Dr. Bruce Siegel

Modern Healthcare - - PHYSICIANS - — Steven Ross John­son

As chief lob­by­ist for the coun­try’s safety-net hos­pi­tals, Dr. Bruce Siegel has had a front row seat to the po­lit­i­cal the­ater in­volv­ing health­care over the past seven years.

With the en­act­ment, im­ple­men­ta­tion and now pend­ing re­peal of the Af­ford­able Care Act, Siegel, CEO of Amer­ica’s Essen­tial Hos­pi­tals, has given voice to the more than 300 hos­pi­tals that serve the coun­try’s most vul­ner­a­ble pa­tients— the unin­sured.

Siegel also has wit­nessed the chang­ing role of the hospi­tal. “The fo­cus on the hospi­tal as a com­mu­nity an­chor, which pro­motes health in all things—that to me has been a ma­jor trans­for­ma­tion,” he said.

In 2011, Siegel pushed to in­clude Amer­ica’s Essen­tial Hos­pi­tals in the CMS’ Part­ner­ship for Pa­tients ini­tia­tive. The pro­gram aimed to re­duce hospi­tal-ac­quired con­di­tions by 40% in the fol­low­ing two years via the Essen­tial Hos­pi­tals En­gage­ment Net­work—the first safety-net provider qual­ity net­work in the coun­try. From 2011 to 2015, the pro­gram was cred­ited with help­ing pre­vent more than 3,500 harm­ful events and is es­ti­mated to have saved more than $35 mil­lion in health­care costs.

Siegel said it has been part of an over­all ef­fort to have essen­tial hos­pi­tals cre­ate a “cul­ture of health” in their com­mu­ni­ties.

Siegel said he learned some of his great­est lessons about how en­vi­ron­men­tal fac­tors can im­pact health dur­ing his ten­ure as New Jer­sey’s health com­mis­sioner. “I saw the rav­ages of lead poi­son­ing, and I saw the im­pact of peo­ple not hav­ing good health in­surance,” Siegel said. “I re­al­ized that health is pre­cious, and it takes a lot of peo­ple work­ing to­gether to achieve it.”

He cul­ti­vated that phi­los­o­phy when he ran two of the na­tion’s largest pub­lic health sys­tems. Siegel was CEO of what is now called NYC Health & Hos­pi­tals and Tampa Gen­eral Health­care.

Dr. Eric Dick­son, CEO of UMass Memo­rial Health Care, an Essen­tial Hos­pi­tals mem­ber, calls Siegel a “true part­ner work­ing to help im­prove qual­ity and pa­tient safety across the as­so­ci­a­tion.”

Siegel’s big­gest chal­lenge is to come, as law­mak­ers de­bate changes to Med­i­caid, the source of close to half the net rev­enue gen­er­ated by mem­bers of Essen­tial Hos­pi­tals. The hos­pi­tals serve a to­tal of 45 mil­lion peo­ple ev­ery year.

The loss of cov­er­age to po­ten­tially mil­lions who gained it un­der the ACA, cou­pled with years of fund­ing cuts to pro­grams that help pay for hospi­tal ser­vices for the unin­sured has some safety-net fa­cil­i­ties wor­ried they might not be able to sur­vive de­ci­sions made on Capi­tol Hill.

“We’re go­ing to have a de­bate over who gets what in Amer­ica when it comes to health­care,” he said. “The stakes are be­com­ing very clear as we have this na­tional dis­cus­sion—that’s a healthy thing. We may have short-term re­ver­sals, but I think the long-term arc is to­ward health­care for ev­ery Amer­i­can.”

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