In this episode of Hospitals in Focus, we revisit a vital topic—disaster preparedness and response. Hurricanes Helene and Milton caused devastating impacts across the Southeast, including catastrophic flooding in Asheville, North Carolina. FAH-member HCA Healthcare stepped up to the challenge, and their Mission Hospital became a beacon of resilience, treating over 500 emergency patients in the first hours after Hurricane Helene, flying in 400 nurses and 40 physicians from sister facilities, and ensuring the community had access to essential services.

Michael Wargo, HCA Healthcare’s Vice President of Enterprise Preparedness & Emergency Operations, provides listeners with a 360-degree view of emergency preparedness. Mike shares lessons learned, the importance of planning for the “known unknowns,” and how HCA’s leadership prioritizes readiness at all levels. Chip and Mike also explore broader considerations for disaster recovery, from practical on-the-ground strategies to policy changes so hospitals can remain resilient in the face of future disasters.

Key Topics Covered:

• HCA’s approach to readiness with the five “R’s” of emergency operations;
• Mission Hospital’s hurricane response;
• Leadership’s role in fostering a culture of preparedness; and,
• Recovery efforts and challenges taxpaying hospitals face, including the need for commonsense, bipartisan policies to support these critical institutions. 

Guest Bio: 

Mr. Michael Wargo serves as HCA Healthcare’s enterprise Vice President for Preparedness & Emergency Operations based in Nashville, TN. Mike joined HCA Healthcare in 2016 as the Assistant VP of Enterprise Emergency Operations, a role in which he was tasked to redesign and lead the organization’s disaster and emergency operations program in readiness, response, and recovery from adverse natural and man-made incidents across both the U.S. and the metro London area of the UK. Mike brings more than 25 years of clinical experience in high quality, patient centered care and nearly two decades in public safety leadership. Mike is the Executive Officer and immediate past Chair of the U.S. Health and Public Health Sector Coordination Council of the National Critical Infrastructure Protection Program sanctioned by Homeland Security Presidential Directive 21. In this role, he collaborates and serves as a trusted advisor to both federal secretary-level & SES leadership and senior private industry executives on readiness, response, and recovery initiatives impacting the U.S. national health security and critical infrastructure protection. Additionally, he served as the Chair of the Emergency Preparedness Committee for the Federation of American Hospitals. 

Mike is a veteran healthcare executive with experience leading the medical operations division of Northeast Regional Counter-Terrorism Task Force based in PA. He is the prior Administrator and Chief of Emergency Operations for Lehigh Valley Health Network, and an experienced flight nurse and Administrator of LVHN-MedEvac. Federally, Mike served in an intermittent position as a Supervisory Nurse Specialist for the U.S. Dept. of Health and Human Services National Disaster Medical Services. His combined experience includes both domestic and international homeland security and medical response training & operations. Mike holds multiple certifications in homeland security, disaster preparedness and is one of the first Certified Medical Transport Executives worldwide. He is a graduate of the American Military University with a Master of Business Administration degree, Kutztown University of PA with a Bachelor of Science Degree in Nursing and is a graduate of St. Luke’s School of Nursing with a Diploma of Nursing. Continuing his post-graduate studies, Mike is near completion of the Doctor of Public Health degree program at Indiana University Fairbanks School of Public Health.

Mike was recently awarded with the “Director’s Award for Outstanding Service to Mission” by the U.S. Secret Service for his leading the Pandemic Health Security & Medical Operations of the final 2020 U.S. Presidential Debate.

Every year, millions of Americans face the life-changing news of a cancer diagnosis. Beyond the battle for survival and recovery, there is another critical fight—the battle to ensure patients and their families have access to affordable care.

In this episode, we look at the intersection of health care policy and cancer care with Pam Traxel, Senior Vice President of the American Cancer Society Cancer Action Network (ACS CAN). ACS CAN champions cancer patients, survivors, and their loved ones by advocating for expanded access to health care, funding for cancer research, and policies that make lifesaving treatments more accessible.

The Enhanced Premium Tax Credits (EPTCs) have proven to be critical tools, helping millions of Americans afford health insurance, including those grappling with the high costs of cancer treatment. With the threat of these credits expiring, the stakes for cancer patients and their loved ones couldn’t be higher. Pam breaks down the potential consequences of losing this critical lifeline and shares how ACS CAN is mobilizing to protect access to affordable health care for all.

Key Topics Covered:

• Role of ACS CAN in fighting for cancer patients and families;
• Potential expiration of Enhanced Premium Tax Credits and its devastating implications;
• Importance of health insurance in cancer diagnosis and survival rates; and,
• Data showing how EPTCs improve patient outcomes and protect access to care.

Studies mentioned in the episode: 

Health insurance status and cancer stage at diagnosis and survival in the United States: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21732

How ACA Tax Credits Impact Patients With Chronic Conditions:
 https://www.oliverwyman.com/our-expertise/insights/2024/sep/premium-tax-credit-ending-chronic-conditions-at-risk.html

Cancer Patients & Survivors Overwhelmingly Support Extending ACA Enhanced Tax Credits: 
 https://www.fightcancer.org/policy-resources/cancer-patients-survivors-overwhelmingly-support-extending-aca-enhanced-tax-credits

Guest Bio: 

Pam Traxel serves as the Senior Vice President for ACS CAN, the advocacy affiliate of the America Cancer Society.  Pam is responsible for helping ACS CAN develop relationships with companies and individuals to help further the fight against cancer through dynamic partnerships, events, and forums.  Pam began her career with ACS CAN in 2007.  She has been integrally involved in helping to establish ACS CAN as a nationwide advocacy organization that influences and shapes public policy at all levels of government to impact our mission and to represent the voices of all cancer patients and their families.   

As the Federation of American Hospitals (FAH) prepares for a pivotal year ahead, this special episode takes a moment to reflect on the progress made in health care policy and the challenges and opportunities on the horizon. Join host Chip Kahn as he sits down with retiring Executive Vice President of Policy, Steve Speil, to discuss his nearly four decades of experience in health care policy and his reflections on his remarkable 27-year tenure at FAH.

Steve’s career has spanned transformative decades in health care, from his early days in Massachusetts state health planning to tackling the evolving complexities of hospital policy in Washington, D.C. His insights in health care policy and the hospital community's resilience shine a light on how far we've come—and the work still ahead to ensure patients have access to 24/7 care.

In this episode, Chip and Steve discuss: 

• Steve's Career Journey Leading to FAH: From a Master in Public Health to law school and a career spanning Massachusetts state health planning, the Dukakis administration, AdvaMed, and ultimately the Federation of American Hospitals.
• Early Days at FAH: A look back at the early years of Steve’s time at FAH, navigating key regulations like IPPS and legislation including the Balanced Budget Act.
• Changing Landscape of Health Policy: Steve reflects on accomplishments during his tenure and insights into how hospital policy has evolved, now facing increased burdens.
• Opportunities Ahead: Steve discusses the continued resilience of hospitals in the face of challenges and the critical role of organizations like FAH in supporting hospitals and the communities they serve.

Guest bio: 

In his capacity as Executive Vice President of Policy, Steve Speil manages the Federation’s broad portfolio of payment policy issues. He serves as the association’s chief liaison on these issues with the Centers for Medicare and Medicaid Services and the Medicare Payment Advisory Commission. Working closely with the senior finance and policy executives in the Federation’s member companies, Steve develops and carries out both issue-specific and general strategic plans designed to advance the finance and payment related regulatory and legislative interests of the FAH.

Prior to joining the Federation, Steve served as Associate Vice President, Policy Coordination and Communication for the Health Industry Manufacturers Association (now AdvaMed), the national trade group representing the medical technology industry. Before moving to Washington, Steve held a succession of increasingly senior management and policy positions in Massachusetts. During his time in the Bay State, Steve served as Legal Counsel to the Lieutenant Governor, Legislative Counsel for the Executive Office of Health and Human Services, Executive Director of the Disabled Persons Protection Commission, and Legal Counsel and Policy Director in the Office of State Health Planning. Steve also taught health law and policy as an Assistant Professor at Simmons College Graduate Program of Health Administration.

At the federal level, Steve served in the Food and Drug Administration’s Office of Legislative and Congressional Affairs. He also worked in the Environmental Protection Agency’s Office of General Counsel.

Steve earned a J.D. degree from American University’s Washington College of Law; a Master in Public Health degree in Health Administration from the University of North Carolina School of Public Health; and a Bachelor of Arts degree in Anthropology/Zoology from the University of Michigan.

In this episode of Hospitals in Focus, host Chip Kahn explores the digital renaissance revolutionizing health care—a golden age of pioneering technologies not seen since the 1960s, when computers first standardized medical records and diagnostics. Today, with nearly everything digitized, organizations are actively discussing the regulatory and ethical frameworks necessary to navigate these advancements, while protecting against the increasing prevalence of cyber threats.

The future of health care looks promising thanks to new innovations, but thoughtful implementation is crucial, and Ardent Health is leading the way forward.

Joining Chip on the episode is Anika Gardenhire, Ardent Health’s inaugural Chief Digital and Information Officer, to explore how Ardent is thoughtfully embracing digital innovation with reason and purpose.

In this episode, Chip and Anika discuss:

• Conceptual Frameworks for Digital Transformation: The importance of leveraging data to drive innovation and improve patient outcomes.
• Use Cases at Ardent Health: Examples where Ardent Health is implementing digital solutions to enhance operational efficiency and patient care.
• Cybersecurity and Protecting Patient Information: Strategies for safeguarding patient data against cyberattacks in an increasingly digital landscape.

Guest Bio: 

As chief digital information officer, Ms. Gardenhire oversees the development and implementation of Ardent's digital strategy across the organization. She is responsible for ensuring digital initiatives are fully integrated into Ardent's strategic plan with a focus on leveraging data to support digital transformation. Ms. Gardenhire also oversees Ardent’s IT infrastructure and systems, as well as data strategy and governance.

An experienced caregiver and clinical informatics leader, Ms. Gardenhire joined Ardent in September of 2023, and has previously served as chief digital officer and regional vice president of digital and clinical systems at Centene Corporation. She also held various roles at Intermountain Healthcare, including assistant vice president of digital transformation. Ms. Gardenhire holds a bachelor of science in nursing from the University of South Carolina’s Mary Black School of Nursing and master’s degrees in clinical informatics and management from Duke University.

In this episode of Hospitals in Focus, we’re pulling back the curtain on an often-overlooked  yet truly “critical” aspect of our health care system—the supply chain. It’s the backbone of  our hospitals, ensuring that essential medical supplies reach patients in need. But what  happens when that chain breaks? 

Host Chip Kahn is joined by Ed Jones, President and CEO of HealthTrust Performance  Group, to discuss recent events that exposed vulnerabilities in this intricate network.  Following Hurricane Helene’s catastrophic impact on a major manufacturing facility for IV  solutions, hospitals nationwide faced a sudden, alarming shortage. This crisis underscores  that our health care supply chain is a fragile, interconnected network, frequently  dependent on a limited number of suppliers and manufacturers. 

In this episode, Chip and Ed discuss: 

• An introduction to Group Purchasing Organizations (GPOs), and how they help  hospitals secure reliable supplies at fair prices. 
• Pandemic and Disaster Preparedness: How the COVID-19 pandemic and  Hurricane Helene revealed and accelerated shifts in our supply chain, and what  parallels these events share. 
• The Role of GPOs in Drug Supply: An examination of how GPOs respond to  shortages and their impact on supply and pricing. 
• International Reach and Recovery: How global supply chains influence our health care systems. 
• HealthTrust’s Unique Approach: What sets HealthTrust apart from other GPOs in  its approach to building a resilient and cost-effective supply chain. 

Guest Bio:  

As President and CEO of Healthtrust Performance Group, Ed has overall responsibility for a  broad set of capabilities focused on supporting healthcare providers. His primary focus is  providing the strategic direction and leadership of a comprehensive spend management  and performance improvement business based in Nashville, Tennessee. Jones oversees  all dimensions of a $52B portfolio; directs all consulting, managed services and  outsourced relationships/alliances, including accountability for HCA Healthcare supply chain, sourcing contingent labor, facility management and clinical education.

Jones’ leadership encompasses several HealthTrust/HCA Healthcare business ventures  that strengthen provider performance and competitive advantage, including: 

• HealthTrust Workforce Solutions - The clinical labor staffing and consulting  company including a proprietary program called StaRN (extensive training program  for all new nurses) 
• HCA Healthcare Center for Clinical Advancement - Responsible for providing  continual education for over 90,000 nurses at HCA Healthcare through a team of  approximately 800+ educators and several simulation labs 
• HealthTrust Europe, which provides sourcing and supply chain services to HCA U.K.  and sourcing services to 39 provider trusts in the U.K. 
• HealthTrust Global Sourcing Office in Shanghai, China 
• Galen College of Nursing 
• Group purchasing organization that delivers clinically integrated solutions and  savings across all sites of care 

He has 40 years of experience within the Healthcare industry, serving in his current role for  the last 11 years and serving previously as the Chief Operating Officer of HealthTrust  Performance Group with responsibility for strategic sourcing, clinical operations, custom  contracting, supplier diversity, and regional operations. Prior to that, Jones served in  several leadership positions within HCA Healthcare for 20 years following front-line roles  at a hospital for seven years. 

Jones is a founding board member of the Health Sector Supply Chain Research  Consortium, and a member and subcommittee leader of the Federation of American  Hospitals. He also serves on the board of Galen College of Nursing and is the chairman of  the finance committee. Jones also serves on the board of CoreTrust. Previously, he served  as board chair on the Healthcare Supply Chain Association (HSCA). He holds a Bachelor of  Science degree from Virginia Commonwealth University.

With over nine million veterans enrolled, the Department of Veterans Affairs (VA) is well known for its health care services. However, the VA’s support extends beyond medical care, helping veterans navigate life after military service. The VA has undergone a significant transformation since the establishment of the Veterans Experience Office in 2015, focusing on improving veterans’ experiences through the use of qualitative and quantitative veteran-customer service data.

In this episode, Dr. Carolyn Clancy, Assistant Under Secretary for Health at the VA, shares insights on the organization’s evolving approach to health care and the patient experience by discussing:

• The role of the VA and its evolution in approaches to health care; 
• Transformation through leadership and the creation of the Veterans Experience Office; 
• Holistic attitude to health care through the ‘My life, my story’ project; and, 
• Broader applications of VA initiatives in other health care settings 

Guest Bio: 

Dr. Clancy serves as the Assistant Under Secretary for Health (AUSH) for Discovery, Education & Affiliate Networks (DEAN), Veterans Health Administration (VHA), effective July 22, 2018. The Office of the DEAN fosters collaboration and knowledge transfer with facility-based educators, researchers, and clinicians within VA, and between VA and its affiliates. 

Prior to her current position, she served as the Acting Deputy Secretary of the Department of Veterans Affairs, the second-largest Cabinet department, with a $246 billion budget and over 424,000 employees serving in VA medical centers, clinics, benefit offices, and national cemeteries, overseeing the development and implementation of enterprise-wide policies, programs, activities and special interests. She also served as the VHA Executive in Charge, with the authority to perform the functions and duties of the Under Secretary of Health, directing a health care system with a $68 billion annual budget, overseeing the delivery of care to more than 9 million enrolled Veterans. Previously, she served as the Interim Under Secretary for Health from 2014-2015. Dr. Clancy also served as the VHA AUSH for Organizational Excellence, overseeing VHA’s performance, quality, safety, risk management, systems engineering, auditing, oversight, ethics and accreditation programs, as well as ten years as the Director, Agency for Healthcare Research and Quality. 

Before the Change Healthcare cyberattack, hospitals were already grappling with insurers' tactics of delaying and denying payments for patient care. The cyberattack only amplified the challenges providers face—not just in delivering care, but also in getting reimbursed for that care. Despite the crisis, insurers continued to use these tactics. Now, six months later, Matt Szaflarski, a director and revenue cycle intelligence leader at Kodiak Solutions, and his team have uncovered something alarming: a surge in insurers’ initial Request for Information (RFI) claim denials.

Kodiak’s latest report, “Death By A Thousand Requests,” highlights the growing trend of payors denying initial claims due to RFIs, creating an enormous administrative burden on hospitals and providers. In 2024 alone, these tactics are projected to cost hospitals $4.6 billion. Szaflarski returns to the show to explain the impact of these denials on the hospital revenue cycle, which ultimately impacts the hospital’s ability to provide care.

In this episode, Szaflarski discusses:

• Updates on the Change Healthcare cyberattack;
• Rising trends in claim delays and denials, particularly RFI denials;
• Revenue cycle data insights;
• Medicare Advantage, the two-midnight rule, and observation stay challenges; and
• Recommendations for improving processes between insurers and providers.

In June, the Supreme Court issued a 6-3 decision in Loper Bright Enterprises v. Raimondo,  overturning the 40-year-old legal precedent known as the "Chevron doctrine." This doctrine  had allowed federal agencies to interpret ambiguous statutes within their jurisdiction. The  ruling marks a significant shift in the regulatory landscape, with major implications for how  federal agencies operate and how regulations are enforced—particularly in health care.  The decision presents both challenges and opportunities for the health care industry,  making it crucial for policymakers, health care leaders, and businesses to understand the  evolving regulatory environment. 

Joining Hospitals in Focus to unpack the potential effects of this ruling on health care  policy making is Thomas Barker, a partner at Foley Hoag and former General Counsel at  CMS and Acting General Counsel at HHS.  

In this episode, we explore: 

Impact on Congress: How does the ruling affect Congress’s legislative process and its  relationship with federal agencies? Will the ruling force Congress to write more precise  laws? 

Changes for Federal Agencies: What does the ruling mean for federal agencies, like CMS  and HHS, which have relied on Chevron deference to implement and enforce regulations?  

Judicial Implications: Will courts, particularly lower courts, take on a larger role in  interpreting statutes? How could this influence future rulings on health and business  regulations? 

Business and Regulatory Implications and Challenges: What will be the effect on businesses, especially those operating in highly regulated sectors like health care, and  what are the potential retroactive effects of the Loper Bright decision?

The work, dedication, and resilience of hospital providers and staff is centered on providing high-quality care for their patients. In this special episode of Hospitals in Focus, we spotlight two compelling stories of patient care from the frontlines, offering unique perspectives from both a health care provider and patient. 

Join us as we hear firsthand from Amy Capella Smith, CEO of Foundations Behavioral Health, a UHS hospital in Doylestown, Pennsylvania, as she navigates the challenges and rewards of providing behavioral health services to children, adolescents, and young adults.  

We also share Jenna Tanner’s story, who survived what is often called the “widow maker,” a massive heart attack, while home alone. Jenna was able to call 911 and get the emergency medical help she needed at Hillcrest Hospital, an Ardent Health hospital, where she received lifesaving care. Her experience serves as a universal message about heart health and the importance of recognizing the early signs of a heart attack. 

Today, we are celebrating the 59th anniversary of Medicare and Medicaid being signed into law by President Lyndon B. Johnson and discussing the profound effect these programs have had in providing health care coverage to the country’s most vulnerable populations.

Medicare and Medicaid laid the foundation for public health insurance in the United States, ensuring that the elderly, low-income families, and individuals with disabilities receive essential health care services. The Affordable Care Act (ACA), enacted in 2010, built upon this foundation by expanding Medicaid eligibility, providing subsidies lower-income individuals and families to purchase private insurance on exchanges, and implementing protections for people with pre-existing conditions. Medicare, Medicaid, and the ACA have created a more comprehensive safety net for millions of Americans, significantly reducing the uninsured rate and improving access to care.

Our guest, Larry Levitt, oversees policy work on Medicaid, Medicare, the ACA, and the health care marketplace for one of the nation’s leading health policy organizations. Larry’s extensive knowledge will guide us through the following topics:

·         Medicaid Coverage: Expansion and post-pandemic redeterminations in the states;

·         Evolution of the ACA: The development and impact of enhanced subsidies;

·         ACA Challenges: Addressing concerns about bad actors and program issues; and

·         Future of Coverage: Insights on the upcoming election and its implications for health care coverage. 

More: 

Larry Levitt is the executive vice president for health policy, overseeing KFF’s policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women’s health, and global health. He previously was editor-in-chief of kaisernetwork.org, which was KFF’s online health policy news and information service and directed KFF’s communications. 

Prior to joining KFF, Levitt served as a senior health policy adviser to the White House and the Department of Health and Human Services, working on the development of the Clinton Administration’s Health Security Act and other health policy initiatives. Earlier, he was the special assistant for health policy with California Insurance Commissioner John Garamendi, a medical economist with Kaiser Permanente, and served in a number of positions in Massachusetts state government. 

Levitt holds a bachelor’s degree in economics from the University of California, Berkeley, and a master’s degree in public policy from the Kennedy School of Government at Harvard University.