Keynote Address: Tha

David
Huffstutler Speech: 2015 THA Conference Final Version

Thank you, Ted, and thank you all for being here as we kick off the
2015 THA Annual Conference…
As I think about what we do every day, I’m reminded that our work is
very humbling.
It’s humbling… because people trust us, and they depend on us. And,
we’re there for them during life’s MOST defining moments – at times
when they are the most vulnerable.
No matter where we live and work,

in a big city,
small community,
or somewhere in between,
we wake up every morning with the chance to make a difference.
Every day,
we get to be part of caring for others when they need it most.
Granted, for many of us here today, our contribution might consist of

developing strategy and policy,
allocating resources,
or establishing high standards of performance,
but the things we do as leaders genuinely matter because this work
supports the front-line caregivers at our hospitals.
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David Huffstutler Speech: 2015 THA Conference Final Version

We all know when it comes to leadership, the stakes are high, and we
sometimes bear significant – but worthwhile – burdens. A lot of
people depend on us – and no matter how big the issue or challenge
that we might face, the buck stops with us.
But, unlike almost any other profession,

we get to be part of saving lives. And, THAT’S a big deal.
Our business of caring for our patients connects us to a higher

purpose.
That singular focus on making a difference has been the common

denominator for every successful member of our profession I’ve ever
known…whether they come to work in scrubs, a lab coat or a suit.
My guess is that everyone in this room got into this business because
they wanted to help people.
We have a lot of smart people in our business. You could have done
other things, but you didn't...because YOU wanted to make a
difference.
And, we’re here in Austin over the next two days to discuss how we
can make an even BIGGER difference.
As leaders in the healthcare industry, people look to us for insight and

guidance on the critical issues facing our healthcare delivery system.
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Some of those people are patients,

others are business and community leaders,
some govern our cities and towns,
and still others are legislators who have the power to shape our future.
As leaders who have the privilege of working in healthcare, we have

both the opportunity AND the obligation to ADVOCATE for our
patients and for the health of our communities.
As the stewards of care who know these issues best, we have a

RESPONSIBILITY to educate, inform and influence.
Collectively, hospitals represent one of the largest employers across

our state. As we go through this legislative session, NO ONE is better
positioned than US to inform and educate the legislators who will
shape the future of OUR industry.
But, to shape that future,

we must be honest about our present reality...
and some of the facts are sobering.
We all know the numbers, right?

Nearly a quarter of our state's population is uninsured.
This represents about 6 MILLION PEOPLE likely to seek care in our
emergency rooms.
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That's almost equal to the population of the entire state of Missouri.

That's a whole lot of ER visits…
about 5 billion dollars’ worth of uncompensated care EVERY YEAR.
That's on par with the entire GDP of some small countries.
As you know very well,

that unfunded mandate is a significant financial burden.
Nonetheless, our hospitals have stepped up to the plate – and we’ve

never wavered in our commitment to the indigent of our communities.
Our doors are ALWAYS open, and we're caring for all who enter,
even as the healthcare environment changes around us in ways we
can’t fully predict or plan for.
We’re having to live with the incentives and payment system that are
in place today, while being asked to transform our system and
transition into a NEW – and largely unknown – delivery model.
When talking to my team about this, I often use the analogy that we
have one foot on the dock, and one in the boat. We’re trying to stay
balanced and not fall into the water.
Everyone in this room is in the same situation, and I suspect you’d

agree – even with all of our efforts, innovations and hard work, we
won’t be able to stay balanced and successfully make this transition
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without having the resources we need.
It's time to acknowledge that there is a large and growing unfunded

population that needs care...
and it will become increasingly difficult to provide that care if we're
not getting paid for it.
The bottom line is:

MEDICAID is underfunded.
We need the legislature to step up…and seriously address this issue.
We’re committed to transformation, but we're in a state with a

growing population – that’s also aging – and as we all know, as we
age, our need for healthcare increases, and those costs will have to be
absorbed somewhere.
Prevention and wellness initiatives are important, but that won’t

completely solve the problem.
I don’t know what the breaking point is, but it moves closer every day
that passes without Texas funding MEDICAID.
To be blunt,
the current system is broken.
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Texas hospitals have done a remarkable job finding and implementing

solutions to hold together the fraying safety net…
…and we’ll KEEP doing it, but we need help.
So we need to engage with legislators, to achieve three specific things:
FIRST… we need full funding of the Disproportionate Share

Hospital program. As you all know, Medicaid base rates are
woefully low – and without rate increases, supplemental payment
programs like DSH are the only way we can provide this care.
SECOND… we need the legislature to work with us to find ways to

further reduce the number of uninsured Texans. The subsidized
care we provide to the uninsured is a hidden tax on healthcare
providers, local taxpayers and those with private health insurance.
And THIRD… we need to continue the 1115 Medicaid

Transformation Waiver which has been so helpful in our efforts to
maintain the state’s safety net. This is a shining example of
collaboration across all levels of government and the private sector.
During this important legislative session, THA and its member

hospitals MUST serve as thought leaders in finding ways to close the
funding gap and continue improving care for our patients.
Some of you might be hesitant to talk with your senators and

representatives.
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After all, we’re in a complex business with complex funding – and

we’re spending our time running hospitals and taking care of patients
– so I can understand why you might be intimidated by people who
spend their days mastering the intricacies of legislation.
Don’t worry about that — we know our business better than they do,
and we know the real-life impact of their policies on our patients, our
hospitals and our communities.
Regardless of what the budget numbers say or HOW the policy reads,
we live it – day in and day out.
What legislators need from us is an understanding of the situation on

the ground, where the care is given and lives are affected.
We can improve that understanding by connecting with the elected

officials who represent us and our communities.
So, it’s important for you to get to know your legislators.

Make sure they have your cellphone number and personal email, in
case they need insights on the impact of a piece of legislation.
You can tell them what their policies look like in the real world,
and share stories of patients who need life-saving care but can’t pay,
and doctors who entered the profession to make a difference but are
now contemplating a career change.
7

Legislators need to know what's at stake, and you know that better
than anybody.
Your insights can help them understand the practical implications of

their policies, and cast informed votes that solve BIG problems.
When we spend time advocating for our industry, speaking up for our
profession and collaborating on legislative solutions,
we’re creating a ripple effect that ultimately benefits our patients.
Our legislators are human beings, and they understand the importance
of quality care, but if we don’t help them understand the issues, then
healthcare can be reduced to just another line item in the budget,
competing with a lot of other important priorities.
In our hospitals, healthcare is a matter of life and death.
As leaders, we have a moral obligation to close the gap of

understanding, and push for change – at the state and federal levels.
We are the fog-cutters. We are the ones who have to translate the
practical implications of policies and help policy makers distill what
that means to our communities.
You've all heard the old saying

"to whom much is given,
much is expected."
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As leaders in our industry,

we have a clear responsibility AND obligation to meet those
expectations, and we need to meet them TOGETHER.
In the past, there has been division in our industry from policy that
BENEFITS one segment over others.
Despite efforts to come together,

the effects have been material enough that they have sometimes
divided us.
While we may not be completely aligned on ALL issues,

now, more than ever,
we have the opportunity AND the obligation to come together as an
industry and move forward.
The great Benjamin Franklin is credited with saying

"we must hang together,
or else we shall most assuredly hang separately."
Let's all commit to hanging TOGETHER in the days to come. We

must speak with one voice to our legislators.
We shouldn’t let the perfect be the enemy of the good.
We still may not agree on everything – but we’ve got to agree on the
important things – what matters most to our patients.
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So let’s embrace the chance to make a difference for the people who
pass through our emergency departments,
our surgical suites,
and our waiting rooms.
It’s the RIGHT thing to do.
Like you, I am proud to be part of a profession,

part of a culture,
and part of an association that emphasize doing the right thing for our
patients, our communities and our state.
As your incoming chairman,

I look forward to keeping us all focused on that core value, and
ensuring we all fulfill our calling to help others.
Because, in doing so, we WILL achieve that higher purpose. And that,
alone, is worth ALL the effort.
As this conference unfolds, let's take advantage of this time to build

new relationships and find EVEN MORE common ground.
Then let's move forward… together.
We have the skills.
We have the vision.
10

And, this is our moment to make a difference.
Thank you.
*********
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David

Huffstutler Speech: 2015 THA Conference Final Version

No matter where we live and work,

Granted, for many of us here today, our contribution might consist of

But, unlike almost any other profession,

Our business of caring for our patients connects us to a higher

That singular focus on making a difference has been the common

As leaders in the healthcare industry, people look to us for insight and

Some of those people are patients,

As leaders who have the privilege of working in healthcare, we have

As the stewards of care who know these issues best, we have a

Collectively, hospitals represent one of the largest employers across

But, to shape that future,

We all know the numbers, right?

That's almost equal to the population of the entire state of Missouri.

That's on par with the entire GDP of some small countries.

As you know very well,

Nonetheless, our hospitals have stepped up to the plate – and we’ve

Everyone in this room is in the same situation, and I suspect you’d

without having the resources we need.

It's time to acknowledge that there is a large and growing unfunded

The bottom line is:

We need the legislature to step up…and seriously address this issue.

We’re committed to transformation, but we're in a state with a

Prevention and wellness initiatives are important, but that won’t

Texas hospitals have done a remarkable job finding and implementing

So we need to engage with legislators, to achieve three specific things:

FIRST… we need full funding of the Disproportionate Share

SECOND… we need the legislature to work with us to find ways to

And THIRD… we need to continue the 1115 Medicaid

During this important legislative session, THA and its member

Some of you might be hesitant to talk with your senators and

After all, we’re in a complex business with complex funding – and

What legislators need from us is an understanding of the situation on

We can improve that understanding by connecting with the elected

So, it’s important for you to get to know your legislators.

Your insights can help them understand the practical implications of

In our hospitals, healthcare is a matter of life and death.

As leaders, we have a moral obligation to close the gap of

You've all heard the old saying

As leaders in our industry,

Despite efforts to come together,

While we may not be completely aligned on ALL issues,

The great Benjamin Franklin is credited with saying

Let's all commit to hanging TOGETHER in the days to come. We

We shouldn’t let the perfect be the enemy of the good.

It’s the RIGHT thing to do.

Like you, I am proud to be part of a profession,

As your incoming chairman,

As this conference unfolds, let's take advantage of this time to build

Then let's move forward… together.

We have the skills.

We have the vision.

And, this is our moment to make a difference.

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