00:07 - >>GOOD AFTERNOON. I'M FRANCINE

00:08 - SCHERTZER, SENIOR VICE

00:09 - PRESIDENT OF POLITICS AND

00:11 - POLICY AT PCN PRESIDENT OF THE

00:12 - PENNSYLVANIA PRESS CLUB AND

00:14 - YOUR HOST FOR TODAY'S LUNCHEON.

00:16 - JOINING ME AT THE HEAD TABLE IS

00:18 - TERRY TRACY OF BROAD AND

00:20 - LIBERTY AND BILL SAXTON STUMP.

00:20 - THANK YOU FOR YOUR SUPPORT AND

00:23 - THANK YOU FOR BEING HERE.

00:25 - THE PENNSYLVANIA PRESS CLUB

00:26 - LUNCHEON SERIES COULD NOT BE

00:28 - POSSIBLE WITHOUT THE SUPPORT OF

00:28 - THE GENEROUS ORGANIZATIONS

00:29 - LISTED ON OUR SPONSOR. BANNER.

00:32 - TODAY'S PROGRAM IS STREAMING

00:34 - LIVE ON PCN SELECT AN AIRING

00:34 - LIVE ACROSS THE STATE ON PCN

00:37 - TV.

00:39 - OUR SPEAKER TODAY IS NICOLE

00:40 - STALLINGS PRESIDENT AND CEO OF

00:41 - THE HOSPITAL AND HEALTHSYSTEM

00:43 - ASSOCIATION OF PENNSYLVANIA.

00:45 - ONE OF THE NATION'S LARGEST

00:47 - STATE HOSPITAL ASSOCIATIONS.

00:48 - THE ASSOCIATION IS

00:49 - PENNSYLVANIA'S CHIEF ADVOCATE

00:51 - FOR HOSPITALS AND THEIR

00:52 - PATIENTS REPRESENTING THEIR

00:54 - INTERESTS WITH STATE AND

00:54 - FEDERAL LEADERS. THE BUSINESS

00:56 - COMMUNITY AND OTHER

00:58 - STAKEHOLDERS HAPP WORKS WITH

01:00 - MORE THAN 235 MEMBER HOSPITALS

01:02 - AND HEALTH SYSTEMS TO SUPPORT

01:03 - ACCESS TO HIGH QUALITY HEALTH

01:05 - CARE IN PENNSYLVANIA,

01:07 - COMMUNITIES DRAWING ON MORE

01:07 - THAN 2 DECADES OF STRONG

01:08 - EXPERIENCE IN HEALTH CARE,

01:10 - ADVOCACY AND POLICY DEVELOPMENT

01:13 - SOLIDS IS ELEVATING HELPS WORK

01:13 - TO ADDRESS AN HISTORIC HEALTH

01:17 - CARE WORKFORCE CRISIS. SECURE

01:18 - THE SUSTAINABILITY OF HOSPITAL

01:19 - CARE THROUGHOUT THE

01:20 - COMMONWEALTH AND SUPPORT

01:21 - HOSPITALS AND IMPROVING

01:21 - MATERNAL HEALTH IN ADVANCING

01:24 - HEALTH EQUITY BEFORE JOINING

01:27 - HAPPENED IN JUNE 2023. STALLING

01:29 - SERVED AS CHIEF EXTERNAL

01:29 - AFFAIRS OFFICER AT THE MARYLAND

01:31 - HOSPITAL ASSOCIATION LEADING

01:32 - EFFORTS SUPPORTING HOSPITALS

01:33 - AND ADDRESSING WORKFORCE

01:36 - SHORTAGES RESPONDING TO

01:36 - COVID-19 ENHANCE IN BEHAVIORAL

01:40 - HEALTH CARE, REDUCING

01:42 - READMISSIONS AND IMPROVING CARE

01:44 - COORDINATION. SHE ALSO

01:44 - REPRESENTED THE HOSPITAL

01:45 - COMMUNITY DURING NEGOTIATIONS

01:46 - FOR MARYLAND'S ALL PAIR

01:48 - HOSPITAL WAIVER CONTRACTS WITH

01:52 - THE FEDERAL GOVERNMENT ON A

01:53 - PUBLIC PRIVATE WORK GROUP

01:54 - FOCUSED ON VALUE-BASED PAYMENT

01:54 - MODELS AND STATEWIDE

01:57 - POPULATION. HEALTH EFFORTS AND

01:58 - NHA STALLINGS ALSO HELD THE

01:59 - ROLES OF SENIOR VICE PRESIDENT

02:02 - GOVERNMENT AFFAIRS AND POLICY

02:04 - VICE PRESIDENT POLICY AND DATA

02:06 - ANALYTICS AND ASSISTANT VICE

02:08 - PRESIDENT QUALITY POLICY AND

02:10 - ADVOCACY. SHE PREVIOUSLY SERVED

02:11 - AS SENIOR POLICY ADVISOR TO THE

02:13 - MARYLAND SECRETARY OF HEALTH

02:14 - AND CHIEF OF GOVERNMENT

02:15 - RELATIONS AND SPECIAL PROJECTS

02:16 - FOR THE MARYLAND HEALTH

02:18 - COMMISSION.

02:19 - SHE STARTED HER CAREER WITH THE

02:21 - NEW JERSEY HOSPITAL ASSOCIATION

02:24 - WORKING ON POLICY AND

02:25 - LEGISLATIVE ADVOCACY STALLINGS

02:26 - HOLD A BACHELOR'S DEGREE IN

02:27 - POLITICAL SCIENCE FROM VIRGINIA

02:30 - TECH. A MASTER'S OF PUBLIC

02:31 - POLICY DEGREE WITH A

02:32 - CONCENTRATION IN HEALTH CARE.

02:33 - AT WRECKERS UNIVERSITY, EDWARD

02:35 - J POSTING SCHOOL OF PLANNING

02:35 - AND PUBLIC SAW POLICY. PLEASE

02:38 - WELCOME TO CULL STALLINGS.

02:47 - THANK YOU FOR THAT

02:47 - INTRODUCTION. AND REALLY A

02:50 - PLEASURE

02:50 - TO BE.

02:52 - >>WITH YOU ALL TODAY. SO I AM

02:53 - NICOLE SONGS. I HAVE THE

02:54 - PRIVILEGE OF SERVING AS HAPPES

02:57 - PRESIDENT AND CEO REPRESENTING

02:58 - OVER 235 HOSPITALS AND HEALTH

03:00 - SYSTEMS IN THE PATIENTS AND

03:02 - COMMUNITIES THAT THEY SERVE.

03:03 - I DO APPRECIATE THE OPPORTUNITY

03:04 - TO BE HERE. TYPICALLY SITTING

03:08 - WHERE YOU ARE RIGHT NOW IN THE

03:10 - AUDIENCE AND WHAT I ALWAYS

03:13 - APPRECIATE ABOUT THIS FORUM.

03:16 - IT IS A VARIETY OF SPEAKERS,

03:18 - BUT ALSO THE DIVERSITY OF

03:20 - PERSPECTIVES. AND AS I WAS

03:21 - THINKING ABOUT THE REMARKS THAT

03:22 - I WANTED TO GET, I TRY TO THINK

03:23 - ABOUT, YOU KNOW, WHAT IS A

03:25 - COMMON THEME THAT I'VE HEARD

03:27 - CONSISTENTLY AT THESE LUNCHEONS

03:30 - AND IT'S IT'S ONE OF COMMUNITY.

03:31 - AND SO THAT'S REALLY WHAT I

03:33 - WANT TO FOCUS. MY REMARKS ON

03:37 - TODAY. SO IT ASK YOU ALL TO

03:37 - THINK ABOUT THE COMMUNITY.

03:38 - THINK ABOUT YOUR THINK ABOUT MY

03:42 - COMMUNITY HERE IN CENTRAL

03:42 - PENNSYLVANIA. AND I'M SURE WE

03:44 - ALL HAVE A DIFFERENT COMMUNITY

03:46 - IN MIND AND THEY HAVE DIFFERENT

03:47 - CHARACTERISTICS. BUT I WOULD

03:48 - EXPECT THAT THEY HAVE SOME OF

03:53 - THE SAME CHARACTERISTICS.

03:54 - THESE ARE PLACES THAT ARE

03:55 - DRIVING WHERE BUSINESSES ARE

03:57 - INVESTING IN, CREATING THAT

04:00 - RIPPLE EFFECT. BUT SPURS

04:03 - ECONOMIC ACTIVITY THERE, PLACES

04:05 - THAT HAVE THE SERVICES AND

04:07 - INFRASTRUCTURE THAT ATTRACTS

04:08 - FAMILIES. THEY'RE PLACES WITH

04:11 - GOOD JOBS AND STRONG HEALTHY

04:12 - WORKFORCE TO FILL THOSE STOPS.

04:17 - AND I WOULD ASK YOU TO THINK

04:18 - ABOUT A COMMUNITY WHERE THE

04:19 - LARGEST EMPLOYER LEFT TOWN.

04:25 - THE POPULATION DECLINES, JOBS

04:27 - GO AWAY. SMALL BUSINESSES CLOSE

04:29 - HOME VALUES, DROP COMMERCIAL

04:32 - REAL ESTATE IS VACANT.

04:35 - PUBLIC SERVICES ARE STRAINED.

04:37 - AND THE MORE THAT THOSE

04:39 - COMMUNITIES UNRAVEL, THE HARDER

04:41 - IT IT BECOMES TO REVERSE THE

04:43 - TREND. AND THAT'S THE REALITY

04:44 - THAT MANY COMMUNITIES ACROSS

04:46 - THE COMMONWEALTH ARE ALREADY

04:47 - FACING WHEN THEY LOSE THEIR

04:50 - LOCAL HOSPITAL.

04:52 - AND IT'S A STORY THAT WE WILL

04:55 - SEE REPEATED THROUGHOUT THE

04:56 - COMMONWEALTH. IF WE DO NOT

05:00 - PRIORITIZE FIXING THE

05:01 - UNDERLYING STRUCTURAL

05:02 - CHALLENGES THAT MAKE KEEPING A

05:05 - HOSPITAL OPEN AND PENNSYLVANIA

05:08 - MUCH MORE DIFFICULT THAN AN

05:10 - OTHER STATES. AND YOU'VE

05:11 - CERTAINLY SEEN THE HEADLINES

05:12 - OVER THE YEARS. BUT EVEN JUST

05:14 - IN THE FIRST 3 MONTHS OF THIS

05:17 - YEAR, WE HAVE SEEN HEADLINES

05:19 - ABOUT HOSPITAL LAYOFFS AND

05:22 - REDUCTIONS OF SERVICES. WE HAVE

05:24 - SEEN A GROWING MATERNITY CARE

05:25 - DESERT THE SIZE OF CONNECTICUT

05:26 - IN THE NORTHWESTERN PART OF

05:29 - OUR STATE AND ALREADY IN MARCH,

05:32 - WE HAVE ALREADY SEEN HOSPITALS

05:35 - ANNOUNCED CLOSURE.

05:39 - AND SO THESE ARE NOT JUST

05:40 - HOSPITAL ISSUES. THESE ARE

05:42 - COMMUNITY ISSUES. AND WHAT

05:43 - REALLY MAKES A DIFFERENCE

05:44 - BETWEEN THOSE 2 COMMUNITIES

05:44 - THAT WE WERE ENVISIONING IS

05:47 - HAVING THAT STRONG, A LOCAL

05:49 - HOSPITAL BECAUSE WE KNOW THAT

05:51 - HOSPITALS ARE ECONOMIC THINKERS

05:56 - CONTRIBUTING TO MORE THAN

05:56 - 195 BILLION DOLLARS IN ECONOMIC

05:57 - IMPACT STATEWIDE. THE TOP

06:00 - EMPLOYERS

06:01 - IN MOST COUNTIES SUPPORTING

06:04 - 785,000 JOBS STATEWIDE, ONE IN

06:07 - EVERY 8 JOBS AND OUR

06:08 - COMMONWEALTH. THEY ARE ECONOMIC

06:10 - ENGINES. WE KNOW BUSINESS IS

06:14 - LOCATE AND INVEST IN

06:15 - COMMUNITIES WHERE THEY HAVE

06:15 - ACCESS TO STRONG HOSPITALS AND

06:18 - HEALTH

06:19 - CARE SERVICES WHEN HOSPITALS DO

06:21 - NOT CONTINUE IN COMMUNITIES DO

06:22 - NOT HAVE A LOCAL HOSPITAL.

06:25 - WE KNOW THAT EMS POLICE AND

06:26 - OTHER FIRST RESPONDERS HAVE TO

06:30 - TRAVEL FURTHER AND STRANGE.

06:30 - THEY'RE ALREADY FACING TO SERVE

06:33 - THEIR COMMUNITIES. AND WE KNOW

06:35 - THAT IT'S A IT'S A MODERN

06:36 - CONVENIENCE. WE EXPECT TO ALL

06:37 - HAVE SERVICES CLOSE BY WHEN WE

06:42 - NEED THEM. EMERGENCY CARE,

06:43 - PRIMARY CARE, BEHAVIORAL HEALTH

06:44 - CARE, MATERNITY CARE AND MORE

06:46 - SOON. THE REALITY IS THAT WE

06:49 - CANNOT HAVE HEALTHY AND VIBRANT

06:52 - COMMUNITIES WITHOUT

06:53 - FINANCIALLY STABLE HOSPITALS

06:54 - AND PENNSYLVANIA CANNOT COMPETE

07:00 - WITH OTHER STATES FOR JOBS AND

07:00 - INVESTMENT AND TALENT. IF WE DO

07:01 - NOT PRIORITIZE HAVING A STRONG

07:04 - HEALTH CARE SYSTEM.

07:06 - IN MY JOB, IT WAS NOTED THAT I

07:09 - STARTED IN 2023, I'M ON THE

07:10 - ROAD A LOT. I REALLY

07:12 - PRIORITIZED GETTING OUT TO

07:13 - HOSPITALS. I THINK IT'S

07:14 - INCREDIBLY IMPORTANT TO WALK

07:17 - THE HALLS. I ALWAYS TRY TO TALK

07:20 - TO THE SECURITY STAFF FOR THE

07:21 - RECEPTION STAFF AND FIND OUT

07:22 - HOW LONG THEY'VE BEEN AT THE

07:24 - HOSPITAL. OFTENTIMES THEY WILL

07:26 - TELL YOU ABOUT OTHER MEMBERS OF

07:27 - YOUR FAMILY WHO HAVE WORKED

07:29 - THERE. SOMETIMES IT'S

07:29 - GENERATIONS WHO HAVE WORKED AT

07:30 - OUR HOSPITALS. AND IT'S A

07:33 - SOURCE OF IMMENSE PRIDE.

07:34 - AND I ALSO TRY TO GET TO THOSE

07:35 - COMMUNITIES EARLY AND TO WALK

07:39 - AROUND THEM. AND 2, I HAVE BEEN

07:40 - KNOWN TO BRING LIKE A SLICE OF

07:42 - PIE FROM A LOCAL DINER TO THE

07:45 - HOSPITAL CEO BECAUSE WHEN YOU

07:46 - UNDERSTAND YOUR COMMUNITIES,

07:49 - YOU UNDERSTAND

07:50 - THE HOSPITAL AND THE SAME.

07:52 - THE INVERSE IS TRUE. AND SO

07:53 - IT'S WHEN I'M WALKING AROUND

07:56 - OUR HOSPITALS WITH HOSPITAL

07:58 - LEADERS. THEY TALK ABOUT THE

07:59 - PROJECTS THAT THEY ARE

08:00 - INCREDIBLY PROUD OF THE THINGS

08:01 - THAT ARE COMING. BUT THEY ALSO

08:04 - ASKED QUESTIONS LIKE. I'M NOT

08:07 - SURE IF OUR HOSPITAL WILL BE

08:08 - HERE IN 5 YEARS. AND WHAT IF

08:11 - WE HAVE TO REDUCE THE SERVICES?

08:12 - AND SO WE HAD HAVE WANTED TO

08:15 - UNDERSTAND.

08:17 - IS PENNSYLVANIA REALLY

08:18 - DIFFERENT? IT FELT AS THOUGH

08:20 - WE WERE DISPROPORTIONATELY

08:22 - SEEING THESE HEADLINES ABOUT

08:25 - CLOSURE IN CERTAIN SERVICE

08:26 - REDUCTION COMPARED 2 OTHER

08:27 - STATES. AND SO WE COMMISSIONED

08:30 - AN EXTERNAL EXPERT AND TO TO

08:31 - LOOK AT THIS, WE ASKED THEM

08:32 - TO COMPARE PENNSYLVANIA'S

08:33 - HOSPITALS TO OTHER STATES TO

08:35 - IDENTIFY WHAT THE BIG FINANCIAL

08:38 - STRESSORS ARE TO PROJECT

08:39 - FORWARD AND SAY, WHAT WILL THIS

08:41 - LOOK LIKE IF WE STAY ON THIS

08:43 - TRAJECTORY AND THEN TO IDENTIFY

08:44 - WHAT WE NEED FROM POLICY

08:46 - CHANGE, BUT ALSO WHAT HOSPITALS

08:48 - COULD BE DOING ON THEIR OWN

08:49 - TO REALLY CHANGE THAT COURSE

08:53 - AND WHAT THEY FOUND WAS IT IS

08:56 - SIGNIFICANTLY HARDER TO KEEP

08:56 - THE HOSPITAL OPEN AND

08:57 - PENNSYLVANIA THAN IN MOST

08:58 - STATES. AND THAT'S PRIMARILY

09:00 - BECAUSE THE COMMONWEALTH HAS

09:03 - FALLEN BEHIND ADEQUATELY

09:04 - SUPPORTING HOSPITAL CARE.

09:06 - AND WE KNOW THAT IT WILL GET

09:10 - WORSE AS WE IMPLEMENT THE

09:11 - PROVISIONS OF THE FEDERAL

09:11 - BUDGET RECONCILIATION BILL.

09:12 - HR ONE. BUT BUT LET'S JUST

09:13 - FOCUS FOR A MOMENT ON TODAY.

09:17 - HOSPITALS ARE ALREADY STRAINED,

09:20 - FEWER THAN HALF HAVE MARGINS

09:21 - NECESSARY FOR SUSTAINABILITY.

09:22 - MORE THAN A 3RD. OUR OPERATING

09:26 - AT A LOSS ALMOST 40% OF OUR

09:27 - HOSPITALS HAVE HAD MULTIPLE

09:30 - YEARS OF CONSECUTIVE LOSSES AND

09:32 - WE HAVE LOWER BOND RATINGS THAN

09:33 - THE NATIONAL MEDIAN AND

09:36 - SURROUNDING STATES.

09:39 - IN THE PAST DECADE. 25

09:39 - PENNSYLVANIA HOSPITALS HAVE

09:42 - CLOSED.

09:43 - AND MANY OTHERS HAVE HAD TO

09:45 - CLOSE SERVICE IS. AND I

09:46 - MENTIONED THAT MATERNITY CARE

09:49 - DESERT, THE SIZE OF CONNECTICUT

09:49 - AND OLIVER WYMAN FOUND THAT

09:50 - IF WE DO NOT CHANGE THIS

09:53 - TRAJECTORY.

09:55 - WE ARE AT RISK OF 12 TO 14

09:58 - HOSPITALS CLOSING BY 2030.

10:00 - THIS MEANS FEWER SERVICES THAT

10:03 - OUR COMMUNITIES DEPEND ON.

10:06 - LIKE LABOR AND DELIVERY,

10:07 - BEHAVIORAL HEALTH AND PRIMARY

10:09 - CARE. IT MEANS A LONGER DRIVE.

10:10 - ADDING 22 MINUTES TO COMMUTE

10:14 - TIME WHEN MINUTES MATTER.

10:15 - OFTEN CROSSING COUNTY LINES OR

10:18 - EVEN STATE LINES. AND THOSE

10:19 - HOSPITALS REPRESENT A

10:20 - SIGNIFICANT NUMBER OF JOBS AND

10:22 - OVER 900 MILLION DOLLARS AND

10:25 - LOST WAGES.

10:28 - AND THE CIRCUMSTANCES ARE

10:29 - DIFFERENT IN EACH OF THOSE

10:30 - COMMUNITIES. BUT EVERY HOSPITAL

10:33 - IS DEALING WITH THAT SAME

10:34 - FUNDAMENTAL ISSUE THAT COST

10:36 - THEM SIGNIFICANTLY MORE TO

10:38 - PROVIDE CARE. THEN THEY

10:39 - RECEIVED BACK AND REIMBURSEMENT

10:39 - AND OUR FOCUS IS ON MEDICAID.

10:43 - MEDICAID IS THE INSURANCE

10:44 - PROGRAM THAT SUPPORTS ABOUT

10:46 - ONE IN EVERY 4 PENNSYLVANIANS.

10:50 - BUT PENNSYLVANIA, MEDICAID IS

10:51 - FAR BELOW THE NATIONAL AVERAGE.

10:53 - 11 PERCENTAGE POINTS BELOW THE

10:54 - NATIONAL MEDIAN FOR OUR

10:55 - HOSPITALS THAT $0.71 ON THE

10:58 - DOLLAR. AND WE KNOW THAT WHEN

11:00 - THE PROVISIONS OF THE FEDERAL

11:02 - BUDGET RECONCILIATION BILL HR

11:05 - ONE KICK AND THAT $0.74 WILL

11:06 - DROP TO ME, THAT'S $0.71 WILL

11:09 - DROP TO $0.64. AND BEYOND THAT,

11:10 - WE KNOW THAT WE WILL HAVE

11:11 - PEOPLE THAT WILL HAVE COVERAGE

11:13 - LOSS.

11:15 - AND THAT MEANS THAT THEY WILL

11:17 - DELAY ROUTINE AND PREVENTATIVE

11:20 - CARE. CHRONIC CONDITIONS

11:21 - WILL GO. UNMANAGED MINOR HEALTH

11:24 - PROBLEMS ARE GOING TO ESCALATE

11:25 - INTO PREVENTABLE EMERGENCIES.

11:26 - PEOPLE ARE GOING TO COME INTO

11:27 - OUR EMERGENCY DEPARTMENT SICKER

11:29 - AND THEY'RE GOING TO STAY

11:31 - LONGER WAIT TIMES FOR EVERYONE

11:32 - WILL INCREASE UNCOMPENSATED

11:33 - CARE FOR HOSPITALS WILL

11:34 - INCREASE. SO THAT MEANS COSTS

11:36 - WILL INCREASE FOR EVERYONE.

11:40 - AND SO OUR HOSPITALS ARE MAKING

11:43 - THOSE DIFFICULT DECISIONS.

11:46 - NOW ABOUT PARTNERSHIPS AND

11:48 - PROGRAMS, TIMELINES FOR CAPITAL

11:49 - PROJECTS ARE BEING

11:50 - RE-EVALUATED. SOME ARE BEING

11:54 - PUT ON HOLD AND HOSPITALS ARE

11:57 - DEVELOPING SCENARIO PLANS FOR

11:59 - EVERYTHING FROM REDUCTIONS IN

12:01 - SERVICE, 2 REDUCTIONS AND

12:04 - FORCE. THEY ARE DEVELOPING

12:05 - PLANS FOR CONSOLIDATION AND

12:08 - EVEN FOR CLOSURE.

12:11 - BEYOND REIMBURSEMENT. OUR

12:13 - REPORT FOUND THAT THERE WERE

12:15 - 3 OTHER WAYS THAT PENNSYLVANIA

12:17 - IS FALLING BEHIND RELATIVE TO

12:18 - OTHER STATES AND PROTECTING

12:23 - ACCESS TO CARE. FIRST OUTDATED

12:24 - REGULATIONS. HOSPITAL LICENSURE

12:24 - REGULATIONS WERE LAST UPDATED

12:27 - IN 1980.

12:30 - NOT ALL OF YOU ARE HERE IN

12:32 - 1980, BUT MOST OF YOU OR I WAS

12:34 - THERE ARE SOME GREAT THINGS

12:36 - HAPPENING IN 1980, THERE IS

12:39 - NO INTERNET. THERE ARE NO

12:43 - ELECTRONIC HEALTH RECORDS.

12:44 - THERE ARE CARE MODELS THAT ARE

12:46 - IN PLACE TODAY THAT WE'RE NOT

12:48 - EVEN ENVISIONED THEN. AND SO

12:49 - IMAGINE HOSPITALS THAT ARE

12:50 - TRYING TO INNOVATE, NAVIGATE

12:54 - ALL OF THESE CHALLENGES THAT I

12:56 - JUST WENT THROUGH IN A

12:56 - FRAMEWORK THAT WAS DEVELOPED IN

12:59 - 1980.

13:01 - THAT NOT ONLY ADDS CONSIDERABLE

13:03 - TIME AWAY FROM THE BEDSIDE, BUT

13:04 - IT ALSO ADDS CONSIDERABLE COST.

13:05 - AND WE KNOW WE CAN DO BETTER.

13:12 - SECOND. OUR HOSPITALS ARE

13:13 - CONTINUING TO NAVIGATE

13:14 - PERSISTENT WORKFORCE SHORTAGES.

13:15 - AND THIS IS TRUE AND ALL PARTS

13:17 - OF THE HEALTHCARE CONTINUUM

13:19 - CERTAINLY LABOR IS THE LARGEST

13:22 - COMPONENT OF HOSPITALS

13:22 - OPERATING EXPENSES UP TO ABOUT

13:25 - 60%. AND OVER THE PAST SEVERAL

13:26 - YEARS, OUR HOSPITALS HAVE BEEN

13:29 - HARD AT WORK WITH PUTTING

13:30 - THINGS IN PLACE TO RECRUIT AND

13:31 - RETAIN THE HEALTH CARE STAFF

13:35 - THAT THEY NEED

13:37 - PAY RAISES BONUSES, NEW

13:39 - FLEXIBLE WORK SCHEDULES,

13:39 - IMPLEMENTING CHILDCARE. AND

13:40 - WE'VE SEEN THAT THAT WORK HAS

13:42 - STARTED TO PAY OFF AND YET WE

13:45 - STILL HAVE A CONSIDERABLE GAP

13:47 - AND THE DEMAND FOR HEALTH CARE

13:48 - AND THE SUPPLY THAT WE HAVE.

13:49 - WE KNOW THAT IS GOING TO

13:52 - WORSEN. WE ARE GOING. WE NEED

13:54 - 22,000 MORE REGISTERED NURSES

13:58 - BY 20 28, WE RANK FORCE IN THE

14:00 - NUMBER OF PHYSICIANS, TRAINS

14:01 - AND YET WE RETAIN LESS THAN

14:04 - HALF OF THEM IN OUR

14:05 - COMMONWEALTH. AND WE HAVE TO

14:08 - ASK WHY ARE THEY CHOOSING TO

14:09 - LEAVE PENNSYLVANIA WISE,

14:11 - PENNSYLVANIA, NOT COMPETITIVE

14:12 - TO KEEP THESE HEALTH CARE

14:14 - PROVIDERS. AND ONE OF THOSE

14:15 - REASONS IS THE 3RD POLICY

14:16 - OPTION. AND THAT'S OUR MEDICAL

14:20 - LIABILITY ENVIRONMENT.

14:21 - YOU KNOW, WHEN I WAS IN

14:22 - MARYLAND, I WORKED ON MEDICAL

14:24 - LIABILITY ISSUES AND I USED TO

14:26 - SAY HE'S THE POINT OF

14:27 - PENNSYLVANIA AND SAY THAT IS

14:29 - THE WORST MEDICAL LIABILITY

14:29 - CLIMATE IN THE COUNTRY. WE DO

14:32 - NOT WANT TO BE LIKE

14:34 - PENNSYLVANIA AND NOW I AM IN

14:36 - PENNSYLVANIA HAVING TO WORK

14:37 - ON THESE ISSUES. BUT WE KNOW

14:40 - THAT WE HAVE THE HIGHEST PER

14:40 - CAPITA COST TO PAY OUTS IN THE

14:44 - COUNTRY. WE KNOW WE HAVE THE

14:47 - SECOND HIGHEST PREMIUM

14:48 - INCREASES YEAR OVER YEAR IN THE

14:49 - COUNTRY. AND WE KNOW THAT WITH

14:50 - THE CHANGE IN THE VENUE RULE,

14:53 - IT'S GOING TO MAKE THE

14:54 - SITUATION EVEN WORSE. AND SO

14:57 - ALL 4 OF THESE AREAS, MEDICAID

14:59 - REIMBURSEMENT, OUTDATED

15:01 - REGULATIONS, PERSISTENT

15:02 - WORKFORCE SHORTAGES AND

15:03 - REFORMING OUR MEDICAL

15:04 - LIABILITY. CLIMATE ARE ALL

15:09 - STATE LEVERS. WE HAVE THE

15:10 - OPPORTUNITY HERE IN HARRISBURG

15:11 - TO PRIORITIZE HEALTH CARE,

15:15 - ACCESS AND JOBS AND ECONOMIC

15:16 - ACTIVITY. AND WE HAVE PUT

15:16 - FORWARD WHAT I BELIEVE, A VERY

15:18 - REASONABLE POLICY SOLUTIONS

15:23 - TO HELP NOT FILLED THE GAP THAT

15:23 - OUR HOSPITALS ARE FACING OR

15:26 - THAT WE KNOW IS GOING TO GET

15:27 - WORSE WHEN WE IMPLEMENT HR ONE.

15:28 - BUT JUST TO GET US A STEP

15:30 - CLOSER TO THE COST OF PROVIDING

15:31 - CARE AND TO BUILD UP THAT FUND

15:32 - THAT'S GOING TO BE NECESSARY

15:35 - FOR HOSPITALS IN DISTRESS

15:36 - BECAUSE WE KNOW THAT IS

15:39 - PAYMENTS START TO DECLINE.

15:39 - WE ARE GOING TO CONTINUE TO

15:41 - SEE HOSPITALS THAT WE'RE GOING

15:44 - TO BE ON THE VERGE AND I WAS

15:46 - ASKED RECENTLY. IF POLICYMAKERS

15:49 - REALLY LISTENING.

15:52 - AND AND, YOU KNOW, I DON'T

15:54 - BELIEVE THAT HOSPITAL

15:54 - SUSTAINABILITY AS A PARTISAN

15:55 - ISSUE. I BELIEVE WE ALL WANT

15:59 - ACCESS TO CARE IN OUR

16:00 - COMMUNITIES AND CERTAINLY THE

16:01 - JOBS AND THE ECONOMIC ACTIVITY.

16:03 - BUT I DO BELIEVE.

16:06 - THAT IT'S HOSPITAL RESILIENCY.

16:09 - THAT'S PART OF THE PROBLEM.

16:10 - I HAVE BEEN WORKING IN

16:10 - HEALTHCARE MY ENTIRE CAREER.

16:14 - AND HOSPITALS ARE ON THIS NEVER

16:16 - ENDING CYCLE TO FIND A WAY TO

16:17 - CONTINUE TO MEET THEIR MISSION

16:21 - OF CARE. AND IT'S THAT

16:24 - RESILIENCY THAT I BELIEVE HAS

16:25 - MADE SOME POLICYMAKERS MAYBE

16:27 - TAKE FOR GRANTED THAT THEIR

16:29 - HOSPITAL IS ALWAYS GOING TO

16:30 - BE THERE BECAUSE EVEN IN THESE

16:33 - CHALLENGING TIMES HOSPITALS ARE

16:35 - FINDING WAYS TO STEP IN INSIDE

16:37 - THEIR HOSPITAL AND IN THEIR

16:40 - COMMUNITIES AND TO PROVIDE CARE

16:42 - AND ADDRESS THOSE MOST PRESSING

16:44 - CHALLENGES EVERY YEAR. WE HAVE

16:45 - ISSUES SOMETHING WE CALL OUR

16:48 - ACHIEVEMENT AWARDS. AND THIS

16:51 - YEAR WE HAD THE MOST

16:54 - SUBMISSIONS EVER AND I HAD THE

16:55 - OPPORTUNITY LAST WEEK TO INFORM

16:57 - THOSE HOSPITAL TEAMS AND CEOS

17:00 - ABOUT THE WINNERS AND THEN 5

17:02 - AREAS, SAFETY AND QUALITY

17:04 - OPERATIONAL OPTIMIZATION

17:04 - WORKFORCE COMMUNITY ENGAGEMENT.

17:09 - AND TELLING THEM THAT THEY HAD

17:10 - WON AND WE ARE RECOGNIZING

17:12 - THEIR GOOD WORK. THE

17:13 - TEAMS WERE OVERWHELMED. THEY

17:14 - WERE THEY WERE SO PROUD.

17:15 - THEY WANT TO CONTINUE THIS

17:17 - WORK.

17:18 - THEY WANT TO CONTINUE TO

17:22 - SUPPORT THEIR COMMUNITIES, BUT

17:23 - THEY DON'T JUST WANT TO

17:24 - SURVIVE. THEY WANT TO THRIVE.

17:26 - AND IN DOING SO COMMUNITIES

17:30 - WILL THRIVE. AND SO I BELIEVE

17:33 - NOW IS REALLY A TIME TO HAVE

17:34 - FRANK CONVERSATIONS ABOUT THE

17:34 - REALITY DEAL THAT OUR HOSPITALS

17:39 - ARE FACING. THE TRAJECTORY THAT

17:42 - THEY ARE ON AN KEEP OUR CALLING

17:44 - THIS ARTICLE THAT I READ AT THE

17:45 - END OF LAST YEAR IN A NATIONAL

17:47 - PUBLICATION THAT TALKED ABOUT

17:49 - WHAT HAPPENS WHEN A RURAL

17:49 - COMMUNITY LOSES ITS ONLY

17:51 - HOSPITAL. AND THEY DESCRIBE

17:55 - IT AS A DEATH SPIRAL WHERE ALL

17:57 - OF THOSE THINGS THAT I WAS

17:57 - TALKING ABOUT PER APP PER

18:01 - CAPITA INCOME DROPPING

18:03 - UNEMPLOYMENT INCREASING

18:04 - POPULATION AND LABOR FORCE

18:07 - DECLINING TAX

18:08 - BASE SHRINKING MORE DIFFICULT

18:09 - TO ATTRACT FAMILIES AND

18:12 - BUSINESSES.

18:13 - THEY SAID THE CLOSURE COMPOUND,

18:15 - THE VERY ECONOMIC STRAINS THAT

18:17 - CONTRIBUTED TO IT IN THE FIRST

18:18 - PLACE. IT'S A DEATH SPIRAL

18:20 - WHERE EACH STEP ACCELERATES

18:23 - THE NEXT.

18:25 - AND WE KNOW THAT CANNOT THAT

18:27 - HEALTH CARE DESERT CAN VERY

18:28 - QUICKLY TURN INTO THE ECONOMIC

18:29 - DOES. SO I WILL CONCLUDE BY

18:33 - SAYING WE DON'T WANT THIS TO

18:34 - HAPPEN IN OUR COMMUNITIES AND

18:35 - WE ALL HAVE A STAKE IN ENSURING

18:38 - THAT IT DOESN'T HAPPEN IN ANNIE

18:41 - COMMUNITY. THANK YOU.

18:50 - OKAY. I'M HAPPY TO TAKE SOME

18:54 - QUESTIONS. WE'RE SEEING LONG

18:55 - WAITS FOR APPOINTMENTS AND

18:56 - PROCEDURES ACROSS THE STATE

18:57 - BECAUSE THEY'RE NOT IN A

18:58 - PHYSICIAN'S. HOW DO WE KEEP AND

18:59 - ATTRACT MORE PHYSICIANS TO

19:01 - PENNSYLVANIA?

19:02 - >>WELL, I CERTAINLY THINK IT

19:03 - STARTS WITH MEDICAL LIABILITY.

19:04 - I TALKED A LITTLE BIT ABOUT

19:06 - THAT.

19:06 - >>BUT I ALSO BELIEVE THERE IS

19:09 - MORE THAT WE CAN DO TO LOOK AT

19:11 - THE INCENTIVES THAT WE HAVE TO

19:12 - ATTRACT POSSESSION AND IN

19:16 - PARTICULAR TO RURAL A COMMUNITY

19:17 - IS NOT JUST THOSE THAT ARE

19:18 - ALREADY HERE, BUT ALSO THOSE

19:20 - THAT HAVE BEEN TRAINED

19:21 - INTERNATIONALLY. WE ARE VERY

19:23 - ENGAGED IN ADVOCACY AT THE

19:24 - FEDERAL LEVEL AND THAT IN THAT

19:27 - REGARD AS WELL.

19:29 - HAS HAPPENED WHERE YOUR MEMBERS

19:30 - BEEN ENGAGED WITH THE STATE ON

19:32 - THE RURAL HEALTH

19:33 - TRANSFORMATION, DOLLARS COMING

19:35 - INTO THE STATE. AND IF SO.

19:36 - >>WHAT IS THE PRIMARY GOAL FOR

19:36 - ALL HOSPITALS TO BENEFIT FOR

19:39 - THESE FUNDS?

19:42 - >>WHEN YOU LOOK AT THE WEBSITE,

19:42 - THEY HAVE 3 GOALS. THE FIRST IS

19:45 - TO IMPROVE RURAL HEALTHCARE.

19:48 - THE SECOND IS TO KEEP RURAL

19:49 - HOSPITALS OPEN. AND THEN THE

19:51 - 3RD IS AROUND. INNOVATION.

19:55 - WE HAVE BEEN VERY ENGAGED IN

19:56 - PROVIDING WHAT WE BELIEVE ARE

19:58 - THE AREAS OF FOCUS THAT WILL

20:00 - PROVIDE THAT BRIDGE FOR RURAL

20:02 - HOSPITALS TO HELP THEM PREPARE

20:02 - FOR WHAT IS TO COMMENT ANY

20:05 - DOLLAR AMOUNT IS WELCOMED.

20:08 - BUT I HAVE TO STRESS THAT IT'S

20:09 - GOING TO BE INSUFFICIENT

20:13 - BECAUSE IT QUITS TO ABOUT $57

20:14 - FOR PER WORLD COMMUNITY.

20:16 - PEARL PERCENT LIVING IN A AND

20:17 - THESE COMMUNITY. SO THINK ABOUT

20:20 - THAT. $57.

20:23 - AND SOME STATES LIKE RHODE

20:26 - ISLAND, IT'S $6,000 PER WORLD

20:29 - RESIDENT. AND SO WE KNOW THAT

20:32 - OUR RURAL COMMUNITIES ARE

20:32 - FEELING THE PRESSURES THAT THAT

20:34 - ALL HOSPITALS ARE FEELING, MUCH

20:39 - HIGHER DEGREE. AND SO I AM

20:40 - INCREDIBLY CONCERNED ABOUT

20:42 - THEIR ABILITY TO SUSTAIN CARE.

20:42 - I THINK THAT FUNDING FROM THE

20:45 - REAL HEALTH

20:46 - TRANSFORMATION PROGRAM. WE WILL

20:49 - WELCOME EVERY DOLLAR, BUT WE

20:50 - NEED TO LOOK UPSTREAM AND AND

20:51 - AND LOOK AT SOME OF THESE MORE

20:52 - LONG-TERM AND SUSTAINABLE

20:54 - POLICY OPTIONS AS WELL. HOW CAN

20:55 - WE KEEP OUR RURAL HOSPITALS

20:57 - OF THEM?

21:02 - >>SEE ABOUT A A.

21:02 - >>AND I ALSO THINK ONE OF THE

21:04 - PRIMARY STRESSORS FOR OUR RURAL

21:06 - HOSPITALS OUT ON A FEW THINGS,

21:07 - OBVIOUSLY WORKFORCE, IT'S

21:10 - HARDER TO RECRUIT. INDIVIDUALS

21:11 - AND 2 WORLD HOSPITALS. YOU

21:12 - OFTEN HAVE TO PAY THEM MUCH

21:14 - MORE. WE'RE SEEING A LOT OF ON

21:15 - OF INNOVATION AND SEEING SOME

21:17 - OF MY FRIENDS FROM AT PENN

21:19 - STATE THEIRS CONCEPTS AROUND

21:20 - AT TAILGATE MEDICINE AND WE

21:23 - ARE SEEING AND MORE INNOVATION

21:26 - IN TERMS OF GOING INTO

21:26 - COMMUNITIES WITH MOBILE UNITS.

21:29 - BUT WHEN YOU THINK ABOUT THE

21:30 - ECONOMIC FRAMEWORK FOR OUR

21:31 - RURAL HOSPITALS, THE MATH JUST

21:34 - DOESN'T

21:35 - WORK ANYMORE. THESE HOSPITALS

21:37 - ARE SIMULTANEOUSLY DEALING WITH

21:40 - A POPULATION THAT IS AGING THAT

21:40 - IS SHRINKING AND INCREASINGLY

21:44 - CANNOT PAY AND THEY ARE

21:47 - EXPECTED TO HAVE THAT. 24 7

21:49 - CARE THAT LARGE URBAN ACADEMIC

21:51 - MEDICAL CENTERS WELL AS WELL.

21:52 - SO THOSE FIXED COSTS ARE HIGHER

21:56 - BECAUSE YOU HAVE 24 7 STAFF.

21:58 - YOU'VE GOT EXPENSIVE EQUIPMENT

22:01 - IF YOUR STAFF ARE VERY

22:02 - SPECIALIZED. BUT YOUR VOLUME IS

22:04 - JUST NOT THERE TO SUSTAIN IT.

22:04 - AND SOUTH FROM A LABOR AND

22:06 - DELIVERY PERSPECTIVE, FOR

22:09 - EXAMPLE, YOU MIGHT BE

22:09 - DELIVERING FREEBIES A WEEK WITH

22:10 - THESE OTHER HOSPITALS ARE

22:13 - DELIVERING 3 A DAY. SO THE MATH

22:14 - DOESN'T WORK ANYMORE FOR OUR

22:15 - RURAL HOSPITALS. AND I DO

22:17 - BELIEVE THAT WE NEED TO LOOK AT

22:20 - INNOVATIVE PAYMENT MODELS TO

22:20 - REALLY ENSURE THAT WE ARE

22:23 - SUSTAINING CARE HERE.

22:24 - WE'VE HEARD THE GOVERNOR'S

22:26 - LEGISLATIVE CZAR LATEST

22:27 - LEGISLATIVE LEADERS ARE TALKING

22:29 - ABOUT REGULATORY REFORM WHERE

22:30 - THERE ARE OPPORTUNITIES TO

22:31 - IMPROVE THE REGULATORY

22:32 - ENVIRONMENT FOR HOSPITALS.

22:35 - >>WE KNEW.

22:37 - >>HAVE A REGULATORY FRAMEWORK

22:38 - THAT IS BUILT ON A STRUCTURE

22:42 - FROM THE 1980'S.

22:44 - >>IT REQUIRES A SERIES OF

22:46 - WAIVERS AND EXCEPTIONS. ALMOST

22:47 - ALL OF OUR HOSPITALS ARE ARE

22:49 - SEEKING THESE WAIVERS AND THESE

22:51 - EXCEPTIONS. AND IT JUST MAKES

22:52 - SENSE THAT IF EVERY HOSPITAL

22:54 - IS GETTING A WAVE OR AN

22:55 - EXCEPTION FOR REGULATION,

22:56 - PERHAPS THAT SHOULD BE IN PLACE

22:56 - ANYMORE AND IT WOULDN'T JUST

23:00 - HELP OUR HOSPITALS THAT HAVE TO

23:01 - EMPLOY OVER 60 INDIVIDUALS JUST

23:02 - ON THE REGULATORY COMPLIANCE.

23:02 - I BUT IT WOULD HELP THE

23:05 - DEPARTMENT OF HEALTH AS WELL.

23:07 - I THINK THAT THERE ARE A LOT OF

23:08 - OPPORTUNITIES TO ENSURE THAT

23:11 - WE HAVE MORE FLEXIBILITY.

23:14 - >>AND AND AND

23:15 - >>HEALTH CARE IS CHANGING SO

23:16 - QUICKLY WITH TECHNOLOGY, IN

23:19 - PARTICULAR, WITH WITH AI.

23:20 - AND SO WE'VE BEEN WORKING

23:21 - CLOSELY WITH THE DEPARTMENT

23:23 - OF HEALTH ON IDENTIFYING WHERE

23:24 - THERE ARE OPPORTUNITIES TO

23:26 - CREATE THAT FLEXIBILITY, MAKE

23:29 - IT LESS BURDENSOME AND SO THAT

23:30 - WE AREN'T HAVING TO CONSTANTLY

23:31 - COME BACK AND AND SEEK THOSE

23:33 - EXCEPTIONS.

23:35 - >>WHAT DO YOU THINK? WORKPLACE

23:36 - VIOLENCE HAS INCREASED IN THE

23:38 - HEALTH CARE ARENA AND WHAT

23:39 - STRATEGIES ARE YOUR MEMBERS

23:39 - FINDING WAS DEFECTED TO PREVENT

23:40 - PROTECT AGAINST SUCH VIOLENCE.

23:44 - I STARTED WORKING AT THE NEW

23:46 - JERSEY HOSPITAL ASSOCIATION IN

23:48 - 2003.

23:52 - >>AT

23:53 - >>THAT TIME WE WERE NOT TALKING

23:55 - ABOUT WORKPLACE VIOLENCE AND

23:57 - IT DOES SEEM LIKE IT'S IT'S

23:59 - AND I'M NOT SAYING THAT WASN'T

24:01 - OCCURRING THEN, BUT IT

24:03 - CERTAINLY WAS NOT A TOPIC

24:04 - THAT'S GENERATED SO MUCH POLICY

24:08 - ATTENTION AND DISCUSSION.

24:09 - BUT I ALSO THINK THERE'S

24:10 - SOMETHING THAT'S HAPPENED IN

24:13 - THE PAST 5, 6, 7 YEARS WHERE

24:20 - VIOLENCE IN COMMUNITIES AND

24:21 - INCIVILITY AND COMMUNITY SPILLS

24:22 - INTO OUR HOSPITALS. AND SO I

24:22 - THINK THAT'S ALSO ONE OF THE

24:25 - REASONS THAT WE ARE SEEING SOME

24:27 - OF THIS INCREASE. THIS IS THE

24:28 - THING THAT KEEPS HOSPITAL

24:31 - LEADERS UP AT NIGHT.

24:36 - THEY HAVE IMPLEMENTED AT

24:37 - EVERYTHING FROM AND AS NEW

24:42 - SECURITY PROTOCOLS TO

24:42 - SIGNAGE, 2 BUTTONS SAID THAT

24:43 - YOU CAN, YOU KNOW, ALERT THAT

24:47 - YOU ARE IN DANGER. AND THIS IS

24:49 - SOMETHING THAT WE SURVEY ON

24:51 - CONSTANTLY. THEY ARE CONSTANTLY

24:52 - EVALUATING THEIR THEIR POLICIES

24:53 - AND MAKING CHANGES WHERE THEY

24:56 - CAN BECAUSE THEIR HEALTH CARE

24:57 - TEAM IS THE HEARTBEAT OF THAT

25:00 - HOSPITAL.

25:03 - I DO BELIEVE THAT THERE IS AN

25:04 - OPPORTUNITY WITH THE WAY IN

25:05 - WHICH WE COLLABORATED A LOCAL

25:06 - LEVEL. WE HAVE BEEN HAVING

25:08 - REGIONAL MEETINGS WHERE WE

25:10 - BRING IN

25:11 - >>HOSPITAL SECURITY TEAMS,

25:12 - LOCAL LAW ENFORCEMENT AND ALSO

25:14 - DISTRICT ATTORNEYS TO TALK

25:17 - ABOUT WHEN WE BRING FORTH

25:18 - INCIDENTS OF VIOLENCE AGAINST

25:19 - HEALTH CARE WORKERS. HOW CAN

25:21 - THAT BE

25:23 - CARRIED THROUGH?

25:24 - >>THROUGH THAT THE LEGAL SIDE,

25:26 - I THINK THERE'S A LOT OF

25:27 - OPPORTUNITY THERE.

25:27 - >>I ALSO THINK THAT THERE ARE

25:30 - SOME HOSPITALS I JUST TALKED

25:30 - ABOUT THE FINANCIAL DISTRESS

25:33 - THAT OUR HOSPITALS ARE FACING

25:36 - THEIR HOSPITALS THAT WOULD LOVE

25:38 - TO IMPLEMENT SECURITY DETECTION

25:39 - SYSTEMS THAT DON'T HAVE THE

25:41 - DOLLARS TO DO THAT RIGHT NOW.

25:45 - SO WE'RE VERY SUPPORTIVE OF

25:46 - SAFETY, COUNTING WORKPLACE

25:47 - VIOLENCE, SAFETY GRANTS THAT

25:47 - WOULD ENABLE THOSE HOSPITALS TO

25:49 - BE ABLE TO PUT IT THOSE THINGS

25:52 - IN PLACE. THIS IS A CONSTANT

25:53 - AREA OF STRESS AND REVISION FOR

25:56 - HOSPITAL LEADERS.

25:57 - PENNSYLVANIA HOSPITAL SUFFER

25:58 - WELL AND CEOS PROSPER AND

26:01 - EXPAND. WHY IS THAT?

26:06 - >>AND I THINK WE'RE AT A VERY

26:07 - INTERESTING PLACE RIGHT NOW

26:10 - WHERE

26:12 - I'M HOSPITALS ARE FEELING

26:12 - PRESSURES THAT I BELIEVE MANY

26:15 - OF OUR IN CEOS ARE

26:17 - AS WELL. AND THERE'S A LOT OF

26:20 - OPPORTUNITY FOR THEM.

26:21 - TO WORK TOGETHER AND NOT JUST

26:23 - FOR MCS BUT ALSO WITH PAYERS.

26:25 - WE ARE VERY MUCH IN THE SAME

26:26 - ECOSYSTEM WHERE FACING THE SAME

26:30 - EXPERIENCE IN TERMS OF PATIENTS

26:32 - ARE SICKER. THEIR ACUITY IS

26:32 - HIGHER AND THEY ARE UTILIZATION

26:36 - IS UP AS WELL AS ARE ALL

26:36 - FEELING THOSE PRESSURES.

26:37 - I BELIEVE THERE'S MORE

26:38 - OPPORTUNITY TO WORK TOGETHER.

26:41 - THEN WE PROBABLY HAVE AND

26:41 - TAKING ADVANTAGE OF. I THINK

26:42 - IT'S REALLY IMPORTANT TO NOTE

26:45 - THAT WHEN AND CEOS ARE NOT

26:47 - FUNDED APPROPRIATELY THOSE

26:48 - NEGOTIATIONS WITH HOSPITALS GET

26:49 - PRETTY PRETTY TOUGH. AND SO

26:53 - AGAIN, IT REALLY IS. AND

26:53 - ECOSYSTEM AND I WOULD ENCOURAGE

26:54 - POLICYMAKERS TO DO IT THAT WAY.

26:57 - GIVEN THE CHALLENGES CREATED

26:58 - BY THE FEDERAL GOVERNMENT WITH

27:00 - RESPECT TO MEDICAID, HOW DC

27:01 - PENNSYLVANIA RESPONDING IN THIS

27:04 - YEAR'S BUDGET AND BEYOND.

27:04 - >>GOING TO REMAIN OPTIMISTIC.

27:11 - I LOOKED TO MY TEAM.

27:11 - >>I BELIEVE THAT WE HAVE HEARD.

27:17 - CONCERN FROM MEMBERS OF THIS

27:20 - ADMINISTRATION AND FROM

27:22 - LEGISLATIVE LEADERS ABOUT THE

27:24 - SUSTAINABILITY OF OF HOSPITALS

27:26 - AND ACCESS IN COMMUNITIES.

27:28 - I AM FULLY AWARE OF THE

27:30 - FINANCIAL PRESSURES THAT

27:31 - EVERYONE IS NAVIGATING AT THIS

27:32 - TIME, WHICH IS WHY I BELIEVE

27:34 - THAT WHAT WE RECOMMENDED IN AND

27:35 - ARE SEEKING IN THIS BUDGET IS

27:36 - IS REASONABLE. IT'S VERY

27:40 - PRACTICAL AND IT GETS US A

27:40 - LITTLE CLOSER. WE'RE GONNA STAY

27:41 - AT THE TABLE UNTIL WE'RE ABLE

27:42 - TO SEE THAT. SEE THAT PRINCE.

27:46 - >>FEDERAL LEVEL LEVEL IN

27:47 - INVESTIGATIONS HAVE DISCOVERED

27:48 - MASSIVE FRAUD AND MEDICAID AND

27:50 - OTHER PROGRAMS. HOW WOULD

27:50 - REIMBURSEMENT BE IMPROVED BY

27:52 - STOPPING FRAUGHT? WE ALL WANT

27:56 - TO STOP CRIME. AND I THINK

27:57 - THAT'S FAIR.

28:00 - >>BUT I ALSO KNOW THAT

28:00 - PENNSYLVANIA IS MEDICARE RATE,

28:01 - FOR EXAMPLE, IS IS QUITE LOW.

28:02 - AND SO WELL, I CERTAINLY CAN

28:04 - APPRECIATE THE ATTENTION TO

28:07 - THE ISSUE. I WOULD LIKE TO ALSO

28:08 - ENSURE THAT WE'RE GIVING

28:09 - ATTENTION TO THINGS LIKE

28:10 - FINANCIAL SUSTAINABILITY OF

28:12 - OUR HOSPITALS.

28:13 - >>ONE LAST QUESTION, WHAT CAN

28:14 - THE GOVERNOR AND GENERAL

28:15 - ASSEMBLY DO TO HELP OUR

28:16 - HOSPITALS BY LIMITING LAWSUIT

28:18 - ABUSE?

28:22 - WE HAVE A WHOLE PACKAGE

28:24 - >>I THINK THAT THERE IS I HAVE

28:25 - HEARD THAT THERE IS A NEED TO

28:26 - BRING DATA TO BETTER EXPLAIN

28:27 - THE PROBLEM. AND THAT'S

28:28 - CERTAINLY SOMETHING THAT WE

28:31 - HAVE HER ARE PREPARED TO DO.

28:33 - THERE IS A VERY WILLING

28:35 - COALITION OF BUSINESS LEADERS

28:37 - HERE HAVE IDEAS ABOUT HOW WE

28:39 - CAN BRING BALANCE BACK TO

28:40 - PENNSYLVANIA HAS LIABILITY.

28:42 - CLIMATE HEPA SAYS ACTIVELY

28:43 - ENGAGED IN THAT GROUP. AND WE

28:44 - HAVE PROPOSALS THAT WE ARE

28:44 - HAPPY TO SIT DOWN AND TALK MORE

28:47 - ABOUT.

28:48 - >>WE'D LIKE TO THANK THE CALL

28:49 - STALLINGS AND WISH HER WELL.

28:51 - WE HAVE SOME IMAGES.

28:56 - ABC AND THE PENNSYLVANIA PRESS

28:57 - CLUB IN CLOSING. WE WANT TO

28:58 - THANK YOU FOR BEING WHAT WITH

28:59 - US. OUR NEXT LUNCHEON IS

29:03 - MONDAY. APRIL 27TH FOR SCHEDULE

29:03 - INFORMATION. VISIT OUR WEBSITE

29:04 - PA PRESS CLUB DOT ORG. THANK

29:06 - YOU FOR JOINING US.