasized the system’s objective to be the preferred provider for highly specialized care. He’s also been frank about the limits of health care affordability. “The majority of health care spending is not all that preventable—but much of it is manageable,” he says. UC Health’s West Chester Hospital is slated to open a $10 million maternity unit this spring.

20 John Prout
president and CEO, TriHealth Inc.

Under Prout, TriHealth has dramatically expanded its presence in Butler County, recently acquiring majority stake in Oxford’s McCullough-Hyde Memorial Hospital, undertaking a multi-million dollar expansion of its Bethesda Butler Hospital, and opening a new Group Health building in West Chester.

21 The Rev. Michael Graham
president, Xavier University

Now in his 15th year as Xavier’s president, Father Graham has overseen dramatic changes at the nation’s sixth oldest Catholic university. Among the physical changes was the opening last year of University Station, a mixed-use development adjacent to campus and the $18 million renovation of Alter Hall.

23 Scott Farmer
CEO, Cintas Corp., and chair of Cincinnati Business Committee

Farmer grew up in the multi-billion dollar uniform and business services company started by his father, Richard T. Farmer, and started as a management trainee after graduating from Miami University in 1981. Besides the CBC, he serves on several community boards.

25 Marty Brennaman 
Reds Radio announcer

Entering his 42nd year in the Reds radio booth, the Hall of Famer isn’t afraid to tell you what he thinks, whether it’s about the Reds’ performance on the field, a caller’s silly question during a rain delay or his own deepest fears about dying alone in a hotel room.

22 Murray Sinclaire, Jr.
president and CEO of Ross, Sinclaire & Associates, a Cincinnati investment firm

Sinclaire is active in a number of community organizations including the Cincinnati Zoo & Botanical Gardens. He is current president of the board of Cincinnati Opera, chairman of the board of Cincinnati Public Radio, and chairman of the Cultural Facilities Task Force.

24 Michael Keating
president and CEO, The Christ Hospital Health Network

The former banker and attorney, who has served as Christ’s CEO since 2012, later this year will take wraps off the largest expansion in its 125-year history. The $280 million project includes a nine-story building and the region’s first comprehensive joint and spine center, providing orthopedic and spine care, sports, medicine, rehabilitation, clinical research and education.

Alphabetical by last name 75 More Power Players in the Tristate

Stuart Aitken, CEO, dunnhumbyUSA

Laura Brunner, President & CEO, Port Authority of Greater Cincinnati

Steve Behler, President & CEO, Kemba Credit Union

Jeffrey Blackwell, Police Chief, City of Cincinnati

Rich Boehne, President & CEO, E,W. Scripps Co.

Neil Bortz, Principal, Towne Properties

Katie Brown Blackburn, Executive Vice president, Cincinnati Bengals

Margaret Buchanan, President & Publisher, Enquirer Media

Otto Budig, President & CEO, Budco Group

Tim Burke, Chairman, Hamilton County Democratic Party

Brian Carley, President & CEO, Cincinnati USA Regional Chamber

Steve Chabot, U.S. Representative, Ohio First District

Alfonso Cornejo, President, Hispanic Chamber of Commerce

Robert Coy, President, CincyTech

Bill Cunningham, Radio/TV Talk Show Host

Claude Davis, President & CEO, First Financial Bancorp

Joe Deters, Hamilton County Prosecutor

Edward Diller, Partner-in-charge, Cincinnati office Taft, Stettinius & Hollister

Jocile Ehrlich, President & CEO, Better Business Bureau

James Ellerhorst, Chairman, Greater Cincinnati United Way Board of Directors

Most Rev. Roger Foys, Bishop, Diocese of Covington

Charles H. Gerhardt III, President & Founder, Government Strategies Group

George Glover, Managing Director, Focused Capitol Solutions LLc, Taft Stettinius & Hollister government affairs group

Trey Grayson, President & CEO, Northern Kentucky Chamber of Commerce

Gary Heiman, President & CEO, Standard Textile Corp.

Joseph Hinson, President & CEO, West Chester Liberty Chamber Alliance

Erin Hoeflinger, President, Anthem Blue Cross & Blue Shield

David Joyce, President & CEO, GE Aviation

Ellen Katz, President & CEO, The Children's Home of Cincinnati

Dr. Dean Kereiakes, Medical Director, The Christ Hospital Heart and Vascular Center, Founder, Ohio Heart and Vascular Center

Kris Knochelmann, Judge Executive, Kenton County

Stephen Leeper, President & CEO, Cincinnati Center City Development Corp. (3CDC)

Wendy Lea, President, Cintrifuse

Dan Lincoln, President & CEO, Cincinnati Convention & Visitors Bureau

Lee Ann Liska, President & CEO, UC Medical Center

Terry Lundgren, President & CEO, Macy's Inc.

Kevin J. Lynch, Dearborn County Commissioner, president Ohio-Kentucky-Indian Council of Governments

Timothy J. Maloney, President & CEO, Carol Ann & Ralph V. Haile Jr./US Bank Foundation

Thomas Massie, U.S. Representative, Kentucky's Fourth District

Candace McGraw, President & CEO, Cincinnati/Northern Kentucky International Airport

Geoffrey Mearns, President, Northern Kentucky University

The Rev. Wendell Mettey, President & Founder, Matthew 25: Ministries

Jill Meyer, Managing Partner, Frost Brown Todd LLC

Chris Monzel, Commissioner, Hamilton County

Karen Mueller, Chair, Butler County United Way Board of Directors

Jim Neil, Sheriff, Hamilton County

Dr. O’dell Owens, President, Cincinnati State Community & Technical College

Mike Prescott, President, US Bank, Cincinnati Region

Mark Policinski, Executive Director, Ohio, Kentucky Indiana Council of Governments

Rob Portman, United States Senator from Ohio

Todd Portune, Commissioner, Hamilton County

Maribeth Rahe, President & CEO, Fort Washington Investment Advisors

Robert Reifsnyder, President & CEO, United Way of Greater Cincinnati

Scott Robertson, President & CEO, RCF Group, Chairman, Cincinnati Regional Business Committee

William T. (Bill) Robinson III, Chairman, Cincinnati/Northern Kentucky International Airport Board

Mary Ronan, Superintendent, Cincinnati Public Schools

Sean Rugless, President & CEO, Greater Cincinnati & Northern Kentucky African American Chamber of Commerce

The Rev. Dennis Schnurr, Archbishop, Archdiocese of Cincinnati

James Schwab, President & CEO, Interact for Health and Interact for Change

P.G. Sittenfeld, Member, Cincinnati City Council

Jamie Smith, Publisher, Cincinnati Business Courier

Harry Snyder, President & CEO, Great Oaks Career Campuses

H. Lytle Thomas, President & CEO, Heritage Bank, President Kentucky Bankers Association

Neil Tilow, President & CEO, Talbert House

Brian Tome, Senior Pastor, Crossroads Church

Ted Torbeck, President & CEO, Cincinnati Bell Inc.

Alex Triantafilou, Chairman, Hamilton County Repubican Party

Matthew Van Sant, President, CEO, Clermont Chamber of Commerce

Dick Weiland, Founder, President, Richard Consulting Group

Brad Wenstrup, U.S. Representative, Ohio's Second District

James Votruba, Chairman, Northern Kentucky CEO Roundtable

George Vincent, Managing Partner, Dinsmore & Shohl

James Wainscott, Chairman, President & CEO, AK Steel Corp.

Stephen Wilson, Chairman & CEO, Lebanon-based LCNB Bank

Charlie Winburn, Member, Cincinnati City Council

Eric Avner, vice president/community development for the Carol Ann & Ralph V. Haile Jr./US Bank Foundation, and CEO of People’s Liberty, a new philanthropic laboratory in Over-the-Rhine funding individuals with unique ideas.

Harry Black, Mayor Cranley’s choice for city manager, he’s responsible for implementing the mayor’s vision for the city.

Dwight Ferrell, new CEO and general manager of Cincinnati Metro, which will pick the operator of the Cincinnati Streetcar and is considering a regional transit tax initiative.

Ryan Messer, president of the Over-the-Rhine Community Council and key figure in keeping the streetcar project alive over the mayor’s opposition.

Johnna Reeder, president & CEO of the Regional Economic Development Initiative (REDI) Cincinnati, which attracted or retained more than 8,000 jobs last year.

Cliff Rosenberger, the new speaker of the Ohio House. The Clinton County Republican is the first Asian American and one of the youngest ever to serve as House speaker.

Carl Satterwhite, president and founder of West Chester’s RCF Group, he’ll become chairman of the United Way of Greater Cincinnati’s board of directors in April.