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A Role for Government: Investing in Better Value Health Care

Posted By Louise Probst, Wednesday, June 3, 2020
Updated: Wednesday, June 3, 2020

Unimaginable only a few months ago, health care organizations have experienced a radical reversal of fortune. Like many things upended by COVID-19, so is the long-held belief that the health care industry is recession proof – clearly, it is not. Health care organizations, like most businesses today, find themselves dependent on lifelines from the federal government, laying off health care workers and dramatically cutting spending.  


Considerable recent attention has focused on the federal grants to health systems across the nation to offset COVID-related losses. The conversations highlight the disparities among hospitals in terms of the populations they serve, their reserve balances, and ownership. The May 25th New York Times article, Wealthiest Hospitals Got Billions in Bailout for Struggling Health Providers, offers a detailed look into issues of equity across “have” and “have not” institutions.  


For me, the article underscores two things: (1) the political difficulties inherent in attempting to distribute money quickly, equitably, and thoughtfully, and (2) how very large and resource-rich some of our non-profit health systems have become. Multiple billions of dollars in reserves might only translate to months of operating income for many health systems.  


Missing from the conversation, and of critical importance, is how the federal government can use these lifelines to nudge our health care system toward long-term and widely-shared goals. These could include such things as payback requirements with forgiveness provisions for:

  1. Investments that yield more primary care physicians;

  2. Better chronic care management, as evidenced by low rates of hospital admissions or emergency department visits for treatable chronic conditions;

  3. Adherence to evidence-based guidelines of care, demonstrated by decreases in services known to have little or no clinical value and that place patients at risk of physical, emotional, or financial harm; and

  4. Limits on the levels of future price increases to private sector payers, already known to be significantly higher than government-sponsored health plans.

The pandemic is still with us. Its full economic impact lies ahead for most of us. The federal government has the opportunity to allocate taxpayers’ precious financial resources in ways that will best serve the American people and economy – ensuring a future in which all enjoy high-quality and affordable health care.


Warm regards,


Louise Y. Probst

BHC Executive Director

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