Bruce Siegel, MD, MPH
VITAL2025, Atlanta
Wednesday, June 11, 2025
Hello, everyone, and welcome to VITAL2025! We have a great program ahead, and I’m delighted so many of you could make time to join us here, in Atlanta.
Speaking of which: Thank you, Shannon [Sale, executive vice president and chief strategy officer of Grady Health System], for the warm welcome to your hometown, and thank you for the kind words about my tenure at America’s Essential Hospitals. Shannon is the incoming chair-elect of our Institute board and a long-time member-leader at AEH. She has been an active volunteer as well as a mentor to many of us. It is people like Shannon who keep us moving ahead.
So, we’re very happy we could host this year’s VITAL in Shannon’s backyard. She spoke about the lifesaving care essential hospitals provide and how they touch everyone. She should know: Grady has a national reputation for innovation in trauma and burns, sickle cell, primary care, and so much else.
Of course, health care innovation is not unique to our Atlanta members. It’s the norm for essential hospitals across the country—and one of the many things that make you essential.
It’s also one of the many reasons why we fight for you in Washington, because innovation benefits everyone, and we all stand to lose when policymakers suggest you can get by with less. As we’ve seen, the current plan in Congress is to spend a LOT less—over $700 billion in health care cuts. The lion’s share of that would come from support you depend on: Medicaid, CHIP, and other federal dollars for safety net care.
We’ve been here before, and we know the playbook…and the players. None of the ideas we’ve seen are new, and some, like per capita caps, have been regurgitated for 30 years. All would be bad. But one thing is new…. this is the first time I’ve ever seen an assault on Medicaid that does not even pretend to somehow improve health care.
But we’re making progress. Policymakers of all stripes understand the value your hospitals bring to all. They understand how you serve everyone with lifesaving care. And they know how the people and communities they represent thrive on the jobs and economic vitality you create.
They also know the plans circulating on Capitol Hill will likely leave states holding the bag, with the only options being to spend more or cut benefits and access. That’s not a winning message at election time, and it’s one that could help tip this fight in our favor.
We will take every opportunity to remind our policymakers about the future we all face if they let these cuts happen. We’re making the case through our members, including with a letter calling on Congress to reject Medicaid cuts, like policies targeting state directed payments, provider taxes, and the FMAP. And our recent ad campaign garnered over 11 million media impressions and drove tens of thousands of people to visit our website for more information.
And we’re supporting our champions through the association’s political action committee, the Essential Hospitals PAC. I urge all of you to learn more about our PAC and consider chipping in. It’s an invaluable tool in our work to change minds in Congress and build support for your hospitals. Jason Pray, our legislative affairs vice president, is with us this week and can answer any questions you have about political giving.
We need all of you in this fight. Our members can tell a story that resonates on Capitol Hill and will help us preserve the support you need to meet your mission. Please stay engaged—this fight is not close to being over. You can make a difference by showing lawmakers why you’re different and why you matter.
I also want to share a few shout-outs. First, I’d like to extend a warm welcome to our newest members: Emory University Hospital Midtown, a 600-bed tertiary care anchor just a few minutes down the road from here; Rochester Regional Health, a nine-hospital system across Western New York; and RWJBarnabas Health, which serves more than 3 million patients across New Jersey. RWJBarnabas is a returning member, by the way, and we’re very happy to have them back in the fold.
I also want to recognize our VITAL sponsors. All are leaders in services and products tailored to hospitals like yours. They are:
- Amazon Web Services, delivering world-leading cloud technologies since 2006
- Clearway Health, a provider of transformative specialty pharmacy services
- FTI Consulting, a market-leading global consulting firm that offers a comprehensive suite of services
- Hartz Search, a health care–focused executive search firm
- Healthcare Innovation Venture Fund, a venture capital firm improving health through transformative therapies and disruptive technologies
- KSM, one of the top 50 largest independent CPA firms in the United States
- Live Data, which provides hospitals with surgical capacity management solutions
- Medical Solutions, one of the nation’s largest health care talent ecosystems
- Premier, a health care improvement company that unites an alliance of more than 4,300 U.S. hospitals and health systems and more than 300,000 other providers and organizations
- Sellers Dorsey, which works with health systems in nearly every state to develop Medicaid financing solutions and navigate the program
Thanks to all our sponsors for their generous support of association programming.
This year’s annual conference is a bittersweet moment for me. It’s the fifteenth time I’ve delivered opening remarks here and it will be my last. As you may have heard, I have announced my retirement for the end of this year…
This is a time for me to start saying some sad goodbyes, and maybe to reflect on my time here.
When I first started thinking about retiring…I was looking forward to a quiet, uneventful last year. Well… As a great son of this state once wrote and sang: dreams don’t always come true. After the last election, I knew it would not be business as usual. And gee was I right!
These are tough times. But when I started in the fall of 2010 things were not that simple either. We were trying to figure out what to do about the huge DSH cuts that were the law of the land. We fought that battle and it continues to this day. But those cuts have never taken place. Then came the threats of readmission penalties that singled out the safety net…and we got congress to blunt those. We faced MFAR, pushed personally by a CMS director who was forced, under intense pressure that you created, to do a complete 180 and withdraw a rule that would have been catastrophic to your mission. Then we faced a pandemic where your hospitals were ground zero, and you made the case that essential hospitals needed relief, which came in three waves totaling $15 billion. And through our efforts, we took a landmark 340B case all the way to the U.S. Supreme Court for a unanimous victory.
This is what a collective voice can do. This is what an ASSOCIATION, rooted in collective values can achieve.
For 44 years we have been a network of smart, grounded people from coast to coast, who have built, expanded and defended a system of care designed to include EVERYONE in America.
When I think back on my time, I think I am most proud that I followed Barbara Eyman and Beth Feldpush’s advice in 2014. They told me to sign a letter….so I did. It asked CMS to lift the prohibition on directed payments. Two years later CMS did just that, and then soon thereafter we saw the first state directed payment programs pegged to the average commercial rate. Today dozens of states have brought new, needed support to our essential hospitals and other sectors, worth $100 billion per year.
These resources begin to correct a legacy of inequity, in which we literally valued the care of the poorest and sickest at 50 cents on the dollar. And because of these programs people are getting care for opioid addiction, mothers and children have better access to care, and rural communities have kept hospitals that were on the brink of closure. This is a testament to the values we hold, that everyone in our America should have access to the best care to ensure the best health.
And by the way, it’s not just about dollars. Over our history, through the Institute, we built leadership development programs that today form the next generation of essential hospital leadership. I am thrilled that we are joined today by our Fellows and members of our Essential Women’s Leadership Academy. These professionals are the talent that will guide our essential hospitals far into the future. And in myriad educational programs we support our members’ work to advance community-integrated health care.
When you walk into our offices in Washington, there’s a motto on our front hallway, by the photos of all our past chairs. I’ve always loved this phrase written in big letters. It reads…..
Essential People–Essential Communities–Essential Hospitals
In just six words…..that is who we are and……what we stand for!
Thank you for the privilege of 15 years of service and purpose on behalf of a great cause!
Thank you for letting me accompany all of you on this leg of a great journey!
And most of all, thank you for being America’s Essential Hospitals!
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