Commentary from CHA's Incoming and Outgoing Board Chairs

Serving in the spirit of the Gospel at a time of hope and challenge

2019-2020 Chairperson
CHA Board of Trustees

It is an honor to work with and represent the people of Catholic health care. I am aware that I take on this role at a time of great hope and great challenge.

At this year's Catholic Health Assembly, we paid tribute to Sr. Carol Keehan, DC, and marked the transition of CHA executive leadership from Sr. Carol to Sr. Mary Haddad, RSM.

We are thankful for the career of service of Sr. Carol, and especially her extraordinary contributions to Catholic health care as a nurse, as an executive and then as chief executive officer of CHA where she represented and advocated for all of us while urging those working in Catholic health care to be the best servants of the Gospel. Sr. Carol served with great dedication and clear principles. Her faith in God and in all of us sustained her in the cauldron of public life in America — a tough place to be these days.

Catholic health care was blessed to have Sr. Carol, and I thank her on behalf of all of us.

We are also thankful and hopeful that Sr. Mary has stepped up to lead Catholic health care forward in a tumultuous world. Sr. Mary will be a great leader as a woman religious with the broad experience, the personal confidence, the interpersonal skills, and the faith to take on this leadership challenge and succeed.

It is a privilege to work with the CHA board, the association's executive team and staff and especially with all of you. Our task is clear: Work together to bring our skills, our experience, and most importantly, our commitment to serving in the spirit of the Gospel to the benefit of the people of this country, especially those who are most in need. We are here for those who the Gospel says hunger and thirst for justice.

A quarter century ago, I had the opportunity at a CHA assembly to make the opening presentation about the importance and relevance of mission in achieving true success in Catholic health care. Those were also challenging times. A new company called Columbia/HCA was devouring health care entities like a giant Pacman; and serious (although misguided) people were predicting that U.S. health care delivery would soon be controlled by three to five companies. It was not clear how Catholic health care would survive in these circumstances.

But Catholic health care did survive the 1990s and indeed has often flourished. In a rapidly consolidating health care sector, Catholic systems came together in the mid 1990s under CHA's facilitation for a deep dialogue, thoughtful analysis of market trends and clarification of ministry goals in a process called the "New Covenant." The New Covenant promoted collaboration as a way to strengthen the ministry and secure its values-based health care.

Today, we again find ourselves facing heightened challenges and risks. Attacks on Medicaid, the stresses on the Medicare Trust Funds and the consolidation of payer strength tell us that we must be proactive and smart in defining and leveraging our strengths in the interest of our mission.

What are those strengths? Catholic health care has institutions today that dwarf their size and capacity in the 1990s in ways we probably couldn't have imagined when we embarked on the New Covenant. We have built highly integrated delivery systems, increased financial and operational strength and developed far more sophisticated tools.

But at a time when public trust in large institutions is wavering, our greatest strength is you and the people on the ground in our institutions who prove Catholic health care is different in ways that matter to real people. If our staffs and the general public believe that being a Catholic health care provider means that patients will be treated lovingly and skillfully when vulnerable and in need, and if it means that our institutions take demonstrated business risks through their service to the poor in the spirit of the Gospel, we will have a great future.

I believe this because of faith, but also because I have seen it.

The Catholic system I served, Holy Cross Health, was successful during this decade in gaining approval to build a new hospital and related capacity. It bested fierce competition for that right and did so in a highly regulated state that had not approved a new hospital in over 25 years. The new facility was constructed on public land — the county's community college campus — something that had not been done before in the United States, overcoming objections about separation of church and state. That success was a direct result of mission-driven planning and action.

Many years before submitting the certificate of need application for the new hospital, at a time of crisis due to a lack of prenatal care for poor immigrants, our institution alone in a county of one million people stepped up to create the Maternity Partnership with our county government. We weren't the biggest health provider, we surely weren't the richest, but we were following the Sisters of the Holy Cross who taught us to "see a need, meet a need."

By the time we opened that new hospital, over 20,000 poor, pregnant women had been served by the Maternity Partnership at our institution. In addition, we had provided gynecological care and primary care at six sites and were providing 50,000 visits per year to people who had no other access to health care.

In opinion surveys and government deliberations on the CON, the respect we had earned for doing what was consistent with our mission carried the day. That is why I believe mission fulfillment is our greatest strength.

So how should CHA relate to this effort? The CHA board's focus is on helping Catholic health care thrive. We believe that thriving means that Catholic health care is:

  • respected as a Catholic ministry by the church and the public.
  • broadly appreciated as a servant of — and an advocate for — the poor and the institutions that serve the vulnerable.
  • sustainable due to its demonstrated excellence, its special standing as a defender of those in need, and its wide range of positive community relationships, including ever stronger relationships with other Catholic institutions.

As long as Catholic health care leaders keep a central focus on innovation, adaptation and service in the spirit of the Gospel, that future is possible.

Catholic health ministry: A future inspired by the Holy Spirit

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

As of this writing, I have served in leadership roles in the Catholic health ministry for over 30 years. And while I've had many amazing experiences, one of the highlights has been the blessing and honor to serve as your chair of the CHA Board of Trustees for this past year. I have had the privilege of developing relationships and friendships with so many colleagues who are passionately committed to our healing ministry.

Working with Sr. Carol Keehan, DC, the CHA staff, fellow board members and the CEO search committee has been a life-changing experience. And while the search process took up the majority of my time as board chair, the association's staff has moved forward many important initiatives in advocacy, sponsor formation and leadership formation. Project Legacy, the Ministry Identity Assessment tool and the launch of a Catholic Clinical Ethics academic program in partnership with Georgetown University and Catholic University of America are a few recent examples of advancements that demonstrate value to all members of CHA.

We are so grateful for Sr. Carol's contributions to the Catholic health ministry. She exemplifies the words, "caring spirit." I have grown more deeply in my faith and my commitment and resolve as a Catholic health care leader as a result of observing Sr. Carol's unrelenting and unflappable commitment to ministry and to advancing — in body, mind and spirit — the human condition for all people, regardless of means, race, religion or creed.

I am grateful for the work of the CEO search committee in vetting candidates to recommend to CHA's board. We are excited and blessed to have Sr. Mary Haddad, RSM, as the association's new president and chief executive officer. As CHA's vice president of sponsorship and mission services and in prior leadership posts with her congregation, Sr. Mary has demonstrated her leadership skills. During her decade with CHA, Sr. Mary has connected with many colleagues and leaders across our ministry and visited many of our ministries. She will "hit the ground running" to advance CHA's three pillars — advocacy, church relations and Catholic identity, and member engagement. She and Sr. Carol have been great partners, and the transition will be smooth.

From a national perspective, this has been another year of changes and challenges for the Catholic health ministry and for CHA. We've had to play a lot of defense with our advocacy efforts. We've defended against continued attempts to weaken or repeal the Affordable Care Act through both legislative and administrative actions; attempts to reduce or eliminate 340B drug pricing supports; and efforts to introduce waivers or block grants for Medicaid.

More and more Medicare members are moving into Medicare Advantage products, and health systems are being treated as commodities by payers. The Centers for Medicare and Medicaid Services is attempting to de-risk and shift all responsibility for cost of care to payers and providers. In the private sector, egregious actions by payers to deny payment for care under the pretense of lack of medical necessity have escalated. Various proposals for health coverage have been proposed, including "Medicare for All." We've seen more states passing bills to legalize physician-assisted suicide. Finally, we've seen several Catholic hospitals close or be sold to secular and for-profit organizations.

It would be easy to throw up our hands and give up, but we aren't succumbing to downward spiral thinking. We are inspired by the Holy Spirit to stay open to possibilities — to seek a better way, to support the people and communities we serve with health care, that most personal of human services.

I am so encouraged by the ways in which Catholic health care providers are attending to excellence in health delivery and advocacy for health care access for all, and I'm inspired by our important work to move upstream and address the social influencers of health that can lead to healthier communities. We are partnering with others and using the resources we have to move outside of traditional health delivery and provide social support — housing, food, behavioral health, education, employment — to improve health status and life quality for those on the economic margins. Our award winners at the Catholic Health Assembly are examples of this commitment. There are thousands of proactive, collaborative initiatives around social determinants of health across our membership.

With Kevin Sexton, CHA's 2019-2020 board chair, and Sr. Mary leading the effort, CHA soon will begin work on the association's next strategic plan. We will strive to approach this work with openness and a "beginner's mind," and we will engage the membership at large in a consideration of how Catholic health ministry can thrive and how it can be distinctive in carrying out and advancing our shared mission. Some of the questions that will be addressed include:

  • How can we differentiate ourselves from other providers in a significant way — beyond "balanced scorecard" measures that everyone measures on cost, quality, safety, stewardship?
  • What would motivate more communities to seek a Catholic health organization to expand in their communities?
  • How can we create a brand reputation that makes Catholic health care ministries the "go to" place for care in our communities for all populations — people who are underserved as well as those who are insured — thereby contributing to growth and sustainability of the ministry?

These, and many other questions, will be addressed by all of us as we work together on an exciting future for CHA and the Catholic health ministry at large. There is a hopeful future for us if we keep our mission and values at the forefront and remain open to the Holy Spirit for inspiration and guidance as we create a better future for the people and communities we serve. God Bless all of you as you engage with CHA in the creation of a better world that furthers God's plan for us while on this earth — to serve and love one another.