Health care in the spotlight. With health insurance influx, hospitals consolidating and more costs shifting to providers. The heats on, those who operate healthcare systems. The chair elect of the American Hospital Association is currently the CEO of New Jersey’s Atlantic health system. Brian Gragnolati joins Correspondent Lyndsay Christian.
Christian: Thanks Mary Alice and thank you Mr. Gragnolati for joining us. As the head of the Atlantic Health System, how do you view the health care landscape in its current state?
Gragnolati: As a country, we are really struggling with a couple of important issues. The first is access to both insurance and care and then the second is affordability. I think in order to understand what’s really going on in health care today you really have to think about those two things because almost everything comes back to that and you seen that certainly in the discussions that have occurred over the past several months.
Christian: That’s a great segue into the national discussion in the stalled effort to repeal and replace the Affordable Care Act. What are your thoughts on that and what specific changes would you want to see in the act?
Gragnolati: You know, I was involved when the ACA was brought forward and one of the things that I often talk to people about is to understand that there are really two things that were happening at that time as part of the ACA. One was to really deal with the issues of coverage and making sure that Americans had access to health care insurance. And then the other piece has gone silent because there’s a lot of work going on but it doesn’t create the drama around it has to do with delivery system reform. As a country, we have to have the health care system that is more affordable, that produces better outcomes and does it in a consistent manner throughout the country. There were a lot of experiments that were enabled by the ACA that were going on all across the country and that work has really been shadowed out by this debate about coverage and so I think its important for people to understand that. As it relates to coverage, I think one of the most important things that we need to remember is that we make great strides in getting more Americans covered with health insurance and because of that we’ve seen the levels of uncompensated care over use of emergency departments as a primary care base really go down. And that was what we were really trying to do is how to do get people into a system of care were we can keep them healthy and keep them in the most appropriate care. What’s happened certainly in this last round of what I would describe as partisan debates, is that I think we lost touch with the fact that the legislation that was proposed was going to turn out anywhere between 22 and 35 million people off of the insurance rules and we were going to revert back to a time eight or nine years ago where so many people in the U.S. just didn’t have access to insurance. So, I think that’s why it was so important that the voices of our patients, the voices of our communities and the voices of our health care organizations really stood up in so many markets around the country and said you know this isn’t right. We can’t go backwards in this country and we expected the political system to work like the political system should which is to work in a bipartisan manner, to have committees that are comprised of both parties, get input from important groups most importantly patients and others who are involved in this like hospitals, doctors and nurses to make sure we come up with solutions here, to deal with the real issues we have, but we don’t go backwards with the coverage provisions that are in place.
Christian: You mentioned something that was really important and that was voice. So you will assume the chair elect role of the American Hospital Association in 2018, assume the full leadership role in 2019, so can you just tell me how you plan to use that voice and that role to push this forward?
Gragnolati: I’ve been involved in the American Hospital Association for over the last 15 years and I’ve been on it’s board in the last four. And what the American Hospital Association does is it really represents the 5,000 hospitals and health systems throughout the country and we really have a few main areas of focus. The first is obviously advocacy because we have to make sure that the policies and laws that are in effect and the regulations that are in effect are doing the right now. So, we are finding the voice of America’s hospitals and health care systems in that regard. The other thing that we do though by convening that many organizations and that many people is we actually act as an agent of change for our industry to say we can continue to do better in providing better healthcare in our communities, providing better access and creating healthy communities in partnership with others. The other thing that we do is we transfer a lot of knowledge because health care is different. I have had to go throughout the country and spend time both in rural and urban settings in inner cities and Indian reservations. Things are different in different settings, one size doesn’t fit all, but what’s important is how do we translate a lot of the quality issues that are going on throughout this country. How do we translate the kind of work that is being done to make health care more accessible and affordable and that’s an exciting part of what we do as an organization. So, as I look forward to moving into this voluntary leadership role, the things that I am going to continue to stress, or the things that I always have stressed, is first we have to have accessible health care. It starts with insurance, but it also is how we could figure the delivery system. The second thing that we have to do is really work hard to make sure that we are inclusive in everything that we do. And then what has emerged more and more is this issue of affordability and the impact that consumers. I use my daughters as an example, she’s on an exchange product. Its almost 40 percent of her income goes towards her health premium and towards the exposure she has towards her deductible. That’s a real issue in the U.S. and she is not an exception, that’s kind of the norm. So, the issue of affordability we have to address. So those are the things that I am working on, access, affordability and inclusion.
Christian: Mr. Gragnolati, I’d like to thank you for joining us.
Gragnolati: Thank you.