Episode 102

An Agent of Change

with Richard Pollack

March 2, 2023

Richard Pollack
President & CEO, American Hospital Association

Rick Pollack is president and CEO of the American Hospital Association (AHA), the nation’s largest hospital and health care system membership organization with nearly 5,000 member hospitals, health care systems, networks, and other providers of care. Serving as the AHA’s top leader since 2015, Rick is widely recognized for his strong, effective advocacy and leadership on behalf of our nation’s hospitals, the patients and communities they serve, and the health care professionals those organizations support. During the height of the COVID-19 pandemic, Rick built a coalition including the American Medical Association, the American Nurses Association, state and regional hospital associations, and other leading health organizations to support efforts in following public health guidelines, promoting vaccination, with a focus on vulnerable communities, and successfully obtaining the financial resources and regulatory flexibility to keep our hospitals open to care for their patients and communities during the most challenging public health crisis of our time.


As a national association, the American Hospital Association can take people out of their competitive environment, where they feel more free to share things together.



Gary Bisbee, Ph.D.: Good morning, Rick, and welcome.

Richard Pollack: Thank you, Gary. Thanks for having.

Dr. Gary Bisbee: And I was just reflecting on your career. You’ve been at the AHA now for 40 plus years, CEO for eight plus years. No one knows association management, health policy, health financing advocacy more than you do. So we’re honored to have you with us today.

Richard Pollack: Thank you. Thank you. It’s fit to be with you. And I remember you were a senior guy when I first came to AHA a very young guy. And I appreciate everything that you have done for the organization and earlier in your career. And you’re someone that was always very well respected.

Dr. Gary Bisbee: Thanks. Why don’t we kick off, Rick, with could you just de describe the AHA, the American Hospital Association. Everybody knows. What it is, but probably not in the nuance and detail that you might describe.

Richard Pollack: Sure. At the very basic level, we are the umbrella association for hospitals and health system in the country. Meaning that we represent all forms of ownership. Whether it’s investor own, whether it’s public, whether it’s private, nonprofit, and there are a lot of other associations nationally that represent hospitals and we consider themselves partners, whether it’s the teaching hospitals, the investor own hospitals, the Catholic hospitals.

You can go down the list and I’m proud to say that can work very well together. I think there are forced functions for an association like. , the first is obviously advocacy and representation and, given that so much revenue for hospitals comes from the federal government in the form of Medicare and Medicaid, and there’s so much regulation.

When it comes to advocacy and representation in public policy, there is a lot that we are engaged in, and that’s one of the primary functions in some respects of court competency. And when they say advocacy and representation, I think it’s important to recognize that it’s not just Capital Hill, it involves regulatory agencies, it involves litigation and the.

it involves influencing the media and the think tanks and academic organizations. So that’s number one. Number two is being a thought leader. That’s a function of our association. We like to be able to be in a position of our offering. Ideas, kind, how to address important challenges that we face as a nation and as.

but we also feel as if there are times when we don’t like what’s going on and there’s an obligation to offer alternatives. So thought leadership is the second one. The third is being an a forum for knowledge exchange. Our members can learn a lot from themselves. They are good teachers to each other.

whether it’s best practices or other approaches where they can learn from each other, we’re gonna have the ability and to provide a lot of forums for that. And one of the things that we can do as a national association is take people out of their competitive environment where they feel more free to share things together.

And then the fourth thing that we’re really focused on is being an agent for change. I’m trying to do the right. Bring the field in the direction of doing the right thing. And you know what, when you do that, it also helps you on your advocacy activities. So whether it’s being an agent for change in improving quality, whether it’s being an agent for change in addressing disparities from diversity, whether it’s being an agent for change in getting our shield up to protect against cybersecurity that’s where we try to be an agent for change.

So those are the four key area.

Dr. Gary Bisbee: Yep. Yeah, that’s a handful. It’s frequently said that the AHA leader in this case, Has one of the toughest jobs in Washington because there’s such a diversity of your members that just keeping them all in the fold, rick is a key part of your job.

Richard Pollack: Yeah. And that’s true. There is incredible diversity within our members and we can talk about that. There’s also an awful lot of common ground. When you think about the issues that we’re facing today around financial challenges, around workforce challenges around cyber security, around the need to improve quality.

Doesn’t matter who you are, where you are, whether it’s regionally or type of organization, all of those things are important to you.

Dr. Gary Bisbee: The Aha just published. Advocacy agenda for 2023. Congratulations on narrowing a list of four . I can remember the old days a lot longer than that. So well done. But could you just review those four topics and then how do you actually get the membership together to agree that those are the four topics of choice.

Richard Pollack: You’re very generous in saying there’s only four because the, I, internally we were joking about it because there were probably about 82 different issues we need. Four and I was congratulating ourselves from getting into 82 to 75, for this year. Clearly there are several that are, go into certain categories and, financial stability and financial relief coming out of cot.

Is clearly one area of which there are multiple issues addressed in the workforce challenge as a second issue of which again, there are multiple things that we’re pursuing, and you can unpack those if you want. The third is in regulatory relief. That certainly has a whole bucket of things that we’re pursuing.

And the fourth is in advancing healthcare transformation. And again, a lot of that is around equity. A lot of that is around delivery. The system reform in terms of warehouse brought fit in a changing environment. So those are the sort of four buckets, if you will, but beneath each one of. There are a lot of key issues that we are pursuing.

Dr. Gary Bisbee: Yeah, that’s for sure. You spoke about thought leadership. Rick, how do you think about thought leadership in the sense of how you do you develop the thought leadership agenda?

Richard Pollack: The key to developing thought leadership agendas, which are inherent in a lot of what we do, is engagement with the members.

We’ve got a lot of smart folks that are leaders in our field and we have a formal process in which we develop agenda nine regional policy boards. We got series committees.

We’ve got a very bright staff and it’s really engagement and, always go by the theory of people are invested in what they help create. So I, I think providing opportunities for people to develop these agendas, for instance, the advocacy agenda I just outlined. That was not the product of us just writing it up at the staff level.

That went through boards, it went through testing things with state associations. So it’s all a process in which we, work with our key constituencies.

Dr. Gary Bisbee: Having been at the AHA for a while back years ago, as we mentioned it was obvious to me pretty quickly that leading the aha, a large membership organization. Is not for the faint of heart is one thing, but also what are the differences between leading a large membership organization and let’s say leading a hospital or a health system or a commercial entity.

I think there’s just a lot of differences there that people may not realize. Rick,

Richard Pollack: Yeah. It goes back in some respects to the four core areas. We are focused on advocacy and representation, thought leadership. Knowledge exchange and being an agent for change I don’t think that necessarily that’s where your typical health system or commercial enterprise is focused.

Now, some of them are certainly focused. on pieces of advocacy for their own personal or own commercial interests. I should say. Some of them are focused on being an agent for change in their own communities, but I think it’s those four things that make it different. The other thing that I think makes it different is that we really strive to have influence over driving the conversation around he.

and furthering our advocacy agenda. And when it comes to having influence, there are probably 15 different levers that you have to use to have influence. And if I were to go through a couple of those different levers, I suspect they’re a little bit different than what an individual health system or commercial enterprise might do for.

Dr. Gary Bisbee: right.

Richard Pollack: We have to impose self-regulation on ourselves when we see that there’s a problem out there. And if we don’t act, then hey, we’re at risk of having bad regulation or legislation imposed. So we’ve done that. When it comes to things like billing and collection guidelines, when it comes to things like.

Creating an equity roadmap to make sure that people are doing what they need to do to ensure the birth and address racial disparities. When it comes to influence holding events is an important way. Being a source, a trusted source of data and information is important. Coalition building with others is a very powerful source of influence.

Our focus on being influential and in driving the discussion is probably a little bit different than where the focus might be for some of those other types of organizations.

Dr. Gary Bisbee: Yeah, for sure. Speaking of coalitions, you’ve done a great job building coalitions around. Specific topics or areas, what are the secrets to building a coalition?

Richard Pollack: I think the secret is being able to compartmentalize sometimes. Cause some of the coalitions where we do have common ground on are with people that we may disagree with on other issues. And you have to learn that’s okay. Certainly we wrestle on a variety of issues with the commercial health insurance companies but we also have an interest in working with them on how you handle expanded coverage.

We wrestle with the labor unions as you max suspect on certain issues. But there again, we have some common ground when are issues around expanding cupboard. So I think the idea about coalitions is inherent in everything we do. Yeah. You name an issue. and I’ll tell you who we’re working with on that issue.

And it’s always more attractive to the politicians when you’re in coalition because coalitions bring more votes and, there’s that expression of strange bedfellows. The stranger, the coalition. The more interesting it is, the more votes you can bring, the more the media is attracted to the story of having the strange Beths fellows being.

Dr. Gary Bisbee: You mentioned politics in one way or another, and just in your time at dha, we’ve moved to a highly polarized society and. And governmental process. How do you manage that, Rick? That just feels like just making things real complicated.

Richard Pollack: very carefully. It it’s been difficult navigate sometimes. . And the fact of the matter is we are a bipartisan organization. While we have a very large political action committee, one of the largest in healthcare, you’ll notice that if you look at our political giving, it’s probably a 50 50 split.

And it’s not reflective of saying that we’ll run any one party to be in power. It’s really a question of working with the people that are members at the grassroots level are closest. that are most accessible, that are sympathetic to our views and wanna work with us. Whatever we do, really try to make it bipartisan.

And if you looked at our agenda and if you looked at the things that we’re involved in, we really trying to make sure that what we’re doing is bipartisan. That our champions are always a Republican and a. And we try to stay below the political radar screen and keep our issues out of the crossfire.

Does that mean that sometimes we don’t get caught in it? Yeah, we do. We and this goes back to in my previous role here at a, we supported the Affordable Care Act. We not only supported it, but we defended it three times in the Supreme. And once during repeal of replace, that was in the political crossfire, but it was also something that we felt very strongly about in terms of the principle of expanding coverage to literally millions of people.

So there are times when you just have to take a principled stand and do it in a gentlemanly way, if you will. Most of the issues we carry, we try to make bipartisan.

Dr. Gary Bisbee: . So you have a Republican house now. That means new committee chairman, new committee assignments. Is there just a lot of plain old educating as part of what you’ll be doing now with the new house? Leaders?

Richard Pollack: Yeah. It is interesting. If you look at the new leaders in the house they haven’t been together as leaders for many years. I think somebody, it’s interesting with speak. Hello, Steve Evening and Sten Hoya, the majority leader, leading and the assistant leader Clyburn now around, but not in one of those top leadership roles.

They had a, I think over 120 years of experience in working together as leaders. If you look at the new Republican leadership, maybe 34 or 35 years of collected experience of working with leaders. If you look at the new democratic leadership in the house, which represents significant generational change, maybe 24 years of leadership, and any of them have not been in either case, chairs of committees that actually produced legislation.

So it is a different set of experiences and your point. So many of the members of the house are new and over half of them, I believe, have never even served in the majority. So yes, a lot of education. A lot of education, and we’ve been doing that with a lot of newer members. One of the things I think we’re gonna see even split government, and this is something that you always see when you hack split government, is a lot more activity on the administrative executive side a lot more.

From the executive side of the house because they know that it’s gonna be difficult to get things done through legislation. Now, having, and I will also say that HHS has a full plate of policy issues in healthcare. that they’re working on that has nothing to do with the legislative process.

They have to implement the infl, the inflation Reduction Act that involves a wholes series of negotiations over drug prices. They are in the midst of doing the remedy based upon our unanimous decision in the Supreme Court. On the three 40 B case, which mandates that store companies provide us with discounts when purchasing outpatient drugs.

Medicare Advantage, they’re looking at auditing the commercial plant in particular. And holding them accountable for a variety of different behaviors. The surprise billing shoot is still in the courts and being implemented. So there are whole series of things that really don’t depend upon legislation where h s has a full place.

Dr. Gary Bisbee: Let’s move to Covid for a moment. and how you played your role, the HA role during that. But one thing you spoke about a bit ago is the trust that people have in the data of the American Hospital Association. And the a has just done a terrific job. I think on that point through the years, we ran into a problem with certain other federal government sources of CDC comes to mind.

Where people did lose confidence in the data, and I think part of it was just the kind of politics entering into all this. How did you have to navigate those trolls During during Covid?

Richard Pollack: Yeah, and I’ll go. Data thing because that was a bump in, in the road for sure. But when you think about the whole Covid experience and you talk about coalitions before, one of the most important parts of the Covid experience was partnerships. And one of the most important partnerships that we had was with the American Nurses Association and American Medical Association.

We were constantly out there working together in a variety of different forums, television ads, radio ads, public service announcements, all kinds of things, to promote following the public health guidelines following the masking up procedures, getting vaccinated. And in fact, just this week, and we are releasing yet a new public service announcement from the three organizations that’s focused on still getting vaccinated and keeping it up to date, but on the government.

With the federal partners, I gotta tell you Gary we really did have incredible accessibility to the key people in both administrations, in both the Trump and the Biden Administrations, not only at the White House level, but at the Heath bitches. and I think we all approached it not as lobbying organizations, but as partners in what was a historic public self crisis.

And I think it was very productive. . You think about what we did during the Trump administration in creating a ventilator reserve in partnership with the administration. When, things were really tough at the beginning and ventilators were an issue. We worked very closely with the Trump administration and the distribution of the provider relief funds and making sure that they were targeted in the right way and the appropriate account buildings were in place to.

That the funds were going to be used with appropriate accountability vaccine distribution and the encouragement of people to get vaccines. That was something that kind of took us into the Biden administration and we were partners there, particularly when getting those vaccines into vulnerable communities.

Now to your. War frustrations with data collection. And some of those frustrations were during the beginning where people were just trying to get the right data in the right time period, and everybody was under all sorts of pressures and. Having to report on certain things that were less important than others, yet we had disagreements over that.

And at one point, I think during the previous administration, there were six different reporting systems that were put in place that went back and forth. Some of them between BC and some of them between hhs. It’s a long story. I think we’ve I think at the end of the day, we were able to work it through.

I think the most serious issue now really is the whole loss of confidence and public trust in medicine, science, and public health as a result of the whole experience. And it’s directly related to the political polarization that I don’t think any of us in healthcare ever believed we would have seen in a circumstance like this.

Dr. Gary Bisbee: Yes. Thankfully, doctors, nurses, and hospitals continued to be high in public confidence . That’s important. I think particularly when it comes to your point about the science and so on being under attack. Here’s another question, Rick, and that is that if you look at the hospital’s role in vaccine administration testing information, you make that point you could look at it like hospitals really took over.

Some of the public health responsibilities for the country because public health just wasn’t organized and funded enough to do that. And I’m not sure that hospitals were compensated for that, by the way. But the question is, going forward, if there are other infectious disease crises, do you think that hospitals will continue to be in this role of taking over certain of what people would traditionally think is a public health role?

Richard Pollack: It, it varies, but community you’re right in so many communities across the. We became the defacto public health system. And in so many of those communities, the public health infrastructure was either Portland funded, neglected, or stepchildren. We stepped in no question about it.

And the health systems and the community hospitals, they were there. And part of that, is, it goes back to the trust that you, we, one of the most trusted partners that came to the public and that h was a place that was a sanctuary for so many people, no question about it.

So looking forward, what does that mean? Where do we go? I think then the recognition that we need to pay more attention to our public health system. And I think that between After Action Analysises by a variety of different. And by congressional action to bolster some about public health infrastructure.

Hopefully we’ll learn some lessons from the past along those lines. And regardless, we’re still gonna be players in public health. We’re still gonna be supporters and it’ll depend upon the community that we’re in in terms of the capabilities. So I don’t think we ever walk away. , but clearly there needs to be stronger support for the public health agencies and those functions.

Dr. Gary Bisbee: Yeah. And when hospitals pick up these public health responsibilities, particularly at the last minute making sure there’s some compensation for that would also be a good thing. Let me turn to another topic of much debate and that is that during c it’s clear that the providers took. Brunt of expenses, brunt of disorientation almost in terms of what was going on while that was going on, the health insurers really felt like they were in a windfall situation.

What’s your view of that, Rick, and how is that going to be resolved in the future?

Richard Pollack: Yeah. There’s no. That they were collecting premiums and they weren’t hanging out much from those premium. And there’s no question that they not only experienced the windfall and you can see that in the financials that have come out. But they never stepped up to the plate to help very much, when CMS was doing things to help us in terms of regulatory relief, in terms of advanced.

To help us get through cash flow problems when the will government mandates to shut down all scheduled procedures. CMS to their credit stepped up. Insurance companies were nowhere to be seen. And I think that was outrageous. And it’s something that is a very unfortunate situation that we.

And you know what? Those insurers, they continue to contribute to some of the problems we face. Whether it’s slow pay or no pay or other types of behaviors. It’s a that, that they create real hurdles. And, we’re facing an incredible workforce challenge right now. Part of the workforce challenge is exacerbated by this prior authorization requirements that they impose on our clinicians that end up having to spend more time, asking for permiss.

and we’re in the business of providing care and it seems like they’re in the business of denying.

Dr. Gary Bisbee: I, I agree with. For sure. Hopefully we can work to some resolution going forward and, this may be a good place to bring up fee for service versus value care. How do you think about that, Rick? Both in terms of what’s likely to be developed, let’s say over the next 10 years, and then how does all of this affect hospitals?

Richard Pollack: In many ways I, I think that the crane has left the station on value-based payment. And if you think about value-based payment, I think you have to think of it as a continuum on one side of the continuum, if you’re a Medicare provider, you’re already doing value-based payment, whether you know it or you’re not.

You know it, it still may be on a fleet of service chassis, but you’re getting penalized for readmissions. , you’re getting penalized for hospital acquired conditions, there is a p pone mechanism in place. So if you’re a Medicare provider, you’re already in that load on one, in one form or another. But if you move down that continuum you get to bun length, and there are a lot of hospitals that are involved in different types of bundling pot mechanisms.

If you move further down that continuum, you get to the whole issue. , accountable care organizations and alternative payment method. . And if you further move further down that continuum, we see a lot of hospitals that are either provider led organizations that are running their own health plans.

And we know that that has a lot of promise. But when you move down that continuum in that regard, and you begin to take responsibility for the total cost of care for an attributed population, that’s one. We have a lot of hospital systems that have been doing that for a long time. I think that that’s one where we need partnerships.

We need partnerships. And in some cases if you’ve seen one model, you’ve just seen one. But I think that we’re all moving down that continuum in one form or another.

Dr. Gary Bisbee: Can the private sector do that by itself? Record? Do we need more federal governmental involvement to encourage that kind of partnerships?

Richard Pollack: The ACA to its credit established the roadmap to move down this continuum. And in some respects as we went forward, During the Obama administration and even during the Trump administration, this was bipartisan by the way. You know the, we talked about the partisan stuff.

There is no divide here. Everybody recognizes that value-based payment is the direction in which we’re headed. And by the way, It represents innovation and it represents private sector activity. So I think that it’s something that will continue for sure. The real question that you are getting at, which is perhaps the most challenging one, is where do we find the partners as hospitals to do it? Because many of the insurers, at least the very big ones, really don’t have an interest in blowing. The big insurers, people criticize us for market consolidation. Big insurers are the ones that are consolidated and many of them have no interest in being partners. in value-based payment because they have the power to just encode rates on us because of their marketplace power.

So we tend to look at smaller regional health insurance plans. Other partners could be positioned groups that can work together with us in building these accountable care organizations or organizations that are. To take responsibility for the total cost of.

Dr. Gary Bisbee: As Rick most of the hospitals in the country, over 50% of their revenues now come from the federal government. and in many cases some of the urban hospitals, a lot higher percentage than that. Baby boomers continuing to come into Medicare. Chronic disease is growing a lot as these boomers age.

What’s your view, Rick, of this increase in federal government payment, which is going to continue for at least through the end of this decade and more and more of a hospital’s revenue is gonna be coming from the Gov federal government. How’s that gonna affect the hospital strategy and how will that affect the h a strategy?

Richard Pollack: Certainly puts the pressure on ensuring that there’s adequate payment under Medicare and Medicaid program for that reason. But remember, a lot of the growth in Medicare is in Medicare Advantage. and Care Advantage is, really a private sector version of the Medicare program. So that’s where growth is taking place.

So it isn’t necessarily under the traditional model. And then with the expiration of the public health emergency there’s going to be a big transition in Medicaid where a lot of people because of Greek determinations that are require. May be losing their Medicaid status and moving into exchanges which are again, private sector oriented.

So I don’t know where it all sorts out from a number perspective. Clearly the demographics of Medicare, we know more Medicare beneficiaries. 10,000 baby Boomer has become 65 every single day, whether they’re in Medicare Advantage, the younger ones Oregon than the older ones. That’s where the numbers start out.

Dr. Gary Bisbee: now.

Richard Pollack: No matter what, the federal government is always gonna have a significant role in the financing of healthcare by virtue of the size of DO programs. And then you throw in the VA on top of that. And they’ll always have a role. Now, one of the things that you mentioned that’s important, and one of the things that’s part of our advocacy agenda is the issue of those hospitals that have such a high utilization of Medicare and Medicaid that they become de facto public entities when you think about it.

And many of those organizations serve very vulnerable communi. , and that’s why we’re suggesting that we create a special category for them. Something called Metropolitan Man Hospitals that sure that they continue to be able to provide the essential public services that they do in those two ends.

Dr. Gary Bisbee: Let me go back to a point you made about consolidation. Hospital’s been consolidating steadily for 30 years and. I think a lot of the impetus was because insurance companies were doing it, but now it seems like they’re having to go to regional pairings because of regulatory issues. But do you see this consolidation of the health systems and hospitals continuing, Rick going forward?

Richard Pollack: I think it’ll continue. Of course, we’re under the spotlight of Federal Trade Commission. Beth is looking very you. Close. They put scrutiny there. Ha, half the hospitals in the country right now are part of system of some kind, whether they’re region or national, and I.

Dr. Gary Bisbee: I think that it’ll continue and it’ll continue for a couple of reasons. First, if we’re moving toward value-based payment, which we are in that trend that is there, that means taking risk and larger organizations are better equipped to take risk.

Richard Pollack: Larger organizations that are part of systems are more able and this is an area you spend a lot of time in when it comes to capital and Wall Street and bonds and capital and bonds. Large organizations have more access to that. If we’re trying to ensure that there’s access that’s seamless for service.

among various organizations putting together systems and system list provide access to a wider variety of things. If we’re interested in taking out clinical variations, systems, systemness are, be better able to leverage than objective. And sometimes, let’s face it systems come together and they preserve hospitals that might have gone out of business.

There are a lot of different reasons that systems have value, and I think during Covid we saw the be value of systems. They were much better positioned to move both human resources and supply ground. And I think that they really demonstrated. Valued in so many ways. Now, does that mean that everybody has to be part of a system?

It depends upon the nature of the community that you serve and the marketplace that you’re in. But clearly they have a wild value.

Dr. Gary Bisbee: Yeah, clearly and that really was emphasized during Covid. I agree with you on that. How do you think about the large cap companies? A lot of capital like CVS or Walgreens and Walmart and Amazon elbowing their way into primary care, and CVS just announced the acquisition of Oak Street Health, for example, 160 units or clinics and 600 doctors involved in that.

But how do you think about that and is there a reason to be concerned about that for hospitals, Rick?

Richard Pollack: I’ll tell you where the reason is to be concerned, but I’ll just say also I think what’s important is to recognize that for hospitals, listen, we’re always gonna be there to provide essential public. Of services as long as we can survive the financial and workforce challenges that we face.

When it comes to providing trauma services, when it comes to provided sophisticated diagnostics and therapies, sophisticated surgeries, I don’t see that happening in the c b s and or the Walgreens. We have a foundational role that we play in providing essential services that is gonna need to be financed properly.

and that involves an investment that involves, the public for sure. Now, the question of how we view them, how can I tell you? Some of these folks need to be viewed as partners and we can work together as we build systems and learn from them in terms of partnerships, whether it’s in digital care, whether it’s in making Campbell Co.

Whether it is trying to, find ways where we can both be productive together. The downside is a lot of them, while we move to our clinical integration, a lot of what they’re engaged is in disintegration on you gotta worry about the continuity of care. To the people that they are engaged with.

But even more fundamentally than that, while some of them are partners, some of them are also predators, they have very deep pockets. They don’t take care of poor people. They only take care of people that are well insured. They don’t take Medicaid in many cases. They’re not an opening 24 7.

And are, they don’t, not nearly the same breaking the turn accountabilities that we. and they don’t provide community benefit. They are in a different place. And in some cases they aren’t predators. I wish they were more partners.

Dr. Gary Bisbee: I agree with that. Coming back to the all important issue of data and you mentioned continuity of care, the one thing that hospitals do have is data systems that will underlie continuity of care. None of these other large cap companies we’re talking about is gonna have that. And I don’t know whether hospitals are appropriately compensated for that data, but it’s really an important asset that they bring to the community.

Richard Pollack: Now.

Dr. Gary Bisbee: Rick, it’s been an awesome interview. We’ve benefited from your wisdom. Today I have two remaining questions if I could. One of them is, what advice do you give young people who might be interested in working in an association like the American Hospital Association? What advice do you give them?

Richard Pollack: One is to understand what an association is, . I don’t think a lot of people really understand it. I started my career working on capital, though I never imagined that I would involved in an association. Yeah, they used to lobby me, but I never really understood the role of an association.

And, some of it goes back to those four core areas that I. For and I think that, if people are interested in associations, it’s a special place. It’s not like we’re a regular business. It’s not like we’re a government entity. It’s not like we have authority over our members.

We can only exert moral SUA and demonstrate value to them. But one of the interesting things that people want to think about is that you want an ability to have an impact. Associations have the ability to have an. Have influence to drive the conversation and to make a difference. And I thought the other thing that associations bring, and of course I’m speaking from the perspective of a fairly large umbrella associations, is multidisciplinary.

Opportunity. We have our clinical folks, we have our BBO folks, we have our frontline lobbies, we have our policy folks, we have people that specialize in education. We have people that specialize in data. So I think that what an association offers is the ability to make a difference. The ability to have influence and multidisciplinary tracks that one.

Dr. Gary Bisbee: Yeah, that’s for sure. Second question, I’m sure you get a lot of people coming up to you and saying, Rick, I would thinking about going into hospital administration in some way, shape or form. What advice do you give them, Rick?

Richard Pollack: One, one of the things that I give us advice is and I’ve been talking about this for some time now, as has my predecessors, that you knew. We are redefining the H So when we think about the H and it’s an iconic symbol that has incredible trust. When people see that sign on the road it says Follow me.

And, you be taking care of people that have, the highest standards for ethics and integrity. , but that ain’t just changing. Half of the surgeries that we do today are on an outpatient basis. So people think about a career in hospitals, just don’t think about hospitals as an inpatient building.

So much of the care is being done outside the four walls. What we do in the four walls, we’ll, Be significant, but it’s beyond that. And if people are thinking about careers, you just gotta think wider. So many of our hospitals, and now like I said they’re taking responsibility for care for an attributed population.

They’re doing healthcare at home. There are so many different aspects to what hospitals do, so I think you have to think wider. Hospital administration in the building, per se. And the other thing you have to think about is partnerships. I think that’s part of the future is partnerships in terms of working with different community entities, but also partnerships and how we transform the system to Help manage care across the continuum, because at the end of the day, one of the things we really have to do is making sure there are seamless coordination and people don’t get bounced around the long facility to the next.

And that’s very different than what we probably are focused on in the pest.

Dr. Gary Bisbee: Well said Rick, thank you very much for your time today. I’ll just make an editorial comment, which is not only are hospitals better off having you as the president and c e o of the American Hospital Association, but I think all of healthcare iss so well done. Thank you for being here.

Richard Pollack: Thanks much. It’s great to be with you.

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