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.

Measles, eradicated in the United States in 2000, is making a comeback. Meanwhile, an estimated 300,000 people died from COVID-19 in cases that could have been prevented through vaccination. Why are we seeing an uptick in conspiracy theories, misinformation, and outright science denial? The consequences of losing trust in science are harmful and even deadly.

Dr. Reed Tuckson, MD, FACP, has dedicated his career to restoring public confidence in scientific research and health care. He joins Chip on the latest episode of Hospitals in Focus to explore the current social climate influencing science denial and how it is exacerbated by those who seek to sow mischief and discontent.

Topics discussed include:

• Tribalism and the “Us vs. Them” mentality;

• Social media’s role as a dissemination mechanism;

• Patient-level impacts on health, particularly on society’s most vulnerable; • Covid-19 and the mistakes made with the best intentions; and

• Bridging the gap to regain trust and promote science literacy.

More/Dr. Tuckson’s Bio:

Reed V. Tuckson, MD, FACP, is Managing Director of Tuckson Health Connections, LLC, a vehicle to advance initiatives that support optimal health and wellbeing.

Currently, Dr. Tuckson’s focus is on his role as a Co- Convener of the Coalition For Trust In Health & Science, which is dedicated to bringing together the entire health related ecosystem to address mistrust and misinformation. In addition, he continues to advance his work as a co-founder of the Black Coalition Against COVID, a multi-stakeholder and interdisciplinary effort working to mitigate the COVID-19 pandemic in Washington D.C. and nationally by coordinating the four historically Black medical schools, the NMA, the National Black Nurses Association, the National Urban League, and BlackDoctor.org.