Hospitals In Focus

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 protections
• The anatomy of a health care cyberattack – effects of ransomware vs. malware
• Vulnerability of 3rd party entities in health care – like Change Healthcare
• Role of the federal government – protecting hospitals, penalizing bad actors
• Moving forward – fighting the next generation of cybercriminals

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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 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

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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; and
• Future of health care and recovering from the hack.

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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

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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 Equity
• Environmental Sustainability
• Learning Health Care/AI
• Performance Improvement and Integration

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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 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.

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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/

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.

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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 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

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

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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 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.

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

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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 Health

More:

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

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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.

Jessica Smith, a respiratory therapist from outside Pulaski, Tennessee, is well known in her small community for her extraordinary dedication and compassion to her patients and family. In this episode, Jessica explains to Chip that like many frontline caregivers she has begun to experience “hero fatigue,” but adds that she still loves her job and does her best to focus on the positive. Her inspiration home life, along with her work ethic led to her winning LifePoint Health’s Mercy Award this year. The episode wraps up with her talking about what that recognition meant to her and her team at Southern Tennessee Regional Health System.

Every year, FAH joins mental health organizations and other proponents across the U.S. and around the world to raise awareness of suicide prevention during September, National Suicide Prevention Month. As society continues to struggle with COVID-19, there has been much discussion of the adverse psychological impacts of social distancing isolation and being away from loved ones. In this episode, Chip is joined by Karen Johnson of Universal Health Services and they discuss a wide range of topics from the ways COVID has affected the psyche of children and how to reemerge back into society after lockdown to what Universal Health Services is doing to help prevent suicides and the importance of celebrities sharing their struggles with mental health.

As the pandemic persists, and the increasing caseload caused by the Delta variant continues to force hospitals to adapt to new challenges, we turn to learning hospital and health systems to understand how they are uniquely positioned to treat patients during the COVID crisis. Chip and his guest Marty Bonick, President & CEO of Ardent Health Services, discuss what hospitals are seeing on the ground during this latest surge. They also spoke about the efforts of integrated health systems, like Ardent, to increase the quality of care for patients during and after the pandemic.

Hospitals are not just the four walls of a building; they are also the backbone in an American community. As the pandemic continues across the country, Chip and Jeff Goldsmith examine how hospitals learned to treat a disease without a proven cure or readily available therapies. They also spoke about what characteristics were displayed by hospitals that demonstrated successes during the past 18 months of this COVID-19 crisis. Jeff is the President of Health Futures, Inc. The two discuss the benefits of the ever-evolving hospital as well as its changing role in health care.

Fiona Chew is the kind of nurse you want at your bedside. Her positive attitude and willingness to go above and beyond make her an excellent advocate for her patients and colleagues. Early on in the pandemic during the New York/New Jersey surge, Ardent Health Services asked for volunteers to assist the hospitals in the hotspot. Fiona didn’t hesitate to go. Listen to Fiona give you her story from the frontline.

The Affordable Care Act (ACA) has just survived its most recent challenge at the Supreme Court. We wanted to hear both its incredible history of survival in the courts and the basic tenets of the ACA. Chip is joined by the founder of Families, USA, Ron Pollack. The two discuss their personal stories of working to help support the ACA and how the ACA should be expanded under the Biden Administration to help end coverage gaps.

Interested in learning more about the ACA and its expansion? Check out What the Nation Could Learn from ACA Health Coverage Expansion in CA with Peter Lee

Medicare at 60 sounds simple enough – but is it? Chip asked expert, Dr. Lanhee Chen, on this episode to explain his latest research exploring the potential policy and its complications. Chip and Lanhee explore the many questions his report exposes that policymakers must consider to make this potential policy an actual possibility - from how to pay for the $400 billion price tag to the impacts on health coverage and access to care.

Read the report entitled “The Fiscal Costs of Medicare at 60”.

In this episode Chip is joined by Dr. Ken Sands – the Chief Epidemiologist at HCA Healthcare, whose system has treated tens of thousands of COVID patients. Together they look at a current Health Affairs blog co-authored by Chip on how COVID is impacting Medicare hospital quality reporting and value-based purchasing programs. These programs are critical for patient decisions and the evaluation of care provided at every hospital in the nation.

Learn more about hospital reporting by listening to Chip’s conversation on HCAHPS with Dr. Claudia Salzberg.

Inaugural episode of Making the Rounds begins with Roxy Hinojosa. She is a nurse at Mission Regional Medical Center in Texas. Roxy shares with Chip how she began her nursing career, what the profession means to her and how the last year has changed nursing on the front lines.

Join Chip as he hears from the health care heroes on the front lines in the new Hospitals In Focus short series: Making the Rounds.

COVID has drastically changed the health care delivery system, perhaps even permanently. Inpatient Rehabilitation Facilities (IRFs), like those operated by Encompass Health, stepped up during the pandemic by partnering with acute care hospitals to help patients recover from the virus. It once again showed how critical IRFs are to the care continuum by making sure patients received the right care in the right setting.

Encompass Health President and CEO Mark Tarr discusses the impact of COVID-19 on IRFs, as well as the innovative ways his company is using new sources of data to inform clinical decisions and improve patient outcomes. Additionally, Chip and Mark touch on the importance of relevant, up to date data on implementation of the IMPACT Act and the Review Choice Demonstration.

Learn more about post-acute care providers in the time of COVID by listening to The Role of Long-term Acute Care Hospitals During COVID-19 with Ben Breier.

Patients often form strong and long-lasting bonds with their care providers and COVID-19 has drastically altered that ever-important doctor-patient relationship. Visits have moved online and fear of the virus has some patients skipping care altogether. This raises three concerning questions for physicians: how are patients with chronic diseases managing their treatment without regular in-person care; are patients putting their lives at risk unnecessarily by delaying care and screenings; and how will their practices survive through the pandemic so they can continue caring for their communities?

Dr. Susan Bailey, president of the American Medical Association, and a practicing allergist/immunologist, joined Chip to discuss how private physician practices have been handling COVID while caring for their patients and how Congress is helping.

Just a few weeks ago, COVID was ravaging hospitals across the country as cases were surging following the December holidays. St. Francis Medical Center is already one of Los Angeles County’s busiest trauma centers. During the surge, St. Francis was up to 120% capacity – and still caring for every patient that came through its doors. With the ER turned into a COVID unit, some emergency services were moved to tents in the parking lot. Chip spoke with St. Francis’ CEO Dan Jones who explained how the hospital was able to meet the challenge with their extraordinary staff, how they are working with staff to mitigate burnout, and how Prime Healthcare is investing in the hospital and the community it serves.

Long-term acute care (LTAC) hospitals are caring for the some of the most medically complex patients during the COVID-19 pandemic. As a post-acute care provider, Kindred Healthcare has been right in the middle of the battle to defeat COVID-19 by partnering with short-term acute care hospitals to help treat patients and ease overcrowding in hot spots across the country. Kindred CEO Ben Breier spoke to Chip about how the company relied on its network of hospitals to ensure its staff were always prepared to provide patients with the highest quality of care.

Breier also discusses a recent report from the consulting firm ATI Advisory that highlights how LTAC providers have been able to bridge gaps and extend care within the care continuum during the pandemic. Based on the COVID experience, the report also recommends key considerations for LTAC hospitals as part of future health policy development. See the full report here.

Hear more about post-acute care from Chip’s conversation with Al Dobson, Getting back to Life: The Growing Demand for Post-Acute Care with Al Dobson.

It has been over a year since COVID-19 has disrupted life for Americans and everyone around the globe. We checked in with regular guest of the pod, Dr. Jonathan Perlin, to find out how HCA Healthcare has weathered the last year. The CMO and President of Clinical Services shared how HCA Healthcare is sharing the learnings from their millions of annual clinical interactions with others in a new consortium of private and public institutions to improve treatments, outcomes and patient care.

Check out Dr. Perlin’s previous appearances on Hospitals In Focus. Dr. Jon Perlin Discusses the Impact of Coronavirus on Hospitals and Dr. Jonathan Perlin Discusses How Patients Benefit from the Use of Big Data.

The ACA is starting a new era with President Biden at the helm of a new administration. We wanted to hear about what happens when a state not only fully embraces the ACA but keeps harmful regulations at bay that hurt marketplaces and patients. Chip is joined by the Executive Director of Covered California Peter Lee on the newest episode of Hospitals In Focus. The two discuss the basic tenets of the legislation, how and why California has been such a success at lowering its uninsured patient rate and what steps President Biden may take to encourage the hold out states to expand Medicaid.

Interested in learning more about Biden’s health agenda? Check out Building Biden’s Health Agenda with Chris Jennings and Doug Badger.

Two health policy experts joined Chip to discuss the new Biden administration’s approach to developing and implementing health policy. With COVID-19 raging across the country, Chris Jennings and Doug Badger touch on Biden’s first 100 days in office and how they expect Biden’s health teams to tackle the health and economic fallout from COVID in contrast to the Trump administration. Importantly, they touch on how the ACA can shore up health care coverage for uninsured Americans. Then they each provide an analysis on how the White House staff, regulatory agencies and Congress work together to achieve their goals. Chris provides the Democratic perspective while Doug responds with the Republican.

Chris Jennings has spent decades working in the White House, Congress and private sector. He spent time 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. Most recently, President-elect Biden appointed Mr. Jennings to him on the Biden-Sanders Unity Task Force.

Doug Badger has been in public policy for many decades and has been 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. Badger represented the White House in negotiations with Congress that resulted in the enactment of the Medicare Modernization Act.

Interested in learning more about how health care coverage can affect a population’s access to care? Listen to Chip’s conversation Advancing Health Equity: Bridging Social Gaps in Health Care with Dr. Chidinma A. Ibe.

The ACA is once again in front of the Supreme Court and a decision on its future will be likely handed down in June 2021. In the meantime, Larry Levitt joined Chip to discuss the ACA’s impact on hospitals and providers over the past decade. The EVP of Health Policy at the Kaiser Family Foundation shared his views on what we could expect from the Supreme Court and if the ACA is settled law once and for all.

How are America’s health care providers building trust with Black patients after years of historic racism? With time, says Dr. Thomas LaVeist. The Dean of the Tulane School of Public Health and Tropical Medicine joined Chip to discuss dispelling health care myths around Covid-19, how we can ensure vaccines are fairly allocated, and what we can learn for the next health emergency. These things are all a part of Dr. LaVeist’s program The Skin You’re In. To learn more about The Skin You’re In, visit www.tsyi.org

Community health workers play a vital role in helping end racial disparities in our health care system. They break down barriers by fostering better relationships between the community and their health care providers. Dr. Chidinma A. Ibe is the Assistant Professor of General Internal Medicine and Health, Behavior and Society at Johns Hopkins University School of Medicine. She joined Chip to discuss the growing importance of these workers and how we can better support them.

In our online world having access to the internet is crucial for a healthy life. Michael Crawford is Howard University’s Associate Dean for Strategy, Outreach and Innovation and Founder of 1867 Health Innovations Project. He joined Chip to discuss how the Project is battling chronic diseases - like diabetes - with technology and data from sources such as remote monitoring. The two also examined how we can bridge the digital divide that keeps so many vulnerable populations from the care they need.

Reporters are more important than ever. The 24/7 news cycle around the Coronavirus pandemic, economic recession and racial inequality can be overwhelming for the public, but the same can be said for those covering the news. Editor of Modern Healthcare Aurora Aguilar joins Chip to discuss the challenges of reporting in the era of “fake news” and how journalism is changing to keep up with unprecedented times.

Women in the United States suffer the worst maternal mortality rates in the developed world. Congresswoman Lauren Underwood is trying to change that with her package of legislation appropriately titled the Momnibus. In this episode she discusses with Chip the social determinants of health that are leading to poor health outcomes for Black and minority mothers, how COVID-19 has advanced patient care approaches like telemedicine to benefit new mothers’ mental health, and how she collaborated with her colleagues across the aisle to find solutions.

America is reckoning with its public health on two fronts: COVID-19 and social determinants of health. Dr. Georges Benjamin is the Executive Director of the American Public Health Association and has spent his career working to achieve health equity for Americans. He joined Chip on our inaugural episode of our series Hospitals In Focus: Achieving Health Equity to discuss how COVID-19 has exposed and amplified issues in our health care system. Dr. Benjamin discusses the obstacles that many in communities of color and other vulnerable populations face when it comes to getting treatment - and what health care providers can do to mitigate some of their challenges.

The Great Influenza and Rising Tide author and historian John M. Barry knows a thing or two about disasters and society. The Tulane School of Public Health and Tropical Medicine professor joined Chip to discuss not just the ramifications of great crises on society and politics, but also how we get there. What are the policy decisions that make or in some cases break the public response? And what can we learn for future policy making by looking at decisions from the past? All is discussed on this episode of Hospitals In Focus.

Initially, Israel had one of the lowest rates of COVID-19 infection in the world, but after the nation’s lockdown was lifted things changed drastically. Chip talks to Dr. Eyal Zimlichman of the Sheba Medical Center about how Israel contained the virus in the beginning and how it is coping with an increased outbreak now. From protecting the elderly to re-opening schools – Chip and Dr. Zimlichman talk about lessons learned and how they translate to the US.

Italy was the early epicenter of the COVID-19 pandemic, but the US is now facing the highest number of cases in the world. Professor Martin McKee of the London School of Hygiene and Tropical Medicine joined Chip to compare US and Europe’s response through the lens of a public health expert. They discussed the lessons to be learned from both responses, the potential vaccine light at the end of the tunnel and the implications of the US pulling out of the World Health Organization.

The health care supply chain wraps around the entire world, so when the COVID-19 pandemic hit, people were worried. News articles about providing front line workers PPE and giving patients needed ventilators were everywhere. What did we learn from the initial onslaught? And how is the supply chain changing to meet the needs of the future? John Pritchard, President & CEO of Share Moving Media joined Chip to discuss all of this and more.

Health finance expert J.B. Silvers joined Chip to discuss his recent nationally published op-ed in which he compared the situation hospitals and health systems are facing due to COVID-19 to that of banks during the 2008 financial crisis. JB, who is a professor of banking and finance at the Weatherhead School of Management at Case Western Reserve University, says the health care system may look much different after pandemic and he offers a look at what the new normal might be.

COVID-19 has changed graduate medical education, perhaps permanently. The option of early graduations at some medical schools has allowed new doctors to join in the fight to defeat COVID-19. Dr. Alison Whelan, the Chief Medical Education Officer at the Association of American Medical Colleges joins Chip to discuss how new and current residents are helping on the front lines, the changing training patterns of our country’s newest doctors and what it means to be starting your medical career during COVID-19.

Right now the health care system is laser focused on defeating COVID-19 and as a result routine diagnostic and treatment patient care, sometimes referred to as elective, has been postponed. Postponing this care was the right choice at the beginning of the pandemic in order to ensure there was enough capacity in the system to care for COVID-19 patients. As the curve continues to flatten, we are slowly restarting the health care system and increasing capacity for patient care. Dr. Frank Opelka the Medical Director for the American College of Surgeons joins Chip to discuss exactly how we are doing it.

In this episode of Hospitals In Focus, we head to the front lines of COVID-19 fight with Dr. James Phillips. He is battling this pandemic daily in his roles as an emergency medicine physician at the George Washington University Hospital in Washington, D.C. and Assistant Professor of Emergency Medicine at the GW school of Medicine and Health Sciences. Chip talks with Dr. Phillips about how coronavirus is effecting the ER of a major city; how he, his colleagues, and the hospital are preparing for a surge of patients; plus - what you can do to stay healthy.

Returning guest Dr. Jon Perlin, CMO and President of Clinical Services at HCA Healthcare, joins Chip to discuss how the Coronavirus is impacting hospitals across the country. They take a deep dive into what makes the coronavirus different from previous epidemics, how hospitals are preparing for this unprecedented challenge and what Congress can do to support hospitals and protect patients.

Thanks to advances in health care, people are living longer, healthier and happier lives than ever before. And that means patients are spending time recovering at post-acute care settings. In this episode, Chip speaks with Al Dobson, one of the foremost health economists and an expert in post-acute care. They took a deep dive into the different kinds of care settings including Inpatient Rehabilitation Facilities, Skilled Nursing Facilities, home health and long term acute care hospitals and what each of these mean for patients.

How is AI being used in hospitals? Are robots doing surgery? Is my doctor still providing my care? Chip speaks with Dr. Jim Jirjis, Chief Health Information Officer at HCA Healthcare, to answers these questions and more! Hear Dr. Jirjis explain how the “nudge” provided by AI is helping providers save lives by making sure patients are receiving the right care at the right time.

Innovation in health care isn’t just high-tech, at LifePoint Health, it’s also “high-touch”. David Dill, President and CEO, spoke with Chip about how the company became a leader in high quality health care by establishing a culture of quality care in its hospitals. David discusses their new dyad leadership model which breaks down organization silos and enhances collaboration and coordination.

People are drawn to rural America for different reasons. For some, it’s the slower pace of life, while others crave the sense of community; in some cases, people are drawn by the lower cost of living. But access to health care services for the 60 million who live in these areas is an ever-growing burden. Chip speaks with CEO of the National Rural Health Association Alan Morgan about how health care providers are doing more with less and what Congress can do to ensure rural Americans get access to the care they need.

On this episode, Chip sits down with Bill McInturff to discuss the results of his demonstration he did with Micah Roberts that focused on recasting and improving the HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems) patient experience survey. The report, concluded that even though the HCAHPS is a well-designed, well-administered survey, it could be strengthened to add items important to patients. The demonstration also added an online delivery mode and found that it increases response rates.

A patient’s health care experience at a hospital is considered one indicator of quality of care. Since 2008, those experiences have been captured and publicly reported at a national level via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. However, it hasn’t been reviewed since its creation more than a decade ago. We were hearing anecdotally that response rates were falling and some of the questions weren’t as relevant as they used to be. So we joined with several other major hospital organizations to investigate. On the episode, Chip and Dr. Claudia Salzberg, FAH’s VP of Quality, discuss our just released study examining the HCAHPS survey from the perspective of Patient Experience Leaders.

Continued rising drug prices, as well as shortages for many critical medications, are impacting patient care and putting strains on hospital budgets and operations. That’s why hospitals and health systems have gathered to create Civica Rx, a not-for-profit generic drug company that is disrupting the pharmaceutical market. Chip spoke with Martin VanTrieste, Civica’s President & CEO about why and how the company was formed, the success it is enjoying so far, and if other drug companies will follow its lead.

EPISODE UPDATE, Since our recording VIZIENT has announced it will collaborate with Civica to help reduce chronic drug shortages by providing insights into purchasing patterns and provider needs. Vizient will apply its expertise in analytics and data capabilities, helping Civica anticipate gaps in drug availability and affordability.

In response to Vizient’s commitment, Civica’s VanTrieste said, “The more people collaborating to solve the nation’s drug shortage problem the better…we applaud Vizient for prioritizing hospital patients by taking action to help them have timely access to the treatments they desperately need on a day-to-day basis.”

Shantanu Agrawal leads the National Quality Forum - one of the most important organizations that you’ve probably never heard of. NQF was originally created during the Clinton Administration as a tool to promote and ensure patient protections and health care quality through measurement and public reporting for Medicare. Today their work touches all patients using three tenets: improvement, accountability, and transparency. In this episode, Chip and Shantanu discuss why NQF was needed, the role it fills today, and how the organization is uniquely positioned to lead quality efforts for health care’s high-tech future.

You’ve been stabilized in the hospital after suffering a life altering medical condition, but now its time to start the path to getting back home – what’s next? When most people think of rehabilitation hospitals they probably imagine a place for a baseball player recovering from a sore elbow or a drug rehab center – somewhere they won’t ever have to go. But physical rehabilitation hospitals are a critical cog in the continuum of care as people recover from a major injury. In this episode, Dr. Richard Senelick of Encompass Health discusses what goes on at a rehabilitation hospital and why their motto is “help do rather than do for”.

For the past 14 years, Sister Carol Keehan has led one of the largest hospital groups in the nation – the Catholic Health Association (CHA). Sister Carol has met with the Pope and cut deals with the President of the United States. Her career spans more than 50 years - from working in a children’s hospital in Florida to CEO of the CHA. She has been a key leader in health care policy decisions. On the eve of her retirement, Chip and Sister Carol share stories about how the health care delivery system has changed over the years, the passage of the Affordable Care Act and the importance of universal coverage.

While most other industries have made the transition from analog to digital, the US health care system has lagged behind. Ed Cantwell, the CEO of the Center for Medical Interoperability, talks to Chip about what his team is doing to drive plug-and-play interoperability among vital medical devices. Plus - they discuss the importance improving caregivers’ access to electronic health records, something that ultimately improves outcomes for patients and saves lives.

Patient care is changing. No longer do you need to be within the four walls of the hospital to receive high quality care from your doctor. From free standing emergency rooms to outpatient clinics - Your community hospital is bringing care to you. In this episode, Sam and Chip discuss how hospitals are extending their reach into neighborhoods and rapidly becoming much more dynamic places to receive care. It is all part of a growing effort to meet patient expectations of having the best care, close to home.

HCA Healthcare is already the largest provider of graduate medical education in the country and it has plans to keep growing the program – doubling it in size in the next few years. Dr. Michael Cuffe, President of the Physician Services Group at HCA Healthcare, is in charge of training the next generation of doctors. Listen in as he and Chip talk about how they are preparing our physicians to treat patients with tomorrow’s medicine.

As the saying goes, there is strength in numbers. David Vandewater, President and CEO of Ardent Health Services explores how the company is forming partnerships with other hospitals and health systems to better serve patients. These partnerships are ensuring access to high quality health care for communities across the country. Listen in as he and Chip talk about how hospital partnerships are key to improving health care for patients and essential for bringing new doctors and jobs to communities.

Right care, right time, right place – it’s something that Ron Rittenmeyer, Executive Chairman and CEO of Tenet Healthcare thinks about a lot. Hospitals are changing and patients have more options than ever on where they want to receive care. In this episode, Chip dives in with Ron on why Tenet Healthcare is focusing on the new ways they are able to deliver care to patients. Free standing emergency departments, outpatient departments, and urgent care centers are filling needs in communities coast to coast because like Ron says, not everything needs to be done at a hospital. Listen in to find out how hospitals are integrating these settings into the continuum of care for patients and raising the quality of care in the process.

While more than 90% of the United States is considered rural, only about 20% of our population calls it home. The people in rural America face unique challenges when accessing health care like extreme distances and, in certain areas, severe weather events. In this episode, LifePoint Health’s Chairman and CEO Bill Carpenter talks with Chip about the creative ways their hospitals are overcoming the obstacles. They discuss how LifePoint is achieving its core mission of keeping people healthy and providing high quality health care. Ultimately, as Bill says, all patients deserve the same level of care regardless of their zip code.

This episode also coincides with the Federation of American Hospitals’ Rural Hospital Week. Please help us #StandUp4RuralHospitals and the people they serve by using our hashtag and sharing your story of care.

From natural disasters to human tragedies, community hospitals have to be ready for anything and everything. Health care and hospitals especially have a role in every disaster that faces our country. In this episode, HCA Healthcare’s Mike Wargo, VP of Enterprise Preparedness and Emergency Operations sits with Chip in their brand new Emergency Operations Center in Nashville, TN. They discuss how hospitals are preparing for everything from major weather events like Hurricane Michael to man-made disasters like electrical grid failures. After our original conversation with Mike in August, two major storms hit the US so we reached out to him again to talk about HCA Healthcare's response. Those stories of incredible cooperation are included in this episode.

Take a look at HCA Healthcare’s Emergency Operations Center in action during Hurricane Florence: https://www.facebook.com/HCACare/videos/274748799807478/

For additional information on how HCA Healthcare responded to Hurricane Michael click here: https://hcatodayblog.com/2018/10/11/hurricane-michael-updates/

Medicine, technology, and data science have merged in the 21st century. Using big data, hospitals and machines have come together to achieve better health outcomes for patients. In this episode, Chip talks with Dr. Jonathan Perlin, CMO and President of Clinical Services at HCA. They discuss how HCA’s size and scale is helping to collect, analyze and act on the wealth of information being collected in the hospital.

Rapidly changing technology and turbulent politics are having a big effect on the health care industry – especially hospitals. The type of care that patients receive and where it is administered is evolving. Health care financing and policies are also in constant flux. In part two of their discussion, Chip and Stuart Altman, a health care economist and professor at Brandeis University, look to the future of community hospitals.

Hospitals are centers of medical care, scientific discovery, education and employment in communities from coast to coast, but how did we get here. In this episode Chip will discuss the making of the modern hospital with health care economist and professor at Brandeis University Stuart Altman. They talk about everything from breakthroughs in care to major changes in health care financing and how each of these developments helped create the community hospital we know today.

On this season of the new podcast from the Federation of American Hospitals, Chip Kahn, President and CEO will take a deep dive into your community hospital with experts in the field. What were hospitals like at the turn of the century? What do hospitals do when disaster strikes? How are hospitals using AI technology to improve patient care? Its all here on Hospitals In Focus with Chip Kahn. Listen, subscribe and leave us a review!