As chief lobbyist for the country's safety-net hospitals, Dr. Bruce Siegel has had a front row seat to the political theater surrounding healthcare over the past seven years.
With the enactment, implementation and now pending repeal of the Affordable Care Act, Siegel, CEO of America's Essential Hospitals, has given voice to the more than 300 hospitals that serve the country's most vulnerable patients—the uninsured.
Siegel also has witnessed the changing role of the hospital. "The focus on the hospital as a community anchor, which promotes health in all things—that to me has been a major transformation," he said.
In 2011, Siegel pushed to include America's Essential Hospitals in the CMS' Partnership for Patients initiative. The program aimed to reduce hospital-acquired conditions by 40% in the following two years via the Essential Hospitals Engagement Network—the first safety-net provider quality network in the country. From 2011 to 2015, the program was credited with helping prevent more than 3,500 harmful events and is estimated to have saved more than $35 million in healthcare costs.
Siegel said it has been part of an overall effort to have essential hospitals create a "culture of health" in their communities.
Siegel says he learned some of his greatest lessons about how environmental factors can impact health during his tenure as New Jersey's health commissioner. "I saw the ravages of lead poisoning, and I saw the impact of people not having good health insurance," Siegel said. "I realized that health is precious, and it takes a lot of people working together to achieve it."
He cultivated that philosophy when he ran two of the nation's largest public health systems. Siegel was CEO of what is now called NYC Health & Hospitals and Tampa General Healthcare.
Dr. Eric Dickson, CEO of UMass Memorial Health Care, an Essential Hospitals member, calls Siegel a "true partner working to help improve quality and patient safety across the association."
Siegel's biggest challenge is to come, as lawmakers debate changes to Medicaid, the source of close to half the net revenue generated by members of Essential Hospitals. The hospitals serve a total of 45 million people every year.
The loss of coverage to potentially millions who gained it under the ACA, coupled with years of funding cuts to programs that help pay for hospital services for the uninsured has some safety-net facilities worried they might not be able to survive decisions made on Capitol Hill.
"We're going to have a debate over who gets what in America when it comes to healthcare," he said. "The stakes are becoming very clear as we have this national discussion—that's a healthy thing. We may have short-term reversals, but I think the long-term arc is toward healthcare for every American."