fah hospital policy blog

Perspectives on health policy affecting America’s hospitals and the patients we serve.

FAH Opposes Bill That Would Allow Patient Cherry-Picking at Physician-Owned Hospitals

November 19, 2019 | FAH Policy Blog Team

Category: Legislation

Today, FAH and American Hospital Association (AHA) sent a letter to every U.S. Senator urging them to oppose any legislation that would repeal the part of the Affordable Care Act that limits self-referral to physician-owned hospitals (POHs).

Recently, Sen. James Lankford (R-OK) reintroduced The Patient Access to Higher Quality Health Care Act of 2019 (S. 2860), which seeks to repeal the ACA’s limit on self-referral to physician-owned hospitals. Repealing this ban would lead to these facilities cherry-picking patients and increasing health care costs on taxpayers.

The letter cites a study by Dobson | DaVanzo to highlight the harmful effects this practice has had on the hospital industry, including that POHs treat fewer medically complex patients as well as enjoy margins nearly three times those of non-POHs.

The FAH/AHA joint letter states, “The empirical record is clear that these conflict-of-interest arrangements of hospital ownership and self-referral by physicians result in cherry-picking of the healthiest and wealthiest patients, excessive utilization of services, and patient safety concerns.”

The letter urges the Senate to reject any legislation that would weaken the current law.

You can find the complete letter here.

Back in June, the companion House bill (H.R. 3062) was introduced by Rep. Michael Burgess, M.D. (R-TX), Ranking Member of the Energy and Commerce Subcommittee on Health and Rep. Vicente Gonzalez (D-TX). This bill is similar to the legislation introduced by former Rep. Sam Johnson (R-TX) in previous Congresses.

Protecting Rural Hospitals: Five Ways Policymakers Can Make A Difference

November 18, 2019 | FAH Policy Blog Team

Category: Rural

While National Rural Hospital Week, November 18-22, is a time to celebrate all of the things that make rural America unique, it is also a time to address the ways policymakers can support access to quality health care for the 60 million Americans who reside in rural communities.

There are five policy areas that lawmakers can champion to protect health care in rural America – the Rural ACO Improvement Act, Medicaid Disproportionate Share Hospital (DSH) payments, Telehealth, Broadband and the Medicare Dependent Hospital (MDH) and Low Volume Hospital (LVH) programs.

Rural ACO Improvement Act

Recently, the FAH, along with 14 other health care organizations, sent a letter in support of a Senate bill that would revise the benchmarking formula for the Medicare Shared Savings Program.

Senators Catherine Cortez Masto (D-NV) and Pat Roberts (R-KS)'s legislation, the Rural ACO Improvement Act (S. 2648), would help ensure accountable care organizations (ACOs) in smaller communities have an equal opportunity to share in the program’s savings. Currently, not all ACOs are treated equally. This flaw in the system hurts programs in rural areas solely because of their geographic location and scope of care.

The FAH letter states, "This legislation fixes an important flaw in the current MSSP benchmarking methodology - a flaw that systematically disadvantages ACOs in rural areas and makes it harder for them to achieve savings even when they improve quality and reduce costs on par with their counterparts in urban areas."

This bipartisan bill would fix this issue and level the playing field to further incentivize health care coordination in rural areas. FAH encourages Congress to enacts this legislation.

 

Medicaid Disproportionate Share Hospital (DSH) Payments

Safety-net hospitals throughout the United States are dependent upon Medicaid DSH payments that help offset the costs of care hospitals incur treating Medicaid and low-income patients, and further preserves access to care in rural America.

In FY 2020, hospitals are scheduled to endure Medicaid DSH cuts of $4 billion that would be detrimental to health care in rural America.  We urge Congress to enact legislation that will eliminate, or at a minimum delay, these cuts.

 

Telehealth

Telehealth is pivotal to bringing personalized care to rural America. New technological advancements can increase timely access to patient-centered care, enhance patient choice and, through early intervention, can help prevent long-term, costly health events for many of the folks who call rural America home.

Specialty care is becoming harder and harder to find in rural communities, the use of telehealth reduces geographic challenges and provides patients convenient and more timely access to providers.

As the utilization of telehealth continues to grow, FAH believes that it should be reimbursed by Medicare, Medicaid, private insurance and other payers at the same level as when those services are delivered in person. Reimbursements should not discriminate based on the technology used. The use of telehealth should be encouraged by federal policies, especially those with a focus on access to care in rural America.

 

Broadband

Using telehealth in rural areas expands access to and improves the quality of health care millions of Americans receive. However, there is often a lack of infrastructure in place to achieve the expansion of telehealth – namely, a lack of broadband internet.

And while broadband is used in everything from agriculture to education, expanding rural America’s access to reliable internet service is pivotal to increasing access to quality health care for rural communities. Policymakers everywhere – at the federal, state and local level – should work to promote the deployment and availability of broadband nationwide, especially in rural areas. Americans should have access to quality health care, and broadband is an important step to achieve that goal in rural areas.

 

Medicare Dependent Hospital (MDH) & Low Volume Hospital (LVH) Programs

The Medicare Dependent Hospital (MDH) and the Low Volume Hospital (LVH) payment programs should be made permanent to ensure patient access to hospitals in rural America. These programs, which currently sunset in 2022, help relieve some of the financial pressure on rural providers.

FAH is committed to the permanent extension of the MDH and LDH programs that are essential for rural hospitals to continue to serve their communities. We urge policymakers to permanently extend these vital programs.

FAH will continue to work with policymakers to achieve the above goals in order to increase access to quality health care for the 60 million people who call rural America home.

FAH Member Hospitals’ Community Partnerships in Rural America

November 18, 2019 | FAH Policy Blog Team

Category: Rural

This year in celebration of Rural Hospital Week (November 18-22), FAH is highlighting stories of cooperation from our member hospitals throughout rural America.

Small communities face different obstacles than their urban counterparts when it comes to health care delivery. With a more Medicare-dependent population and challenging geography, community leaders and hospitals are coming together to create unique partnerships that allow residents to take control of their own health. Below are just a few of the success stories seen at FAH member hospitals around the country:

1. Maria Parham Franklin FSED Opening

When Franklin Medical Center closed in 2015, the residents of Louisburg, North Carolina lost a critical access point for care. The 2018 opening of the new Maria Parham Franklin (MPF), a free-standing emergency department and geriatric psychiatric unit, restored critically important 24/7 emergency care, diagnostic services and behavioral health care to the community.

Since its opening, Maria Parham has added the Maria Parham Multispecialty Clinic for primary and specialty care and has broken ground on a 20-bed adult behavioral health unit that is set to open in early 2020.

“We are honored to restore vital health services to the communities of Louisburg, Franklin County and the surrounding areas,” says Bert Beard, chief executive officer of Maria Parham Health. “This project underscores our commitment to ensuring that high-quality healthcare is accessible close to home.”

The project was made possible by Duke LifePoint Healthcare, the Dorothea Dix Hospital Property Fund, the Golden Leaf Foundation and the North Carolina Department of Commerce through the North Carolina Community Development Block Grant.

 

2. Sovah Health – Danville/Community Health Workers Program

In 2016, Sovah Health, the Danville Regional Foundation, Gateway Health and other community partners joined together to launch the Community Health Workers (CHWs) program to address health disparities in southern Virginia’s Dan River Region.

CHWs are public health workers who serve as a vital link between health care, social services and members of the community to enhance access to services and improve health management. CHWs improve patients’ ability to manage their health – following a hospital stay or emergency room visit – through a series of activities, including outreach, community education, informal counseling, screenings, social support and advocacy.

As a result of the CHWs program, Sovah Health – Danville has seen a significant decline in readmissions and unnecessary emergency room visits. But the greatest payoff? Seeing patients take charge of their health.

 

3. Sovah Health – Martinsville/Harvest Foundation and PHCC Education Grant

Like other hospitals and health systems across the country, Sovah Health - Martinsville has been challenged by the nursing shortage in recent years. Hospital leadership met with other local community leaders from Patrick Henry Community College (PHCC) and the Harvest Foundation to address this challenge. From those meetings, a big idea was born – to build a state-of-the-art Clinical Simulation Lab for Nursing Education. Thanks to a grant from the Harvest Foundation, PHCC – in partnership with Sovah Health – is set to open the lab at the hospital later this year.

The “Sim Lab” will feature the latest advanced patient simulator programs and equipment to provide valuable “hands-on” training for PHCC nursing students and current Sovah Health staff. Most importantly, the lab will be an important bridge between nursing students and the community’s largest healthcare provider and employer.

“We are thrilled to further our partnership with PHCC through the implementation of this cutting-edge technology in Martinsville,” says Jacquelyn Wilkerson, market chief nursing officer at Sovah Health. “This simulation lab will take our nurse education and training to the next level, ensuring our region has the highest clinically-trained workforce capable for the diverse healthcare needs of our community.”

 

4. UP Health System Rural Psychiatry Program Pilot

In rural areas, there is often a personal connection between a hospital and its patients, with healthcare facilities committed to providing the best care possible in numerous specialties. That can often mean enhancing a service line to fill a local care need. Every county in Michigan’s Upper Peninsula (UP) except Marquette is a federally designated Health Professional Shortage Area for mental healthcare, based on the number of psychiatrists per capita. Primary care providers across the UP have reported that their patients encounter barriers in accessing behavioral care resources.

The pilot rural psychiatry residency program at the Michigan State University College of Human Medicine in Marquette is set to change that. A joint venture between four Michigan medical schools and the state itself, the program will help ensure that the UP has access to the psychiatric care necessary to meet the behavioral healthcare needs of its communities.

The program provides funding to expand residency positions where half of the instruction will occur in a rural site and is designed to help increase the number of behavioral care providers and improve care in the UP. The goal is to have two psychiatry residents each year graduate from the program and stay in the area to practice, beginning with the class of 2023.

“If the retention rate is as successful as the Family Medicine Residency Program (with 40 percent of graduates staying in the area long-term), there would be a positive impact on the way care is provided in this rural area within a few years,” said Stuart Johnson, DO, chief executive officer and community assistant dean, MSU College of Human Medicine UP Campus. “I am grateful for the way the State of Michigan is partnering with medical schools, residency programs and local providers, as well as the commitment from our local psychiatrists, to improve care in shortage areas like ours.”

 

5. Bolivar Medical Center ER Tours

In an effort to educate local school children on how to help a parent, grandparent or any other person who may be in need of emergent care, Cleveland, Mississippi’s Bolivar Medical Center staff and paramedics, along with Pafford Medical Services EMS, led groups of second and fifth graders from local elementary schools through Bolivar’s Emergency Department, Imaging Department and an ambulance.

A cardiopulmonary resuscitation (CPR) was demonstrated, and chest pain was emphasized as a focus topic during the tours. The paramedics led an engaging conversation to ensure that the children understood what constitutes an emergency and how Bolivar Medical Center and Pafford can help. They were able to view a trauma room and see how care is administered during an emergency, and were shown how x-ray and CT machines work. Paramedics also led them through the inside of an ambulance to educate them on how much can take place in the vehicle. These tours take place annually, and approximately 40 children attend each year.

FAH Celebrates National Rural Hospital Week (November 18-22)

November 18, 2019 | FAH Policy Blog Team

Category: Rural

The Federation of American Hospitals is celebrating National Rural Hospital Week November 18th through 22nd to highlight the unique and essential role hospitals play in rural communities across the United States.

Rural America faces countless health care obstacles: fewer providers in less populated areas, technological and transportation accessibility issues and high costs for service. Rural hospitals overcome these challenges every day and are vital to these smaller communities across the country.

More than 60 million Americans live in rural America – that’s one in five Americans relying on rural hospitals for timely and quality care. These 60 million Americans are scattered across 90% of the United States, living in countless communities, each presenting its own unique challenges to the health care system. Rural hospitals are often the sole comprehensive care provider in these communities and face everything from challenging geography, weather and distance to provide care for their patients – each and every day!

Aside from rural hospitals’ unique geographic hardships, they also provide care for a different population than the average urban hospital. On average, the rural communities these hospitals provide for are older and from lower-income backgrounds, relying heavily on Medicare. Though these hospitals provide for a smaller volume of patients, partly because of the high reliance on Medicare, rural hospitals are financially vulnerable and facing continuous operational and funding cuts in Congress.

But these rural hospitals are not only vital for their lifesaving and comprehensive health care services, they are the economic backbone of rural communities. Closures of rural hospitals would not only affect the health care system but would result in massive job loss and unemployment for rural communities. Across the country, rural hospitals are often the largest or second-largest employer in their region, providing an invaluable economic backbone to the community. If these hospitals are forced to close, entire communities could be left without health care providers and employment.

Since the inception of FAH, the Federation has advocated on behalf of rural hospitals to highlight to legislators and policymakers the vital role hospitals play in providing quality care to rural communities across the United States. But there is more work to be done to protect these essential hospitals from future vulnerability. The Medicare Dependent Hospital (MDH) Payment and Low-Volume Hospital (LVH) Adjustment will expire in 2022 and are critical to rural hospitals’ ability to provide quality and affordable care to their patients.

 

This week and every week, rural hospitals work diligently to combat the unique challenges facing rural communities. They play a vital role in the economic prosperity of disadvantaged populations and provide invaluable care to smaller communities across the country.

Joint Statement from National Hospital and Health System Groups on Public Disclosure of Privately Negotiated Rates Final Rule

November 15, 2019 | FAH Policy Blog Team

Category: Statement, Transparency

WASHINGTON, D.C. (November 15, 2019) - The American Hospital Association (AHA), Association of American Medical Colleges (AAMC), Children’s Hospital Association (CHA) and Federation of American Hospitals (FAH) issued the following joint statement on today’s final rule from CMS:

Today’s rule mandating the public disclosure of privately negotiated rates between commercial health insurance companies and hospitals is a setback in efforts to provide patients with the most relevant information they need to make informed decisions about their care. Instead of helping patients know their out-of-pocket costs, this rule will introduce widespread confusion, accelerate anticompetitive behavior among health insurers, and stymie innovations in value-based care delivery. America’s hospitals and health systems have repeatedly urged CMS to work with hospitals, doctors, insurers, patients, and other stakeholders to identify solutions to provide patients with the information they need to make informed health care decisions and know what their expected out-of-pocket costs will be. We continue to stand ready to work with CMS to achieve this goal.
 

Because the final rule does not achieve the goal of providing patients with out-of-pocket cost information, and instead threatens to confuse patients, our four organizations will soon join with member hospitals to file a legal challenge to the rule on grounds including that it exceeds the Administration’s authority.

Final Hospital Price Transparency Rule Will Result in "Patient Overload of Useless Information"

November 15, 2019 | FAH Policy Blog Team

Category: Statement, Transparency

WASHINGTON – FAH President and CEO Chip Kahn released the following statement in response to the release of the administration's final regulation on hospital price transparency:

"Patients should have readily available and easy-to-understand cost-sharing information when they need to make health care decisions. Health care price transparency ought to be defined by the right information at the right time. 

"This final regulation on hospital transparency fails to meet the definition of price transparency useful for patients. Instead, it will only result in patient overload of useless information while distorting the competitive market for purchasing hospital care.

"Beyond these patient concerns, the fact is that this regulation exceeds the administration’s authority, and we plan on joining with hospitals to file a legal challenge."

Follow us on Twitter @FAHhospitals

FAH Sponsors Drug Shortage Briefing on Capitol Hill

November 06, 2019 | FAH Policy Blog Team

Category: FAH News, Pharmaceuticals

FAH, along with eight other health care organizations, sponsored a briefing on Capitol Hill delving into the impact prescription drug shortages have on patients and on the entire health care system.

Drug shortages can cause a hefty burden for providers, adding $230 million a year to U.S. drug costs and $216 million a year in increased labor costs. The briefing focused on the urgency for Congress to act to address issues like these.

Senator Susan Collins (R-ME) opened today's briefing, focusing on her legislation, the MEDS Act (S.2723). In addition to Senator Collins, expert panelists spoke to the crowd of Hill staffers, including: Brian Marden, PharmD, Chief Pharmacy Officer, MaineHealth; Edward R. Mariano, MD, MAS, Chief, Anesthesiology and Perioperative Care Service and Associate Chief of Staff for Inpatient Surgical Services, VA Palo Alto Health Care System; and Daniel Teich, PharmD Vice President of Pharmacy Purchasing and Contracting, Fairview Pharmacy Services.

FAH and the American Hospital Association (AHA) released a study on the topic earlier this year that found that 80% of hospitals say it has become "extremely difficult" to obtain drugs. Additionally, the study found that the average total drug spending per hospital admission increased by 18.5% between FY2015 and FY2017. The FAH/AHA joint study can be found by clicking here.

Along with the Federation, America's Essential Hospitals, American Hospital Association, American Society of Anesthesiologists, American Society of Clinical Oncology, ASHP, ASPEN, Children's Hospital Association and Premier sponsored the briefing.

FAH Is Now @FAHhospitals on All Social Media

November 01, 2019 | FAH Policy Blog Team

Category: FAH News

Today, FAH is streamlining our social media accounts to all have the same handle: @FAHhospitals.

This switch will ensure FAH’s social media handles are accessible and easy to find, optimizing our presence on various platforms.

If you already follow us on Facebook, Twitter or Instagram – you don’t have to do a thing. You will still see our posts – the only difference is that our handle has switched.

Follow along with FAH on social – Facebook, Twitter and Instagram at @FAHhospitals.

FAH Expresses “Strong Support” for Nursing Bill

October 31, 2019 | FAH Policy Blog Team

Category: Legislation, Rural

This afternoon FAH President and CEO Chip Kahn sent a letter to leaders of the Senate HELP Committee expressing “strong support” for S. 1399, Title VIII Nursing Workforce Reauthorization Act of 2019.

The legislation will extend critical nursing workforce development programs that invest in the education and training of our nation’s nurses.

It also includes the text of S. 1045, the Nursing Where it is Needed Act - bipartisan legislation introduced by Sens. Doug Jones (D-AL) and Todd Young (R-IN).

FAH says in the letter that the legislation as a whole will benefit nurses and the patients they care for.

“This legislation will play a vital role in ensuring that nurses continue to provide high-quality care to patients across the nation, including in rural and underserved communities, by supporting nursing education, practice, recruitment, and retention. The legislation will also ensure that all nurses in critical shortage facilities are eligible for the loan repayment program. We thank you for your leadership in advancing this legislation. We look forward to working with you to secure the legislation’s passage through the Senate,” Kahn wrote.

The letter, which can be found here, was sent to Sens. Lamar Alexander (R-TN) – Chair of the HELP Committee – and Patty Murray (D-WA) – Ranking Member.

FAH Applauds Congressional Action on Vital Nursing Bill

October 28, 2019 | FAH Policy Blog Team

Category: Rural, Statement

FAH President and CEO Chip Kahn released a statement in response to the U.S. House of Representatives passing the Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728), including legislation reauthorizing the incentive program for nurses to practice in underserved areas.

“For patient care in rural and underserved communities, it is often a struggle for hospitals to attract and retain nurses. The legislation passed tonight by the House helps solve this problem. It ensures nurses in any hospital in a critical shortage area are eligible for a vital loan repayment program. I look forward to the Senate joining the House and acting on this bill soon so patients everywhere receive the kind of nursing care they expect and deserve.”

FAH Member Officials Named to Modern Healthcare’s Top 25 Emerging Leaders

October 21, 2019 | FAH Policy Blog Team

Category: FAH News

Modern Healthcare’s recently released list of the Top 25 Emerging Leaders includes two officials from FAH member companies - Daniel Deslatte of Ardent Health Services and Brian Elisco of Tenet Healthcare.

The Top 25 Emerging Leaders program, which was previously entitled Up & Comers, is an annual list honoring young leaders in the health care management field. The list represents rising stars under 40 who have made significant contributions in administration, management or policy.

Daniel Deslatte is the Senior Vice President of Business Affairs and External Relations for the University of Texas Health Science Center in Tyler, Texas. Deslatte helped lead the joint venture acquisition with FAH member Ardent Health Services to take control of East Texas Medical Center.

Brian Elisco serves as the Texas Group Chief Financial Officer for Tenet Healthcare Corp. Elisco oversees finances for Tenet’s largest group, which generates $2 billion of net revenue annually. He also helps with an initiative that provides improved access to care for psychiatric patients and helps relocate emergency observation beds to community settings.

FAH congratulates Daniel Deslatte and Brian Elisco for their outstanding service in the field – we are confident they will continue to be leaders for years to come. For more information about Daniel and Brian, and to learn more about all of the 25 Emerging Leader honorees, click here.

Wayne T. Smith Receives FAH’s Mike Bromberg Lifetime Achievement Award

October 17, 2019 | FAH Policy Blog Team

Category: FAH News

Wayne T. Smith, Chairman of the Board and CEO of Community Health Systems, was honored with the Federation of American Hospitals’ Mike Bromberg Lifetime Achievement Award at its conference earlier this week.

Wayne is a three-time chair of the FAH board and a pillar of the health care industry.

Wayne has been CEO of Community Health Systems for more than 20 years, dedicating more than four decades to the health care sector. He has always been focused on greatly improving health services and patient care in communities across America.

During Wayne’s time at the helm of CHS, he has been committed to clinical and operational excellence in the delivery of accessible, safe, high-quality and compassionate care for millions of people. He has also built the company into one of the nation’s largest health care systems, which also contributes to communities through economic development, significant capital investments, and as a major employer.

Wayne has also been named one of Modern Healthcare’s 100 Most Influential People in Health Care since the inception of that prestigious list.

Wayne reflects many qualities with the namesake of the award he was given. Mike Bromberg, who led the Federation for 25 years, stood for a commitment to quality health care and access to hospitals for all Americans.

We in the FAH community sincerely congratulate Wayne T. Smith on receiving this much-deserved award.

 

FAH Announces 2020 Chairman and Board of Directors

October 15, 2019 | FAH Policy Blog Team

Category: FAH News, Statement

The Federation of American Hospitals (FAH) announced today that LifePoint Health President and CEO David Dill will be the organization’s Chair for the 2020 calendar year. Serving with him will be a new slate of Board of Directors.

The Board of Directors is comprised of the executives of FAH’s member companies. Dill will begin his term in January 2020, exchanging the gavel with 2019 FAH Chair Ron Rittenmeyer, Chairman and CEO of Tenet Healthcare Corporation. Also of note - Prem Reddy, MD, Chairman, President & CEO of Prime Healthcare was named Chair-Elect for 2021.

“David Dill is a tireless advocate for health care in our local communities and the important role of hospitals to the patients we serve. Seeing health care at the forefront of Congress’ agenda and a tough presidential election on the horizon, 2020 will be a pivotal year for health policy. With David at the helm, FAH is well-positioned to meet the challenges that the new year will bring,” said Chip Kahn, President and CEO of FAH.

“It is an honor to be chosen to serve as Chair of the Federation next year. I look forward to working with my colleagues on the Board and the FAH team to ensure every American has access to personalized, quality care in their local communities. 2020 will surely bring challenges, but I am confident in FAH’s mission. This organization has a proven track record of affecting the policy process for the best interests of the patients we serve,” said David Dill, President and CEO, LifePoint Health.

CHAIR

David Dill
President and CEO
LifePoint Health

DIRECTORS

Benjamin Breier
President and CEO
Kindred Healthcare, Inc.                                                                

Samuel N. Hazen
Chief Executive Officer
HCA

Alan B. Miller
Chairman and CEO
Universal Health Services, Inc.

Prem Reddy, MD (Chair-Elect for 2021)
Chairman, President and CEO
Prime Healthcare

Ronald A. Rittenmeyer
Executive Chairman and CEO
Tenet Healthcare

Wayne T. Smith
Chairman and CEO
Community Health Systems

Mark J. Tarr
President and CEO
Encompass Health

David T. Vandewater
President & CEO
Ardent Health Services

New Report Shows Cumulative Hospital Cuts Top $252 Billion

October 15, 2019 | FAH Policy Blog Team

Category: Statement

The cumulative reductions in federal payments to hospitals since 2010 will reach $252.6 billion by 2029, according to a report released today by the health economics consulting firm Dobson | DaVanzo and Associates.

The study, which was commissioned by the Federation of American Hospitals (FAH) and the American Hospital Association (AHA), examined how 11 pieces of legislation combined with numerous regulatory changes would affect hospital funding from 2010 through 2029.

The leaders of FAH and AHA reacted to the results.

“Hospitals are nearing the tipping point we have predicted for so long. The disruptions that come with Medicare and Medicaid cuts of this magnitude have a real-world impact on our ability to deliver the vital services to the patients and the local communities that depend on us. As these cuts pile up, we urge policymakers to understand there comes a point where enough is enough. For the sake of our patients we need to stop this troubling trend,” said Chip Kahn, FAH President and CEO.

AHA President and CEO Rick Pollack added, “Hospitals and health systems are doing more to meet the needs of patients and communities than ever before. They not only work to ensure the highest quality care in delivering essential public services, but also address the social determinants of health, community violence, and ensure they are always there and ready to care in the case of any emergency. The pile-up of reductions in funding for patient services outlined in this report is already creating very serious challenges to ensure access to care. Enough is enough.”

A complete copy of the Dobson | DaVanzo study can be found on fah.org and aha.org. To view the Enough Is Enough infographic click here.

FAH Welcomes Joe Britton as Executive Vice President, Public Affairs

October 09, 2019 | FAH Policy Blog Team

Category: FAH News, Statement

The Federation of American Hospitals is pleased to announce the addition of Joe Britton as Executive Vice President, Public Affairs. Joe will join the Federation on November 4th. 

“It is a distinct pleasure to welcome an individual with Joe’s experience and strategic vision to the Federation team. He brings a unique perspective of the intersection of politics and policy. Joe knows the Congress and the policymaking process and will be a great value add for the Federation’s members as well as the patients we serve,” said Chip Kahn, FAH President and CEO.

During his 16-year career in Washington, Joe has had a wide range of positions in both the Senate and the administration, most recently serving as the Chief of Staff to New Mexico Senator Martin Heinrich.

“I look forward to working on behalf of Federation hospitals and the millions of patients they serve. Over the years, this organization has maintained a solid reputation of fighting for access to quality care for all Americans. It is an honor to join the Federation team and continue that mission,” said Britton.

Before working for Sen. Heinrich, Joe was Senior Advisor to Agriculture Secretary Thomas Vilsack and Deputy Chief of Staff for Colorado Senator Mark Udall. He got his start on Capitol Hill working for Sen. Ben Nelson of Nebraska. Joe has also held positions with high profile campaigns – both national and statewide.

Joe earned his Masters in Government and Masters in Business Administration from The Johns Hopkins University and graduated with a double major in Government and Economics from the University of Virginia.

FAH: Proposed OPPS Rule “Misses Mark” on Transparency; Patients Need “Actionable” Info

September 27, 2019 | FAH Policy Blog Team

Category: Statement, Transparency

FAH President and CEO Chip Kahn released the following statement after the organization submitted comments on the Calendar Year 2020 Outpatient Prospective Payment System (OPPS) proposed rule:

“Patients and their families need actionable information to make their health care decisions. The CMS proposed regulation on negotiated price transparency wholly misses the mark on providing financial information Americans can actually use.

“To start, the regulation’s transparency mandate cannot be implemented, and HHS lacks the authority to even require these disclosures. Beyond that, if carried out, the mandate would backfire, resulting in unnecessary patient confusion and misinformation while distorting the current competitive free market.

“All stakeholders in health care should work towards effective approaches to provide patients with the actionable cost-sharing information they need.

“We hope CMS will carefully consider our concerns about this important regulation.”

You can find FAH’s complete comment letter by clicking here.

Follow us on Twitter @FedAmerHospital

FAH, Others Concerned about Cures Act Implementation, Send Letters to Congress

September 23, 2019 | FAH Policy Blog Team

Category: HIT, Statement

Alarmed that HHS implementation of the information blocking provisions of the 21st Century Cures Act (Cures Act) are not ready for prime time, FAH, along with six other organizations representing clinicians, hospitals, health systems, health informatics and health information management sent letters to congressional leaders today. They called on lawmakers to ensure the Office of the National Coordinator for Health Information Technology (ONC) effectively and appropriately implements the law.

“It is imperative that we get this right to realize the promise of health IT and improve the quality and efficiency of care provided to patients while reducing provider burden," said FAH President and CEO Chip Kahn.

Adding, “FAH supports the goals of the Cures Act to further interoperability by ensuring the appropriate movement of clinical data among health care providers and other stakeholders and ensuring patients have access to their data. However, ONC’s proposals to implement this important legislation – particularly the information blocking provisions – threaten to hinder rather than advance interoperability and will lead to significant confusion among health care providers and patients.”


Specifically, the letter recommends that the regulations implementing the Cures Act incorporate the following:

•    Additional rulemaking prior to finalization: To ensure a sufficient level of industry review and to appropriately respond to stakeholder feedback, ONC should issue a supplemental rulemaking to address outstanding questions and concerns.
•    Enhanced privacy and security: The proposed rule does not sufficiently address the Cures Act’s directives to protect patient data privacy and ensure health IT security. Further, it is imperative that the Committee continue its oversight of privacy and security issues that fall outside of the Health Insurance Portability and Accountability Act (HIPAA) regulatory framework.
•    Appropriate implementation timelines: ONC should establish reasonable timelines for any required use of certified health IT (CEHRT). Providers must be given sufficient time to deploy and test these systems, which must take into account competing regulatory mandates.
•    Revised enforcement: The U.S. Department of Health and Human Services should use discretion in its initial enforcement of the data blocking provisions of the regulation, prioritizing education and corrective action plans over monetary penalties.

The complete letter to Senate leaders can be viewed here. A similar letter was sent to leaders in the House.

FAH Appreciates Congress Addressing Rising Drug Costs

September 19, 2019 | FAH Policy Blog Team

Category: Statement

FAH President and CEO Chip Kahn released the following statement in reaction to the release of Speaker Nancy Pelosi’s plan to lower the price of prescription drugs:

"Skyrocketing drug costs are causing a crisis for Americans who depend on their prescription medications. As reports have shown, the rapidly rising price of vital medications is driving up the costs of patient care for local hospitals.

"Hospitals are at the forefront of this fight and we appreciate Speaker Pelosi taking meaningful action to address drug costs. FAH looks forward to working with Congress to ensure our patients have access to affordable medications."

FAH Leaders Nominated for Modern Healthcare’s “100 Most Influential” List – Vote Now!

September 09, 2019 | FAH Policy Blog Team

Category: FAH News

Every year, Modern Healthcare magazine honors industry leaders in its “100 Most Influential People In Healthcare” list. This annual ranking is based upon input from Modern Healthcare readers and the magazine’s senior editors.

This year, FAH is proud to announce that Modern Healthcare’s list of 300 nominees includes 10 leaders from our membership, as well as FAH President & CEO Chip Kahn.  Voting is underway and will continue through October 7th.  We encourage everyone to place their vote by clicking here so we can acknowledge the great work of our industry’s leaders.

FAH leaders nominated for the 2019 “100 Most Influential People In Healthcare” list are:

  • Benjamin Breier, President and CEO, Kindred Healthcare
  • David Dill, President and CEO, LifePoint Health
  • Samuel Hazen, CEO, HCA Healthcare
  • Chip Kahn, President and CEO, Federation of American Hospitals
  • Alan Miller, Chairman and CEO, Universal Health Services
  • Dr. Jonathan Perlin, President, clinical services and chief medical officer, HCA Healthcare
  • Dr. Prem Reddy, Chairman, President and CEO, Prime Healthcare
  • Ronald Rittenmeyer, Executive chairman and CEO, Tenet Healthcare Corp.
  • Wayne Smith, Chairman and CEO, Community Health Systems
  • Mark Tarr, President and CEO, Encompass Health Corp.
  • Dr. Tony Tedeschi, CEO, Detroit Medical Center

You can learn more about Modern Healthcare’s awards on its recognition page.  Voters are required to vote for exactly five nominees.  Don’t forget to vote now!

Public Charge Rule Could Have Chilling Effect on Access to Care

August 12, 2019 | Chip Kahn

Category: Insurance, Medicaid

Federation of American Hospitals President and CEO Chip Kahn issued the following statement in response to the release of the final public charge regulation:

"Hospitals are concerned that today’s decision will put the health of millions at risk by creating a chilling effect on enrollment for vital health safety net programs. Many eligible people won’t sign up for health insurance coverage, like Medicaid, over fears it could hurt their or their loved ones’ immigration status.

"We hope the administration will reconsider these damaging changes to the public charge regulation."


Follow us on Twitter @FedAmerHospital

REPORT: A Medicare Public Option Puts Majority of Rural Hospitals at Risk

August 07, 2019 | FAH Policy Blog Team

Category: Research, Rural

What would a Medicare public option do to rural hospitals? A new study released today says more than half could be at high risk of closure if a Medicare public option becomes a reality.

The study, released by Navigant, shows that a Medicare public option could put as many as 55% of rural hospitals – or 1,037 hospitals in 46 states – at high risk of closure.  Beyond those hospitals at greater risk for closure, the study demonstrates that all rural hospitals would face increased risk from the public option, noting that rural hospitals may have to eliminate critical services harming access to care.

Patients and rural Americans not only rely on hospitals to provide invaluable care when and where they need it, these hospitals often are the largest or second-largest employer in their communities.

According to Navigant, these are the three main findings of their study:

  1. Revenue loss to rural hospitals is projected to be 2.3% under a Medicare public option if only the uninsured and current individual market participants shift to the public option, placing an estimated 28% of rural hospitals at high risk of closure (Scenario 1).
  2. If employers shift between 25% and 50% of their covered workers from commercial coverage to a Medicare public option, hospital revenues are projected to drop between 8% and 14% and cause an estimated 51% to 55% to face high risk of closure, with an additional 39% to 41% facing moderate risk (Scenarios 2 & 3).
  3. To keep hospitals whole from the financial consequences of any of these scenarios, Medicare would have to increase hospital payment levels for a public option between 40% and 60% above present Medicare rates, costing between $4 billion and $25 billion annually (depending on the severity of the employer shift).

For the full Navigant report, THE POTENTIAL IMPACT OF A MEDICARE PUBLIC OPTION ON U.S. RURAL HOSPITALS AND COMMUNITIES: A SCENARIO ANALYSIS, click here.

To learn more about how essential rural hospitals are to their communities click here.

Follow FAH on Twitter @FedAmerHospital

In the News – FAH’s Study on Modernizing the HCAHPS Patient Experience Survey

August 02, 2019 | FAH Policy Blog Team

Category: Quality

Last week, FAH and four major hospital associations rolled out a study on modernizing the HCAHPS patient experience survey. The report, Modernizing the HCAHPS Survey: Recommendations from Patient Experience Leaders, found that response rates to the HCAHPS survey are falling and could be improved by updating the questions and implementing an online modality.

The new report was covered in major publications and as FAH President and CEO Chip Kahn says, the HCAHPS survey is “in need of a serious update. Care in hospitals is vastly different than 13 years ago."

In Case You Missed It…

Modern Healthcare’s article detailed the study’s recommendations for “major changes to the survey including adding an electronic version, shortening the length, changing questions and re-evaluating the survey every few years. The recommendations were based on feedback from patient experience leaders at 27 hospitals and health systems nationally.”

Becker’s Hospital Review created a Five Things to Know post about the HCAHPS study, saying “the HCAHPS survey must be modernized to better reflect changes in care delivery, healthcare technology and patient expectations.”

Healthcare Dive’s brief, Hospital Groups Propose Overhaul to Patient Satisfaction Survey, noted Chip Kahn’s urge for modernization, saying, “HCAHPS has a great track record, but it has not been closely looked at in more than a decade."

Patient Engagement HIT said that “the time is ripe for the medical industry to overhaul the Hospital Consumer Assessment of Healthcare Processes and Systems (HCAHPS) survey” in their article.

 

For more information on the study, including the report, key findings and recommendations click here.

Follow FAH on Twitter @FedAmerHospital

Joint Statement from National Hospitals Associations on Proposed CY 2020 OPPS Rule

July 30, 2019 | FAH Policy Blog Team

Category: Transparency

Below is a joint statement from the American Hospital Association, America’s Essential Hospitals, the Association of American Medical Colleges, the Children’s Hospital Association, and the Federation of American Hospitals on the proposed calendar year 2020 Outpatient Prospective Payment System rule:

"Hospitals and health systems want to ensure that patients have access to information they need to choose their health care, including their out-of-pocket obligations. This rule, however, is a misguided attempt to improve price transparency for patients because it fails to give them the information they need. Disclosing the negotiated rate between insurers and hospitals will not help patients make decisions about their care. Instead, this disclosure could harm patients by reducing patient access to care. This is the wrong approach to price transparency, and the administration should reverse course on this provision."

Demonstration: Strengthening and Improving HCAHPS Patient Experience Surveying

July 29, 2019 | FAH Policy Blog Team

Category: Media, Quality, Research

Today, Bill McInturff and Micah Roberts, Partners at Public Opinion Strategies, are unveiling a groundbreaking report demonstrating how the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) patient experience survey can be recast and improved.

The report, sponsored by the Federation of American Hospitals, concludes that, even though the HCAHPS survey has a solid track record, it can be strengthened to better reflect changing patient care and varying patient social backgrounds and medical literacy.

The demonstration also found that an online option to administer the survey can work well for many patients and likely increase response rates.

“Patient experience is critically important to improving hospital care. We need an HCAHPS that evolves with the advances in treatment we’ve seen within the past decade. We need an HCAHPS that is relevant to all types of patients - regardless of background or their social determinants of health. It’s time to take the HCAHPS online and modernize it to fit the lives of today’s patients,” said Chip Kahn, FAH President and CEO.

“The demonstration worked very well online and we hope that the results of the survey will help lead CMS and others to say that there’s every indication that an online option should be considered as one of the ways to administer the survey,” said Bill McInturff, Partner at Public Opinion Strategies. “I hope that in a small way, this project opened the door about further strengthening and improving the HCAHPS product.”

The demonstration builds on the study FAH and four other hospital associations released last week, Modernizing the HCAHPS Survey: Recommendations from Patient Experience Leaders. Researchers found that response rates to the HCAHPS survey are falling and that after ten years in the field, it needs a refresh. Recommendations include, among others, adding a digital modality and shortening the survey. The report can be found here.

The demonstration conducted by Public Opinion Strategies tested those key findings. It found that by adding items important to patients, the HCAHPS survey would better measure patient experience.

Some of the measures that could be improved from the current HCAHPS survey include:

The importance of doctors and nurses to listen, show courtesy and show respect.
Experiences that were reported more frequently than existing measures being used.
Chief among these - efficiency of care is a leading experiential factor that drives perceptions about hospitals.
Wait times in general, wait times for discharge specifically and understanding reasons for wait times overall during the care experience are important factors driving hospital ratings and recommendation likelihood.


FAH worked with Public Opinion Strategies to update the survey. This revised survey was administered to 500 recently hospitalized adults nationwide and it accomplished the following:

It better captured experience, reducing the number of experience questions from 20 to 18.
It was administered online in only 8.5 minutes, a statistically significant 1.3 minutes less than the HCAHPS survey.
It was even stronger than the current HCAHPS survey in predicting satisfaction with hospital stay and recommendation of the hospital to friends and family.

 

In concert with FAH’s report and McInturff’s study, the Federation’s “Hospitals In Focus” podcast released two new episodes focused on the HCAHPS survey. The first episode features Dr. Claudia Salzberg, FAH’s VP of Quality discussing the newly released study examining the HCAHPS survey from the perspective of Patient Experience Leaders. That episode can be found by clicking here. The second episode of the podcast features a discussion between Chip Kahn and Bill McInturff about the findings of his demonstration. That podcast can be found by clicking here.

Follow us on Twitter @FedAmerHospital

New Report Shows Benefit of Modernizing HCAHPS Patient Experience Survey

July 25, 2019 | FAH Policy Blog Team

Category: FAH News, Publications, Quality, Research

Today, five major hospital associations released Modernizing the HCAHPS Survey: Recommendations from Patient Experience Leaders, a paper that explores how to update patient experience surveying to best improve patient care.

The HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems) is a 32-question patient satisfaction survey required by CMS for all U.S. hospitals. Researchers found that response rates to the HCAHPS survey are falling and that after ten years in the field, the survey needs a refresh. Recommendations include the creation of a digital avenue for patients to respond to the survey (right now phone and mail are the only options), as well as shortening the survey. A full list of key findings and recommendations can be found below.

The paper was co-authored by the Federation of American Hospitals (FAH), American Hospital Association (AHA), America's Essential Hospitals, the Association of American Medical Colleges (AAMC) and the Catholic Health Association of the United States (CHA).

“Great hospital care needs to be patient-centered. Providing the best care, meeting patient expectations and keeping them comfortable and well informed is key,” said FAH President and CEO Chip Kahn. “Updating and improving the HCAHPS survey could have a major impact on improving care.”

“Being a nurse on the frontlines of providing care showed me why including the patient experience is crucial in order to have a complete quality picture,” said Robyn Begley, chief nursing officer of the American Hospital Association and chief executive officer of the American Organization for Nursing Leadership. “America’s hospitals and health systems believe strongly that HCAHPS is a critical patient experience survey that has important benefits for both patients and the providers that care for them. But, as our report clearly lays out, it is time to re-think HCAHPS to ensure it is capturing information on critical aspects of care as it is delivered today and that patients can choose to provide their responses in the way that is most convenient for them.”

“Our hospitals work hard to overcome the social and economic challenges their vulnerable patients face and that affect the care experience – language barriers and low health literacy, for example,” said Bruce Siegel, MD, MPH, president and CEO of America’s Essential Hospitals. “This research shows more work is needed to ensure all hospitals ask the right questions in a culturally competent, easily understood way and without burdening patients or providers.”

“This important work demonstrates the commitment of hospitals in improving the experiences of care for patients. Our recommended approaches to modernizing the HCAHPS survey to reflect changes in health care delivery and advancements in technology will help ensure patients are empowered to provide valuable feedback,” said Janis Orlowski, MD, chief health care officer of the Association of American Medical Colleges.

“The patient is at the center of all we do as Catholic healthcare. An updated HCAHPS survey will give us a better understanding of how patients experience the care they receive in our hospitals and how we can improve our care delivery,” said Sr. Mary Haddad, CHA President and CEO.

The associations interviewed hospital and health system patient experience leaders (PELs), the people who operate and manage the patient experience activities within their organizations. This allowed the authors to gather real-world insights into the effectiveness of the HCAHPS. The paper examines in detail the current survey and the way it can be updated to better reflect the many changes and advancements that have happened in health care over the last 10 years.

KEY FINDINGS

  • Response Rates Are Falling. PELs found that their HCAHPS survey response rates were falling each year. We examined national data and identified a drop in the national rate of patient responses from 33% in 2008 to 26% in 2017. Low response rates erode the validity of the survey.
  • There Is Consensus the HCAHPS Survey Needs Updating. While most PELs thought the HCAHPS survey’s ability to provide patients with comparable data on patient experience was good, all felt the survey needs improvement.
  • Topics Covered Are Important but Incomplete. When asked to identify the questions most important to keep PELs identified eight of the 27 core questions including questions related to communication with doctors and nurses. PELs further identified five topics/questions they would like to see added to the survey, such as questions related to efficiency and team-work of the care team.
  • Research Is Needed on Additional Factors That Influence Patient Experience. More research needs to be done to identify social determinants of health that are outside of the hospital’s influence that impact the HCAHPS survey scores to ensure a level playing field when comparing hospitals.
  • Literacy Levels Need to Be Re-evaluated. PELs generally felt that the health literacy level of the survey was too high and that responses of patients with lower health literacy levels were not being captured adequately. PELs also indicated the absence of appropriate literacy levels in non-English language HCAHPS survey versions. These segments of the population risk being under-surveyed and are not properly represented in the reported HCAHPS survey results.

TOP RECOMMENDATIONS

  • Add a digital mode of delivery to existing modalities;
  • Shorten survey;
  • Revise the survey in light of today’s shift to value-based care, changes in health care delivery, improvements in technology, and evolving patient priorities;
  • Reframe the care transitions and discharge planning sections of the HCAHPS survey; and
  • Periodically re-evaluate the HCAHPS survey.

The full report can be found by clicking here.

FAH President and CEO Joins AHRQ’s National Advisory Council

July 19, 2019 | FAH Policy Blog Team

Category: FAH News

Today, the Agency for Healthcare Research and Quality (AHRQ) announced eight new members joining its National Advisory Council, including FAH President and CEO Chip Kahn.

AHRQ’s National Advisory Council for Healthcare Research and Quality is comprised of private-sector health care leaders who advise the agency’s research into improving the quality, outcomes and cost-effectiveness of clinical practice. Chip Kahn will join the Council at its next meeting - July 24, 2019.

“It is gratifying to join the AHRQ’s National Advisory Council, which advises an agency so critical to patients and the quality and performance of Americans’ health care. AHRQ has always facilitated and disseminated important clinical and health services research central to understanding how best to finance and deliver care in America.”

It is noteworthy that Mr. Kahn, as a House Ways and Means Committee Minority Health Counsel 30 years ago, contributed to the drafting of the law that authorized the original AHRQ.

The other seven new members of the Council are:

Gregory L. Alexander, Ph.D., R.N., FAAN, professor,
Sinclair School of Nursing, University of Missouri, Columbia, Missouri.
Peter J. Embi, M.D., M.S., FACP, FACMI, president and chief executive officer,
Regenstrief Institute, Indianapolis, Indiana.
Christine A. Goeschel, Sc.D., M.P.A., M.P.S., R.N., FAAN, assistant vice president,
MedStar Institute for Quality and Safety, and director, Center for Improving Diagnosis in Healthcare, MedStar Health, Washington, D.C.
Rahul Gupta, M.D., M.P.H., M.B.A., FACP, senior vice president and chief medical and health officer,
March of Dimes, Arlington, Virginia.
George Kerwin, M.B.A., president and chief executive officer (Retired),
Bellin Health, Green Bay, Wisconsin.
Edmondo J. Robinson, M.D., M.B.A., M.S., chief transformation officer, senior vice president, Consumerism, senior vice president and executive director,
Christiana Care-Wilmington, Wilmington, Delaware.
Yanling Yu, Ph.D., president, Washington Advocates for Patient Safety, Seattle, Washington.

 

For more information on the National Advisory Council for Healthcare Research and Quality click here.

FAH Reacts to Energy and Commerce Health Markup

July 17, 2019 | Chip Kahn

Category: Legislation

Protecting patients from surprise medical bills should be job one. We appreciate the significance of the Energy and Commerce Committee’s surprise bill measure that now recognizes the need to protect patient access to care by offering an arbitration option. The Committee is taking a step in the right direction.

We remain concerned with the precedent embedded in the bill that empowers the federal government to set private rates. We look forward to working with lawmakers to protect patients and further improve the legislation while moving away from unnecessary government intervention.

FAH also sent letters to Committee leaders today outlining support for other important provisions approved in the Committee markup - including the roll back of cuts in Medicaid disproportionate share payments, the reauthorization of the incentive program for nurses to practice in underserved areas and the funding for the important quality and performance measures oversight by the National Quality Forum.

Those letters can be found here and here.

FAH Responds to Energy and Commerce Health Subcommittee Markup

July 11, 2019 | Chip Kahn

Category: Hearings, Legislation

"Today’s House Energy and Commerce Health Subcommittee markup reflects a clear consensus that federal action is essential to protect patients from surprise bills.

"We agree.

"It is encouraging that many Subcommittee members expressed concern about the rate-setting approach this legislation imposes on providers that would affect patient access to care. Once the patient is protected, it is critical that providers are able to obtain a fair payment from payers unencumbered by government intervention. We look forward to working with the Congress on a patient-centered solution to surprise bills.

"We also applaud the Subcommittee for taking action on other bills vital to patient care, including rolling back cuts in Medicaid disproportionate share payments, advancing the reauthorization of the incentive program for nurses to practice in underserved areas and funding the important quality and performance measures oversight work of the National Quality Forum."

For more details, see the letter FAH sent to Subcommittee leaders this morning by clicking here.

Chip Kahn Speaks on Capitol Hill Panel to End Surprise Billing

July 10, 2019 | FAH Policy Blog Team

Category: FAH News

group Physicians for Fair Coverage entitled “Ending Surprise Billing.”

Chip was part of a panel discussion where he focused his remarks on protecting patients from surprise bills, saying “hospitals very strongly support the patient protections in all of the legislation.” He added, “we feel strongly that there are issues but not the justification of government intervention into those relationships.” Chip also stated that once the patient is protected, when it comes to determining payment between insurers and providers, negotiation works in most cases, pointing to arbitration as a good fallback.

The event began with speeches from Congressman Joseph Morelle (D-NY) and Senator Bill Cassidy (R-LA) on the different surprise billing legislation proposals being discussed on Capitol Hill. Chip spoke from the hospital perspective on a panel that included Melissa Williams of the National Patient Advocate Foundation, Sherif Zaafran of Physicians for Fair Coverage and Scott Behrens of Lockton Companies.

To watch the full Ending Surprise Billing panel click here.

What Democratic Presidential Hopefuls Should Address Heading into Tonight’s Debate

June 26, 2019 | FAH Policy Blog Team

Category: General

The 2020 Democratic presidential primary debates offer an opportunity for candidates to focus on the health care issues that matter most to Americans – access to high-quality care and lowering their health care costs. While more Americans have health care coverage today than before the Affordable Care Act, much more can be done to improve coverage for those who have slipped through the cracks. Further, efforts to improve coverage must take into account their impact on access. Coverage without access would be meaningless.  

Before the Democratic debates kick off tonight and tomorrow, there are a few things FAH hopes to hear from the presidential hopefuls.

 

Rural Health

In a time when nearly a quarter of rural hospitals are at risk of closure, voters across the country are looking to the 2020 candidates to address health care’s most pressing issues.

A recent survey from the Bipartisan Policy Center found that the majority of Americans, including both Republicans and Democrats, consider access to care in rural communities an important issue heading into the 2020 election. Additionally, the survey found that three in five voters would vote for a candidate who prioritized rural health care in their campaign platform.

Rural hospitals are increasingly vulnerable. These facilities traditionally serve older, low-income populations that rely more heavily on Medicare than their urban counterparts. This creates a dichotomy of a Medicare-dependent population but a lower volume of patients overall.

With nearly one in four Americans residing in rural America, it’s essential for Democratic 2020 candidates to address their plans to protect and increase access to quality, affordable health care in rural communities.

 

Expanding and Supporting the ACA

The Affordable Care Act allowed millions of Americans to gain access to affordable health care insurance through federal and state health care Marketplaces, as well as through the expansion of existing Medicaid programs. Now is not the time to abandon the current law for government-run, one-size-fits-all health care proposals.

Instead, FAH hopes that candidates will embrace and preserve the ACA and present plans to strengthen the current law. We support building on the strength of the employer-provided health care system that currently serves 180 million Americans. Now is the time to improve the ACA and make it truly universal so that all Americans can have quality coverage and access to care.

 

Medicare for All

Medicare for All proposals will undoubtedly be discussed at the debates in Miami tonight and tomorrow night. But, will the presidential hopefuls set the record straight on how much the proposal will cost and how much it will dramatically change America’s health care system?

A Kaiser Family Foundation poll of the American awareness of elements in Medicare for All found that 40% of respondents believe private insurers would continue to cover most Americans and 55% say people who are covered through their jobs would be able to keep that coverage. Both are wrong.

It’s clear that the voters are unaware of the devastating impact Medicare for All would have on the health care system. Presidential contenders should be honest with American families tuning in. The truth is under Medicare for All - everyone would be forced into a government-run health care plan that dramatically raises taxes and leads to longer wait times for lower quality care.

It is important that we focus on giving patients and consumers the power to choose the care and coverage that works best for them and their families while keeping the promise of Medicare for our nation’s seniors.

 

Medicare Public Options and Buy-Ins

Public option proposals or buy-in plans have become very popular among candidates running for president. The problem is they don’t talk about the effects it could have on your access to care.

A recent report by FAH and the American Hospital Association (AHA) looked at the impact a Medicare public option proposal - Medicare X - would have on the ability of hospitals and health systems to continue to provide access to high-quality care to their patients and communities. The study showed that a one-size-fits-all proposal could create the largest ever cut to hospitals - nearly $800 billion - and be particularly disruptive to the employer-sponsored health insurance market.

Instead of supporting these disruptive proposals that would dramatically change the health care system, 2020 contenders should embrace the ACA and build upon what is currently working.

FAH Applauds Ways & Means' Work to Reauthorize NQF

June 26, 2019 | Chip Kahn

Category: Hearings

The National Quality Forum (NQF) is critical to ensuring the reliability and effectiveness of the quality and performance measures used in American health care today. Funding for NQF is an investment in improving patient care, making patients, providers and clinicians accountable for care, and making care quality and performance transparent. It is gratifying the House Ways and Means has decided to further the nation’s investment in NQF’s work for another three years. FAH supports extending NQF’s funding and the Committee’s modernization of the organization's role. This move provides long-needed authority to recommend the removal of measures to assure Medicare beneficiaries continue to have metrics that drive improvements in quality and performance.

FAH Responds to HELP Committee Mark Up

June 26, 2019 | Chip Kahn

Category: Hearings

Today’s HELP Committee legislation unfortunately misses the mark. While hospitals agree with the overarching aim of the Lower Health Care Costs Act, key provisions of this will ultimately lead to higher prices and fewer options for patients.

We are united with other hospital groups to protect patients and end the problem of surprise billing. This bill solves the immediate problem for patients, but the unintended consequences of rate setting will lead to more narrow networks and a precedent of government interference in free market negotiations.  

FAH appreciates the bipartisan group of Senators who today voiced significant concern about rate setting.

In a letter sent to Committee leaders, community hospitals also expressed our concerns with contracting provisions contained in this legislation. These could hit vulnerable communities hardest by limiting access to care – especially in rural areas and inner cities.

We remain opposed to this legislative package as currently constructed and look forward to working with lawmakers on solutions that address health care affordability without limiting access.

FAH Supports Ways and Means Committee Action on Vital Health Care Bills

June 25, 2019 | FAH Policy Blog Team

Category: Legislation

The Federation of American Hospitals (FAH) sent a letter to House Ways and Means Committee leaders today expressing support for several of the health care related bills that are scheduled to be marked-up on Wednesday.

“We appreciate the Committee taking action to, among other items, improve the Medicare experience for beneficiaries, reauthorize the important work on quality improvement being done at the National Quality Forum (NQF), extend mental health benefits via telehealth, continue work to address the opioid crisis, and improve the delivery of care for patients with chronic medical conditions,” wrote FAH President and CEO Chip Kahn.

The letter, which was sent to Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX), highlighted several important bills supported by FAH, including:

H.R. 3417, the Beneficiary Education, Tools, Telehealth, and Extenders Reauthorization Act of 2019

“We support increasing access to mental health services via telehealth and appreciate the legislation’s relaxing of existing Medicare rules which serve as an impediment to the expansion and adoption of telehealth services. The use of telehealth to deliver care, especially in rural settings, is an important means to preserving access to vital health care services. We encourage the Committee to consider additional ways to incent the delivery of care via telehealth and specifically consider how to incent the use of these technologies in rural settings including hospitals.”

Another FAH supported provision will change Medicare GME (Graduate Medical Education) treatment of hospitals by establishing new medical residency training programs.

This bill also includes an extension of funding for The National Quality Forum (NQF).

“We applaud the Committee’s inclusion of language to reauthorize the NQF through fiscal year 2022. The NQF has been critical to ensuring the reliability and effectiveness of quality measures, and we are pleased to see continued investment in their important work. FAH also supports the Committee’s expansion of the NQF’s scope, providing long-needed authority to recommend the removal of measures to ensure they continue to drive measurable improvements in quality for Medicare beneficiaries.”

The HEARTS and Rural Relief Act

FAH supports the extension of enforcement instruction on supervision requirements for outpatient services in critical access and small rural hospitals through 2021. “Many small rural and critical access hospitals have insufficient staff available to furnish direct supervision, especially due to difficulties in recruiting physician and non-physician practitioners to practice in rural areas.”

H.R. 3414, The Opioid Workforce Act of 2019

This legislation proposes the addition of 1,000 Medicare-supported GME positions over five years to hospitals that have established or are establishing substance use disorder (SUD) treatment and prevention programs. “Expanding and funding residency slots for this purpose will help ensure that tomorrow’s physicians are fully equipped with the training and skills necessary in addiction medicine, addiction psychiatry, or pain management.”

Finally, FAH expressed support for a bill that will remove cost sharing responsibilities for chronic care management services under the Medicare program.

The full letter can be found here.

FAH Responds to White House Executive Order

June 24, 2019 | Chip Kahn

Category:

“FAH believes that American consumers should have actionable out-of-pocket cost information to assist them in making important health care decisions. We appreciate the administration’s executive order where it will meet consumer transparency needs. If implementing regulations take the wrong course, however, it may undercut the way insurers pay for hospital services resulting in higher spending. The Federal Trade Commission has said that spending would likely increase if hospital-insurer payment arrangements were published.

"So much progress has been made in holding down health care prices. Now is not the time to increase the costs of care. Instead, we hope the administration will focus its effort to inform Americans on their out-of-pocket costs. We look forward to working with the administration to assure that transparency works for Americans when they seek health care.”

3 FAH Member Execs Named to 50 Most Influential Clinical Executives List

June 20, 2019 | FAH Policy Blog Team

Category:

Three FAH member company executives were named to Modern Healthcare’s 2019 50 Most Influential Clinical Executives program.

The 2019 50 Most Influential Clinical Executives list honors physician, nursing and medical leaders in the health care industry who are recognized by their peers as outstanding in their field.

The FAH member Executives named to the list are:

  • Dr. Jonathan Perlin, President of clinical services and chief medical officer, HCA Healthcare
    • As the magazine highlighted, “Perlin oversees a corporate team at investor-owned HCA of 400 physicians, nurses, data scientists and researchers. He also has executive responsibility for HCA’s 45,000 physicians, 95,000 nurses and 35,000 other health professionals. He plays an integral role in spreading best practices across the organization. That includes a program that uses artificial intelligence to reduce sepsis rates, credited with saving nearly 9,000 lives since 2013.”

 

  • Jane Englebright, Senior vice president and chief nursing executive, HCA Healthcare
    • Modern Healthcare noted of Englebright, “As head of the CNO Council, she plays an integral role in shaping the for-profit chain’s nursing agenda, including shaping future leaders and setting clinical outcomes. Earlier this year, HCA pledged to invest money it saved from the tax reform law into staff benefits, including tuition reimbursement and loan repayment. A lot of that investment will be geared toward nurses.

 

  • Dr. Tony Tedeschi, CEO, Detroit Medical Center, Tenet Healthcare Corporation
    • When explaining why Dr. Tedeschi made the list, the magazine said, “He has 20-plus years of experience in operational and clinical leadership positions. Earlier this year, DMC announced plans to add 79 slots to its graduate medical education program. DMC currently has more than 100 residency and fellowship positions. Adding that many positions at once is rare for hospitals given the costs, but the system did so in hopes of meeting primary-care needs in the Detroit area.”

For a full list of honorees on Modern Healthcare’s 2019 50 Most Influential Clinical Executives program click here.

FAH Reacts to Release of Lower Health Care Costs Act

June 19, 2019 | Chip Kahn

Category: Legislation

Surprise billing is a problem for patients that needs to be solved. The Senate HELP Committee Chair’s Lower Health Care Costs Act resolves the patient’s problem, but the bill also includes a misguided arbitrary, government-dictated ‘benchmark’ payment rate for out-of-network services. FAH must oppose the bill until the Committee finds a better way.

Fortunately, appropriate payment for unavoidable out-of-network care can be left to providers and insurers to negotiate or when there are disputes the legislation can define a fair and objective arbitration process. 

The bill also contains contracting proposals that are apparently intended to reduce health care costs, but in reality will reduce patient access to vital medical care and have other unintended consequences for providers and payers alike.

FAH believes in the spirit of Lower Health Care Costs Act – protecting patients and lowering health care costs – though sees it as a work in progress that needs refinement. We look forward with working with the policymakers to help resolve the surprise billing problem for patients.

FAH Reacts to Senate HELP Hearing on Health Costs

June 18, 2019 | Chip Kahn

Category: Hearings

No hospital patient should receive a surprise bill - the message at today’s Senate HELP Committee hearing was clear.

The best way to protect patients is with a requirement that only holds them responsible for their in-network cost sharing amount for unavoidable out-of-network care.

It should then be up to providers and insurers to negotiate an appropriate payment. If policymakers want a fallback plan – arbitration best fits the bill."Proposals that extend the hand of government into private negotiations through rate setting or ‘network matching’ are unnecessary, untested and frankly amount to a cure searching for a problem.

The HELP Committee also examined an array of other proposals that are designed to reduce health care costs. These proposed rules and regulations are well-intentioned, but many of them don’t achieve the goal of helping patients navigate their medical care costs. While they likely would increase red tape for providers. It’s time to take a breath and carefully consider the effects of these plans on patients and caregivers.

FAH looks forward to working with the Committee as it seeks to perfect the legislation.

FAH Reacts to Senate HELP Hearing on Health Costs

May 29, 2019 | Chip Kahn

Category: Hearings

No hospital patient should receive a surprise bill - the message at today’s Senate HELP Committee hearing was clear.

The best way to protect patients is with a requirement that only holds them responsible for their in-network cost sharing amount for unavoidable out-of-network care.

It should then be up to providers and insurers to negotiate an appropriate payment. If policymakers want a fallback plan – arbitration best fits the bill.

Proposals that extend the hand of government into private negotiations through rate setting or ‘network matching’ are unnecessary, untested and frankly amount to a cure searching for a problem.

The HELP Committee also examined an array of other proposals that are designed to reduce health care costs. These proposed rules and regulations are well-intentioned, but many of them don’t achieve the goal of helping patients navigate their medical care costs. While they likely would increase red tape for providers. It’s time to take a breath and carefully consider the effects of these plans on patients and caregivers.

FAH looks forward to working with the Committee as it seeks to perfect the legislation.

“Positive Step Forward” – FAH on CMS’s Voluntary Appeals Settlement Option for IRFs

June 17, 2019 | Chip Kahn

Category: Medicare, Rehabilitation Care

Federation of American Hospitals President and CEO Chip Kahn issued the following statement on CMS’s Voluntary Appeals Settlement Option for Inpatient Rehabilitation Facilities (IRFs), which was announced this evening:

“CMS’s voluntary settlement offer to the inpatient rehabilitation community regarding claims stuck in the Medicare appeals backlog is a positive step forward.

“We appreciate partnering with CMS to achieve fair outcomes for the Medicare program, inpatient rehabilitation hospitals, and the patients who benefit from the unique intensive therapeutic care they provide.”

FAH Leader Comments on Energy and Commerce's Surprise Billing Hearing

June 12, 2019 | Chip Kahn

Category: Financing, Hearings

Federation of American Hospitals President and CEO Chip Kahn issued the following statement on the House Energy and Commerce Committee's surprise billing hearing:

"Hospitals agree no patient should ever receive a surprise medical bill. We appreciate the Committee engaging on this compelling concern.

"The best resolution to surprise billing is federal policy that protects patients, only holding them responsible for their in-network cost sharing amount for unavoidable out-of-network events.

"With the patient protected, caregivers and insurers can negotiate an appropriate payment - with the law putting in place an arbitration process if necessary.

"The Committee’s draft legislation amounts to rate setting. This is simply unnecessary and would have unintended consequences that would ultimately limit access to care.

"We look forward to working with Congress on a solution that achieves our common goal of protecting patients." 

FAH Leader Comments on Ways and Means' Hearing on "Pathways to Universal Health Coverage"

June 12, 2019 | Chip Kahn

Category: Affordable Care Act, Financing, Hearings

Federation of American Hospitals President and CEO Chip Kahn issued the following statement on the House Ways and Means Committee's hearing entitled "Pathways to Universal Health Coverage":

"It is no time to reject the ACA for the untested. ACA health care coverage has meant the difference between life and death for millions. We should build on the ACA to make it truly universal so that all Americans can have coverage now. We urge the House Ways and Means Committee not to waver from the ACA and instead focus on how to make it all it can be for all Americans.

"Efforts to replace the ACA and the private employer coverage millions depend on today is just wrong. It is no time to impose a one-size-fits-all program such as Medicare for All, a public option or Medicare buy-in that will lead to Americans paying more and waiting longer for worse care." 

FAH Leader Comments on Insurance Industry Push for Rate Setting

June 11, 2019 | FAH Policy Blog Team

Category:

The same people who brought us high deductible plans and narrow networks now expect patients to trust them to solve the surprise billing crisis.

Rather than finding the simplest path to resolve a real issue for patients, this group is advocating for single payer-type 'solutions' that create more problems than they solve and could even limit access to care.

The Federation and other caregivers are focused on ensuring no patient receives a surprise medical bill. We believe people should only be held responsible for their in-network cost sharing amount for unavoidable out-of-network events.

Once the patient is protected - caregivers and insurers should negotiate an appropriate payment and any new policy should provide for arbitration when necessary.

FAH Opposes Bill That Would Allow Patient Cherry Picking at Physician-Owned Hospitals

June 06, 2019 | FAH Policy Blog Team

Category: Legislation

FAH and the American Hospital Association (AHA) sent a letter to members of Congress today urging them to oppose H.R. 3062, the Patient Access to Higher Quality Health Care Act of 2019, which seeks to repeal the Affordable Care Act’s limit on self-referral to physician-owned hospitals. Repealing the ban on self-referral would lead to these facilities cherry-picking patients and increasing health care costs on taxpayers.

The letter uses recent data to highlight the harmful effects this practice has on the hospital industry.

“The empirical record is clear that these conflict-of-interest arrangements of hospital ownership and self-referral by physicians result in cherry-picking of the healthiest and wealthiest patients, excessive utilization of care and patient safety concerns,” wrote FAH and AHA.

You can find the complete letter here.

H.R. 3062 was introduced by Rep. Michael C. Burgess, M.D. (R-TX), Republican Leader of the Energy and Commerce Subcommittee on Health, and Rep. Vicente Gonzalez (D-TX). This bill is similar to the legislation introduced by Former-Rep. Sam Johnson (R-TX) in previous Congresses.

FAH Leader Comments on Critical Bills Discussed at E&C Hearing

June 04, 2019 | FAH Policy Blog Team

Category: Hearings

Federation of American Hospitals President and CEO Chip Kahn issued the following two statements about critical legislation discussed at today’s Health Subcommittee of the Committee on Energy and Commerce:

H.R. 3031 (funding for NQF):

Improving medical care for Americans, keeping our caregivers accountable and making care quality and performance transparent to consumers depends on proper care measurement. The quality of that measurement depends in no small part to the oversight and initiatives of the National Quality Forum (NQF).

Congressional funding is mission critical for sustaining and enhancing NQF’s work to improve the care for Medicare beneficiaries and all patients.

As health care depends more on big data and emerging IT technologies, NQF’s work becomes all the more important. The organization is uniquely positioned to expand and meet the challenges of assuring good measurement of high-tech innovation and care advancement. 

FAH deeply appreciates the House Energy and Commerce Committee considering renewed funding for NQF, whose work will shape the future for care quality and performance measurement. We support the legislation of Reps. Chu, Engel and Carter which will push the crucially important work of NQF forward.

Medicaid DSH Payments:

The most vulnerable Americans depend on hospitals for their critical medical care. Medicaid DSH payments are crucial to making that care possible and cutting them would have a devastating impact on millions.

It is so important that the House Energy and Commerce Committee is focusing today on this critical Medicaid issue. We deeply appreciate the more than 300 Members of Congress, led by Reps. Eliot Engel and Pete Olson, who support a delay of Medicaid DSH cuts and we welcome discussion of how to repeal the cuts in their entirety. This is vital to assuring the access to care for Americans in most need.

FAH Urges Congress to Lower Insurance Premiums

May 29, 2019 | FAH Policy Blog Team

Category: Insurance

This week, FAH, the American Hospital Association (AHA) and other major health care groups sent a letter to House and Senate leadership urging prompt Congressional action to "establish a premium reduction/reinsurance program to help cover the costs of people with significant health care needs and improve the affordability of health care coverage."

The letter, sent by eight groups in total, points out commonsense solutions that would "significantly lower premiums, which would greatly improve access to coverage and care."

High individual market premiums are often unaffordable for many middle-class families. Now that health insurers are finalizing their premium rates for 2020, the letter asks Congress to act now to lower premiums to increase the affordability of care for millions of Americans across the country.

"Independent analyses, including ones by Oliver Wyman and Avalere Health, show that a premium reduction/reinsurance program could reduce premiums by up to 20% while preserving the comprehensiveness of coverage, primarily helping those who are not subsidy eligible."

The letter was sent to Senate Majority Leader Mitch McConnell (R-KY), Minority Leader Chuck Schumer (D-NY), House Speaker Nancy Pelosi (D-CA) and Minority Leader Kevin McCarthy (R-CA).

Click here to read the full letter.

FAH, Other Hospitals Groups Advocate to Protect Patients; Warn about Dangers of Rate Setting

May 29, 2019 | FAH Policy Blog Team

Category: Legislation

The Federation of American Hospitals sent a letter today to leaders of the House Energy and Commerce Committee regarding the recently released “No Surprises Act” discussion draft highlighting areas of support and points where the policy needs to be improved.

FAH also joined the major hospital groups in sending a second letter to Committee leaders outlining a unified desire to protect patients from surprise medical bills.

Both letters explain the pitfalls of proposed rate setting policies and express support for dispute resolution methods like mediation and arbitration. In our letter, FAH reiterated support for a federal legislative solution that protects patients, noting that “policy solutions must have patients at their center, and we support the draft’s intent to prohibit balance billing and hold the patient to in-network cost-sharing in circumstances where the patient has no reasonable control over the network status of the providers administering care.”

While FAH supports the Committee’s efforts to protect patients, we do not support the discussion draft’s mechanism for determining payment from the health plan to the health care provider – rate setting that creates more problems than it solves.

As the letter states, “the discussion draft’s provider/health plan payment provisions will upend private payment negotiations between providers and health plans with ramifications far beyond the narrower issue the legislation seeks to cure.  By setting a payment ceiling, through a plan driven, non-transparent process, the discussion draft disincentivizes plans to create comprehensive networks – contrary to the preferred outcome, and harmful to patients… Instead of incenting plans to negotiate network agreements with providers in good faith, the payment ceiling will be used as inappropriate leverage  and have outsized influence not only on the small part of the market the legislation intends to address but on in-network payment and contracting across the country.”

FAH expressed strong opposition to any legislation that includes such set payments and instead said policy makers should focus on mediation (similar to a law just passed in Texas) or arbitration (like the system currently used in Florida or New York).

“We believe that such a dispute resolution process that allows a neutral third party to mediate or determine fair payment is far superior to setting a statutory payment rate and will avoid the negative consequences for patients that setting a rate will likely incur.”

FAH looks forward to continuing to engage with Committee leaders to protect patients from surprise medical bills.

You can find the complete letter here.

Many of these same points are made in the unified letter from hospitals, which can be found here. It was signed by FAH, the American Hospital Association, Catholic Health Association of the US, America’s Essential Hospitals, the Children’s Hospital Association and the AAMC.

FAH Reacts to Draft Legislation Released by HELP Committee

May 23, 2019 | Jeff Cohen, Executive Vice President, Public Affairs

Category: FAH News, Legislation

Addressing high drug costs, improving public health and ensuring patients are protected from surprise bills are important goals and FAH will continue to work with Congress towards long-term, material solutions. 

We appreciate Chairman Alexander and Ranking Member Murray including hospitals in the discussions leading up to this draft and we look forward to continuing to work with them.

We need to find a solution to surprise billing that protects patients, supports development of robust insurer networks and preserves market-based payment determination through negotiation or processes - like arbitration - to determine payment amounts for the services.

FAH Statement on House Single-Payer Hearing

May 22, 2019 | Jeff Cohen, Executive Vice President, Public Affairs

Category: Hearings

“Complicated,” “challenging,” “disruptive,” and “substantial changes for all participants” - words that cannot be ignored from CBO officials at today’s House Budget Committee hearing on a single-payer health care system.

Medicare for All repeals the ACA, it repeals employer-based health insurance, it repeals Medicare, it repeals Medicaid and throws millions of kids off the insurance they have today. It will force patients into an untested system that will disrupt care for every American.

Medicare for All, a public option and Medicare Buy-in plans are all ill-advised and unnecessary to achieve the common goal of ensuring better, more affordable coverage. Instead, we hope Congress will refocus on real-world policies - like stabilizing the Affordable Care Act – that will increase options and affordability for tens of millions of American families.

17 FAH Member Facilities Named to Best Places to Work List

May 22, 2019 | FAH Policy Blog Team

Category: FAH News

Seventeen FAH member facilities were named in Modern Healthcare’s 2019 List of the Best Places to Work in Healthcare.

Modern Healthcare curated this list of best places by finding companies, hospitals and health care employers who “stand out in their efforts to create an empowered and satisfied workforce. They did so by nurturing a sense of loyalty and building engagement.”

FAH is proud to have 17 member company facilities represented in this year’s list:

  • Bailey Medical Center, Owasso, OK – Ardent Health Services
  • Hillcrest Hospital Cushing, Cushing, OK – Ardent Health Services
  • Hillcrest Hospital Henryetta, Henryetta, OK – Ardent Health Services
  • Hillcrest Hospital Pryor, Pryor, OK – Ardent Health Services
  • Lee's Summit Medical Center, Lee’s Summit, OK – HCA Healthcare
  • Lovelace Medical Center, Albuquerque, NM – Ardent Health Services
  • Lovelace UNM Rehabilitation Hospital, Albuquerque, NM – Ardent Health Services
  • Lovelace Women's Hospital, Albuquerque, NM – Ardent Health Services
  • Methodist Ambulatory Surgery Hospital, San Antonio, TX – HCA Healthcare
  • Oklahoma Heart Institute, Tulsa, OK – Ardent Health Services
  • Physicians Surgical Hospitals, Amarillo, TX – Ardent Health Services
  • Rio Grande Regional Hospital, McAllen, TX – HCA Healthcare
  • Seton Medical Center Harker Heights, Harker Heights, TX – Ardent Health Services
  • Southern Tennessee Regional Health System-Pulaski, Pulaski, TN – LifePoint Health
  • Texas Orthopedic Hospital, Houston, TX – HCA Healthcare
  • Tulsa Spine & Specialty Hospital, Tulsa, OK – Ardent Health Services
  • West Valley Medical Center, Caldwell, ID – HCA Healthcare

Click here to view the entire 2019 Modern Healthcare Best Places to Work list.

We congratulate all the facilities and companies honored this year.

FAH Comments on Surprise Billing Hearing

May 21, 2019 | FAH Policy Blog Team

Category: Hearings

We appreciate the Ways and Means Committee taking the time to examine this very important issue. Hospitals agree with both members and witnesses that no patient should ever receive a surprise medical bill. A federal legislative solution is needed - one that protects patients by ending balanced billing and ensures that a patient’s cost-sharing is based on an in-network rate.

Once patients are protected, health care providers and insurers should work together to determine payment amounts for the services provided. This would make untested ideas like bundled payments and rate setting unnecessary.

We look forward to working with Congress on a solution that achieves our common goal of protecting patients.

FAH Supports Bipartisan PLACE Act

May 17, 2019 | FAH Policy Blog Team

Category: Legislation

A FAH-supported bill that would help hospitals continue to provide affordable care to patients, including in rural communities, was recently introduced in the House of Representatives.

The legislation, the Protecting Local Access to Care for Everyone (PLACE) Act (H.R. 2552), aims to prevent site-neutral payment reductions for hospital outpatient clinic visit services furnished in off-campus provider-based departments.

The bill has bipartisan support and was introduced by Reps. Derek Kilmer (D -WA) and Elise Stefanik (R-NY). Both Reps. Kilmer and Stefanik thanked FAH and the American Hospital Association for supporting the legislation.

In his release, Rep. Kilmer urged that “Hospitals should be encouraged to bring their services closer to the people they care for, not be penalized for it.” Kilmer also noted that the PLACE Act would be particularly beneficial for rural areas already facing a shortage of qualified care providers. Similarly, Rep. Stefanik’s statement emphasized how the legislation “would prevent the CMS policy from being enacted so that rural community hospitals can continue to provide high quality, accessible health care to their patients.”

This legislation is important to our hospitals and the communities they serve.  We urge Congress to act on this legislation soon. 

Click here to learn more. 

FAH Leader Comments on House Passage of Major Health Legislation

May 16, 2019 | Chip Kahn

Category: FAH News

Congress is moving in the right direction with legislation focused on assuring Americans affordable, comprehensive health coverage through the exchanges. The path couldn’t be clearer. We need to preserve what works and make improvements where needed. Today’s House vote is in an important step toward reaching the goal of universal coverage embedded in the current law.

FAH Celebrates 2019 National Hospital Week

May 10, 2019 | FAH Policy Blog Team

Category:

FAH and its member companies are joining other health care industry leaders to celebrate 2019 National Hospital Week May 12- 18. National Hospital Week represents FAH’s appreciation for the more than 5,000 community hospitals across our country.

Each year, we take this week to show our gratitude to the dedicated physicians, nurses, therapists, clinicians, engineers, custodial workers, food service workers, volunteers and administrators who keep hospitals operating all day, every day to care for anyone who walks through their doors.

In line with this year’s theme, “Celebrating Hope and Healing” we are highlighting the dedicated work of the men and women who support the well-being of hospitals and communities across the country. Our hospital heroes, whose stories can be found here, are improving the places they work and communities where they live through hard work and acts of kindness.

This week FAH is celebrating the hospitals and caregivers who are healing our veterans as they return home from service, teaching our next generation of providers and assisting those recovering from serious illness.

These hospitals are not just providing life-saving and vital care to our communities, they are economic pillars providing jobs to our friends and neighbors and millions of people across the country.

National Hospital week begins on May 12th on the birthday of Florence Nightingale, the founder of modern nursing. FAH extends its gratitude to the dedicated and compassionate professionals who care for millions of patients each day.

Please join us this week by using #HospitalWeek to join in on the conversation.

Click here to learn more about the Hospital Heroes FAH will be highlighting this week.

Honoring Hospital Heroes: Working in Health Care, Serving their Community

May 10, 2019 | FAH Policy Blog Team

Category:

From the halls of the hospital to the heart walk, the folks we are honoring this week are dedicated every day to saving and improving lives in big cities and small towns.

A hospital hero is someone who serves their community while working and on their free time. They are nurses, ER managers and CEOs, but they also operate non-profits and donate countless hours to charities.

This Hospital Week the FAH is shining a light on people who work in health care and continue to give back to their community once they leave the hospital.

There are thousands upon thousands of stories from coast to coast – we want to share these five with you:

 

Lynett Anderson – Athens, TX

Lynett is the Emergency Department Director at UT Health Athens where she established a program that helps victims of sexual abuse.

Lynett started the SANE (Sexual Assault Nurse Examiner) Program back in 2011. The goal is to train nurses on the front lines how to not only medically treat survivors, but to also give them the emotional support they need so they can begin the path to healing.

The SANE Program has served more than 220 patients in Henderson County since its inception.

 

Maria Elena Atencio - Albuquerque, NM

Maria is a Manager CP/STEMI at Heart Hospital of New Mexico at Lovelace Medical Center, but her love of heart health extends beyond her occupation.

Maria co-founded the Resuscitation Rangers – a hands-free CPR training program that has trained more than 14,430 people since 2016.

Treatment for cardiac arrest is a race against the clock. Rangers in the Albuquerque community are trained to recognize the signs and symptoms then implement CPR and use an AED – more than doubling a victim’s chance of survival.

 

Mat Gooch -Middletown, DE

Mat is the CEO of Encompass Health Rehabilitation Hospital of Middletown, but it is what he is doing in his community that earned him the title of Hospital Hero.

Last year, Mat organized a golf tournament to raise money to benefit the 2018 American Heart Association Heart Walk. That money went right back into efforts in Middletown to help folks dealing with cardiac issues and educate them about hearth health. 

 

Keith McClure – Memphis, TN

When Keith isn’t working as an RN and Assistant Nursing Manager at Saint Francis Hospital - Memphis, he’s helping the comfort the homeless in his community.

Keith operates Memphis’ only non-profit food truck, which provides food and clothing to those in need. He has also organized an army of volunteers to stock and manage 10 freestanding small food pantries.

 

Barbara Stanfield – Danville, VA

Barbara has worked at Sovah Health – Danville for more than 40 years. Her official title is Coordinator, House Supervisors, but she is more known for what she does outside the hospital.

Her small acts of kindness have a big impact on thousands of people in the community. Barbara is involved with several charitable organizations, including Relay for Life, United Way, and the Boys & Girls Club.

 

Please help us say thank you by sharing their stories using #HospitalWeekHero and if you have a hospital hero in your area – share their story with us!

Major Nurse Bill will Include FAH-Supported Loan Repayment Provision

May 10, 2019 | FAH Policy Blog Team

Category: Legislation

​This week, FAH sent a letter to Senators Jeff Merkley (D-OR) and Richard Burr (R-NC) thanking them for introducing the Title VIII Nursing Reauthorization Act of 2019

This legislation will extend critical nursing workforce development programs that invest in the education and training of our nation's nurses.

The bill also includes a provision vitally important to FAH member facilities - the Nursing Where It's Needed Act (Nursing WIN Act). This, which was originally introduced by Sens, Doug Jones (D-AL) and Todd Young (R-IN), would make nurses working at investor-owned critical shortage facilities eligible for an education loan repayment program.

In the letter, FAH President and CEO Chip Kahn wrote, "This legislation will play a vital role in ensuring that nurses continue to provide high-quality care to patients across the nation, including rural and underserved communities, by supporting nursing education, practice, recruitment and retention. We urge Congress to swiftly enact this legislation."

You can find the complete letter here.

FAH Leader Comments on RAND Study

May 10, 2019 | Chip Kahn

Category: General, Medicare, Publications, Research

"Medicare is no benchmark for value judging hospital payments. It is wrong to assume that Medicare, which pays hospitals 11% below cost, sets a standard that assures all patients access to the hospital care they deserve and expect.

"It is a fantasy to think that the hospital care will be there for all Americans without a financial balance between the Medicare and Medicaid underpayment for services, those patients who are uninsured and pay little or nothing and those with private coverage."

BACKGROUND:

• The authors of the RAND report acknowledge the study’s small sample size: less than 5% of people covered in about half of all states, and only 2% of the 181 million Americans with employer-sponsored health insurance. 

• Hospital Medicare margins will hit an all-time low in 2019 of negative 11% according to MedPAC’s most recent estimate.

• CBO estimates that between 40-50% of hospitals could have negative margins by 2025.

•Altarum's most recent (April 2019) Health Sector Economic Indicators report notes a "history making" ongoing stretch of economy-wide prices growing faster than health care prices and hospitals are leading the way. Hospital price growth fell to its lowest level – 1.6 percent - since September 2017, and private pay prices “fell sharply” to 1.7 percent.

FAH Leader Comments on Surprise Billing Event

May 09, 2019 | Chip Kahn

Category:

No patient should ever receive a surprise medical bill. We appreciate the administration’s efforts to engage on this issue and we support a federal legislative solution that protects patients. That means ending balance billing and ensuring a patient’s cost-sharing is based on an in-network rate.

Once patients are protected, health care providers and insurers should work together to determine payment amounts for the services provided.

Ideas like “bundled payments” and rate setting may seem straightforward, but the truth is they are untested, unproven and an unnecessary government intrusion into the private market.

We look forward to working with the administration and the Congress on a solution that achieves our common goal of protecting patients.

#TBT: Hospitals Outline Solutions to Protect Patients from Surprise Bills

May 09, 2019 | FAH Policy Blog Team

Category:

In a few hours the White House is scheduled to hold an event to advocate for protecting patients from surprise medical bills.

Health care providers are united in our support of this objective.

#TBT – Over the past several month hospitals have sent letters to Congress calling for a federal legislative solution to the issue of surprise out-of-network billing.

In February, every major hospital group outlined principles for policy makers to consider as they develop solutions to address surprise billing. The letter can be found here.

In April, FAH, AHA and the AMA sent a letter to leaders on Capitol Hill that once again reiterated this point: “No patient should have the added stress and financial burden of receiving a bill for out-of-network emergency care that they could not avoid or out-of-network care that they reasonably could have expected to be in-network.”

We support a federal solution that provides patients certainty regarding their cost-sharing obligations based on an in-network amount, while providers and health plans arrive at a fair payment rate for services.

It is a simple solution that is in stark contrast to what some are calling for – hospital bundled billing.

The April letter, which can be found here, points out the pitfalls of this complex, untested concept and highlights why bunding payments is the wrong way to protect patients from surprise bills.

We appreciate the Administration’s focus on this issue and look forward to working with policy makers on practical solutions.

FAH Celebrates National Nurses Week 2019

May 06, 2019 | FAH Policy Blog Team

Category:

The Federation of American Hospitals and our member hospitals join the American Nurses Association (ANA) in celebrating National Nurses Week May 6-12. The theme for 2019 is “4 Million Reasons to Celebrate” – acknowledging the positive impact America’s 4 million registered nurses have had on the health care system.

Nurses play a vital role in delivering consistent, quality care every day in facilities across the country. The official celebration may only last a week, but every day of every year, hospitals deeply appreciate the care and compassion that nurses provide – as do our patients, their families, their communities, and the entire health care system.

Nurses deliver excellent care coast to coast – 24/7/365. Their important work cannot be overstated and is reflected in the theme of “4 Million Reasons to Celebrate” for this year’s National Nurses Week. Nurses are on the front lines of making sure patients leave medical facilities safe and healthy.

The FAH salutes the professionalism, commitment and dedication of the nurses who work in our member company hospitals and in other health care settings and we thank them for the outstanding care they deliver to our patients.

We urge everyone to track National Nurses Week on Social Media with the hashtag #NationalNursesWeek and to learn more about participating in National Nurses Week activities on the ANA website.

Each year’s National Nurses Week ends on May 12th in celebration of Florence Nightingale’s birthday, the founder of modern nursing.

FAH Leader Reacts to CBO Report on Single-Payer

May 01, 2019 | Chip Kahn

Category: Research

Today's CBO report on single-payer health care raises sobering questions. But what needs to be asked, is it worth the risk of upending health care for every American when the law on the books already contains a roadmap to universal coverage? Instead of such a high stakes gamble, lawmakers should build upon the current foundation so we can continue to improve quality and affordability for families across the country.

FAH Leader Reacts to Medicare for All Hearing

April 30, 2019 | Chip Kahn

Category: Hearings, Legislation

Today’s hearing on Medicare for All is all about unicorns. Health care coverage is too important to American families to depend on some quest for mythical aberrations. Instead, we should preserve what works. Policymakers need to focus on improving the ACA so the current law can meet its intended mission of universal coverage.

Dose of Facts: Will We Hear the Truth about Medicare for All at Today’s Hearing?

April 30, 2019 | FAH Policy Blog Team

Category: Hearings, Legislation

This morning Congress will hold it’s first ever hearing on the topic of Medicare for All. 

A wide range of witnesses are scheduled to testify before the Rules Committee this morning, but the big question remains - will we get real answers about the devastating effects Medicare for All would have on families across the country?

Before lawmakers entertain the idea of forcing patients into an untested system that will disrupt care for every American, here are some of the facts we hope they will address today:

Hospitals have long been committed to assuring that everyone has access to high quality, affordable health coverage, but Medicare for All or a Public Option aren’t the ways to accomplish that goal. We hope that after the facts come out at today’s hearing – lawmakers will agree.

Hospitals Lead Way Towards ‘History Making’ Price Growth Slowdown

April 12, 2019 | FAH Policy Blog Team

Category: Research, Spending Slowdown

Altarum released its monthly Health Sector Economic Indicators reports today, noting a “history making” ongoing stretch of economy-wide prices growing faster than health care prices. Hospitals led the way in March.

The pricing report found annual year-over-year health care price growth of only 1.2 percent in March 2019, its lowest growth rate since September 2017. Year-over-year hospital price growth also fell to its lowest point since September of 2017, falling from 1.9% in February to 1.6% in March of this year. Private pay hospital price growth “fell sharply” from 2.8 percent in February to 1.7 percent in March.  

 Altarum wonders if “the phenomenon of economy-wide prices growing more quickly than the HCPI (health care pricing index) for 19 months and counting” is indeed a “new normal.”

Regarding spending, Altarum noted that over the past 12 months, expenditures for hospital care grew 2.9% in January 2019, the slowest rate among the major categories, and a key reason why overall national health spending slowed to 4.1 percent – the 16th consecutive month health spending grew less than GDP.

To view the full reports from Altarum click here and here.

ICYMI: Sanders’ Medicare for All Means Higher Taxes, No Private Plans

April 11, 2019 | FAH Policy Blog Team

Category: Legislation

Sen. Bernie Sanders (I-VT) reintroduced the latest edition of his signature Medicare for All legislation in the Senate Wednesday, offering no mention of how it’s massive price tag will be paid for. While Sen. Sanders’ bill would add coverage for long-term care in home and community settings, it would also all but abolish private and employer-based health insurance plans.

FAH President and CEO Chip Kahn released a statement on the legislation saying, “Medicare for All's promises can't be kept. Medicare for All means that Americans would lose the coverage they trust. Medicare for All repeals the ACA, it repeals the employer-based coverage 180 million people depend upon, it repeals Medicare, it repeals Medicaid and throws millions of kids off the insurance they have today. It will force patients into an untested system that will disrupt care for every American.” To read Chip’s full statement click here.

Here’s what others are saying about this legislation:

Axios delves into “How your health care would change under ‘Medicare for All,’” highlighting the legislation’s tax increases. Axios points out “you could not keep your existing plan” and your “taxes would go up. A lot. That’s the tradeoff for eliminating premiums and deductibles. Sanders has not said which taxes he would raise.”

NBC focuses on the massive price tag associated with Sanders’ Medicare for All Plan noting that “critics challenged the new Sanders bill over its cost — $32 trillion over 10 years, according to one estimate by the conservative Mercatus Center — and its elimination of existing private plans.”

CNN’s article, "Bernie Sanders to unveil new Medicare for all bill as the party rallies around Obamacare," points out that “Sanders' plans to pay for a program that could virtually wipe out the private insurance industry. More than 150 million Americans are currently covered by private insurance through their employers and tens of millions more through Medicare Advantage. Millions more buy coverage via the Affordable Care Act's exchanges.”

An op-ed in The Hill simply states that “There are so many flaws with 'Medicare for all.'” A doctor writes that “this bill seeks utopia by giving government centralized power and control over every aspect of medicine via a single-payer model, and comes with an astronomical price tag. The cost in dollars is in the trillions, but there is also another, hidden cost: the elimination of the conscience rights of nurses and doctors.”

Politico points out that the Medicare for All bill does not include “a price tag or specifics on what tax increases would be needed to pay for a coverage expansion that analysts project could cost upwards of $30 trillion over a decade — a sticking point critics have seized on in dismissing the concept as a pipe dream.”

In another article, Axios explains how “Medicare for All redistributes who pays for health care.” It projects workers and wage earners will foot the bill of the massively expensive plan: “A 4% "income-based premium" for workers who make more than $29,000 and a 7.5% "income-based premium" on employers (exempting the first $2 million in payroll) are two of the financing options. Most economists assume that the employer tax would get passed onto employees through lost wages.”

FAH Leader Reacts to Bernie Sanders' Medicare for All Bill

April 10, 2019 | Chip Kahn

Category: Legislation

FAH President and CEO Chip Kahn released the following statement on the introduction of Bernie Sanders' Medicare for All legislation:

Medicare for All’s promises can’t be kept. Medicare for All means that Americans would lose the coverage they trust. Medicare for All repeals the ACA, it repeals the employer-based coverage 180 million people depend upon, it repeals Medicare, it repeals Medicaid and throws millions of kids off the insurance they have today.  It will force patients into an untested system that will disrupt care for every American.

Hospitals have long been committed to assuring that everyone has access to high quality, affordable health coverage, but this isn’t the way to accomplish that goal.

We oppose this bill and urge lawmakers to do the same. We should be working on increasing options and affordability for patients and consumers, not creating a one-size-fits-all system that needlessly upends coverage for hundreds of millions and limits access to care.

FAH Supports STAR Act

April 08, 2019 | FAH Policy Blog Team

Category: Legislation

FAH sent a letter to the House Ways and Means Committee Chairman Richard Neal (D-MA) and Ranking Member Kevin Brady (R-TX) in support of the Prescription Drug Sunshine, Transparency, Accountability and Reporting (STAR) Act.

In the letter, FAH applauds the Committee’s bipartisan effort to address the rising cost of prescription drugs, calling the legislation an “important step in beginning to find solutions to lower prescription drug costs for patients.” The STAR Act seeks to provide price transparency by requiring certain drug manufacturers to report on product samples provided to particular health care providers.

FAH also highlighted in the letter the recent drug pricing study we released along with the American Hospital Association (AHA) and the American Society of Health-System Pharmacists (ASHP). It detailed how continued rising drug prices, as well as shortages for many critical medications, are impacting patient care and putting strains on hospital budgets and operations. According to the study, the average total drug spending per hospital admission increased by 18.5% between FY2015 and FY2017.

To read FAH’s full support letter click here.

ICYMI: JAMA Report says Medicare for All Would Hit Hospitals Hard

April 05, 2019 | FAH Policy Blog Team

Category: Legislation, Medicare

Leads to Massive Funding Cuts, Extensive Job Losses

An article published this week in The Journal of the American Medical Association (JAMA) highlights the devastating effects of Medicare for All on community hospitals, which include massive cuts to financial resources and extensive job losses.

The authors looked at what would happen to hospital funding if a Medicare for All system extended the current fee schedule to all patients.

Among the eye-opening findings:

  • A loss of $150 billion per year to the nation’s hospitals.
  • An estimated 1.5 million in hospital clinical and administrative jobs could be cut.

If payment rates for Medicare were raised to 100% of cost - as some plans have proposed – the JAMA article says “annual Medicare spending by the federal government would increase by $40.7 billion and annual Medicaid spending by the federal and state governments would increase by $25.6 billion.”

A price tag that would have to be absorbed by American families through massive tax increases.

This is the latest report to show the destructive effects of a single-payer system or public option on hospitals and access to care.

Last month, FAH and AHA released a report showing the impact a Medicare public option could have on the ability of hospitals and health systems to continue to provide access to high-quality care to their patients and communities. The study found that such a proposal, which would create a government-run Medicare-like health plan on the individual exchange, would lead to the largest ever cut to hospitals - nearly $800 billion over 10 years. This sort of plan would also be particularly disruptive to the employer-sponsored health insurance market.

FAH Supports Bipartisan Nursing WIN Act

April 04, 2019 | Chip Kahn

Category: Legislation

FAH President and CEO Chip Kahn released the following statement on the introduction of the Nursing WIN Act:

"It’s a struggle to attract critically-needed nurses to the many parts of the United States grappling with nursing shortages. The Nursing WIN Act provides loan repayment incentives to new nursing graduates while enabling them the freedom to choose from any hospital in a critical shortage community.

"FAH applauds the bipartisan leadership of Sens. Todd Young (R-IN) and Doug Jones (D-AL) to expand eligibility for this vital program. The Nursing WIN Act provides an important lifeline for patients, communities and the new nurses that choose to serve them."

Letter to Congress from FAH, AHA & AMA on Surprise Billing

April 02, 2019 | FAH Policy Blog Team

Category:

Below is a joint letter sent to leaders of several Congressional Committees today from the Federation of American Hospitals (FAH), the American Hospital Association (AHA) and the American Medical Association (AMA) on the issue of surprise billing.

The letter shows a unified front among health care providers to protect patients from surprise medical bills, but it also points out pitfalls of the complex, untested concept of hospital bundled billing to address this important issue.

The letter was sent to the leaders of the House Energy and Commerce Committee, Ways and Means Committee & Education and Labor Committee, as well as the Senate Finance and HELP Committees.

Dear Chairman Pallone and Ranking Member Walden:
 
America’s physicians, hospitals and health systems are fully committed to protecting patients from
surprise medical bills. No patient should have the added stress and financial burden of receiving a bill for
out-of-network emergency care that they could not avoid or out-of-network care that they reasonably
could have expected to be in-network. Our organizations support a federal legislative solution to protect
patients in these scenarios that limits patients’ cost-sharing obligations to the in-network amount, and
prohibits balance billing when the opportunity for health plans and providers to arrive at a fair payment
rate is ensured.

The simplicity of the solution outlined above is in stark contrast to the complexity of another, untested
idea that has been raised as part of the important dialogue about solving this issue: hospital bundled
billing. This concept may seem simple and straightforward in theory; in reality however, this approach
would be administratively complex, fundamentally change the relationship between hospitals and their
physician partners, and alone, does nothing to protect patients from surprise bills. We strongly oppose
such a model.

Bundled billing is not appropriate for many types of medical services. For example, the unique nature of
emergency care – namely uncertainty and the potential for high variation – makes it a poor candidate for
bundled payments. Several variations of bundled payments for episodes of care have been implemented
over the past decade with mixed success. Developing such an arrangement involves a complex array of
clinicians, statisticians, lawyers and others to define the services and duration of the bundle, to
appropriately price it, and to ensure that any financial relationships between the various providers adhere
to state and federal law, including the Stark law and the Anti-Kickback Statute. To-date, bundling has
been tested by the Center for Medicare & Medicaid Innovation and some commercial payers in limited
circumstances and, in general, early results indicate it could work for services for which the clinical care
pathway is well defined and little variation is expected, such as for certain planned joint replacements.
Even so, for the vast majority of these bundles, physicians and hospitals continue to negotiate their own
rates with insurers. Any individual visit to an emergency department can involve countless possible
services – from initial diagnosis and confirmatory tests to complicated trauma and surgical procedures
involving multiple physicians and other providers, depending on an array of factors. Simply put: bundled
payments are not appropriate for emergency care and have not been sufficiently tested for widespread
adoption for other types of care.

Surprise bills are a direct result of a lack of negotiated contract between the patient’s insurer and the
hospital and/or physicians that provided their care. We support solutions that focus on arriving at a fair
payment from an insurer to a provider while protecting patients from the consequences that can arise
when an insurer lacks adequate contracted providers. In contrast, bundling facility and physician
payments in these situations simply allows insurers to transfer to hospitals their responsibility for
establishing comprehensive physician networks and managing the associated financial risk.
We should remain focused on taking patients out of the middle of standard negotiations between insurers
and providers and protecting them from “surprise bills” when they have not had the opportunity to choose
who provides their care, while rejecting unproven proposals that would up-end the foundation of
relationships that hold the health care system together.

Sincerely,

Federation of American Hospitals
American Hospital Association
American Medical Association

You can also find the letter online by clicking here.

FAH Leader Reacts to Medicare X Proposal

April 02, 2019 | Chip Kahn

Category: Legislation, Medicare

FAH President and CEO Chip Kahn released the following statement on the introduction of Medicare X legislation:

“A Medicare public option may fit on a bumper sticker, but it won’t fit with the access to health care that Americans expect.

“The public option may be well-intentioned, but it will undermine the private options available for coverage not expand them. Even worse, it will make it dramatically more difficult for hospitals and caregivers to be there to serve their patients and communities.

“Instead, we urge policymakers to focus on strengthening the Affordable Care Act and achieving the universal coverage and access to care that is the law’s aim.”

FAH Files Joint Amicus Brief in Support of the ACA

April 02, 2019 | FAH Policy Blog Team

Category: Affordable Care Act

Today, FAH joined other hospital associations in filing an amicus brief in support of upholding the Affordable Care Act (ACA) in State of Texas v. USA. The lawsuit, filed by Republican Attorneys General (AGs), led by Texas, argues that Congressional action zeroing out the ACA's individual mandate penalty makes mandate unconstitutional and the entire ACA invalid. Last December, a Texas district court judge ruled in favor of the Republican AGs, striking down the entire ACA.

Democratic Attorneys General, led by California, as well as the U.S. House of Representatives, have intervened in the lawsuit to defend the ACA, and have they appealed the case to the 5th Circuit. The administration recently told the Appeals Court that the district court decision should be affirmed, and the entire ACA should be ruled invalid.

Today's amicus brief asks the Appeals Court to reverse the district court's order declaring the individual mandate unconstitutional and declaring the rest of the ACA inseverable from the mandate. It argues that striking down the ACA will harm patients that depend on the ACA, the hospitals that serve them, and the ongoing progress in health care innovation.

You can read the amicus brief here.

FAH Leader Reacts to House Leadership's Plan to Build on the ACA

March 26, 2019 | FAH Policy Blog Team

Category: Affordable Care Act, Legislation

FAH President and CEO Chip Kahn released the following statement on House leadership's plan to build on the Affordable Care Act:

"The House leadership’s efforts to strengthen the Affordable Care Act are timely and necessary. Tens of millions of Americans depend on ACA health coverage and millions more could be covered. This is why the Federation sees the new initiative as mission critical to improve and protect care for the patients we serve.

"As caregivers, our goals have been and continue to be: increase access to affordable health care coverage for all Americans – including those with pre-existing conditions – and protect and strengthen programs that take care of seniors and our most vulnerable.

The ACA framework can accomplish these objectives. We need to build on what works. The Federation is committed to working with the Congress to ensure access to high-quality, affordable coverage and care for all Americans."

FAH Leader Reacts to Administration's ACA Statement

March 26, 2019 | FAH Policy Blog Team

Category: Affordable Care Act

FAH President and CEO Chip Kahn released the following reaction to the Trump administration's ACA statement:

"The administration’s decision to sustain Texas vs. Azar and affirm the district court ruling invalidating the entire Affordable Care Act is unfortunate but not unexpected considering their long-held views on the health law.

"Millions of Americans depend on the ACA to access health care and rely on the insurance protections afforded in the law. We continue to believe the district court judge got it wrong and trust that this decision will be overturned in the appeals process."

Senate HELP Interoperability Hearing

March 26, 2019 | FAH Policy Blog Team

Category: Hearings

This morning, the Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing to examine the recent interoperability proposed rules from the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), which are intended to implement the 21st Century Cures Act. FAH member company LifePoint Health’s Chief Medical Informatics Officer Christopher Rehm, M.D. testified before the Committee.

Making health electronic information freely available to patients, families, and health care providers has been a top priority for hospitals and health systems. In his testimony before the HELP Committee, Dr. Christopher Rehm offered a clinician’s view of some of the health IT and regulatory policies that currently hinder interoperability:

  • Complying with new regulations are time consuming and resource intensive, taking a year (or longer) for a provider organization to fully integrate into day to day work.
  • The lack of an underlying interoperability infrastructure necessary for the successful and secure sharing of medical electronic information. The security and privacy of consumers’ data could be at risk if entities with access to that data do not meet consumer expectations regarding appropriate use and safeguarding of their information.  

To address these concerns, LifePoint Health’s Dr. Rehm commended ONC’s proposals to require health IT vendors demonstrate their products are usable in a “real-world” environment, as opposed to simply a testing environment. He also highlighted the need for appropriate timelines for vendors to develop and test products and for health care providers to appropriately train and safely implement the new and/or updated technology required by the proposed regulations. Lastly, Dr. Rehm recommended an industry-backed process to independently vet and test third-party applications, particularly those entities that are not required to follow HIPAA regulations. Such vetting should ensure that these entities are meeting relevant security standards and using data appropriately (e.g., not selling it to other companies without consumers’ knowledge).

As Dr. Rehm pointed out in his testimony, interoperability is not the end goal – “it is important we all remember that deployment of health information technology, interoperability, data exchange, privacy and security are all in service of delivering the highest quality care. It is not about the technology; it is about the patients, their care and their outcomes.”

To watch the full testimony and hearing click here.

Earlier this year, FAH and AHA outlined steps towards achieving interoperability in a joint op-ed in Modern Healthcare, “Providers have made strides on interoperability; let's add urgency to finally cross the finish line.” Additionally, FAH, AHA, and other national hospital organizations released a report urging all stakeholders to unite in accelerating interoperability to fuel improved health and care, engage individuals, and promote value. The report offers pathways to improve interoperability among health information technology (IT) systems, including:

  • Security and Privacy
  • Efficient, Usable Solutions
  • Cost Effective, Enhanced Infrastructure
  • Standards that Work
  • Connecting Beyond Electronic Health Records
  • Shared Best Practices

FAH Member Facilities Named in Top 100 Hospitals of 2019

March 20, 2019 | FAH Policy Blog Team

Category: FAH News

IBM Watson Health published its 100 Top Hospitals annual study earlier this month and 21 FAH member facilities made the prestigious list.

FAH member companies represented include Ardent Health Services, Community Health Systems, HCA Healthcare, Kindred Healthcare, LifePoint Health, Prime Healthcare Services, and Tenet Healthcare.

The Watson Health study bases its list on public data, clinical quality, operational efficiency, patient satisfaction, and financial metrics. The list is then divided into groupings: teaching facilities and small, medium, and large facilities. Learn more about the IBM Watson Health study here.

FAH member hospitals in IBM Watson Health’s top 100:

  • Garden City Hospital, Garden City, MI (Prime Healthcare Systems)
  • Brandon Regional Hospital, Brandon, FL (HCA Healthcare)
  • BSA Health System, Amarillo, TX (Ardent)
  • Mercy Hospital St. Louis, St. Louis, MO (Kindred Healthcare)
  • Rose Medical Center, Denver, CO (HCA Healthcare)
  • Sky Ridge Medical Center, Lone Tree, CO (HCA Healthcare)
  • St. Mark's Hospital, Salt Lake City, UT (HCA Healthcare)
  • Mercy Hospital Oklahoma City, Oklahoma City, OK (Kindred Healthcare)
  • St. David's Medical Center, Austin, TX (HCA Healthcare)
  • Dupont Hospital, Fort Wayne, IN (Community Health Systems)
  • East Cooper Medical Center, Mt. Pleasant, SC (Tenet Healthcare)
  • East Liverpool City Hospital, East Liverpool, OH (Prime Healthcare Systems)
  • Garden Grove Hospital Medical Center, Garden Grove, CA (Prime Healthcare Systems)
  • Montclair Hospital Medical Center, Montclair, CA (Prime Healthcare Systems)
  • Mountain View Hospital, Payson, UT (HCA Healthcare)
  • West Valley Medical Center Caldwell, ID (HCA Healthcare)
  • Brigham City Community Hospital, Brigham City, UT (HCA Healthcare)
  • Lakeview Hospital, Bountiful, UT (HCA Healthcare)
  • Lone Peak Hospital, Draper, UT (HCA Healthcare)
  • San Dimas Community Hospital, San Dimas, CA (Prime Healthcare Systems)
  • Southern Tennessee Regional Health System, Lawrenceburg, TN (LifePoint Health)

For a full list of the recognized hospitals click here.

How a Medicare Public Option Could Affect Access to Care in Your State

March 18, 2019 | FAH Policy Blog Team

Category:

FAH and AHA’s newly released joint study highlights the impacts a Medicare Public Option proposal could have on the ability of hospitals and health systems to continue to provide access to the high-quality care patients and communities need and deserve. Among the effects, the proposal would inflict the largest ever cut to hospitals – nearly $800 billion – and be particularly disruptive to the employer-sponsored health insurance market. State by state, the Medicare Public Option proposal would be equally as devastating, with cuts as high as $130.6 Billion. 

The executive summary and full analysis can be found here.

Here’s how the proposal could impact your state:

State Hospital Spending Cuts 2025-2034 

AK

$ 2.1 B

AL

$ 12.8 B

AR

$ 3 B

AZ

$ 14.6 B

CA

$134 B

CO

$ 13.6 B

CT

$ 6.3 B

DC

$ 1.6 B

DE

$ 1.6 B

FL

$ 81.6 B

GA

$ 24.8 B

HI

$ 3.6 B

IA

$ 4.1 B

ID

$ 6.4 B

IL

$ 28.1 B

IN

$ 17.7 B

KS

$ 6.7 B

KY

$ 6.8 B

LA

$ 7.2 B

MA

$ 10.4 B

MD

$ 6.1 B

ME

$ 4.8 B

MI

$ 15.8 B

MN

$ 9.4 B

MO

$ 15.1 B

MS

$ 8.4 B

MT

$ 3.9 B

NC

$ 32.9 B

ND

$ 1.2 B

NE

$ 4.9 B
NH

$ 2.7 B

NJ

$ 25.1 B

NM

$ 4.6 B

NV

$ 6.7 B

NY

$ 41.3 B

OH

$ 22.6 B

OK

$ 8.4 B
OR

$ 12.8 B

PA

$ 32.6 B

RI

$ 1 B

SC

$ 13.8 B

SD

$ 2.5 B

TN

$ 15.8 B

TX

$ 91.8 B

UT

$ 9.8 B

VA

$ 23.1 B

VT

$ 0.5 B

WA

$ 19 B

WI

$ 9.3 B

WV

$ 1.3 B

WY

$ 1.4 B

Joint Statement from FAH & AHA: Hospitals Seek Common Sense Solutions to Surprise Bills

March 18, 2019 | FAH Policy Blog Team

Category: FAH News

FAH President and CEO Chip Kahn and AHA President and CEO Rick Pollack issued the following joint statement reacting to a letter from insurer and business groups on surprise bills:

"Our patients come first and the hospital community has proposed a plan to protect them from surprise bills. Consumers, health insurers, employers, and hospitals all agree and should seek a common solution.

"That solution is simple: patients should not be balance billed, and they should have certainty regarding their cost-sharing obligations based on an in-network amount.

"Beyond protecting patients and ensuring adequate health plan provider networks, it is essential that insurers and providers of care retain the ability to negotiate appropriate payment rates. Not only is it a dangerous precedent for the government to start setting rates in the private sector, but it could also create unintended consequences for patients by disrupting incentives for health plans to create comprehensive networks.

"The hospital community is actively engaged in finding solutions to this issue for our patients. We want to ensure that patients are protected from surprise gaps in coverage that result in surprise bills, and we look forward to working with policymakers to achieve this goal."

 

Navigant Study Shows “One Size Fits All” Health Care Proposals Correlates with Hospital Cuts

March 18, 2019 | FAH Policy Blog Team

Category: Legislation, Medicare

Today, the consulting firm Navigant released a study showing that government-run health care proposals, like Medicare for All, would directly result in financial stress on hospitals. This comes on the heels of a study from FAH and AHA that found a Medicare public option could have a significant impact on patient access to care by leading to the largest ever cut to hospital funding – nearly $800 billion.

Navigant found that Medicare for All-style proposals could force hospitals to limit the care they provide, drive significant “layoffs” and “potentially force the closure of essential hospitals.” Navigant projected the impact on hospitals by using a hypothetical mid-sized regional hospital as the base for comparison. This sample hospital has 1,000 beds, a $1.2 billion annual revenue, and an operating margin of 2.3%.

Using that as a baseline, Navigant found that Medicare as a single-payer, also known as Medicare for All, has the most dramatic negative impact on hospitals, cutting operating margins to -22.1% and reducing revenues by approximately $330 million. The study found that a Medicare public option would cut the hospital’s revenues by approximately $157 million and reduce operating margins to -6.3%.

Additionally, Navigant asserted that continuing the status quo does not leave hospitals unharmed. The continued migration of baby boomers from the employer-based market into Medicare, along with other contributing factors, would also result in financial stress to hospitals. Navigant estimates that this would result in a reduction of $94 million in operating margin over a “period of years.”

MedPac reports hospital Medicare margins are already at a historic low of -11%. Navigant’s Jeff Leibach says any expansion of the program "would potentially accelerate those headwinds significantly.”

Navigant’s study comes just one week after FAH and AHA released a joint study that showed the devastating impact a Medicare public option proposal would have on hospitals and the health care system. FAH and AHA’s study found that the proposal would be the biggest cut to hospitals ever – an unprecedented $774 billion.

To see the full Navigant study click here. For FAH/AHA’s study click here.

New Report Outlines Negative Impact of Medicare Public Option Proposal on Hospitals and Patients

March 12, 2019 | FAH Policy Blog Team

Category: Financing, Legislation, Medicare

August 9, 2019 Update: The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) have updated this report.  The updated findings, which reflect current legislative specifications, can be found here.  


The American Hospital Association (AHA) and the Federation of American Hospitals (FAH) today released a new report that details the impact that a Medicare public option proposal could have on the ability of hospitals and health systems to continue to provide access to high-quality care to their patients and communities. The study finds that such a proposal, which would create a government-run Medicare-like health plan on the individual exchange, could have a significant impact on patient access to care. It would create the largest ever cut to hospitals - nearly $800 billion - and be particularly disruptive to the employer-sponsored health insurance market. The study further finds these significant disruptions would result in only a modest drop in the number of uninsured compared to how many people would gain coverage through expanding the existing coverage framework. The report was prepared by KNG Health Consulting on behalf of the AHA and FAH.

“This buy-in to a Medicare-like public option may fit on a bumper sticker, but it is no solution for health care coverage. This ill-conceived program would undermine access to care and threaten the ability of providers and clinicians to meet the needs of their patients,” said FAH President and CEO Chip Kahn. “Moreover, this study highlights the disruption proposals like this would have on the private coverage Americans are satisfied with today.”

“It is not practical to disrupt coverage provided through employer-sponsored plans that already cover more than 150 million Americans. America’s hospitals and health systems remain committed to working together with policymakers to help expand coverage and reduce costs for all Americans. However, a ‘Medicare for All’ approach would impede, not advance, our shared goals,” said Tom Nickels, AHA executive vice president.

The analysis specifically examined the Medicare-X Choice Act, a proposal which would compound the stresses already faced by many of the nation’s hospitals. Providers would be reimbursed at Medicare rates under this proposal. Public programs such as Medicare and Medicaid historically reimburse providers at less than the cost of delivering services. In 2017, combined Medicare and Medicaid underpayments totaled $76.8 billion. The dramatic shift of tens of millions of Americans from private coverage to Medicare-like public coverage would destabilize commercial insurance markets and hospital finances alike, jeopardizing access to care.

Specifically, the findings in the report show that the proposal could:

  • Result in only a modest drop in the number of uninsured compared to the 9 million Americans that would gain insurance by taking advantage of the existing public/private coverage framework.
  • Lead to a significant disruption to the employer-sponsored insurance market, which provides coverage to more than 150 million Americans.
  • Lead to a cut of nearly $800 billion for hospital-based services over a 10-year period from 2024-2033, while utilization (and therefore, costs) will grow as a result of increased coverage.
  • Impact the ability of providers, many of which are already absorbing more than $200 billion in Medicare cuts, to continue to care for patients under new public plans.
  • Stifle hospitals’ ability to keep pace with new life-sustaining advances in medicine, to continue to invest in new payment and delivery models and to manage rapidly escalating drug prices.
  • Continue to put pressure on other commercial plan rates, further undermining coverage for Americans not on Medicare, as well as other unintended consequences.

A copy of the executive summary and full analysis can be found here.

FAH Leader Reacts to White House's FY2020 Budget

March 11, 2019 | Chip Kahn

Category: FAH News, Financing, Medicare

The new White House budget imposes arbitrary and blunt Medicare cuts to hospitals who care for the nation’s most vulnerable. The impact on care for seniors would be devastating. Not to mention that massive reductions would drastically reduce resources critical to care for low-income Americans and cripple efforts to stave off the looming physician shortage.

Hospitals are less and less able to cover the cost of care for Medicare patients, it is no time to gut Medicare.

Milton Johnson Receives FAH’s Mike Bromberg Lifetime Achievement Award

March 04, 2019 | FAH Policy Blog Team

Category: FAH News

The Federation of American Hospitals was honored to give its Mike Bromberg Lifetime Achievement Award to HCA’s Milton Johnson Monday morning during the FAH Annual Meeting in Washington, D.C.

Presenter Ron Rittenmeyer, Chairman of the Federation of American Hospitals gave the award to Mr. Johnson.

Milton retired as HCA’s CEO at the end of 2018, and still serves on the company’s board. He started at HCA back in 1982 and served as the Federation’s Chairman in 2017. His dynamic leadership of FAH has enabled a seamless transition to the all CEO Board that the Federation has today.

During Milton’s long and distinguished career, he came to be recognized as one of the most influential figures in the health care sector.  Johnson devoted his professional life to the nation’s health care delivery system. 

Among his notable achievements - leading HCA’s efforts to advance clinical quality throughout its hospitals. By using data from its tens of millions of patient encounters annually, HCA has identified leading clinical practices, which help to continually improve care and save lives.

Johnson has always represented the investor-owned hospital community with distinction, and there is no doubt that Milton has earned the great respect of his colleagues. He is a wise voice who has made our industry better through his knowledge, experience and understanding of the intersection of the health care, policy and politics. Health care and the very lives of millions of rural Americans have been improved by Milton’s leadership and vision.

Milton is also a valued member of his community, giving generous amounts of time and support to various charitable causes. The Nashville area and health care in America today are better for the contributions that Milton has made.

FAH President and CEO Chip Kahn offered his personal congratulations to Milton, saying “he brought leadership and wisdom to his time at the helm of HCA. I want to add to his legacy the unique role he played for the Federation in the last few years. We owe so much to him because his guidance was key to achieving our new governance structure.”

Please join us in sincerely congratulating Milton Johnson on receiving this much-deserved award.

FAH Presents Annual Corris Boyd Leadership Award to Deborah Williams

March 04, 2019 | FAH Policy Blog Team

Category: FAH News

This week the Federation of American Hospitals presented Deborah Williams, Senior Director of Program Management at Premier Inc., with the 13th annual Corris Boyd Leadership Award.  Williams was honored March 4th during the FAH Annual Meeting in Washington, D.C.

Presenter Ken Kuiper, Chairman of the FAH Exposition Advisory Committee, was joined on stage by a special guest – Corris Boyd’s wife, Vanessa.

“This award is given annually in memory of our late friend. Corris Boyd was an exceptional person and an outstanding leader in workplace diversity. This award is our way of keeping his legacy of excellence going and we are so happy to have Vanessa here to take part,” Kuiper said.

It has become a tradition to surprise the winner and this year was no different. Ms. Williams was unaware of the honor until her name was called.

Nominators used words like diligence, coach, mentor, positive drive and instrumental to describe Ms. Williams. As one wrote, Ms. Williams has “propelled positive and measurable changes” in her industry. She has been “instrumental in working with diverse suppliers and our members to help contribute to the overall economic growth and well-being of the communities in which we live and work.”

But if you talk to those who know her best, they will highlight not only her professional accolades but her personal attributes. Her passion for coaching and mentoring, her desire to see others succeed, and her dedication to diversity.

Deborah Williams has served the health care industry for nearly 40 years – specializing in supplier diversity, ensuring minority, women - and veteran-owned suppliers and small businesses receive the resources they need.

Deborah Williams is an amazing example of what our industry strives to achieve.

The Corris Boyd Leadership Award honors an individual or company that has made an outstanding contribution in fostering leadership in the health care industry.   The FAH established the Corris Boyd Leadership in 2007 to honor the late Corris Boyd, who spent his career working with hospital management companies and group purchasing organizations.  Corris Boyd committed his life to diversity and excellence in health care. He believed that leadership development is crucial to success and was devoted to the success of minority- and women-owned business enterprises.

FAH is honored to present Deborah Williams as the 2019 Corris Boyd Award winner and extends its thanks for her outstanding work which embodies the ideals the award represents.

HCA Healthcare Named a 2019 World’s Most Ethical Company

March 01, 2019 | FAH Policy Blog Team

Category:

HCA Healthcare has been recognized for the 10th consecutive year as one of The World’s Most Ethical Companies by The Ethisphere Institute, a global leader in defining and advancing the standards of ethical business practices.

Sam Hazen, Chief Executive Officer of HCA Healthcare, said that being recognized for the 10th year in a row “reflects the culture we have built here at HCA Healthcare. We have 265,000 colleagues who share a strong sense of purpose to improve the lives of our patients and to enrich the communities we serve.”

The World’s Most Ethical Companies assessment follows the Ethisphere Institute’s Ethics Quotient framework, evaluating the following criteria:

  • corporate citizenship and responsibility
  • ethics and compliance program
  • corporate governance leadership
  • innovation and reputation
  • culture of ethics

Please join FAH in congratulating HCA Healthcare on this honor.

To learn more about how HCA earned this recognition, visit their website at HCA Today Blog.

FAH Leader Speaks at Nashville Health Care Council

February 27, 2019 | FAH Policy Blog Team

Category:

Today, the Nashville Health Care Council hosted a discussion about the future of health care featuring FAH’s Chip Kahn and Matt Eyles, president and CEO of America’s Health Insurance Plans (AHIP). Kahn and Eyles spoke to a crowd of 250 Council members in a conversation moderated by Melinda Buntin, professor and Mike Curb Chair, Department of Health Policy, Vanderbilt University Medical Center.

The discussion ranged from topics like House Democrats’ introduction of Medicare for All legislation, the Partnership for America’s Health Care Future, rising drug costs, surprise billing and more.

When addressing Medicare for All, Kahn stated that, “Once President Trump was elected and Bernie Sanders continued to tout Medicare for All, I thought that we in the industry really needed to take the momentum for it seriously. We are for having everyone covered, but we already have a structure for how to do this—the ACA. As an industry, we needed to have some counter-messaging around why Medicare For All is not the way to go.” 

Read Nashville Health Care Council’s full coverage of the event here.

FAH Leader Reacts to Medicare for All Bill

February 27, 2019 | Chip Kahn

Category: Legislation, Medicare

"Hospitals oppose legislation that would needlessly upend coverage for hundreds of millions of Americans. We have long been committed to assuring that everyone has access to high quality, affordable health coverage. This legislation eliminates private health insurance and would lead to a massive disruption in care for patients."

Before the Finger Pointing Begins – Here are the Facts about Drug Costs

February 26, 2019 | FAH Policy Blog Team

Category: Hearings, Pharmaceuticals

This morning the leaders of seven major pharmaceutical companies are going to testify before the Senate Finance Committee. It is widely expected that they will downplay their role in the out-of-control price increases for lifesaving drugs needed by American families.

But the truth – skyrocketing drug costs and shortages are causing a crisis across the health care system,

Just last month, a joint study released by the Federation of American Hospitals (FAH), the American Hospital Association (AHA), and the American Society of Health-System Pharmacists (ASHP) found that continued rising drug prices, as well as shortages for many critical medications, are impacting patient care and putting strains on hospital budgets and operations.

Key findings include:

  • Average total drug spending per hospital admission increased by 18.5% between FY2015 and FY2017.
  • Outpatient drug spending per admission increased by 28.7% while inpatient drug spending per admission increased by 9.6% between FY2015 and FY2017. This 9.6% increase was on top of the 38% increase in inpatient drug spending between FY2013 and FY2015 included in the previous report.
  • Very large percentage increases (over 80%) of unit price were seen across different classes of drugs, including those for anesthetics, parenteral solutions, and chemotherapy.
  • Over 90% of surveyed hospitals reported having to identify alternative therapies to manage spending.
  • One in four hospitals had to cut staff to mitigate budget pressures.
  • Almost 80% of hospitals found it extremely challenging to obtain drugs experiencing shortages, while almost 80% also said that drug shortages resulted in increased spending on drugs to a moderate or large extent.

The full report can be found HERE. You can view a short video explaining the issue HERE and find an infographic HERE.

The report was prepared based on analysis conducted by NORC at the University of Chicago, an independent research institution.

FAH, Major Hospital Groups Outline Surprise Billing Solutions in Letter to Congress

February 20, 2019 | FAH Policy Blog Team

Category: Financing

This afternoon, the Federation of American Hospitals, along with five major hospital groups, sent a letter laying out principles for Congress to consider as it develops solutions to address surprise billing.

“No patient should be surprised by a medical bill. We are fully committed to working with Congress to protect our patients from the stress and financial burden of surprise bills,” said Chip Kahn, FAH President and CEO.

Joining the Federation on the letter were the American Hospital Association, America’s Essential Hospitals, Association of American Medical Colleges, Catholic Health Association of the United States and the Children’s Hospital Association.

You can find the complete letter here

Hospital Mergers & Quality

February 15, 2019 | FAH Policy Blog Team

Category: Quality

The funny thing about studies is that no matter the topic you can almost always find “evidence” to prove what you have already decided to be true – whether it is based in fact or not.

This is the case with the recent opinion piece in the New York Times written by Austin Frakt entitled “Hospital Mergers Improve Health? Evidence Shows the Opposite.”

The issues begin with his title when he uses the word evidence. Frakt’s attack on the quality of care in consolidated U.S. hospitals is based largely on a mix of studies none of which allow one to make that claim. Most of the studies he mentions examine health care in the United Kingdom or outcomes at physician practices. As the old adage says – this is comparing apples to oranges.

The truth is that the studies he mentions have serious limitations that prevent us from making broad generalizations; some of the studies look at single year time frames, some look at specific conditions. Others only find marginal results in very small sub-populations. Few have a comparison group. Most only look at mortality in a single procedure.

There are studies published by the Robert Wood Johnson Foundation and the Journal of the American Medical Association that point to the positive effect on quality associated with hospital mergers. Positives like improvements in quality and reductions in mortality. Conveniently, these are not mentioned in the article.

Among the benefits of hospital consolidation is a way to reduce care fragmentation and improve outcomes and efficiencies through economies of scale.

Hospitals are facing increasing cost pressures as well as payments from government programs like Medicare and Medicaid that fall far below the cost of care.  Consolidation can save hospitals from closure and ensure communities have access to needed care.

Before jumping to conclusions we need to make sure we are comparing apples to apples and using current, complete, and meaningful data. At this point the literature looking into the association of competition and quality is nascent, riddled with limitations, non-generalizable and as a whole inconclusive. The jury is still out – more rigorous and longitudinal research is needed. In the meantime, we need to refrain from misleading conclusions that consolidation does not improve, or even worsens quality.

ICYMI: FAH Statement on Medicare Buy-in Legislation

February 14, 2019 | FAH Policy Blog Team

Category: Legislation, Media

FAH President and CEO Chip Kahn released a statement yesterday following the introduction of legislation that would allow people over 50 to buy into Medicare.

 

National media took note of FAH’s comment, stating the Federation “came out swinging” against the one size fits all plan.

 

In Case You Missed It…

 

Washington Examiner’s article “Democrats seeking Obamacare fix before ‘Medicare for all’ roll out 'Medicare at 50’” highlighted Kahn’s statement emphasizing the importance of Medicare, saying it “works for seniors and others who depend on it. But expanding the program with hospitals facing the lowest Medicare margins in history will make it more difficult to provide the critical care that all Americans expect and deserve."


Politico Pulse, a daily newsletter, said the Federation “came out swinging” against the Medicare buy-in bill. The article “Push for Medicare buy-in picks up with '50 and over' bill” published on Politico’s website said FAH warned against the financial pressure on hospitals that serve large Medicare populations.

 

Modern Healthcare highlighted Kahn’s statement in “Medicare buy-in at 50 leads way for Democratic public-option proposals,” focusing on his plan for next steps, saying Congress should work to "sustain and expand affordable private coverage."

 

Bloomberg Government included FAH President and CEO’s statement in “‘Medicare for More’ Campaign Kicks Off With Buy-In Legislation.” Bloomberg’s coverage included that expansion would hurt those currently in Medicare. “Instead of focusing on Medicare buy-ins and other variations of single-payer proposals, Congress should work to sustain and expand affordable private coverage,” Chip Kahn, president and chief executive officer of the Federation of American Hospitals, said in a statement. “Medicare should be left alone to continue its successful mission of making sure seniors have access to care.”

 

Yahoo Finance’s article “Senators introduce bill to allow people to buy into Medicare at age 50” also called attention to FAH’s opposition by acknowledging that it would weaken coverage for Americans already enrolled in Medicare.

 

FAH Leader Chip Kahn’s statement was also included in:

 

ThinkProgress: Major hospital lobbying group comes out against 'Medicare at 50' bill

 

Splint: A Preview of the Bloody Uphill Battle for Single-Payer

 

Money and Markets: Moderate Dems Shift Gear From Far Left’s Single-Payer to ‘Medicare for More’

 

WPRI: Reed, Whitehouse want Medicare coverage offered to 50-year-olds

FAH Leader Comments on Medicaid Buy-In Bill

February 14, 2019 | Chip Kahn

Category: Legislation, Medicaid

The FAH is unwavering in its strong support for expanding coverage to Americans who lack insurance. However, we shouldn’t waive the white flag on Medicaid expansion and leave millions of Americans in the coverage gap.  Any legislation to expand coverage must avoid disrupting the insurance millions of Americans already depend on. Instead, we should focus on encouraging more states to expand Medicaid to their low-income residents.

FAH Leader Reacts to Medicare Buy-In Bill

February 13, 2019 | Chip Kahn

Category: Affordable Care Act, FAH News, Legislation, Medicare

The so-called Medicare buy-in for those over 50 would harm more Americans than it would help. That is why we strongly oppose this legislation.

Allowing more people into Medicare actually weakens the coverage options of people who currently depend on the individual insurance market, leaving them with fewer choices.

There is no question that Medicare works for seniors and others who depend on it. But expanding the program with hospitals facing the lowest Medicare margins in history will make it more difficult to provide the critical care that all Americans expect and deserve.

Instead of focusing on Medicare buy-ins and other variations of single-payer proposals, Congress should work to sustain and expand affordable private coverage. Medicare should be left alone to continue its successful mission of making sure seniors have access to care.

HCA Healthcare Ranked in Top Health Systems for Quality Care by Advisory Board

February 12, 2019 | FAH Policy Blog Team

Category: FAH News

In a recent survey published by Reaction Data, FAH member HCA Healthcare of was ranked a top eight health system for delivering high quality care at a sustainable cost.

The survey polled over 300 hospital and health system leaders to identify the leading national organizations for various achievements.

When respondents were asked, "What health care system comes to mind as a model for delivering high quality care at a sustainable cost?", the eight most-cited hospitals were:

Kaiser Permanente;
Cleveland Clinic;
Mayo Clinic;
Intermountain Healthcare;
Geisinger Health;
Johns Hopkins;
Advocate Health; and
HCA Healthcare (Nashville, Tennessee).

Please join FAH in congratulating HCA on this honor.

For more information regarding the top ranked health care systems, including the full survey, can be found on Advisory.

FAH, AHA Leaders Outline Steps to Interoperability in Modern Healthcare

February 11, 2019 | FAH Policy Blog Team

Category: Publications

FAH CEO and President Chip Kahn and AHA CEO and President Rick Pollack wrote a joint op-ed in the most recent edition of Modern Healthcare discussing the importance of interoperability to the health care system and the six pathways to achieve full interoperability.

The op-ed, entitled “Providers have made strides on interoperability; let's add urgency to finally cross the finish line,” details the current state of interoperability and the progress that has been made in recent years toward achieving full, secure transferring of health information between patients, families, and providers.

This builds upon a report released last month by FAH, AHA and several other national hospital associations.

Kahn and Pollack explain that despite “commendable progress, our system of sharing, securing and transferring complete patient health data is still limited in many cases by differing vendor platforms, geographic region, inconsistent use of standards and other factors.”

The FAH and AHA leaders recommend six pathways to advance a system that works for everyone:

Security and privacy. Stakeholders must be able to trust that shared data is accurate, secure and used in accordance with best practices and patient expectations.
Efficient, usable solutions. Data must be available where and when it is needed and in a useful format.
Enhanced infrastructure. The infrastructure to connect information-sharing networks will require consistent use of standards, semantics and a common set of “rules of the road” for exchange.
Standards that work. Connected systems require standards implemented to minimize proprietary solutions and gatekeeping.
Beyond EHRs. Interoperable systems must expand to include population health, the social determinants of health and patient-generated data.
Best practices. All stakeholders should exchange best practices so we can continue to build on what works.

Full interoperability will benefit patients, families, and the entire health care system, meaning improved quality, safety, and efficiency. Tremendous progress has been made thus far, but Kahn and Pollack leave readers with a call to action: “we’ve come far and the finish line is in sight. Let’s cross over it.”

FAH, AHA Briefing Drug Prices Draws Full House on Capitol Hill

February 08, 2019 | FAH Policy Blog Team

Category: Pharmaceuticals, Research

The Federation of American Hospitals along with the American Hospital Association (AHA) and the American Society of Health-System Pharmacists (ASHP) held a briefing on Capitol Hill this week to present the findings from a recent joint study on drug pricing.

Presenting to a room packed with Congressional staffers and media members, the expert panel detailed the burden of skyrocketing drug prices on hospitals and outlined market-based solutions to ensure patients receive quality and affordable medicines.

The panel included Martin VanTrieste, president and CEO of Civica Rx; Jack Hoadley, research professor emeritus at Georgetown University's Health Policy Institute; Molly Smith, AHA vice president for coverage and state issues; and Erik Rasmussen, AHA vice president of federal relations. 

Panelists used real-world examples to illustrate how relentless drug price increases and frequent shortages are eroding hospitals' ability to care for patients. They also highlighted these main findings from the study, including:

  • Average total drug spending per hospital admission increased by 18.5% between FY2015 and FY2017.
  • Outpatient drug spending per admission increased by 28.7% while inpatient drug spending per admission increased by 9.6% between FY2015 and FY2017. This 9.6% increase was on top of the 38% increase in inpatient drug spending between FY2013 and FY2015 included in the previous report.
  • Very large percentage increases (over 80%) of unit price were seen across different classes of drugs, including those for anaesthetics, parenteral solutions, and chemotherapy.
  • Over 90% of surveyed hospitals reported having to identify alternative therapies to manage spending.
  • One in four hospitals had to cut staff to mitigate budget pressures.
  • Almost 80% of hospitals found it extremely challenging to obtain drugs experiencing shortages, while almost 80% also said that drug shortages resulted in increased spending on drugs to a moderate or large extent.

The full report can be found HERE. You can view a short video explaining the issue HERE and find an infographic HERE.

FAH Strengthens Public Affairs Team

February 07, 2019 | Chip Kahn

Category: FAH News

Welcomes Caitlin Gallagher, New Director of Media and Communications, Paige Mihalik Promoted to Director, Digital and Political Affairs

The Federation of American Hospitals is pleased to announce two moves that will strengthen our public affairs team further enhancing our efforts to advocate for the patients and communities served by our hospitals.

Paige Mihalik is being promoted to Director, Digital and Political Affairs.

Paige has been with the Federation for more than three years and during that time she has been responsible for the FAH’s political action committee and grassroots programs.  She has also grown the Federation’s social media footprint and played an integral role in the successful launch of our podcast series – Hospitals In Focus.

Paige will continue her leadership role in political affairs and will take an enhanced role in the association’s public affairs’ digital efforts.  Before joining FAH, she was active in the political affairs field working on compliance issues.

Paige is a graduate of Florida Gulf Coast University.

Caitlin Gallagher is joining FAH as our new Director, Media and Communications.

Caitlin’s experience both on political campaigns and on Capitol Hill will bring tremendous value to our public affairs team.

She most recently served as Press Secretary for the National Republican Senatorial Committee. She also worked in the Washington office of Senator John Cornyn (R-TX) and on the presidential campaign of Jeb Bush.

Caitlin will play a key role in the FAH media outreach strategy, which includes telling compelling stories from our member companies and promoting patient-centered messages across our social media channels. 

Caitlin is an alum of Baylor University.

FAH Announced New Board Chair, New Member

February 06, 2019 | FAH Policy Blog Team

Category: FAH News

The Federation of American Hospitals (FAH) announced its Board of Directors and Chairman for 2019. We are also excited to welcome a new member – Prime Healthcare.

The FAH board is comprised of the leaders of member companies. The 2019 Chair will be Ron Rittenmeyer, Executive Chairman and CEO of Tenet Healthcare.

“Health care will continue to be at the forefront of political and policy debates in the upcoming year. The FAH Board, with Ron as our leader, is well positioned to advocate for common sense solutions that will protect our ability to care for patients and meet the challenges that threaten the ability of hospitals to serve their communities.” said Chip Kahn, President and CEO of FAH.

“I am pleased to become Chair of the Federation for what is shaping up to be a pivotal year for health care policy. FAH members will continue building a strong advocacy platform that gives a clear voice to patients and their healthcare needs. We remain steadfast in our commitment to provide important perspectives to policymakers and drive solutions that we believe will improve the delivery of care in the communities we serve,” said Rittenmeyer. 

Prime Healthcare is also joining FAH in 2019.

Prime Healthcare is a leading health system dedicated to its mission of "Saving Hospitals, Saving Jobs, Saving Lives." It has 45 hospitals in 14 states and employs more than 40,000 people. Prem Reddy, MD, Prime Healthcare’s Chairman, President and CEO, has joined the FAH Board.

“The Federation welcomes Prime Healthcare to our membership. Since its founding, Prime Healthcare has been committed to assuring patients access to high-quality hospital care in their own communities. Dr. Reddy has been extremely successful as an entrepreneur, physician, and philanthropist. We look forward to him bringing his leadership and experience to the Federation,” added Kahn.

“Prime Healthcare shares the Federation’s focus on making sure America’s hospitals provide the best treatment possible for the patients who depend on us,” said Dr. Reddy.

Adding, “For more than 50 years the Federation has built a reputation in Washington of being an organization that focuses on constructive, patient-centered policy and political solutions to the issues facing our nation’s health care system. I look forward to working with Chip and the leadership at FAH and sharing our experience in revitalizing community hospitals as we deliver on our shared mission to provide quality care to the patients and families we serve.”

Members of the FAH Board of Directors for 2019 include:

CHAIR

Ronald A. Rittenmeyer
Executive Chairman and CEO
Tenet Healthcare

DIRECTORS

Benjamin Breier
President and CEO
Kindred Healthcare, Inc.                                                                

David Dill
President and CEO
LifePoint Health

Ralph de la Torre, MD
Chairman and CEO
Steward Health Care System LLC

Samuel N. Hazen
Chief Executive Officer
HCA

Alan B. Miller
Chairman and CEO
Universal Health Services, Inc.

Prem Reddy, MD
Chairman, President and CEO
Prime Healthcare

Wayne T. Smith
Chairman and CEO
Community Health Systems

Mark J. Tarr
President and CEO
Encompass Health

David T. Vandewater
President & CEO
Ardent Health Services

New Study on Hospital Prices Uses Limited Data to Draw Flawed Conclusions

February 05, 2019 | FAH Policy Blog Team

Category: FAH News, Financing

FACT: Hospital Price Growth Across All Payers Averages Just 1.8% Over Last Three Years

A study published by Health Affairs on Monday evening uses limited, old data to draw flawed conclusions about hospital prices.

The groups of six researchers based their study on the Health Care Cost Institute's (HCCI) limited claims data for people with employer-sponsored insurance from Aetna, Humana and United Healthcare Group (which recently announced it was dropping out of HCCI). It is noteworthy that this data base is not comprehensive – covering only 27.6% of individuals who have employer-sponsored coverage.

The researchers also focused on data going back 12 years - from 2007 to 2014 - completely ignoring recent trends of slowing hospital price and spending growth.

The January 2019 report from the Altarum Center for Value in Health Care shows that hospital price growth across all payers averaged just 1.8 percent over the last three years (2016 through 2018). Altarum also found that hospital year over year spending growth through November 2018 was lower than all other categories of services, including physician and clinical services and prescription drugs.

In comparing differential price growth between hospitals and physicians, the researchers also didn’t take into account the significant costs borne by hospitals that do not apply to physicians.

According to data from the American Hospital Association, it is estimated that nationally hospitals, health systems and post-acute providers spend nearly $39 billion annually on the administrative aspects of regulatory compliance. And an average-sized community hospital spends $7.6 million per year, or $1,200 per admission, to support compliance with regulations from just four federal agencies.

The report in Health Affairs also ignores other consequential costs that hospitals bear in order to provide lifesaving care to anyone who comes through their doors 24/7 – costs like purchasing drugs and medical devices.

A recent study conducted for FAH and AHA found that the average total drug spending by hospitals per admission increased 18.5% between fiscal years 2015 and 2017 – the main driver was price increases from pharmaceutical companies.

It is estimated that during the period that the researchers studied, 2007 to 2014, hospitals invested more than $300 billion in health information technology operating and capital expenses.

Clearly these researchers were looking in the rearview mirror and didn’t dig deep enough into current data and trends - while ignoring cost pressures hospitals face providing care for the patients and communities they serve. We hope this isn’t overlooked in the future.     

New Report From National Hospital Associations Outlines Agenda for Interoperability

January 22, 2019 | FAH Policy Blog Team

Category: FAH News, Health Care Delivery

Seven leading national hospital associations released a report urging all stakeholders to unite in accelerating interoperability to fuel improved health and care, engage individuals, and promote value.

The report, Sharing Data, Saving Lives: The Hospital Agenda for Interoperability, sets forth pathways to improve interoperability among health information technology (IT) systems—a goal that holds great promise for lasting improvement in patient care.

“We see interoperability in action all around us. Mobile phones can call each other regardless of make, model, or operating system. The hospital field has made good headway, but it’s time to complete the job. We are united in calling for a truly interoperable system that allows all providers and patients to benefit from shared health records and data, leading to fully informed care decisions,” said AHA President and CEO Rick Pollack.

“For the best care today, it’s the data stupid. Quality care depends on having the right information at the right time so our patient’s records need to be available in the hospital or wherever our patients receive care. Hospitals are joining together to support improving interoperability because it is the key to assuring the best for our patients,” said Federation of American Hospitals President and CEO Chip Kahn.

Hospitals and health systems are making progress in sharing health information, with 93 percent making records available to patients online and 88 percent sharing records with ambulatory care providers outside their system. They have worked to create the most interoperable systems possible given the tools available to them, but at great cost and effort. Working with policymakers and other stakeholders, hospitals and health systems believe the following elements are the pathway to advance interoperability:

  1. Security and Privacy
  2. Efficient, Usable Solutions
  3. Cost Effective, Enhanced Infrastructure
  4. Standards that Work
  5. Connecting Beyond Electronic Health Records
  6. Shared Best Practices

The report further discusses the benefits of fully interoperable data for patients and providers, outlines current challenges, and provides suggestions for how all stakeholders can work together to achieve the goal of the best possible health for each individual.

The contributors to this report include: America’s Essential Hospitals, American Hospital Association, Association of American Medical Colleges, Catholic Health Association of the United States, Children’s Hospital Association, Federation of American Hospitals and the National Association for Behavioral Healthcare. Click here to view the report and click here to view the infographic.

New Report Shows Impact of Rising Drug Prices and Drug Shortages on Patients and Hospitals

January 15, 2019 | FAH Policy Blog Team

Category: Pharmaceuticals, Research

Today, the Federation of American Hospitals (FAH), the American Hospital Association (AHA), and the American Society of Health-System Pharmacists (ASHP) released a new report finding that continued rising drug prices, as well as shortages for many critical medications, are impacting patient care and putting strains on hospital budgets and operations. The report was prepared based on analysis conducted by NORC at the University of Chicago, an independent research institution.

“We see a developing crisis. Relentless drug price increases and all too frequent shortages of critical medications are eroding the capacity of hospitals to provide our patients needed care,” said FAH president and CEO Chip Kahn. “We believe policymakers should act now to protect patients.”

“This report confirms that we are in the midst of a prescription drug spending crisis that threatens patient access to care and hospitals’ and health systems’ ability to provide the highest quality of care,” said AHA president and CEO Rick Pollack. “Solutions must be worked on to rein in out-of-control drug prices and ease the drug shortages that are putting a strain on patient care.”

“ASHP is at the forefront of efforts to combat the systemic impact of ongoing drug shortages and rapidly rising drug prices,” said ASHP CEO Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP. “By working with government agencies and partners such as AHA and FAH, we will continue to offer policy solutions and a roadmap for the changes necessary to ensure optimal care for patients.”

This report updates and expands on a previous AHA/FAH report from 2016 on skyrocketing inpatient hospital drug cost increases by also analyzing outpatient drug costs and the impact of drug shortages. The report found that hospital budget pressures resulting from the continued dramatic increases in drug prices have negative impacts on patient care, with hospitals being forced to delay infrastructure investments, reduce staffing, and identify alternative therapies. Hospitals also struggle with drug shortages, which can disrupt typical work patterns and patient care, and often require significant staff time to address. 

Specifically, the report showed that:

  • Average total drug spending per hospital admission increased by 18.5% between FY2015 and FY2017.
  • Outpatient drug spending per admission increased by 28.7% while inpatient drug spending per admission increased by 9.6% between FY2015 and FY2017. This 9.6% increase was on top of the 38% increase in inpatient drug spending between FY2013 and FY2015 included in the previous report.
  • Very large percentage increases (over 80%) of unit price were seen across different classes of drugs, including those for anesthetics, parenteral solutions, and chemotherapy.
  • Over 90% of surveyed hospitals reported having to identify alternative therapies to manage spending.
  • One in four hospitals had to cut staff to mitigate budget pressures.
  • Almost 80% of hospitals found it extremely challenging to obtain drugs experiencing shortages, while almost 80% also said that drug shortages resulted in increased spending on drugs to a moderate or large extent.

The full report can be found HERE. You can view a short video explaining the issue HERE and find an infographic HERE.

FAH Leader Expresses Opposition to Ruling that Overturns 340B Medicare Regulation

January 02, 2019 | Chip Kahn

Category: Financing, Medicare, Pharmaceuticals

The DC Federal District Court’s ruling to stop reforms to Medicare payment for drugs acquired under the 340B drug discount program is unfortunate because it undermines HHS efforts to cut drug costs and promote fairer payments.

The current HHS policy will ultimately lower drug costs for patients. It also benefits the vast majority of hospitals, including some 80 percent of rural facilities. 

This ruling puts all those benefits at risk

We look forward to an appeals process that will recognize HHS authority to advance these program improvements.