Rick Pollack, president and CEO of the American Hospital Association, envisions a future where the iconic “H” comes to symbolize much more than a building where people go for acute inpatient care.

“I hope that in 10 years we have more of a focus on prevention,” he told Fixing Healthcare cohosts Dr. Robert Pearl and Jeremy Corr. “I hope we have more integrated delivery systems that are providing the care to people where they’re not bounced around from one unconnected facility to the next. I would hope that 10 years from now, we’re in a position where there is a real focus on ensuring that people get care in a very convenient way. I hope in 10 years, we will have built on the Affordable Care Act to get to almost universal coverage.”

Pollack acknowledges that hospitals aren’t there yet. But as the head of the AHA, he has called on the organization’s nearly 5,000 members to reevaluate, reboot and reimagine care so that, together, they can create a better future for American patients.

“We support hospitals that mandate vaccines for their employees, and we’ve worked really closely with the American Medical Association and the American Nurses Association and encouraging the public to get vaccinated. We’ve been involved in all sorts of public service announcement campaigns, and we’ve been working with the Black Physicians against COVID. We’ve been working with a lot of different coalitions to encourage people to get vaccinated, to make the case of why it’s important and why it’s safe.”

“We worked hard on the Affordable Care Act. We supported it. We defended it in the courts. We still continue to believe that that is a platform on which to build, both in terms of expanding coverage, building on the delivery system reforms that were inherent in it and, certainly, the quality improvements that were a part of it … I think that the Affordable Care Act is still the basis for the future.”

“We probably couldn’t have created a more complicated system if we tried, when it comes to the billing system. And we have been engaged in various, what we call, ‘patient friendly billing initiatives’ … to try to make things more comprehensible. And that is ongoing. But at the end of the day, the real way to get at this problem is through prepaid care or capitation or some form of prepayment, which really doesn’t involve focusing on line-items … That’s the ultimate solution for the puzzle that we’ve got going on right now.”

“We need to think about the rural hospital more as a network of caring there as a building … So much of our healthcare expense and need in the future is going to be managing chronic conditions. Fact of the matter is most people want to have those situations or conditions managed at home. They don’t want to have to leave their community for care. So, for rural hospitals, they also need to be thinking about different pathways for the future. They need to be thinking about how they redefine who they are, what they are and what they do.”

“The issue that is on the minds of most hospital CEOs that I talked to, and I talked to a lot of them all the time, you ask them what their priorities are and it’s workforce, workforce, workforce, resiliency, resiliency, resiliency. Right now, it’s not an issue of having enough supplies. It’s not an issue of having enough equipment. It’s not even an issue sometimes of having enough beds. The issue is really having the staff available … And there is no higher priority than ensuring that our workforce is taken care of. Without them, the system breaks down. Simple as that.”

READ: Full transcript with Rick Pollack 

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Dr. Robert Pearl is the author of a new book about medicine’s invisible yet highly influential physician culture. Check out “Uncaring: How Physician Culture Is Killing Doctors & Patients.”

Fixing Healthcare is a co-production of Dr. Robert Pearl and Jeremy Corr. Subscribe to the show via Apple, Google, Spotify, Stitcher or wherever you find podcasts. Join the conversation or suggest a guest by following the show on Twitter and LinkedIn.

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