Assembly 2018, San Diego | June 10-12

Remarks from CHA's Incoming and Outgoing Board Chairs

Spiritual grounding will guide the health ministry through challenges

2018-2019 Chairperson
CHA Board of Trustees
President and chief operating officer
Trinity Health
Livonia, Mich.

I am grateful for the opportunity to serve as chair of the CHA Board of Trustees. I am excited and humbled to support Sr. Carol and staff, our outstanding board, and, most importantly, our membership as we move the Catholic health ministry forward during these challenging and uncertain times.

As a membership organization, CHA will continue to lead at three strategic themes in supporting its membership: advocacy, church relations and member support. Your board spent considerable time during its retreat earlier this year in defining ways to advance all three of these strategies.

As leaders of Catholic health care, we recognize that our world is changing, and the environment is rapidly changing from a social, political and economic perspective. I would like to reflect on some of the trends and challenges that I know are probably keeping us all up at night, as well as some of the opportunities we have to sustain our health ministry and excel at serving the people and communities we support. Some, but not all, of these challenges include:

  • From a public policy perspective, we are facing many challenges to the Affordable Care Act and our efforts to expand coverage for all. While the ACA has not been dismantled, we are facing an onslaught of "death by 1,000 cuts" as federal promotion and subsidies of the health exchanges have been minimized, the individual mandate has been eliminated, and Medicaid is under siege with efforts to characterize it as a welfare/entitlement program.
  • As Catholic health providers, our mission is to care for those who are poor and underserved and to remain serving in disadvantaged communities — so the burden may be disproportionately higher on us versus other providers who are more selective in serving populations and growing communities with a better payer mix.
  • Niche competitors, especially those who are for-profit, are springing up in large numbers to provide urgent care, ambulatory surgery, telemedicine and other services that target insured consumers or those who can afford to pay out of pocket for services. And in instances where it may be prudent for us to partner with these organizations to serve our communities, we must be careful to align with those who share our values and enable us to maintain our Catholic identity.
  • The movement to population health and total cost of care contracts with commercial payers has been slow. Government payers keep changing the rules on programs and payments that shift increasing risk to us without commensurate opportunity for incentives when we improve outcomes or manage the cost of care for a population.
  • Inflation in wages and supplies are outstripping net payment increases, especially with only modest commercial payer rate increases and a shift of business to government payers and self-pay as individuals find exchange products unaffordable and are dropping coverage.
  • We have been slower to shift to a consumer focus in health care delivery and meet customer expectations for access, information and lower cost and price transparency for care provided.
  • With a robust economy, we are experiencing a shortage of talent, especially nursing and clinical staff and technical specialists; and with restrictions from professional practice organizations and regulations, we aren't creating new roles fast enough to enable clinicians to practice at the top of their professional licenses.

So, with all of these challenges, what is Catholic health care doing?

  • CHA and Catholic providers are continuing our advocacy efforts to be the voice for the voiceless, with a special emphasis on supporting both the importance and vitality of Medicaid as a safety net and robust health exchanges for coverage.
  • Catholic health care providers have been advocates for public policy supporting population health and have aggressively participated in programs that provide incentives for effectively managing the triple aim.
  • Catholic providers have moved upstream in order to have a positive influence on the communities we serve, including through numerous community benefit activities and reporting as well as by participating in many initiatives to mitigate factors that negatively impact upon social determinants of health.
  • Catholic health care providers are learning how to become more consumer friendly in offering telehealth and other ambulatory services and access points to better serve their communities. We are shifting more care to the home and community settings, and we are engaging the people we serve in making better decisions regarding their health.
  • Many Catholic health care providers are merging or aligning with one another in various forms to leverage skill, scale and learning and are expanding the influence and role of Catholic health care in our society.
  • We are aligning with partners who share our values to support our communities and to infuse innovative approaches to care throughout our ministries.
  • We are working with bishops to maintain an open dialogue as we partner with others to serve our communities and meet public health needs while remaining in fidelity to the Ethical and Religious Directives for Catholic Health Care Services and Gospel values.
  • We are engaging with our employees to redesign care and services to be more person-centered, cost-effective and efficient.

Those of us in Catholic health ministry strive to offer our very best to individuals and communities. We strive to help everyone, but especially those in our society who are poor and vulnerable and need extra help in one form or another. Regardless of each person's faith tradition, our mission is about providing the most personal of human services -- body, mind and spirit.

In summary, I am inspired by the commitment and accomplishments that we as Catholic health care providers are advancing to further Jesus' work on earth. Even with all of the challenges that Catholic health care faces today, we must stay focused on the spiritual vision that initially inspired and nourished us to serve in the health professions. It is hard work with a higher purpose! Pope Francis praises hard work as an essential aspect of God's design for the family. He applauds our personal readiness to contribute to the common good.

Let's keep inspiring one another with our powerful mission of healing and the difference that each of us makes every day. Our mission remains the same, but the way in which we are advancing our mission is very different. We must continually ask ourselves: Are we moving fast enough? Are we being proactive and changing before we have to? If we remain in "possibility thinking" mode and engage all of our people in continuous improvement, breakthrough thinking will lead to transformation.

I look forward to working with you and advancing CHA's mission in the upcoming year. Thank you so much for all that you do for the people and communities that we serve!

Peace to you.

In era of disruptive change, Catholic ministry called to innovate, lead and partner

2017-2018 Chairperson
CHA Board of Trustees
Chief executive
Providence St. Joseph Health
Renton, Wash.

This year marks my 40th anniversary as a physician. After all these years, I'm as passionate about health care today as I was as a medical student in Boston. I continue to believe it's one of the most sacred services we provide as a society because, at the end of the day, health care is about being a source of healing love for one another when we're at our most vulnerable.

While I've seen many changes over the decades, nothing compares to the level of disruption we're experiencing today. The role of the traditional care provider is blurring as new entrants — such as retailers, tech giants and start-ups — make forays into health care.

Amazon, for example, shook up the health care world when it announced plans to team up with Berkshire Hathaway and JPMorgan Chase to attempt to create a better, more affordable health care experience for their employees. The drug store chain CVS also made waves when it announced plans to acquire Aetna earlier this year in an effort to deliver care in the more convenient, lower-cost retail setting.

Meanwhile, health care is feeling pressure from other directions, as well. The fate of Medicaid and coverage for those who are poor and vulnerable hangs in the balance as lawmakers debate the future of health care policy. In addition, our nation's health care personnel have been called to step up, time and time again, as first responders on everything from mass shootings to wildfires and hurricanes. The feeling of upheaval and uncertainty can be overwhelming.

As a Catholic health care ministry, we have a responsibility to be a steadfast presence in this time of unprecedented change. I believe there are six ways we can respond and evolve with the times while continuing to lead with our values.

  1. Care for our caregivers – The people who care for our patients are our greatest assets. We must continue to support them in bringing their best selves to work every day so they can contribute their gifts and talents to those we serve.
  2. Care for our communities – We have long been a trusted pillar in our communities, and we must continue to play that leadership role especially in challenging times. From the opioid epidemic and the mental health crisis to mass violence and natural disaster, our communities count on us to respond to these events and provide leadership in times of greatest need.
  3. Innovate with the times – The digital age is upon us, and we can no longer deny it. It's time to bring health care into the 21st century. We have an unparalleled opportunity to improve access and service by delivering care when and where people want it whether it's on their mobile device, a laptop, at their neighborhood drug store or in their homes. Our founding congregations of sisters were never afraid to shake things up to improve the lives of those we serve. We shouldn't shy away from it either.
  4. Focus on clinical excellence – Every community in the United States deserves the highest standard of care. We must relentlessly work to promulgate best, evidence-based clinical practice and reduce variation across the country. We must also streamline our systems of care to ensure individuals in remote areas have access to the care they need.
  5. Forge partnerships – Catholic health care has a long tradition of partnering with those of good will to meet the needs of our communities. Going forward, this spirit of collaboration will need to include nontraditional partners to help us improve the way we deliver care. We will need outside experts in cloud computing and artificial intelligence, for example, to harness the power of data to help clinicians and patients make more informed decisions about their health. 
  6. Communicate and advocate – As Pope Francis has said, health care is a universal human right, not a privilege. We must continue to advocate for health care for all and use our collective voice to preserve Medicaid, which covers many of the most vulnerable individuals in our communities. We must also continue to be a voice for the voiceless, including immigrants, victims of human trafficking and the health of the planet.

Columnist Tom Friedman recently wrote that, in this age of accelerated change, communities must be anchored in strong values. He likens it to being in the eye of a hurricane, which "moves along with the storm, draws energy from it, while creating a sanctuary of stability inside it. It is both dynamic and stable — and so must we be," he writes. As a Catholic health care ministry, we are called to do the same. By staying centered in our values, we will lead our communities through this highly transformational period while continuing to be a source of hope and healing for each person we serve.