Trump considers payroll tax cut — what it could mean for healthcare

https://www.beckershospitalreview.com/finance/trump-considers-payroll-tax-cut-what-it-could-mean-for-healthcare.html?origin=cfoe&utm_source=cfoe

The White House is considering a payroll tax cut, President Donald Trump confirmed Aug. 20, according to The Washington Post.

The president’s confirmation comes after the White House disputed that it was considering a payroll tax cut, the Post reported Aug. 19. The tax would help jump-start a slowing economy by giving low- and middle-income Americans more spending power.

However, payroll taxes do help fund Medicare. A cut could significantly handicap that program, which is just seven years away from running dry, depending on how the tax is designed. A payroll tax cut of two percentage points in 2011-12 reduced taxes by more than $100 billion each year, according to The Washington Post. During those years, the Obama administration redirected revenue to Social Security programs and the federal deficit took the hit, according to the report.

Read more here.

 

 

Allegheny Health Network adds 9th hospital

https://www.beckershospitalreview.com/hospital-transactions-and-valuation/allegheny-health-network-adds-9th-hospital.html?origin=cfoe&utm_source=cfoe

Highmark's Allegheny Health Network has reached an affiliation agreement with Grove City Medical Center in Mercer County.

Pittsburgh-based Allegheny Health Network signed an affiliation agreement with Grove City (Pa.) Medical Center, the organizations said Aug. 19.

AHN, a subsidiary of Pittsburgh-based Highmark Health, and GCMC plan to close the affiliation in the next few months, pending government approval. GCMC will become AHN’s ninth hospital.

Under the agreement, AHN and GCMC will co-fund an independent Grove City Health Care Foundation, with an initial endowment of up to $30 million. In addition, GCMC will get a $40 million investment from AHN to support GCMC’s clinical programs, technological assets and physical infrastructure over the next 10 years. GCMC will also go live on Epic as part of the transition.

GCMC, a small, rural hospital, has faced growing financial struggles, according to the Pittsburgh Post-Gazette. For the past five years, the hospital has recorded negative operating margins. 

 

Coalition of 181 CEOs say society should matter alongside profit

Chief executives who are members of the Business Roundtable, include, left to right, front row: Julie Sweet of Accenture North America, Brian Moynihan of Bank of America, Tim Cook of Apple, Robert F. Smith of Vista Equity Partners of Austin. Back row: Jeff Bezos of Amazon, Mary Barra of General Motors and Larry Fink of BlackRock.

Nearly 200 chief executives, including the leaders of Apple, Pepsi and Walmart, tried on Monday to redefine the role of business in society — and how companies are perceived by an increasingly skeptical public.

Breaking with decades of long-held corporate orthodoxy, the Business Roundtable issued a statement on “the purpose of a corporation,” arguing that companies should no longer advance only the interests of shareholders. Instead, the group said, they must also invest in their employees, protect the environment and deal fairly and ethically with their suppliers.

“While each of our individual companies serves its own corporate purpose, we share a fundamental commitment to all of our stakeholders,” the group, a lobbying organization that represents many of America’s largest companies, said in a statement. “We commit to deliver value to all of them, for the future success of our companies, our communities and our country.”

The shift comes at a moment of increasing distress in corporate America, as big companies face mounting global discontent over income inequality, harmful products and poor working conditions.

On the Democratic presidential campaign trail, Senators Bernie Sanders and Elizabeth Warren have been vocal about the role of big business in perpetuating problems with economic mobility and climate change. Lawmakers are looking into the dominance of technology companies like Amazon and Facebook.

There was no mention at the Roundtable of curbing executive compensation, a lightning-rod topic when the highest-paid 100 chief executives make 254 times the salary of an employee receiving the median pay at their company. And hardly a week goes by without a major company getting drawn into a contentious political debate. As consumers and employees hold companies to higher ethical standards, big brands increasingly have to defend their positions on worker pay, guns, immigration, President Trump and more.

“They’re responding to something in the zeitgeist,” said Nancy Koehn, a historian at Harvard Business School. “They perceive that business as usual is no longer acceptable. It’s an open question whether any of these companies will change the way they do business.”

The Business Roundtable did not provide specifics on how it would carry out its newly stated ideals, offering more of a mission statement than a plan of action. But the companies pledged to compensate employees fairly and provide “important benefits,” as well as training and education. They also vowed to “protect the environment by embracing sustainable practices across our businesses” and “foster diversity and inclusion, dignity and respect.”

It was an explicit rebuke of the notion that the role of the corporation is to maximize profits at all costs — the philosophy that has held sway on Wall Street and in the boardroom for 50 years. Milton Friedman, the University of Chicago economist who is the doctrine’s most revered figure, famously wrote in The New York Times in 1970 that “the social responsibility of business is to increase its profits.”

This mind-set informed the corporate raiders of the 1980s and contributed to an unswerving focus on quarterly earnings reports. It found its way into pop culture, when in the 1987 movie “Wall Street,” Gordon Gekko declared, “Greed is good.” More recently, it inspired a new generation of activist investors who pushed companies to slash jobs as a way to enrich themselves.

“The ideology of shareholder primacy has contributed to the economic inequality we see today in America,” Darren Walker, the president of the Ford Foundation and a Pepsi board member, said in an interview. “The Chicago school of economics is so embedded in the psyche of investors and legal theory and the C.E.O. mind-set. Overcoming that won’t be easy.”

The Business Roundtable included its own articulation of the theory in an official doctrine in 1997, writing that “the paramount duty of management and of boards of directors is to the corporation’s stockholders.” Each version of its principles published over the last 20 years has stated that corporations exist principally to serve their shareholders.

But by last year, the Business Roundtable’s language was out of step with the times. Many chief executives, including BlackRock’s Larry Fink, had begun calling on companies to be more responsible. Businesses were pledging to fight climate change, reduce income inequality and improve public health. And at gatherings like the World Economic Forum in Davos, Switzerland, the discussions often centered on how businesses could help solve thorny global problems.

“The threshold has moved substantially for what people expect from a company,” Klaus Schwab, the chairman of the World Economic Forum, said in an interview. “It’s more than just producing profits for the shareholders.”

Last year, Jamie Dimon, the chief executive of JPMorgan Chase and the chairman of the Business Roundtable, began an effort to update its principles. “We looked at this thing that was written in 1997 and we didn’t agree with it,” Mr. Dimon said in an interview. “It didn’t fairly describe what we think our jobs are.”

Mr. Dimon proposed making a formal revision to the annual statement at a Business Roundtable board meeting in Washington this spring. It then fell to Alex Gorsky, the chief executive of Johnson & Johnson, who runs the group’s governance committee, to create the language.

“There were times when I felt like Thomas Jefferson,” Mr. Gorsky said in an interview.

While the group cast the change in language as an embrace of new corporate ideals, it was also a tacit acknowledgment of the heightened pressures facing companies across the country — including many that signed the document.

In 2017, after the president’s initially tepid response to the violent white supremacist protests in Charlottesville, Va., the chief executives of several major companies disbanded White House business advisory groups in protest. Walmart, the nation’s largest gun seller, is under pressure after a series of mass shootings, including the recent massacre at its store in El Paso. Amazon, the giant online retailer, is facing scrutiny from lawmakers who say it avoids paying taxes and uses its dominance to hurt competitors.

And protesters have mobilized across the country to call for a higher minimum wage.

For companies to truly make good on their lofty promises, they will need Wall Street to embrace their idealism, too. Until investors start measuring companies by their social impact instead of their quarterly returns, systemic change may prove elusive.

Nowhere has the new scrutiny on corporations been more pronounced than on the presidential campaign trail. On Monday, Mr. Sanders said in an interview that the Business Roundtable was “feeling the pressure from working families all over the country.”

“I don’t believe what they’re saying for a moment,” he said. “If they were sincere, they would talk about raising the minimum wage in this country to a living wage, the need for the rich and powerful to pay their fair share of taxes.”

In a statement Monday, Ms. Warren called the announcement “a welcome change” but cautioned that “without real action, it’s meaningless.

“These big corporations can start following through on their words by paying workers more instead of spending billions on buybacks,” she said.

While the new statement of purpose represents a sizable shift from the group’s longstanding principles, it was not the first time Business Roundtable had taken a position on a social issue. Last August, the group denounced President Trump’s immigration policies, describing family separations as “cruel and contrary to American values.”

Monday’s statement represented an even broader shift, signaling companies’ willingness to engage on issues of pay, diversity and environmental protection. Several of the executives who signed the letter said the group would soon offer more detailed proposals on how corporations can live up to the ideals it outlined, rather than focusing purely on economic policies.

“It’s a real divergence considering everything we’ve done in the past has been around policy,” said Chuck Robbins, the chief executive of Cisco, who is on the group’s board, adding, “This is just the first piece.”

The executives quickly pointed out that they had not forgotten about investors.

“You can provide great returns for your shareholders and great benefits for your employees and run your business in a responsible way,” said Brian Moynihan, the chief executive of Bank of America.

But the statement’s lack of specific proposals also drew skepticism.

“If the Business Roundtable is serious, it should tomorrow throw its weight behind legislative proposals that would put the teeth of the law into these boardroom platitudes,” said Anand Giridharadas, the author of “Winners Take All: The Elite Charade of Changing the World.” “Corporate magnanimity and voluntary virtue are not going to solve these problems.”

 

 

 

Where the AHA is focusing its lobbying efforts in September

https://www.aha.org/news/perspective/2019-08-16-perspective-gearing-busy-september-capitol-hill

Image result for american hospital association headquarters

Two weeks ago, I wrote about the important role AHA member hospitals and health system leaders play in advocating for the field. This week, I’ll tell you exactly what we’re advocating for when Congress returns in September … and how you can help.
 
Here’s where things stand: There will be three issues before Congress next month that could greatly affect our field: surprise medical billing, the planned Medicaid disproportionate share hospital cuts and prescription drug pricing.
 
The AHA and its members strongly support protecting patients from surprise medical bills. However, we have concerns about the proposals in the House Energy & Commerce Committee and the Senate Health, Education, Labor & Pensions Committee, which both contain a rate-setting approach for settling out-of-network claims.
 
We believe providers and insurers should continue to be permitted to negotiate payment rates for services provided … and we strongly oppose approaches that would impose arbitrary rates on providers. Hospitals and health systems work hard to align physician networks, but we cannot compromise independent physicians’ abilities to negotiate fair contract terms with payers. These approaches would add unnecessary complexity and burden to the system.
 
On Medicaid DSH, legislators need to act before Oct. 1 or $4 billion in automatic cuts to hospitals and health systems will go into effect. This will be followed by another $8 billion the following year. If these cuts proceed, they will threaten our ability to care for the most vulnerable members of society. The good news is that there’s strong support in the House for preventing these cuts from kicking in: The House Energy and Commerce Committee passed legislation last month that would eliminate the Medicaid DSH cuts for the next two fiscal years and reduce the cuts by half in the following year. So let’s make sure the Senate acts on this.
 
In addition, on drug pricing, legislators recognize that skyrocketing drug prices — as well as shortages for many critical medicines — are hurting patients and the hospitals and health systems that care for them each day. The Senate Finance Committee has taken an important step forward by advancing a drug pricing package to the full Senate. More work needs to be done, though … especially in the House.
 
Here’s where you come in: Your legislators need to hear from you. Urge them to protect patients while rejecting proposals such as rate-setting or setting a “reference” or “benchmark” price. Keep encouraging them to prevent the Medicaid DSH cuts from kicking in so we can make sure the most vulnerable can access care. And tell them how important it is to rein in the skyrocketing costs of prescription drugs.
 
You can read our latest Action Alert here, which includes key resources for talking with your legislators over the congressional recess.
 
On Sept. 10, we’re holding an advocacy day on Capitol Hill … so please make plans to join us if you can and add your voice to those of your colleagues.
 
At the same time, as we all know, the recent tragic events in El Paso, Dayton and Gilroy have increased the focus on addressing gun violence. Be certain: We will continue to give voice to the fact that violence is a serious health problem, as hospitals and health systems are on the front lines of taking care of the victims and serving their communities. Beyond supporting research and education and highlighting the innovative actions taken by our members to address all forms of community violence, we’ll also continue to closely monitor evolving efforts to develop bipartisan, consensus legislation in regard to more specific approaches to address this serious problem. 
 
You are leaders in your communities. You are the experts on health care. And when you speak up, your senators and representatives listen. Together, it’s time to engage with them so we can ensure every hospital and health system has the tools they need to always be there, ready to care.