Latest / Becker’s Healthcare Podcast / Brian Peters, CEO of the Michigan Health & Hospital Association

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Brian Peters, CEO of the Michigan Health & Hospital Association · Becker’s Healthcare Podcast

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Hello, and welcome to the Becker's Hospital Review
0:35
podcast. My name is Will Riley from r
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one. With me today is Brian Peters. Brian
0:41
is CEO of Michigan Health and Hospital Association.
0:46
Brian, welcome to the podcast. Thank you so
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much for having me on today.
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To start off, can you tell us a
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little bit about,
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your role, your organization,
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and maybe what's on your mind heading into
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2026?
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Absolutely.
1:00
I have been blessed to work at the
1:03
Michigan Health and Hospital Association
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for
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thirty six years now, the last ten,
1:08
as CEO, and we are an association based
1:11
in the state capital of Lansing, Michigan,
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and we have the privilege of representing
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literally every hospital and health system, large and
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small, urban and rural, all ownership types, throughout
1:22
the entire state. And we advocate for them
1:25
primarily in the State Capitol Building on public
1:27
policy issues, but also in the courts,
1:30
in the regulatory
1:31
arena.
1:32
We have a number of other issues that
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we address as well through our MHA Keystone
1:37
Center for Patient Safety and Quality. We're very
1:39
involved in quality improvement work. And then also
1:43
a for profit arm that is engaged,
1:45
with a number of services, unemployment
1:47
compensation,
1:49
data services,
1:50
and a host of other issues as well.
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But our real priority
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in this current environment,
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quite honestly, it's protecting access for patients. We're
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very concerned about that issue,
2:01
What that means for us as an advocacy
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organization,
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first and foremost,
2:06
we need to advocate for fair and adequate
2:08
funding.
2:09
First of all, at the state level with
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a Medicaid budget,
2:13
which we fortunately just protected.
2:16
The state fiscal year just began October 1
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and we
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approved all of the MHA board
2:23
adopted priorities in that state budget. So good
2:26
news there,
2:27
but that's balanced by the real concerns we
2:29
have with the passage of the reconciliation bill
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at the federal level
2:34
and all of the the changes that that
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will entail down the road. But we have
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a lot of irons in the fire, as
2:39
you can see. Mhmm. Mhmm. Excellent. Tell us
2:42
I mean, perhaps a good way to start
2:44
might be
2:46
as you think about the, all of the
2:48
providers that you represent or that you
2:50
you you you are part of your organisation.
2:53
Like, what what are you've talked about Medicare
2:55
funding being probably one key thing. What are
2:58
what are a couple of the other things
2:59
that are on their minds,
3:01
that you're most concerned about? Well, in addition
3:04
to Medicaid and Medicare funding, the 340B
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drug pricing program
3:09
is a critical priority for a very large
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swath of our members,
3:13
particularly our small rural hospitals. Many of the
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critical access hospitals in our state
3:19
tell us that without the three forty b
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program,
3:23
they would be unable to continue to provide
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services to many of the residents of their
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respective communities. And that holds true as well
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for some of our large academic medical centers
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in the inner cities
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of our state.
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The three forty b program, just critically important.
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And we're involved in that issue both at
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the state level,
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in the courts,
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and certainly,
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at the federal level with our conversations
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with,
3:50
Congress as well. So that's a high priority.
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Really making sure that medical liability costs
3:56
are reined in. We see a creep in
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those rates
4:00
in the state of Michigan, even though we
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have very significant medical liability reforms that have
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protected
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access to care for patients for many years,
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those are constantly under attack.
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We have a very strong certificate of need
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program in the state of Michigan and every
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year we advocate to protect that CON program
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because we really believe it goes a long
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way towards
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ensuring affordability
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of care, ensuring we're not duplicating
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services,
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ensuring that we have a rational approach to
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the care delivery system. So those are a
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few of the items that are front and
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center for us at the moment and there's
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always the looming threat of cybersecurity.
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We know that the FBI has identified
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hospitals as one of the very top targets
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for cyber criminals globally,
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and that comes with it a lot of
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attention, a lot
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of investment of resources,
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both financial and human capital.
4:59
On that point, that must be a a
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challenge for many of your membership who perhaps
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are smaller community hospitals,
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that maybe lack resources
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to
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have robust cybersecurity
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initiatives and yet are just as vulnerable as
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any other provider.
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How do how do they,
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how do they provide adequate
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defenses in in in that in that sense?
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Well, you're exactly right. In fact, we have
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had several
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small rural hospitals in Michigan that have been
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the victims of successful cyber attacks and have
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disrupted operations,
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without any question.
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So you're spot on. The Michigan Health and
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Hospital Association
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about a decade ago saw this emerging threat
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and we actually formed our own HSOC,
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a healthcare cybersecurity
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operations center,
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along with a number of our members.
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And that is still in operation today. It
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serves as an early warning system so that
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if we detect an emerging threat,
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we can get the word out very quickly,
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to our members so that they can
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take action quickly,
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unplug
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the the system so to speak before a
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cyber attack
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becomes
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critically invasive. And and so that's been a
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success for us. I think it staved off,
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some things that could have happened
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And we're very proud of that. What kinds
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of resources are available then to
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smaller community hospitals through that program or through
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that initiative? And we're signing up more and
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more small hospitals. It began with large systems.
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I see. So now small hospitals have the
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opportunity to buy in at a very low
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cost, relatively speaking. So they have access to,
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the resources
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that we've brought together along with our
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endorsed business partner, CyberForce Q. They really are
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the backbone. They're the expertise.
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But this is very similar in my mind
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to the Federal Patient Safety Act years ago
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that allowed us to form a federally certified
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PSOs or patient safety organizations. The idea being
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we're gonna collect information on adverse events and
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near misses.
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And whether you're a large or small hospital,
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part of a big system or a true
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independent,
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the PSO concept gave everyone access to the
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same set of information so that we can
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learn,
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from each other
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in the, benefit of patient care. So we're
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we're preventing future harms.
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And really in the cybersecurity realm, the concept
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with the HSOC is very similar and we're
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seeing it play out that way. We wanna
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make sure that everyone regardless of size,
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can do the right thing in terms of
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protecting,
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data
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and protecting information and protecting patient care. Yeah.
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Okay.
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You mentioned,
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the state level
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legislative
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agenda, at the start of our conversation.
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What about the federal,
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agenda? I mean, you talked about three forty
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b, for example. But, it's a very, obviously,
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a pretty dynamic environment. What kinds of challenges
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or opportunities does that present for your members?
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Well, it's incredibly concerning that
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even though, the president did sign the OBBPA
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earlier this year, and and we know what,
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that's going to mean from an economic perspective
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in the healthcare ecosystem, it's concerning that even
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though that's already,
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teed up, we have a number of other
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conversations
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that are front and center right now on
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Capitol Hill that could add insult to injury.
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And what what I mean by that is
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if the premium tax credits actually expire at
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the end of this calendar year, and Congress
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and the administration
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don't act to renew those,
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we know that we're going to see a
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rise in,
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on the uninsured rate in the state of
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Michigan and elsewhere throughout the country. We know
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that translates to uncompensated
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care for our member hospitals,
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And ultimately, that translates to a lack of
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access because at some point, you have to
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talk about
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staff layoffs. You have to talk about,
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diminishing or eliminating service lines and then perhaps
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even closing entire hospitals. We've seen this movie
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before, right? This is what led to the
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passage of the Affordable Care Act in the
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first place. So the premium tax credits,
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that's the, the primary issue.
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There are other considerations.
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Site neutral payment continues to be under discussion
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at the federal level. We believe that hospitals
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play a very unique role and have justified,
9:25
the need to have a higher reimbursement
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for the services they provide because we're open
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twenty four seven, three sixty five. We take
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the most complex patients.
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We take everyone regardless of their ability to
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pay. There are reasons why we have that
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this reimbursement
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scheme in place to begin with. So site
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neutral payment reforms,
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deeply concern us. And then the last thing
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I'd lift up at the federal level,
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did you know that if we,
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assaulted
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a flight attendant on a commercial airline flight
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today, that's a federal felony offense. But if
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we assault a nurse in a Michigan hospital
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or a hospital anywhere throughout the country, it's
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not.
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What's wrong with this picture? We really believe
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that congress should pass a law
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that equates those two, that makes assaulting a
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frontline hospital worker a federal felony offense because,
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unfortunately, we see this violence against health care
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workers,
10:20
on the rise. It's not getting better, and
10:22
that's really, getting in the way of our
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efforts to recruit and retain
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an adequate number of clinical staff in this
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era where we have so many people
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aging into retirement. That pipeline becomes incredibly important.
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So these are a few of the things
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that we're talking routinely with our congressional delegation
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about.
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Thank you.
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You mentioned,
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challenges around, reimbursement, Medicare and Medicaid reimbursement. Mhmm.
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Can we broaden that out? And can you
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talk a little bit about the broader picture
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of
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reimbursement in general,
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through commercial payers as well? What's that environment
11:00
like right now in Michigan?
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That environment has changed dramatically over time predominantly
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because
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the population demographics have changed. So in a
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state like Michigan, we have about 10,000,000 residents.
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And
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thirty years ago, in the state of Michigan,
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Medicare and Medicaid was only a small sliver
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of that 10,000,000.
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Today,
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it's north of 50%,
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trending towards 60%.
11:26
But what it means is that the private
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insurance sector, starting with Blue Cross Blue Shield
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of Michigan, which is by far the largest
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private insurer in our state, they've moved into
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that public arena, meaning they provide Medicaid managed
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care plans,
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and they provide Medicare Advantage Plans.
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And so when you talk about those public,
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quote, unquote,
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services, Medicare and Medicaid,
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now you have the private sector insurers that
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are fully engaged as well.
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The other thing that's really changed over time
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is the fact that we are moving dramatically
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towards
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a value driven reimbursement. So the new contracts
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between private insurers in Michigan and our member
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hospitals and health systems,
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more and more, those come with value driven
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metrics, value driven design.
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And it really means that rather than just
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giving,
12:20
a Michigander a card, an insurance card that
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says you have open access
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to every hospital, every doctor,
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and we treat them all the same,
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We're really starting to steer those patients and
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incentivize those patients to go to the high
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value,
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high quality, low cost providers, whether that's hospitals
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or physicians.
12:43
Now that's not a new concept. It's been
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around for some time,
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but we're really seeing that start to escalate
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given all of the other financial pressures that
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exist. I see.
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And the relationship between payers and providers in
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many states, many regions has been
12:59
contentious and difficult over the last couple of
13:01
years. Has that is that true in Michigan?
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I mean, with perhaps with so much Medicare
13:06
Medicaid,
13:07
maybe it's different. I don't know. And
13:09
and and how is technology playing a role
13:12
in facilitating some of those relationships between payers
13:15
and providers? It's a great question. I I
13:17
think in Michigan,
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we tend to have a better relationship
13:21
between the health insurance
13:23
community and the provider community than you see
13:25
in most other states. And there's a a
13:27
long history,
13:28
to explain that, but we do have a
13:30
formal relationship,
13:32
for example, with Blue Cross Blue Shield of
13:34
Michigan that allows
13:37
us, the association and our members, to sit
13:39
around a formally sanctioned table
13:42
with the health insurer
13:44
and their team, and at least have open
13:46
conversation about the issues,
13:49
that we need to address together. It doesn't
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always mean that we agree or that the
13:53
insurers are going to do what we'd like
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to see them do. We still argue about
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things like prior authorization and payment denials and
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the same conversations you would see, elsewhere around
14:04
the country. There's no question. But I think
14:06
in Michigan,
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we have a a good enough relationship
14:11
that we're addressing
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a lot of those things, at least in
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a better way at the macro level. Now
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having said all of that, we were successful
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just a couple of years ago in passing
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that legislation
14:22
at the state level. It doesn't touch the
14:24
ERISA plans, of course, and doesn't touch Medicare
14:26
and Medicaid. But for everyone else,
14:28
this was related to prior authorization.
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So the legislature saw that we needed to
14:34
do a better job, treat patients and providers
14:36
more fairly,
14:37
in that realm. So there's gonna be ongoing
14:40
conversation
14:41
between our members and the insurance field,
14:44
as we go forward, but again it's going
14:46
to revolve around this emphasis on value driven
14:49
care. Yeah. Okay.
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As we wrap it up, Brian, anything else
14:53
on your mind as you look at 2026
14:56
that we haven't touched on? Well, I'm a
14:58
big believer that technology can be a game
15:00
changer.
15:01
And when it comes to our workforce,
15:04
you look at the advent of artificial intelligence,
15:07
the advent of virtual nursing programs,
15:10
these can be what I like to call
15:12
force multipliers
15:13
for our workforce.
15:15
They're challenged as it is, no question, But
15:18
this technology
15:19
really does have an opportunity to, to help
15:21
in terms of, the care that we deliver
15:24
every single day in Michigan hospitals and hospitals
15:26
throughout the country. I'm excited to see what
15:28
the next,
15:29
phase in this evolution will be.
15:32
Brilliant. Brian, it's been a pleasure talking to
15:34
you. Thank you so much for spending time
15:35
with us today. Thank you for the opportunity.
15:37
Thank you.