Hospitals In Focus

Latest Episodes:

The Health Coverage Cliff and Efforts to Protect Patients’ Access to Care Apr 17, 2024

Show notes

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 recipients
Congressional 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 marketplace

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.

Navigating the Change Healthcare Fallout: An Insider’s Look Mar 27, 2024

Show notes

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; and
Future 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/

Throwing a Lifeline to Lifesaving Care in Rural America Mar 13, 2024

Show notes

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

The Impact of AI and Environmental Sustainability on Hospital Care Feb 28, 2024

Show notes

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 Equity
Environmental Sustainability
Learning Health Care/AI
Performance 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/

How Hospitals are Helping Tackle the Drug Shortage Crisis Feb 06, 2024

Show notes

IN THIS EPISODE:

For the past 15 years, drug shortages have been a persistent problem for hospitals and the
patients they serve – and extreme cases can even lead to rationing, delaying, or canceling
treatments or procedures.

Tackling the drug shortage crisis is a complicated issue requiring creative solutions. That’s where
Civica comes in – a non-profit pharmaceutical company created by hospitals and health systems
to address these critical shortages.

In this episode, Chip speaks with Civica’s Senior Vice President for Public Policy Allan Coukell
about why the company was formed, the challenges they are tackling, and how it plans to help
patients into the future. Topics include:

The state of hospital drug shortages in the US today
Taking the bull by the horns: how a non-profit company created by hospitals is helping
patients.
The success of Civica's model:
- Long-term purchase and supply contracts directly with hospitals that add stability
  to 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, with
more than 140 million containers delivered to hospitals over five years, serving 60 million
patients.

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/

Voter Views: Politics of Health Care During a Presidential Election Jan 18, 2024

Show notes

Guest:

Phillip Morris, Partner & Leads Strategic Insights Practice, LSG

In this episode:

It is only January, but the campaign season is already in full swing. From the White House to
control of Congress - power in Washington is up for grabs. In this episode, Chip Kahn talks with
Phillip about what issues matter most to voters and where health care fits into that list of
priorities.

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.

Improving Care & Lowering Costs: Is CMMI Accomplishing Its Mission? Dec 07, 2023

Show notes

Chip and Dr. Liz Fowler, Deputy Administrator of CMS and Director of the agency’s Center for
Medicare and Medicaid Innovation (CMMI), discuss CMMI’s mission to improve health
outcomes, overcome the obstacles to health equity, and reduce care costs. They look back on
what CMMS has accomplished in its first 10 years, what we have learned from this
experimentation, 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 bundled
payment program.
Goals of the newly announced state-based AHEAD model and how it will interact with
other 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 was
Chief Health Counsel to Senate Finance Committee Chair, Senator Max Baucus (D-MT), where
she played a critical role in developing the Senate version of the Affordable Care Act. The
framework for the CMMI was embedded in the law – so now, after several roles in the private

30 Miles or 30 Minutes: The Fight to Access to Care in Rural America Nov 13, 2023

Show notes

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 Association

MORE:
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.

Hospital Workforce Crisis: How It Impacts Patient Care & Search for Common Sense Solutions Sep 06, 2023

Show notes

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 Healthcare

Dr. 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.

Patients First: How AI is Improving the Care Continuum & Cutting Costs Aug 02, 2023

Show notes

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 Services

FAH Board Member, Past Chair

MORE:

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.

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