Hospitals In Focus with Chip Kahn

Rural America is a vital part of our nation—rich in culture, community, and resilience. But potential Medicaid cuts coupled with the impending expiration of enhanced tax credits further threatens rural communities' access to health care and puts the strength of rural communities at risk. In this episode, Chip Kahn is joined once again by Alan Morgan, CEO of the National Rural Health Association, to explore the impacts of Medicaid cuts and Americans' loss of health coverage on rural hospitals and what is at stake for patient care if lawmakers fail to protect these institutions.Key topics include: The current state of rural health care and why it matters to all Americans;What hospital closures mean for rural patients;The policy levers that could make or break the future of rural hospitals; and,Why Medicaid and the enhanced tax credits are essential to access care.References: Washington Post “Republican Medicaid cuts could shutter rural hospitals, maternity care” (https://www.washingtonpost.com/health/2025/03/08/medicaid-cuts-rural-hospitals/)About: Alan Morgan joined NRHA staff in 2001 and currently serves as Chief Executive Officer of the association.  Recognized as among the top 100 most influential people in health care by Modern Healthcare Magazine, Alan Morgan serves as Chief Executive Officer for the National Rural Health Association. He has more than 30 years experience in health policy at the state and federal level, and is one of the nation's leading experts on rural health policy.Mr. Morgan served as a contributing author for the publications, “Policy & Politics in Nursing and Health Care,” “The Handbook of Rural Aging” and for the publication, “Rural Populations and Health.” In addition, his health policy articles have been published in: The American Journal of Clinical Medicine, The Journal of Rural Health, The Journal of Cardiovascular Management, The Journal of Pacing and Clinical Electrophysiology, Cardiac Electrophysiology Review, and in Laboratory Medicine. Mr. Morgan served as staff for former US Congressman Dick Nichols and former Kansas Governor Mike Hayden. Additionally, his past experience includes tenures as a health care lobbyist for the American Society of Clinical Pathologists, the Heart Rhythm Society, and for VHA Inc.He holds a bachelor's degree in journalism from University of Kansas, and a master's degree in public administration from George Mason University.

Medicaid provides health coverage for more than 70 million Americans, including children, veterans, seniors, and people with disabilities. But as Congress works toward a reconciliation bill, proposed cuts totaling $880 billion have raised serious concerns about the program's future and the impacts on patients and providers.In this episode, Chip Kahn sits down with Dr. Bruce Siegel, President and CEO of America's Essential Hospitals, as he reflects on his 15 years of leadership, the critical role of serving uninsured and low-income patients, and the high stakes of the Medicaid debate unfolding in Washington.Key topics include:The evolving role of essential hospitals and the need to serve uninsured and low-income patients;Medicaid's role in the health system and why it is essential for patient care;The real-world impact of Medicaid cuts, including consequences for nursing home stays, community-based services, and hospital operations;Debunking the misconception that having insurance doesn't improve health outcomes; and,Bruce's advice for future health care leaders and what's next for him after America's Essential Hospitals.Guest Bio: With an extensive background in health care management, policy, and public health, Bruce Siegel, MD, MPH, has the blend of experience necessary to lead America's Essential Hospitals and its members through the changing health care landscape and into a sustainable future. With more than 350 members, America's Essential Hospitals is the only national organization representing hospitals committed to serving those who face financial and social barriers to care. Since joining America's Essential Hospitals in 2010, Siegel has dramatically grown the association as it strengthened its advocacy, research, and education efforts. His intimate knowledge of member needs comes in part from his direct experience as president and CEO of two member systems: New York City Health and Hospitals Corporation and Tampa General Healthcare. Just before joining America's Essential Hospitals, Siegel served as director of the Center for Health Care Quality and professor of health policy at The George Washington University School of Public Health and Health Services. He also served as New Jersey's commissioner of health. Among his many accomplishments, Siegel led groundbreaking work on quality and equity, with funding from the Robert Wood Johnson Foundation. He is a past chair of the National Quality Forum board and the National Advisory Council for Healthcare Research and Quality. Modern Healthcare recognized him as one of the “100 Most Influential People in Healthcare” from 2011 to 2019 and 2022 to 2024; among the “50 Most Influential Clinical Executives” in 2022, 2023, and 2024; among the “Top 25 Diversity Leaders in Healthcare” in 2021; one of the “50 Most Influential Physician Executives” from 2012 to 2018; and among the “Top 25 Minority Executives in Healthcare” in 2014 and 2016. He also was named one of the “50 Most Powerful People in Healthcare” by Becker's Hospital Review in 2013 and 2014. Siegel earned a bachelor's degree from Princeton University, a doctor of medicine from Cornell University Medical College, and a master's degree in public health from The Johns Hopkins University School of Hygiene and Public Health.

Medicaid, the largest health insurance program in the country, provides critical coverage for more than 79 million Americans—including children, pregnant women, seniors, and people with disabilities. As Congress considers ways to achieve $2.5 trillion in deficit reduction, Medicaid is at risk of significant changes and proposals that could seriously harm patient care.In this episode, Chip Kahn sits down with Hemi Tewarson, Executive Director of the National Academy for State Health Policy, to discuss the potential impact of Medicaid cuts on patients, hospitals and providers, and state governments. Key topics include: The current state of Medicaid and its economic impact;What's on the legislative agenda, including, proposed changes like work requirements, per capita caps, and shifts in state-directed payments; and,The role of data, policy decisions, and the future of Medicaid at the state level.Guest Bio: Hemi Tewarson, JD, MPH is the executive director of the National Academy for State Health Policy (NASHP), a nonprofit and nonpartisan organization committed to improving the health and well-being of all people across every state. At NASHP, Hemi leads an organization that is at the forefront of engaging state leaders and bringing together partners to develop and advance state health policy innovations. Under her direction, NASHP is leading efforts with states in areas including state COVID-19 recovery, health care costs and value, coverage, child and family health, aging, family caregiving, health care workforce, behavioral health, social determinants of health, health equity, and public health modernization. Previously, Hemi worked at the Duke-Margolis Center for Health Policy as a senior fellow and served as the director of the Health Division at the National Governors Association's Center for Best Practices. She also served as senior attorney for the Office of the General Counsel at the U.S. Government Accountability Office addressing Medicaid and related health care topics for members of Congress.  She holds a JD from George Washington University, an MPH from George Washington University, and a BA in Psychology, University of Pennsylvania. She lives in Maryland with her husband and two daughters.

With a new Administration and a Republican-controlled Congress stepping into power, a wave of changes is sweeping across Washington. From immigration and military renewal to energy dominance and tax cuts, the agenda is ambitious. But what does this mean for health care policy, hospitals, and patient care?In this episode, Joel White, President and CEO of Horizon Government Affairs, unpacks the evolving health policy landscape. Together, Chip and Joel explore how federal priorities, budgetary concerns, and legislative goals are shaping health care's future under a new administration.Key Topics Covered:What's driving federal policymaking in the current landscape;The GOP agenda and health care priorities for the Administration including Make America Healthy Again and the Department of Government Efficiency;The art of the possible and the policies that stand a chance of crossing the finish line; and, Budget reconciliation, funding challenges, and potential impacts on Medicare and Medicaid.Guest Bio: Joel is the Founder and President of Horizon Government Affairs (HGA), a health care consultancy that represents two dozen clients and runs four coalitions comprised of 200 organizations dedicated to reforms that improve our health system. Since Horizon's founding in 2007, his team has helped enact more than 50 laws and helped shape countless regulations governing all aspects of the U.S. health care system. Joel is also the President of the Council for Affordable Health Coverage, an HGA-managed coalition to improve affordability, increase competition in health care, and protect and strengthen employee health coverage. Recent campaigns include reforming the Inflation Reduction Act, promoting outcomes-based arrangements for gene therapies, and expanding small-group coverage. Previously, Joel spent twelve years on Capitol Hill including as Staff Director of the Ways and Means Health Subcommittee. While on the Hill he helped enact nine laws, including the 2002 Trade Act, which created health care tax credits for private coverage, the 2003 law that established the Medicare prescription drug benefit and Health Savings Accounts, the 2005 Deficit Reduction Act, and the 2006 Tax Reform and Health Care Act, which reformed Medicare payment policies. Joel is on the Boards of Directors of Samaritan Inns, Arlington Bridge Builders, the Schizophrenia and Psychosis Action Alliance, SafeNetRx, and Chaddock Behavioral Health. Joel holds a B.S. in Economics from the American University and is the co-author of the book, Facts and Figures on Government Finance.

In this episode of Hospitals in Focus, we revisit a vital topic—disaster preparedness and response. Hurricanes Helene and Milton caused devastating impacts across the Southeast, including catastrophic flooding in Asheville, North Carolina. FAH-member HCA Healthcare stepped up to the challenge, and their Mission Hospital became a beacon of resilience, treating over 500 emergency patients in the first hours after Hurricane Helene, flying in 400 nurses and 40 physicians from sister facilities, and ensuring the community had access to essential services.Michael Wargo, HCA Healthcare's Vice President of Enterprise Preparedness & Emergency Operations, provides listeners with a 360-degree view of emergency preparedness. Mike shares lessons learned, the importance of planning for the “known unknowns,” and how HCA's leadership prioritizes readiness at all levels. Chip and Mike also explore broader considerations for disaster recovery, from practical on-the-ground strategies to policy changes so hospitals can remain resilient in the face of future disasters.Key Topics Covered:HCA's approach to readiness with the five “R's” of emergency operations;Mission Hospital's hurricane response;Leadership's role in fostering a culture of preparedness; and,Recovery efforts and challenges taxpaying hospitals face, including the need for commonsense, bipartisan policies to support these critical institutions. Guest Bio: Mr. Michael Wargo serves as HCA Healthcare's enterprise Vice President for Preparedness & Emergency Operations based in Nashville, TN. Mike joined HCA Healthcare in 2016 as the Assistant VP of Enterprise Emergency Operations, a role in which he was tasked to redesign and lead the organization's disaster and emergency operations program in readiness, response, and recovery from adverse natural and man-made incidents across both the U.S. and the metro London area of the UK. Mike brings more than 25 years of clinical experience in high quality, patient centered care and nearly two decades in public safety leadership. Mike is the Executive Officer and immediate past Chair of the U.S. Health and Public Health Sector Coordination Council of the National Critical Infrastructure Protection Program sanctioned by Homeland Security Presidential Directive 21. In this role, he collaborates and serves as a trusted advisor to both federal secretary-level & SES leadership and senior private industry executives on readiness, response, and recovery initiatives impacting the U.S. national health security and critical infrastructure protection. Additionally, he served as the Chair of the Emergency Preparedness Committee for the Federation of American Hospitals. Mike is a veteran healthcare executive with experience leading the medical operations division of Northeast Regional Counter-Terrorism Task Force based in PA. He is the prior Administrator and Chief of Emergency Operations for Lehigh Valley Health Network, and an experienced flight nurse and Administrator of LVHN-MedEvac. Federally, Mike served in an intermittent position as a Supervisory Nurse Specialist for the U.S. Dept. of Health and Human Services National Disaster Medical Services. His combined experience includes both domestic and international homeland security and medical response training & operations. Mike holds multiple certifications in homeland security, disaster preparedness and is one of the first Certified Medical Transport Executives worldwide. He is a graduate of the American Military University with a Master of Business Administration degree, Kutztown University of PA with a Bachelor of Science Degree in Nursing and is a graduate of St. Luke's School of Nursing with a Diploma of Nursing. Continuing his post-graduate studies, Mike is near completion of the Doctor of Public Health degree program at Indiana University Fairbanks School of Public Health.Mike was recently awarded with the “Director's Award for Outstanding Service to Mission” by the U.S. Secret Service for his leading the Pandemic Health Security & Medical Operations of the final 2020 U.S. Presidential Debate.

Every year, millions of Americans face the life-changing news of a cancer diagnosis. Beyond the battle for survival and recovery, there is another critical fight—the battle to ensure patients and their families have access to affordable care.In this episode, we look at the intersection of health care policy and cancer care with Pam Traxel, Senior Vice President of the American Cancer Society Cancer Action Network (ACS CAN). ACS CAN champions cancer patients, survivors, and their loved ones by advocating for expanded access to health care, funding for cancer research, and policies that make lifesaving treatments more accessible.The Enhanced Premium Tax Credits (EPTCs) have proven to be critical tools, helping millions of Americans afford health insurance, including those grappling with the high costs of cancer treatment. With the threat of these credits expiring, the stakes for cancer patients and their loved ones couldn't be higher. Pam breaks down the potential consequences of losing this critical lifeline and shares how ACS CAN is mobilizing to protect access to affordable health care for all.Key Topics Covered:Role of ACS CAN in fighting for cancer patients and families;Potential expiration of Enhanced Premium Tax Credits and its devastating implications;Importance of health insurance in cancer diagnosis and survival rates; and,Data showing how EPTCs improve patient outcomes and protect access to care.Studies mentioned in the episode: Health insurance status and cancer stage at diagnosis and survival in the United States: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21732How ACA Tax Credits Impact Patients With Chronic Conditions: https://www.oliverwyman.com/our-expertise/insights/2024/sep/premium-tax-credit-ending-chronic-conditions-at-risk.htmlCancer Patients & Survivors Overwhelmingly Support Extending ACA Enhanced Tax Credits:  https://www.fightcancer.org/policy-resources/cancer-patients-survivors-overwhelmingly-support-extending-aca-enhanced-tax-creditsGuest Bio: Pam Traxel serves as the Senior Vice President for ACS CAN, the advocacy affiliate of the America Cancer Society.  Pam is responsible for helping ACS CAN develop relationships with companies and individuals to help further the fight against cancer through dynamic partnerships, events, and forums.  Pam began her career with ACS CAN in 2007.  She has been integrally involved in helping to establish ACS CAN as a nationwide advocacy organization that influences and shapes public policy at all levels of government to impact our mission and to represent the voices of all cancer patients and their families.   

As the Federation of American Hospitals (FAH) prepares for a pivotal year ahead, this special episode takes a moment to reflect on the progress made in health care policy and the challenges and opportunities on the horizon. Join host Chip Kahn as he sits down with retiring Executive Vice President of Policy, Steve Speil, to discuss his nearly four decades of experience in health care policy and his reflections on his remarkable 27-year tenure at FAH.Steve's career has spanned transformative decades in health care, from his early days in Massachusetts state health planning to tackling the evolving complexities of hospital policy in Washington, D.C. His insights in health care policy and the hospital community's resilience shine a light on how far we've come—and the work still ahead to ensure patients have access to 24/7 care.In this episode, Chip and Steve discuss: Steve's Career Journey Leading to FAH: From a Master in Public Health to law school and a career spanning Massachusetts state health planning, the Dukakis administration, AdvaMed, and ultimately the Federation of American Hospitals.Early Days at FAH: A look back at the early years of Steve's time at FAH, navigating key regulations like IPPS and legislation including the Balanced Budget Act.Changing Landscape of Health Policy: Steve reflects on accomplishments during his tenure and insights into how hospital policy has evolved, now facing increased burdens.Opportunities Ahead: Steve discusses the continued resilience of hospitals in the face of challenges and the critical role of organizations like FAH in supporting hospitals and the communities they serve.Guest bio: In his capacity as Executive Vice President of Policy, Steve Speil manages the Federation's broad portfolio of payment policy issues. He serves as the association's chief liaison on these issues with the Centers for Medicare and Medicaid Services and the Medicare Payment Advisory Commission. Working closely with the senior finance and policy executives in the Federation's member companies, Steve develops and carries out both issue-specific and general strategic plans designed to advance the finance and payment related regulatory and legislative interests of the FAH.Prior to joining the Federation, Steve served as Associate Vice President, Policy Coordination and Communication for the Health Industry Manufacturers Association (now AdvaMed), the national trade group representing the medical technology industry. Before moving to Washington, Steve held a succession of increasingly senior management and policy positions in Massachusetts. During his time in the Bay State, Steve served as Legal Counsel to the Lieutenant Governor, Legislative Counsel for the Executive Office of Health and Human Services, Executive Director of the Disabled Persons Protection Commission, and Legal Counsel and Policy Director in the Office of State Health Planning. Steve also taught health law and policy as an Assistant Professor at Simmons College Graduate Program of Health Administration.At the federal level, Steve served in the Food and Drug Administration's Office of Legislative and Congressional Affairs. He also worked in the Environmental Protection Agency's Office of General Counsel.Steve earned a J.D. degree from American University's Washington College of Law; a Master in Public Health degree in Health Administration from the University of North Carolina School of Public Health; and a Bachelor of Arts degree in Anthropology/Zoology from the University of Michigan.

In this episode of Hospitals in Focus, host Chip Kahn explores the digital renaissance revolutionizing health care—a golden age of pioneering technologies not seen since the 1960s, when computers first standardized medical records and diagnostics. Today, with nearly everything digitized, organizations are actively discussing the regulatory and ethical frameworks necessary to navigate these advancements, while protecting against the increasing prevalence of cyber threats.The future of health care looks promising thanks to new innovations, but thoughtful implementation is crucial, and Ardent Health is leading the way forward.Joining Chip on the episode is Anika Gardenhire, Ardent Health's inaugural Chief Digital and Information Officer, to explore how Ardent is thoughtfully embracing digital innovation with reason and purpose.In this episode, Chip and Anika discuss:Conceptual Frameworks for Digital Transformation: The importance of leveraging data to drive innovation and improve patient outcomes.Use Cases at Ardent Health: Examples where Ardent Health is implementing digital solutions to enhance operational efficiency and patient care.Cybersecurity and Protecting Patient Information: Strategies for safeguarding patient data against cyberattacks in an increasingly digital landscape.Guest Bio: As chief digital information officer, Ms. Gardenhire oversees the development and implementation of Ardent's digital strategy across the organization. She is responsible for ensuring digital initiatives are fully integrated into Ardent's strategic plan with a focus on leveraging data to support digital transformation. Ms. Gardenhire also oversees Ardent's IT infrastructure and systems, as well as data strategy and governance.An experienced caregiver and clinical informatics leader, Ms. Gardenhire joined Ardent in September of 2023, and has previously served as chief digital officer and regional vice president of digital and clinical systems at Centene Corporation. She also held various roles at Intermountain Healthcare, including assistant vice president of digital transformation. Ms. Gardenhire holds a bachelor of science in nursing from the University of South Carolina's Mary Black School of Nursing and master's degrees in clinical informatics and management from Duke University.

In this episode of Hospitals in Focus, we're pulling back the curtain on an often-overlooked  yet truly “critical” aspect of our health care system—the supply chain. It's the backbone of  our hospitals, ensuring that essential medical supplies reach patients in need. But what  happens when that chain breaks? Host Chip Kahn is joined by Ed Jones, President and CEO of HealthTrust Performance  Group, to discuss recent events that exposed vulnerabilities in this intricate network.  Following Hurricane Helene's catastrophic impact on a major manufacturing facility for IV  solutions, hospitals nationwide faced a sudden, alarming shortage. This crisis underscores  that our health care supply chain is a fragile, interconnected network, frequently  dependent on a limited number of suppliers and manufacturers. In this episode, Chip and Ed discuss: An introduction to Group Purchasing Organizations (GPOs), and how they help  hospitals secure reliable supplies at fair prices. Pandemic and Disaster Preparedness: How the COVID-19 pandemic and  Hurricane Helene revealed and accelerated shifts in our supply chain, and what  parallels these events share. The Role of GPOs in Drug Supply: An examination of how GPOs respond to  shortages and their impact on supply and pricing. International Reach and Recovery: How global supply chains influence our health care systems. HealthTrust's Unique Approach: What sets HealthTrust apart from other GPOs in  its approach to building a resilient and cost-effective supply chain. Guest Bio:  As President and CEO of Healthtrust Performance Group, Ed has overall responsibility for a  broad set of capabilities focused on supporting healthcare providers. His primary focus is  providing the strategic direction and leadership of a comprehensive spend management  and performance improvement business based in Nashville, Tennessee. Jones oversees  all dimensions of a $52B portfolio; directs all consulting, managed services and  outsourced relationships/alliances, including accountability for HCA Healthcare supply chain, sourcing contingent labor, facility management and clinical education.Jones' leadership encompasses several HealthTrust/HCA Healthcare business ventures  that strengthen provider performance and competitive advantage, including: HealthTrust Workforce Solutions - The clinical labor staffing and consulting  company including a proprietary program called StaRN (extensive training program  for all new nurses) HCA Healthcare Center for Clinical Advancement - Responsible for providing  continual education for over 90,000 nurses at HCA Healthcare through a team of  approximately 800+ educators and several simulation labs HealthTrust Europe, which provides sourcing and supply chain services to HCA U.K.  and sourcing services to 39 provider trusts in the U.K. HealthTrust Global Sourcing Office in Shanghai, China Galen College of Nursing Group purchasing organization that delivers clinically integrated solutions and  savings across all sites of care He has 40 years of experience within the Healthcare industry, serving in his current role for  the last 11 years and serving previously as the Chief Operating Officer of HealthTrust  Performance Group with responsibility for strategic sourcing, clinical operations, custom  contracting, supplier diversity, and regional operations. Prior to that, Jones served in  several leadership positions within HCA Healthcare for 20 years following front-line roles  at a hospital for seven years. Jones is a founding board member of the Health Sector Supply Chain Research  Consortium, and a member and subcommittee leader of the Federation of American  Hospitals. He also serves on the board of Galen College of Nursing and is the chairman of  the finance committee. Jones also serves on the board of CoreTrust. Previously, he served  as board chair on the Healthcare Supply Chain Association (HSCA). He holds a Bachelor of  Science degree from Virginia Commonwealth University.

With over nine million veterans enrolled, the Department of Veterans Affairs (VA) is well known for its health care services. However, the VA's support extends beyond medical care, helping veterans navigate life after military service. The VA has undergone a significant transformation since the establishment of the Veterans Experience Office in 2015, focusing on improving veterans' experiences through the use of qualitative and quantitative veteran-customer service data.In this episode, Dr. Carolyn Clancy, Assistant Under Secretary for Health at the VA, shares insights on the organization's evolving approach to health care and the patient experience by discussing:The role of the VA and its evolution in approaches to health care; Transformation through leadership and the creation of the Veterans Experience Office; Holistic attitude to health care through the ‘My life, my story' project; and, Broader applications of VA initiatives in other health care settings Guest Bio: Dr. Clancy serves as the Assistant Under Secretary for Health (AUSH) for Discovery, Education & Affiliate Networks (DEAN), Veterans Health Administration (VHA), effective July 22, 2018. The Office of the DEAN fosters collaboration and knowledge transfer with facility-based educators, researchers, and clinicians within VA, and between VA and its affiliates. Prior to her current position, she served as the Acting Deputy Secretary of the Department of Veterans Affairs, the second-largest Cabinet department, with a $246 billion budget and over 424,000 employees serving in VA medical centers, clinics, benefit offices, and national cemeteries, overseeing the development and implementation of enterprise-wide policies, programs, activities and special interests. She also served as the VHA Executive in Charge, with the authority to perform the functions and duties of the Under Secretary of Health, directing a health care system with a $68 billion annual budget, overseeing the delivery of care to more than 9 million enrolled Veterans. Previously, she served as the Interim Under Secretary for Health from 2014-2015. Dr. Clancy also served as the VHA AUSH for Organizational Excellence, overseeing VHA's performance, quality, safety, risk management, systems engineering, auditing, oversight, ethics and accreditation programs, as well as ten years as the Director, Agency for Healthcare Research and Quality. 

Before the Change Healthcare cyberattack, hospitals were already grappling with insurers' tactics of delaying and denying payments for patient care. The cyberattack only amplified the challenges providers face—not just in delivering care, but also in getting reimbursed for that care. Despite the crisis, insurers continued to use these tactics. Now, six months later, Matt Szaflarski, a director and revenue cycle intelligence leader at Kodiak Solutions, and his team have uncovered something alarming: a surge in insurers' initial Request for Information (RFI) claim denials.Kodiak's latest report, “Death By A Thousand Requests,” highlights the growing trend of payors denying initial claims due to RFIs, creating an enormous administrative burden on hospitals and providers. In 2024 alone, these tactics are projected to cost hospitals $4.6 billion. Szaflarski returns to the show to explain the impact of these denials on the hospital revenue cycle, which ultimately impacts the hospital's ability to provide care.In this episode, Szaflarski discusses:Updates on the Change Healthcare cyberattack;Rising trends in claim delays and denials, particularly RFI denials;Revenue cycle data insights;Medicare Advantage, the two-midnight rule, and observation stay challenges; andRecommendations for improving processes between insurers and providers.

In June, the Supreme Court issued a 6-3 decision in Loper Bright Enterprises v. Raimondo,  overturning the 40-year-old legal precedent known as the "Chevron doctrine." This doctrine  had allowed federal agencies to interpret ambiguous statutes within their jurisdiction. The  ruling marks a significant shift in the regulatory landscape, with major implications for how  federal agencies operate and how regulations are enforced—particularly in health care.  The decision presents both challenges and opportunities for the health care industry,  making it crucial for policymakers, health care leaders, and businesses to understand the  evolving regulatory environment. Joining Hospitals in Focus to unpack the potential effects of this ruling on health care  policy making is Thomas Barker, a partner at Foley Hoag and former General Counsel at  CMS and Acting General Counsel at HHS.  In this episode, we explore: Impact on Congress: How does the ruling affect Congress's legislative process and its  relationship with federal agencies? Will the ruling force Congress to write more precise  laws? Changes for Federal Agencies: What does the ruling mean for federal agencies, like CMS  and HHS, which have relied on Chevron deference to implement and enforce regulations?  Judicial Implications: Will courts, particularly lower courts, take on a larger role in  interpreting statutes? How could this influence future rulings on health and business  regulations? Business and Regulatory Implications and Challenges: What will be the effect on businesses, especially those operating in highly regulated sectors like health care, and  what are the potential retroactive effects of the Loper Bright decision?

The work, dedication, and resilience of hospital providers and staff is centered on providing high-quality care for their patients. In this special episode of Hospitals in Focus, we spotlight two compelling stories of patient care from the frontlines, offering unique perspectives from both a health care provider and patient. Join us as we hear firsthand from Amy Capella Smith, CEO of Foundations Behavioral Health, a UHS hospital in Doylestown, Pennsylvania, as she navigates the challenges and rewards of providing behavioral health services to children, adolescents, and young adults.  We also share Jenna Tanner's story, who survived what is often called the “widow maker,” a massive heart attack, while home alone. Jenna was able to call 911 and get the emergency medical help she needed at Hillcrest Hospital, an Ardent Health hospital, where she received lifesaving care. Her experience serves as a universal message about heart health and the importance of recognizing the early signs of a heart attack. 

Today, we are celebrating the 59th anniversary of Medicare and Medicaid being signed into law by President Lyndon B. Johnson and discussing the profound effect these programs have had in providing health care coverage to the country's most vulnerable populations.Medicare and Medicaid laid the foundation for public health insurance in the United States, ensuring that the elderly, low-income families, and individuals with disabilities receive essential health care services. The Affordable Care Act (ACA), enacted in 2010, built upon this foundation by expanding Medicaid eligibility, providing subsidies lower-income individuals and families to purchase private insurance on exchanges, and implementing protections for people with pre-existing conditions. Medicare, Medicaid, and the ACA have created a more comprehensive safety net for millions of Americans, significantly reducing the uninsured rate and improving access to care.Our guest, Larry Levitt, oversees policy work on Medicaid, Medicare, the ACA, and the health care marketplace for one of the nation's leading health policy organizations. Larry's extensive knowledge will guide us through the following topics:·         Medicaid Coverage: Expansion and post-pandemic redeterminations in the states;·         Evolution of the ACA: The development and impact of enhanced subsidies;·         ACA Challenges: Addressing concerns about bad actors and program issues; and·         Future of Coverage: Insights on the upcoming election and its implications for health care coverage. More: Larry Levitt is the executive vice president for health policy, overseeing KFF's policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women's health, and global health. He previously was editor-in-chief of kaisernetwork.org, which was KFF's online health policy news and information service and directed KFF's communications. Prior to joining KFF, Levitt served as a senior health policy adviser to the White House and the Department of Health and Human Services, working on the development of the Clinton Administration's Health Security Act and other health policy initiatives. Earlier, he was the special assistant for health policy with California Insurance Commissioner John Garamendi, a medical economist with Kaiser Permanente, and served in a number of positions in Massachusetts state government. Levitt holds a bachelor's degree in economics from the University of California, Berkeley, and a master's degree in public policy from the Kennedy School of Government at Harvard University. 

Measles, eradicated in the United States in 2000, is making a comeback. Meanwhile, an  estimated 300,000 people died from COVID-19 in cases that could have been prevented  through vaccination. Why are we seeing an uptick in conspiracy theories, misinformation,  and outright science denial? The consequences of losing trust in science are harmful and  even deadly. Dr. Reed Tuckson, MD, FACP, has dedicated his career to restoring public confidence in  scientific research and health care. He joins Chip on the latest episode of Hospitals in  Focus to explore the current social climate influencing science denial and how it is  exacerbated by those who seek to sow mischief and discontent. Topics discussed include:  • Tribalism and the “Us vs. Them” mentality; • Social media's role as a dissemination mechanism; • Patient-level impacts on health, particularly on society's most vulnerable; • Covid-19 and the mistakes made with the best intentions; and  • Bridging the gap to regain trust and promote science literacy. More/Dr. Tuckson's Bio:  Reed V. Tuckson, MD, FACP, is Managing Director of Tuckson Health Connections, LLC, a  vehicle to advance initiatives that support optimal health and wellbeing. Currently, Dr. Tuckson's focus is on his role as a Co- Convener of the Coalition For Trust In  Health & Science, which is dedicated to bringing together the entire health related  ecosystem to address mistrust and misinformation. In addition, he continues to advance  his work as a co-founder of the Black Coalition Against COVID, a multi-stakeholder and  interdisciplinary effort working to mitigate the COVID-19 pandemic in Washington D.C. and  nationally by coordinating the four historically Black medical schools, the NMA, the  National Black Nurses Association, the National Urban League, and BlackDoctor.org.

Artificial intelligence (AI) is dominating headlines and conversations, from how it will change our day-to-day routines to the debate on how far regulation of the ever-changing technology should go. AI's impact on health care is profound, promising advancements in diagnostics, treatment plans, and patient care, but also raising questions about privacy, bias, and the role of human oversight.Our guest, Dr. Michael Schlosser, MD, MBA, Senior Vice President, Care Transformation and Innovation at HCA Healthcare, is a leading expert in AI applications within the health sector. In this episode, he and Chip delve into the multifaceted world of AI. Dr. Schlosser's insights will guide us through the complexities of integrating AI into medical practices, highlighting both the transformative benefits and the critical safeguards needed to ensure ethical and effective use.Topics discussed include: Defining AI – whether we should anticipate a better future or be worried Leveraging AI – use cases in health care A human-centric approach – understanding risks and ways to mitigate harm and biasThe federal government – finding the sweet spot for regulation Future of AI – the benefits of incorporating AI into health care for providers and caregiversMore: Michael Schlosser, MD, MBA, is Senior Vice President, Care Transformation and Innovation for HCA Healthcare. Reporting directly to the CEO of HCA, he is responsible for leading care delivery innovation and transformation for the enterprise. His department's vision is to design, develop, integrate, implement, and optimize technology and processes that drive care delivery with the common goal of improving the experience and outcomes for HCA Healthcare's leaders, care teams, and patients. As part of this strategy, he leads the implementation and optimization of HCA Healthcare's electronic health record systems, the data science and data strategy teams, and the enterprise Responsible AI program.Prior to this role, he served as group Chief Medical Officer, leading the clinical operations for 100 HCA hospitals, overseeing quality, patient outcomes, and clinical strategy. He has also previously served as the chief medical officer for Healthtrust.Dr. Schlosser is a neurosurgeon and completed his residency and fellowship at Johns Hopkins, has served as a medical officer with the FDA, and holds a degree in chemical engineering from MIT and an MBA from Vanderbilt.

Maryland's 50-year experiment with the hospital rate-setting system stands out as a unique and long-lasting initiative – but has it accomplished its goal of reducing health care costs? This rate-setting scheme has been sustained due to additional Medicare funds supplementing the model, an additional $20.6 billion through 2017. It's also inspired CMS's All-Payer Health Equity Approaches and Development (or AHEAD) pilot program. The Maryland model has come under scrutiny with a paper published in HFM Magazine entitled “Maryland's example is no solution to healthcare's true crises.” It finds that the state's health costs remain higher than the national average, even though the system was designed to reduce hospital and overall health care costs.Our guest is the author of the paper and president of Health Futures, Inc. - Jeff Goldsmith. In this episode, will discuss the history of the Maryland model, the findings of his paper, the impact on hospitals and health care costs, and propose alternative solutions for reducing costs.Topics discussed include:Implications for the state – findings from Goldsmith's paperEmulating the scheme – feasibility of replicating the Maryland model elsewhere and cautionary notes for policymakersRefocusing health care goals – what solutions to access and cost should CMS be considering instead?What's next – the future for hospitals More: Jeff Goldsmith is the President of Health Futures, Inc. He speaks on the future of health care- covering topics like technology, economics, leadership health care trends and policy analysis. Goldsmith is also a strategist and mentor to leaders in the health care industry.  He has also taught at several prestigious universities and worked in the private sector as a consultant. 

Cybersecurity is a central part of every nation's infrastructure – especially when it comes to health care. The availability and free flow of health information is critical to providing care. Unfortunately, patient information isn't just valuable to caregivers, it's also becoming a primary target for criminals across the globe.In this special episode, Chip Kahn moderates a panel of cybersecurity experts, with significant experience in the health care sector, from around the world. The discussion, entitled 'Navigating Today's Cyber Threats for Tomorrow's Healthcare,' was organized by Future of Health, a group made up of thought leaders from hospital systems, academia, policymaking, payers and patient advocacy.Topics discussed include:Current state of cyber defenses today – vulnerabilities, variabilities across the worldGoals of cybercriminals targeting health care entities – money, data, or mayhem Paying ransom – views from different countriesPolitical implications – how to react when cyber breaches become geopolitical events Proper role of governments in cyber defense and attack mitigation – the role of mandates and the threat of penaltiesLasting advice – the one thing health care entities must do to protect themselves.The virtual panel:US: Meredith Griffanti, Senior Managing Director, Global Head of Cybersecurity & Data Privacy Communications, FTI ConsultingUK: Dr. Saif Abed, Director of Cybersecurity Advisory Services, The AbedGraham Group and Cybersecurity Consultant, World Health Organization Singapore: Kim Chuan, Group Chief Information Security Officer, SingHealthIsrael: Alon Rozen, CEO of Elements Group, and former Chief of Staff at the Israeli Ministry of Defense and Director General of the Israeli Homefront Defense MinistryMore: Established in 2018, Future of Health's diverse membership represents the foremost health organizations and thought leaders from hospital systems, academia, policymaking, payers, industry, and patient advocacy. Each year, FOH members address, through discussion and research process, pivotal issues facing health care across the world. From this process FOH develops insights and recommendations disseminating findings through published papers which serve as a blueprint for a common vision for the future of health.

With zero-dollar premiums, caps on out-of-pocket costs, and perks that range from meal delivery to gym memberships – even loaded debit cards – membership in Medicare Advantage (MA) plans is surging in enrollment and popularity among seniors.  In fact, earlier this year, enrollment in Medicare Advantage plans surpassed enrollment in traditional Medicare, with more than 50 percent of eligible seniors now choosing this privatized version of coverage.  However, aggressive marketing campaigns and a lack of transparency in coverage often hide the downsides of Medicare Advantage, which include limited networks and strict prior authorization policies that make it harder for millions of seniors to quickly get the care they need. As we explore in this episode, these downsides also impact care providers, like hospitals, as well as the taxpayers who are footing the bill.Our guest, Tricia Neuman, is the executive director of KFF's Program on Medicare Policy and has been with the organization for almost 30 years. She looks back on the creation of MA, discusses the program's unexpected rapid growth, examines its impact on the health care system, and shares what she thinks comes next for seniors' coverage.Topics discussed include:Evolution of Medicare Advantage – popularity and benefitsFlooding the airwaves – impact of overzealous marketingWhat's in it for insurers? – how insurers game the system Impact on patients– from narrow networks to excessive prior authorizations Problems for providers – limitations on care from denials and delays Taxpayers pay the price – MA now spends more per beneficiary than Traditional MedicareWhat's next – the future of Medicare Advantage More:KFF is an independent source for health policy research, polling, and journalism. Its stated mission is to serve as a nonpartisan source of information for policymakers, the media, the health policy community, and the public.KFF has four major program areas: KFF Policy; KFF Polling; KFF Health News (formerly known as Kaiser Health News, or KHN); and KFF Social Impact Media, which conducts specialized public health information campaigns.

The recent cyberattack on Change Healthcare exposed fissures in the American health care system that are still reverberating - impacting patients and providers alike months after it was exposed.As hospitals, physicians, and other providers get back on their feet, they're also improving their cyber defenses to stay one step ahead of increasingly persistent hackers.This crisis also sparked conversations among policymakers weighing the implementation of new regulations on health care entities, including potential penalties for those who have been victimized.In this episode, Lynn Sessions looks at the cyber-security issues facing hospitals and health care organizations, from evolving threats to how we need to think about mitigation and resiliency. Lynn is a partner at the law firm BakerHostetler and leads the Healthcare Privacy and Compliance practice, where she has handled more than 1,000 health care data breaches and ransomware attacks.Topics discussed include:Evolving efforts of hospitals to increase cybersecurity protectionsThe anatomy of a health care cyberattack – effects of ransomware vs. malwareVulnerability of 3rd party entities in health care – like Change HealthcareRole of the federal government – protecting hospitals, penalizing bad actorsMoving forward – fighting the next generation of cybercriminals More:BakerHostetler has a diverse team with wide experience in counseling health systems, physician groups, insurers and employers across the country regarding risk assessments, developing comprehensive incident response plans, and responding in a timely and accurate manner to privacy and security incidents, from lost paper files and laptops to the largest cyber incident ever reported involving medical information.More here - https://www.bakerlaw.com/services/digital-assets-and-data-management/healthcare-privacy-and-compliance/ 

Good health care depends on good health coverage, particularly for the most vulnerable. The Affordable Care Act expanded Medicaid eligibility and created exchanges where many Americans could access health insurance, often at a subsidized price. These new pathways to affordable coverage led to the uninsured rate dropping to record lows.Unfortunately, those recent gains in coverage and access now face new hurdles. After the end of the Covid public health emergency, states began a process of redetermining Medicaid eligibility which caused tens of millions to lose coverage. Many were forced to find a new source of insurance coverage, or lost it completely. The passage of the Inflation Reduction Act created enhanced subsidies for individuals seeking insurance on the ACA marketplace exchanges, leading to a record high enrollment this year. Those subsidies are set to expire in 2025.  Unless Congress steps in, this could increase premiums, making coverage too expensive for many, threatening access to health care. In this episode, Stan Dorn, who has worked on coverage issues for almost 40 years and currently serves as the Director of the Health Policy Project at UnidosUS, explains what these dual threats to coverage mean for individuals and their families.Topics discussed include:Current state of the Medicaid redetermination process and its impact on coverage for recipientsCongressional action needed to avoid looming marketplace coverage cliff  Long-term policy changes that will improve the ACA by protecting Medicaid expansion and continuing affordability in the exchange marketplaceMORE: UnidosUS, previously known as NCLR (National Council of La Raza), is the nation's largest Hispanic civil rights and advocacy organization. Through a unique combination of expert research, advocacy programs, and an Affiliate Network of nearly 300 community-based organizations across the United States and Puerto Rico, UnidosUS simultaneously challenges the social, economic, and political barriers that affect Latinos at the national and local levels. When it comes to health care, the group is focused on ensuring access to affordable coverage with an emphasis on helping people through the Medicaid unwinding process and enrolling them in exchange plans.

The Change Healthcare cyberattack on February 21st upended a huge slice of the U.S. health care system, virtually crippling all aspects of the patient care continuum when the clearinghouse's services were hacked. That is because Change Healthcare processes 15 billion claims totaling more than $1.5 trillion a year and may handle 50 percent of all medical claims in the country. The impact has been devastating for many patients, hospitals, and providers, particularly those already operating under financial constraints. Having an understanding of the size and scale of this cyberattack has been critically important to ensuring lawmakers and regulators understand the outsized impact on providers. Enter Matt Szaflarski, a revenue cycle intelligence leader at Kodiak Solutions. In the aftermath of the attack, Matt has become a leading voice in clarifying the role, scale, and impact within the care continuum and quantifying its impact. In this episode, Szaflarski discusses:The role of a clearinghouse in patient care from start to finish;A breakdown of the Change Healthcare cyberattack and subsequent fallout, including the effect on patients and loss of provider safety nets; andFuture of health care and recovering from the hack.More: Kodiak Solutions is a leading technology and tech-enabled services company that simplifies complex business problems.Kodiak has built a high-performing business for healthcare provider organizations revolving around a proprietary net revenue reporting solution, Revenue Cycle Analytics, and expanded to a broad suite of software and services in support of CFOs. Kodiak's 400 employees engage with more than 1,850 hospitals and 250,000 practice-based physicians across all 50 states.Learn more here: https://www.kodiaksolutions.io/

There are two Americas - rural and urban – particularly when you look at access to health care.  With roughly 60 million people, or one in five Americans, living in small communities from coast to coast, how do we ensure patients have access to the care they need when they need it? And what policies can help bridge the gap? Former Senator Heidi Heitkamp has dedicated her life to representing the interests of rural America and fighting to save this way of life. She currently serves as founder and board chair of the One Country Project, an organization dedicated to advancing rural America through and ensuring its priorities and values are represented and reflected in Washington, D.C.  In this episode, Sen. Heitkamp discusses the issues facing small communities and how lawmakers can help solve health inequities between rural and urban areas.  Topics include: Unique health care challenges faced by rural Americans Hospital closure crisis Impact of public programs like Medicare, Medicaid, and the Affordable Care Act Threat of funding cuts to rural health care programs, like site-neutral, low-volume and Medicare-dependent hospitals  Unintended consequences of Medicare Advantage Mission of the One Country Project MORE:   The One Country Project is dedicated to reopening the dialogue with rural communities, rebuilding trust and respect, and advancing an opportunity agenda for rural Americans. Its mission is to ensure rural America's priorities and values are heard, understood, well-represented and reflected in policy in Washington.  Learn more here: https://onecountryproject.com 

GUEST: Dr. Jonathan Perlin, President and CEO, The Joint Commission IN THIS EPISODE:  The Joint Commission is possibly the most impactful health care quality and performance organization in the world. With the rise of AI and concerns growing over issues like environmental sustainability, its mission has never been more critical.Dr. Jonathan Perlin, in his second year at the helm of The Joint Commission, is on a quest to reshape safety and performance measurement and its impact on care delivery for hospitals and other settings.In this episode, Dr. Perlin outlines his H.E.L.P agenda and explains how the acronym is a guide for the organization as it aims to better ensure patients' safety and effective hospital care.H.E.L.P Agenda includes: Health EquityEnvironmental Sustainability  Learning Health Care/AIPerformance Improvement and Integration MORE: The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.It aims to accomplish this goal by setting quality standards, evaluating an organization's performance, and providing an interactive educative experience that provides innovative solutions and resources to support continuous improvement.Learn more here: https://www.jointcommission.org/

IN THIS EPISODE:For the past 15 years, drug shortages have been a persistent problem for hospitals and thepatients they serve – and extreme cases can even lead to rationing, delaying, or cancelingtreatments or procedures.Tackling the drug shortage crisis is a complicated issue requiring creative solutions. That's whereCivica comes in – a non-profit pharmaceutical company created by hospitals and health systemsto address these critical shortages.In this episode, Chip speaks with Civica's Senior Vice President for Public Policy Allan Coukellabout why the company was formed, the challenges they are tackling, and how it plans to helppatients into the future. Topics include:The state of hospital drug shortages in the US todayTaking the bull by the horns: how a non-profit company created by hospitals is helpingpatients.The success of Civica's model:Long-term purchase and supply contracts directly with hospitals that add stabilityto the market.Maintaining an approximately 6-month buffer inventory of every drug.US sourcing whenever possible.Intensive quality oversight of suppliers.A single cost-plus price, available to every purchaser.How the company got into drug production.Policy solutions to ease drug shortages.GUEST:Allan Coukell, Senior Vice President. Public Policy, Civica Inc.MORE:Civica currently delivers 80+ drugs, all chosen by US hospitals for being at risk of shortage, withmore than 140 million containers delivered to hospitals over five years, serving 60 millionpatients.It currently works with 1,500+ hospitals from 55-member health systems, like HCA Healthcare,Mayo Clinic, Common Spirit & US Department of Veterans Affairs.Learn more here: https://civicarx.org/

Guest:Phillip Morris, Partner & Leads Strategic Insights Practice, LSGIn this episode:It is only January, but the campaign season is already in full swing. From the White House tocontrol of Congress - power in Washington is up for grabs. In this episode, Chip Kahn talks withPhillip about what issues matter most to voters and where health care fits into that list ofpriorities.Topics they examine include:Most important issues to likely voters in this year's election - inflation, the economy, and immigration.Views on health care – voters point to big insurance and pharmaceutical companies as the main reasons for rising costs and lack of pricing transparency.Growing concern over Medicare Advantage plans delaying and denying doctor-ordered care for seniors.Voter's view hospitals favorably and consider them among the most essential providers of health care in their communities.Overwhelming support for lawmakers ensuring hospitals have the necessary funding to provide 24/7 care.Political trends for 2024 and into 2025.MORE:Phillip Morris and his firm, LSG. recently conducted a poll on behalf of FAH and found wide support for hospitals and hospital funding among likely voters. The survey also discovered the vast majority are concerned about cuts to Medicare and abuses by Medicare Advantage plans, including denials and delays of care through prior authorization, denied payments for necessary treatments, and network restrictions limiting provider choice.Key findings include:Voters view hospitals favorably and consider them among the most essential providers of health care in their communities.Nearly three-quarters (72%) of likely voters view hospitals favorably.The vast majority (82%) believe the federal government should provide adequate funding to ensure hospitals serving rural and underserved communities remain open.Lawmakers' positions on hospital funding will affect voters' actions at the ballot box.Seventy percent of voters would be less likely to vote for a Member of Congress who supported cuts to hospitals that threatened their ability to stay open.An overwhelming majority (89%) would be willing to take action to support policies that would ensure access to hospital care.Voters are concerned about the impact of Medicare Advantage practices on consumers' access to health care.The vast majority (78%) of voters are concerned about the trend of Medicare Advantage plans delaying or denying access to care for seniors.A majority (56%) of voters believe there should be more regulation and oversight of Medicare Advantage plans.Likely voters blame health insurers most for the lack of transparency in health care costs.You can learn more here.

Chip and Dr. Liz Fowler, Deputy Administrator of CMS and Director of the agency's Center forMedicare and Medicaid Innovation (CMMI), discuss CMMI's mission to improve healthoutcomes, overcome the obstacles to health equity, and reduce care costs. They look back onwhat CMMS has accomplished in its first 10 years, what we have learned from thisexperimentation, and the future of care and payment innovation.Topics they examine include: CMMI's successes over the last decade and what programs have resonated most. Controversial CBO report that says CMMI's programs have increased federal spending –not lowered it. Performance of CMMI bundled payments and rationale behind a new mandatory bundledpayment program. Goals of the newly announced state-based AHEAD model and how it will interact withother ACO and value-based care programs. Dealing with the challenges created by massive growth in Medicare Advantage. How CMMI is addressing the broad issue of health equity.MORE:Dr. Fowler has the unique role of leading an agency she helped create. From 2008-2010, she wasChief Health Counsel to Senate Finance Committee Chair, Senator Max Baucus (D-MT), whereshe played a critical role in developing the Senate version of the Affordable Care Act. Theframework for the CMMI was embedded in the law – so now, after several roles in the private

In this episode:  As we recognize Rural Hospital Week 2023, Chip and Alan Morgan, CEO of the National Rural Health Association, discuss the importance of having medical care 30 miles or 30 minutes away and the battle to maintain patients' access to vital services in small communities across the country. They also examine the ways lawmakers can throw a lifeline to hospitals struggling to keep their doors open. Topics include:  Growing health care workforce shortage in rural areas Rural hospital closure crisis Impact so-called site-neutral policies would have on access to care Unintended consequences of the rapid growth of Medicare Advantage  Importance of extending government assistance through the Low-Volume Hospital and Medicare Dependent Hospital programs GUEST:  Alan Morgan, CEO, National Rural Health AssociationMORE: With more than 30 years experience in health policy at the state and federal level, Alan Morgan is one of the nation's leading experts on rural health policy.Alan has been CEO of the National Rural Health Association since 2001 and he sat down with Chip to talk about the current state of health care access in small communities across the country, with a focus on hospitals.According to the Sheps Center for Health Care Research at the University of North Carolina, there have been 149 rural hospital closures since 2010 – and COVID only made the situation worse. These facilities are grappling with lower reimbursement rates from programs like Medicare Advantage and chronic underpayment from Medicare and Medicaid.Alan also highlights actions Congress can take to maintain critical hospital care in rural areas across the nation. 

In this episode: Chip and Dr. Sammie Mosier, SVP & Chief Nurse Executive at HCA Healthcare, discuss the growing health care workforce crisis in health systems – from how it is affecting care at the bedside to developing cutting-edge programs aimed at training the next generation of nurses. Topics they examine include:  COVID-19's lasting impact on nursing Using innovative care models and virtual nursing to improve patient care  Ways to increase enrollment at nursing schools Prioritizing nurse retention and caregiver continuity Future of nursing GUEST: Dr. Sammie Mosier, SVP & Chief Nurse Executive at HCA HealthcareDr. Mosier started her career at HCA Healthcare in 1996 as a medical-surgical nurse at Frankfort Regional Medical Center in Frankfort, Kentucky and last year she was promoted to the role of Chief Nurse Executive where she oversees approximately 93,000 registered nurses.Her time as a floor nurse has shaped her leadership style and gives her a unique perspective on the issues and opportunities facing the field.In this episode, Dr. Mosier explains the challenges facing the nursing workforce in hospitals as it rebounds after the COVID-19 pandemic and how to use new technology, like AI, to improve patient care.She also highlights programs HCA is using to retain current nurses, while training new caregivers through the Galen School of Nursing, which the company owns and operates.

In this episode:Chip and Marty Bonick, President and CEO of Ardent Health Services, discuss how cutting-edge technology is reshaping the health care system - by treating patients like consumers, and doing it while improving quality and cutting costs. Topics they examine include: Prioritizing patient centered care and cost containment  Embracing disruptors - Using technology to make care more accessible  Impact of AI, machine learning on the patient experience Transforming from a hospital system to a health service organization Utilizing virtual nursing to mitigate current workforce shortage and support care in different ways GUEST:Marty Bonick, President & CEO, Ardent Health ServicesFAH Board Member, Past ChairMORE: Marty Bonick has been a leader in the health care field for more than 25 years, but when he was recently injured in a bicycle accident – he was transformed into a patient.His experience reshaped the way he views the care continuum and the way Ardent treats patients.Under his guidance, Ardent Health Services is using technology, like AI and virtual nursing, to improve care quality, along with the patient experience.Marty also explains both how these innovations can help by reducing costs for everyone, and the importance of treating patients more like consumers.

Chip and Dr. Lynn Blewett put a spotlight on Medicaid, which is now the largest government-funded health program in the nation – covering more people than even Medicare. Crucial topics they discuss include: The current state of the Medicaid program and where it is headed in the future. Medicaid redetermination has led to more than a million people being disenrolled from the program. What is the redetermination process and why has it risen to such importance this year? Significance of health plans' role in Medicaid redetermination and the effects it will have on hospitals, as well as patients' access to care. Implications of work requirements for Medicaid coverage and discussion of results from states where it has been used.  Importance of Medicaid Disproportionate Share Hospital Payments (DSH Payments) for patients and providers. Guest:Dr. Lynn Blewett, founding Director of State Health Access Data Assistance Center (SHADAC), Professor at the University of Minnesota, School of Public HealthMore:In this episode, we will look at the Medicaid program, which now covers over 86 million of the most vulnerable Americans - ranging from young mothers and babies to seniors in nursing home care.Currently the largest government-funded health program in the nation, Medicaid has been in the headlines consistently this year as policy makers on state and federal levels debate ways to manage enrollment and bring spending under control.

In this episode: Chip sits down with Wendell Primus, former Senior Policy Advisor on Budget and Health Issues to Speaker Nancy Pelosi, to discuss:    The current state of the Affordable Care Act – have the effects met the expectations when the law passed 13 years ago?  The lasting impact of recently passed drug reform legislation on Medicare and beneficiaries  Many are pushing for health care price transparency – will it be transformative?    How insurer consolidation – both vertical and horizontal – will affect the nation's health care system.  Ramifications of Medicare Advantage's explosive growth - both for patients with increasing coding abuses and overuse of prior authorization and for the Medicare program where predicted savings aren't being realized.   True effects of work requirements on the Medicaid program and its beneficiaries.  Tackling the growing health care workforce shortage – especially when it comes to nurses.   Guest:   Wendell Primus, served for 18-years as Senior Policy Advisor on Budget and Health Issues to Speaker Nancy Pelosi   More:   We take a deep dive into the current and past state of health care policymaking on Capitol Hill with one of the central players of the last many decades - Wendell Primus. The pair discuss a few of the major health policy accomplishments of recent years as well as a look to the future. Wendell gives his preview on what could be coming as the Republican majority in the House and its Democratic counterpart in the Senate settle in and start to consider legislation.   Wendell just wrapped up an unprecedented and impactful career on Capitol Hill serving for 18-years as Senior Policy Advisor on Budget and Health Issues to Speaker Nancy Pelosi – where he played a keystone role in the passage of the Affordable Care Act – and just about every other important piece of health care legislation for the past two decades.    

In this episode: What is prior authorization and how does the process work in the real-world. Startling results of a recent American Medical Association physician survey highlighting the negative impact of prior authorization on patient care: 94% of physicians report that prior authorization delayed access to necessary care for patients; 89% report prior authorization had a negative impact on patient outcomes – sometimes even leading to death.  Effects of additional administrative burden prior authorization places on caregivers and hospitals. Efforts to pushback against insurers and stop the harmful overuse of the prior authorization process.  Impact of new CMS rules aimed at reforming prior authorization and what it could mean for patients. Guest:Todd Askew, Senior Vice President of the Advocacy Group for the American Medical Association

In this episode: Why non-compete clauses are important in health care setting. How proposed rule from Federal Trade Commission (FTC) banning employers from using non-compete clauses on employees could impact patients' access to care. The additional burden new non-compete rule could have on tax-paying systems. Effect of FTC's increased scrutiny on health systems integration. Repercussions of slowing integration on access to hospital care in rural areas. Guest:Dr. Subbu Ramanarayanan chairs NERA's Health care Antitrust practice and is an adjunct Associate Professor of Competitive Strategy at UCLA Anderson School of management. Dr. Ramanarayanan has extensive experience advising clients on antitrust reviews of proposed mergers and acquisitions before the Federal (FTC and DOJ) and state antitrust agencies across a variety of settings in health care including hospital services, health insurance, physician services, medical devices, and Healthcare IT services.    The Federal Trade Commission's recent activity to end noncompete clauses has potential to cause severe ramifications for health care systems. At the same time, the FTC is taking a dim view of important hospital system integration.Each of these things can have an immediate and powerful impact on the health care landscape. The latest controversial proposed rule – which would ban employers from imposing noncompete clauses on their employees - would make it more difficult for health care systems to staff up while also increasing already high workforce costs --- all potentially effecting access to patient care and available services. 

In this episode: What are the prospects of McCarthy Speakership? Functionality of Washington with divided government?    Comparing similarities/differences between the House in the late 1990s and now.   Discuss Speaker Gingrich's experience leading a Republican House and how he dealt with health care while balancing the budget and attempting to reform entitlements.   Speaker Gingrich's outlines his vision for the future of American health care.   How hospitals can prioritize preventative care and aging.  The role hospitals play for the future of health.   What policymakers can do to support and elevate health care innovation.  There are very few people who know more about the House, navigating divided government or developing major budget legislation than former Speaker Newt Gingrich. Chip has known Gingrich for more than 50 years and in this episode, the Speaker shares his perspective and provides deep insight into the current  House majority and looming policy debates – especially when it comes to health care.

In this episode:  What is Medicare Advantage (MA)? We examine the roots of this supplementary private health insurance coverage for seniors and its explosive growth, which now includes almost half of all Medicare beneficiaries (more than 28 million people).  There are increasing cases of abuse by insurance companies in charge of MA plans. Reports show they are denying and delaying doctor's requests for necessary – and in some cases lifesaving - care. We discuss how this harms patients and burdens the hospitals caring for them.  We dive into how COVID-19 compounded the issues with MA as insurers continued adding barriers to care for seniors during surges.  How can we address MA issues? We highlight bipartisan efforts in Congress to fix the problem, like the Improving Senior's Timely Access to care Act.  Important to note - not long after our recording - CMS released two separate proposed regulations that address some aspects of prior authorization in Medicare Advantage, as well as Medicaid and ACA private plans. The two rules address some of the challenges highlighted in this podcast and the proposals may help to ameliorate certain of the abuses directly affecting patients that you will hear outlined. The proposed regulations are open for public comment.     Guest: Sunitha Reddy, MBA, MPH, FACHE Chief Revenue Officer & Vice President, Operations, Prime Healthcare   Medicare Advantage (MA) is on a growth path to become the dominant part of Medicare in many states across the country. This means that many of our most vulnerable seniors will, on one hand, receive the added benefits and discounts that these plans offer up front, but may find pathways to receive care more difficult than they bargain for – as insurance companies delay or even deny necessary care. Chip speaks to Sunitha Reddy about how this can be more than an inconvenience for patients – it can be harmful. 

In this episode: We'll discuss the major stresses and challenges facing rural hospitals, including geography, patient mix, a growing workforce crisis, and funding shortfalls.   Since 2010, 140 rural hospitals have closed, including 25 since the start of the pandemic. Congressional support helped keep that number from being even higher, but what happens now as COVID-19 relief runs out? What's the impact on a small, rural community when a hospital closes? Congress needs to take actions to preserve funding for rural hospitals during Lame Duck session. What will be the impact on access to care if Medicare Dependent Hospital and Low-Volume Hospital programs aren't extended and lawmakers don't waive PAYGO? How will divided government affect rural hospital policy moving forward in 2023? Is there room for bipartisan compromise?  Guest: Brock Slabach, Chief Operating Officer, National Rural Health Association.

In this episode: The Joint Commission's role in working to reduce the health care workforce shortage. How TJC is addressing health equity moving forward. How hospital measurement is used to assure patients that their hospitals are safe and providing quality care.  Guest: Dr. Jonathan Perlin, M.D., Ph.D., M.S.H.A., M.A.C.P., F.A.C.M.I., President and CEO, The Joint Commission The Joint Commission is celebrating its 70th anniversary this year; at the helm is Dr. Jon Perlin, previously of HCA Healthcare. Chip talks to Dr. Perlin about his vision for the future of The Joint Commission and the ways the organization can confront issues like social determinants of health and providers impact on climate change.

In this episode:  How the Sarah Cannon Cancer Center's integrated care model allows for high quality patient care close to home.  The research being done at Sarah Cannon, including finding the potential cure for sickle cell disease.  Hospitals are safe and patients should not put off cancer screenings – they save lives.  Guest: Dr. Dax Kurbegov, Vice President and Physician-in-Chief of Clinical Programs of the Sarah Cannon Cancer Center  The Sarah Cannon Cancer Center offers patients the unique opportunity to receive world class cancer care without traveling far from home. Dr. Dax Kurbegov joined Chip to discuss the benefits of the center's integrated structure for patients, the research they are working on, and the importance of patients being regularly screened for cancer from their providers.  

The overturning of Roe V Wade has far reaching implications for hospitals and health care providers. Hospitals have a duty to care for every patient that walks through their emergency room, however that care may create a gray area that conflicts with new state laws on abortion. Hospitals are in every community across the country and will continue to care for women with very real and dangerous conditions in need of care. Tom Barker is a partner at Foley Hoag and focuses his practice on complex federal and state health care legal and regulatory. He was previously General Counsel for the Center for Medicare and Medicaid Services and Acting General Counsel for the Department of Health and Human Services. He joins the conversation today to highlight the critical questions that need to be addressed as the fallout from the SCOTUS decision continues.

Our country is facing a doctor shortage of nearly 124,000 physicians in just 2 years and the impact on patient access could be devastating. The problem is especially acute in economically disadvantaged areas, like California's Inland Empire which is comprised of San Bernadino and Riverside Counties east of Los Angeles. The Inland Empire is also now the home of the California University of Science and Medicine, a unique institution built on a public private partnership. CUSM was created to promote health equity by training the next generation of caregivers in their own community by the Prime Healthcare Foundation. The school just graduated its very first class of doctors last month and Chip wanted to learn more about the school and the graduates. Joining Chip is Dr. Paul Lyons, President of CUSM and Dean of the school of Medicine. Then at 18:51 hear our latest Making the Rounds from Paddi Juliano, the Nurse of the Year at Lakewood Ranch Medical Center – a Universal Health Services hospital in Florida. Paddi knew she wanted to be in a helping profession since a young age and dreamed of being a Buffalo, New York Firefighter! She achieved her dream and then transitioned into nursing after moving to Florida. Tune into hear Paddi tell us her story of caregiving and what her profession means to her.

Hospitals have learned a lot about treating COVID-19 since the world first learned of the novel disease at the end of 2019. Integrated hospital systems worked together to share knowledge and best practices to treat this disease at unprecedented speeds and the advancements continue to come. Out of these advancements is a new normal for our hospitals. Chip spoke with Dr. Michael Cuffe and Prof. Martin McKee about what hospitals are experiencing now and how governments in both the UK and US can support them moving into the future. Martin McKee is a Professor of European Public Health at the London School of Hygiene and Tropical Medicine and soon-to-be president of the British Medical Association. Dr. Michael Cuffe is the Executive Vice President and Chief Clinical Officer for HCA Healthcare, the largest integrated health system in the US.

Rachel Watson is a survivor. Last year Rachel and her husband David fell ill with COVID-19. Though David recovered without intervention, Rachel needed extreme measures. When HCA Florida West Marion Hospital received Rachel she was immediately placed on oxygen, but it wasn't enough. She was transferred to another HCA Florida facility, HCA Florida North Florida and placed on an ECMO (extracorporeal membrane oxygenation) machine where she remained for 89 days. The family credits hospital integration and outstanding caregivers for saving her life. Rachel and David joined Chip to share the story of her care and recovery on the Federation's new campaign, The Real Story. Learn more about The Real Story at fah.org/TheRealStory.

Courtney Clarke is a nurse at Lake Cumberland Regional Hospital in Somerset Kentucky and her efforts to help a patient and protect her kids during treatment made such an impact that she was recognized by the state's governor. The Federation's new campaign is embarking on a mission to tell The Real Story of hospitals through the eyes of patients and caregivers. Courtney's story is our first.   Learn more about The Real Story at fah.org/TheRealStory.

Dr. Ana Pineda has grown her health care career within HCA Healthcare. In fact, the doctors she works alongside today are the very ones that inspired her to take the first steps towards becoming an Emergency Medicine Physician. Dr. Pineda shared with Chip how her career has taken shape over the years, how COVID has affected her role, and her work in training the next generation of physicians at HCA Healthcare. Dr. Ana Pineda is the Associate Medical Director of Emergency Rooms at HCA Florida Kendall Hospital and Free-standing Emergency Rooms in Doral and South Kendall. Want to hear more from our caregivers? Hear from Jennifer Brady on Making the Rounds: The Nurse You Want At Your Bedside.

Jennifer Brady is a nurse at LifePoint Health's Havasu Regional Medical Center in Arizona. A recent recipient of a DAISY Award, she exemplifies every quality you'd want in your nurse. Jennifer was inspired by her children to become a nurse later in life. She joined Chip on Making the Rounds to discuss her journey to nursing and her inspiration in providing high quality care to her patients. Interested in hearing more from caregivers? Fiona Chew is a nurse on the frontlines of COVID-19 who traveled to the hot spot in New York; hear her story.

The pandemic poured gasoline on the health care workforce shortage. Between nurse burnout, lower immigration numbers for trained caregivers, and a growing negative narrative surrounding health care careers, it's no wonder we are facing a shortage sooner than we imagined. Lisa Dolan, Chief Nursing Officer at Ardent Health Services joined Chip to examine how it is using its size and scale to meet this challenge and continue to provide quality, compassionate care to all those who need it. Want to learn more about the origin of the nursing shortage? Check out this conversation No Silver Bullet: Diagnosing Hospital Workforce Crisis with Peter Buerhaus.

One of the biggest challenges facing hospitals during the pandemic is workforce shortages – specifically beside nurses. This crisis started before COVID-19 and will continue after – fueled by a myriad of developing issues. One constant is that we face an increasing need & a decreasing supply of the hospital nurses who are critical to providing the lifesaving care that patients need every day. Dr. Peter Buerhaus joins Chip to discuss the cyclical nature of these shortages, how COVID has made it worse, and what hospitals and policymakers can do to alleviate some of these challenges. A nurse by training, Peter is also a health care economist and active researcher on the economics of the nursing workforce. His most recent research was published in Health Affairs titled “Nurse Employment During The First Fifteen Months Of The COVID-19 Pandemic” and detailed critical information about the country's nursing infrastructure. A short summary of the findings was outlined by Montana State University. Would you like to hear from a nurse who travelled to one of the nation's first hotspots to battle COVID-19? Listen to Fighting on the Frontlines with Fiona Chew for a firsthand depiction of saving patients during the pandemic.

In many ways 2022 is starting off just like 2021 with COVID-19 dominating our lives and health care policy taking centerstage in front of a gridlocked Congress.  And just like last year, Chris Jennings and Doug Badger return to Hospitals In Focus to prognosticate on the upcoming year in health policy. Coming from each side of the political spectrum, the two long-time health policy wonks discuss with Chip how the Biden administration has handled the COVID crisis. - What did they get right and where do they need to course correct? The three also examine the seemingly new role of the Supreme Court in the role of legislating in a divided Washington and what this could mean for  health care policy. Chris Jennings has spent decades working in the White House, Congress and private sector. He served in both the Clinton and Obama White Houses as Senior Advisor to the President for Health Policy and helped pass, enact and implement the ACA, Children's Health Insurance Program (CHIP) and numerous other health reforms. Doug Badger has been in public policy for many decades serving as a policy advisor to the White House, U.S. Senate, Department of HHS and the SSA. Doug worked in the Bush (43) administration and developed the administration's proposal for adding prescription drug coverage to Medicare. He also represented the White House in negotiations with Congress that resulted in the enactment of the Medicare Modernization Act.  Interested in hearing Doug and Chris' first episode of HIF? Take a listen to Building Biden's Health Agenda with Chris Jennings and Doug Badger.

In this special edition of Hospitals in Focus, we are sharing a fireside chat Chip recently had with retiring Senator Roy Blunt (R-MO). It was recorded last month at the Federation's Board of Governors meeting.    This is a wide-ranging, informative discussion where Chip and Sen. Blunt talk about everything from Medicaid expansion to the growing partisan divide in Washington, DC.     After serving more than 25 years in Congress and nearly 50 years in public service, Senator Blunt has a unique perspective on where we are today – and where health care policy is headed in the future. He is also one of the few members of Congress to ever hold leadership positions in both the Senate and House.    We hope you enjoy this conversation as much as the audience did. 

Despite being pushed to the brink during the COVID-19 pandemic, rural hospitals answered the call – fighting adversity to save millions of lives. It was just another example of the important role these facilities play in the communities they serve. During this episode Chip talks to a veteran of rural hospitals – Doug Weaver, CEO of Hillcrest Hospital Pryor in Oklahoma, which is part of FAH member Ardent Health Services. He discusses the unique challenges his facility, and others like it, faced at the height of the COVID-19 surge. Doug also talks about the changes in rural health care he has seen during his 40-year career – from the rise of telemedicine to growing staffing shortages. Additionally, Doug explains to Chip how being part of an integrated health care system, like Ardent, helps smaller hospitals keep their doors open to patients.