Hospitals In Focus Federation of American Hospitals & Voxtopica

Good health care depends on good health coverage, particularly for the most vulnerable. The Affordable Care Act expanded Medicaid eligibility and created exchanges where many Americans could access health insurance, often at a subsidized price. These new pathways to affordable coverage led to the uninsured rate dropping to record lows.

Unfortunately, those recent gains in coverage and access now face new hurdles. After the end of the Covid public health emergency, states began a process of redetermining Medicaid eligibility which caused tens of millions to lose coverage. Many were forced to find a new source of insurance coverage, or lost it completely. 

The passage of the Inflation Reduction Act created enhanced subsidies for individuals seeking insurance on the ACA marketplace exchanges, leading to a record high enrollment this year. Those subsidies are set to expire in 2025.  Unless Congress steps in, this could increase premiums, making coverage too expensive for many, threatening access to health care. 

In this episode, Stan Dorn, who has worked on coverage issues for almost 40 years and currently serves as the Director of the Health Policy Project at UnidosUS, explains what these dual threats to coverage mean for individuals and their families.

Topics discussed include:
Current state of the Medicaid redetermination process and its impact on coverage for recipientsCongressional action needed to avoid looming marketplace coverage cliff  Long-term policy changes that will improve the ACA by protecting Medicaid expansion and continuing affordability in the exchange marketplaceMORE: 
UnidosUS, previously known as NCLR (National Council of La Raza), is the nation’s largest Hispanic civil rights and advocacy organization. Through a unique combination of expert research, advocacy programs, and an Affiliate Network of nearly 300 community-based organizations across the United States and Puerto Rico, UnidosUS simultaneously challenges the social, economic, and political barriers that affect Latinos at the national and local levels. When it comes to health care, the group is focused on ensuring access to affordable coverage with an emphasis on helping people through the Medicaid unwinding process and enrolling them in exchange plans.

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

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

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

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

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