- This is the Becker's Healthcare Podcast created
by the team at Becker's Healthcare,
a multimedia company devoted to the people
who power us healthcare.
Four new 15 minute episodes are released daily containing
industry news analysis and thought leadership.
From powerful healthcare decision makers Support our show
by leaving it a five star rating and review on Apple Podcast
or other platforms you use.
It's a chance to tell us what you like about the show
and act on your feedback.
Thanks for listening. Now here's the episode.
- This is Chris Oster with the Becker's Healthcare Podcast.
I feel today to be joined by Larry Levine, president
and CEO of Live Dale Children's Hospital in New York.
Larry, thank you for joining us today.
- A pleasure to be with you, Chris. Thank you for having me.
- Much appreciated. Larry,
would you mind introducing yourself
and telling us a bit more about your background?
- Oh, sure. So I'm the, uh, president
and CEO here at Blythedale Children's Hospital in New York.
Uh, I've been CEO here since 2001,
and um, this is my 48th year
of work in the healthcare field.
Uh, started way back in 1976 as a graduate at the University
of Michigan School of Public Health.
And Chris, my, my career has kind
of spanned three different jobs.
I've worked in Capitol Hill, I worked then as a consultant,
as a healthcare management consultant
with expertise in children's hospitals
and of course the last several years working in
children's hospital management.
- Larry, we definitely appreciate you bringing your
expertise to our podcast today.
Here's where we're gonna start. So while I understand it's a
very long list, what issues facing children's hospitals do
you find most preceding today?
- Well, sure. Well, there's, uh, a few that I can,
I can click off the top of my head.
One is, uh, it's really important for children's hospitals
to protect Medicaid from funding cuts.
And the reason for that is nationally, Chris, about 50%
of kids are covered by Medicaid.
And Medicaid is the leading payer by far at most
of our nation's children's hospitals,
around 55% on average.
And here at Blythedale, more than 70%
of our patients are covered by Medicaid.
So you can understand when the budget is being talked about
nationally and even at the state level when the deficit
hawks come out.
Medicare and social security are always protected,
but Medicaid is never considered as a sacred cow.
We really have to worry about Medicaid funding
'cause it's so important for children's health.
Second, what's really interesting is there's a lack
of adequate numbers of home care nurses in the nation
to care for medically complex kids.
It's a real national problem.
And what's happening in pediatrics is
that many kids can be treated on an ambulatory basis.
So the kids who remain hospitalized tend to be much sicker
with complicated illnesses and conditions.
In order for these kids to be successfully discharged home,
you have to have home care nurses in numbers
and with experience to care for kids on ventilators, kids
that have tracheostomies or complex medication regimens.
And yet there is a national shortage of these nurses
which places burdens on parents to care for these kids
as well as on hospitals and discharging them safely home.
So that's kind of a second problem for us.
A third one is really protecting children's
GME funding GME funding.
Chris is important for children's hospitals
as it's an important funding source for pediatricians
and pediatric specialists coming out of, uh, residency
and training programs.
Since freestanding children's hospitals don't get CGME
funding through Medicare,
children's hospitals have a separate program of,
uh, C-H-C-M-E funding.
And again, unlike Medicare, GME, which is mandatory funded,
C-H-C-M-E is a discretionary grant
and we have to get that reauthorized every five years.
What's really important for us to note is
that CME funding GGME hospitals make up only 1%
of our nation's hospitals, only 59 per 59
of us get C-H-G-M-E funding,
and yet we train nearly 40% of the workforce.
So those are some of the most important, the top three
problems I think that we have.
- Thank you for laying laying those out for us, Larry.
So on that note, why is it so important
for healthcare executives, particularly those
that pediatric care centers
to come involved in legislative process?
- Yeah, I think we as CEOs could really utilize our position
to vigorously advocate for our patients and our families
and to fully engage in the public policy process.
You know, Chris, there's two types of advocacy.
So we can do, one is first and foremost is to protect
and advance the interests of our hospitals,
but also to advocate for broader policies
to help our patients and families,
and particularly for children's hospitals, we have
to educate policy makers about what the needs of kids are,
write legislation, comment or testify regarding regulations,
and certainly to weigh in on state
and federal and state budget.
Um, you know, I just mentioned three of the top
institutional concerns that we have at children's hospitals,
uh, Medicaid funding, C-H-C-M-E funding
and home care nurses,
but children's hospital CEOs are also really worried about
broader issues that impact a child's physical
and mental health and their quality of life.
And so, you know, I think we as a group of
children's hospitals have to really go to bat for these kids
and these families, many of whom are at a very
vulnerable time in their life.
Thank God most children don't get sick,
but those that are sick that have a lot of different issues,
I think as CEOs, we really need to advocate
for policies and for regulations and budgets to protect
and advance the quality of life
and the healthcare of these kids.
And I've always taken that as a mantle of importance for me
as a CEO to be an, uh, an activist
to really work at the federal
and the state level, um, to put together policies that, um,
that help these children and families.
- Clearly patients
and caregivers need people like yourself,
Larry, to be doing that work.
And you've been doing this clearly a
long time as you mentioned.
Uh, zooming in a little bit, could you detail a little bit
policies that you've helped bring to fruition
and what that process entails?
- Yeah, so Chris, I've gotten,
actually in my tenure here at blythedale,
I've gotten three pieces of legislation written passed
by our state legislature
and signed into law by three different governors.
And they've dealt with improving covered benefits
under the SSIP
or the Child Health Plus program, uh, here in New York, uh,
Medicaid hospital reform for children's hospitals.
And most recently our governor, uh, signed into a law,
uh, a statute which provides sweeping requirements
for Medicaid managed care
and commercial payers in determining the way medical
necessity, uh, is defined and provides special protections
and accommodations for medically fragile children.
And that law went into effect on September one.
- That's excellent, Larry, thank you
for letting us know about those efforts.
Looking ahead a little bit, are there changes
policies you're hoping to enact next?
And what advice would you give others, CEOs in particular
who are looking to follow in footsteps that you've laid out?
- Yeah, so right now, uh, an important policy, uh,
in front of Congress is to extend the child tax credit.
This helps lift many children out of poverty.
Uh, and it has during the pandemic when, um, the, uh,
American Recovery Act, uh, was, uh, um, passed, it
provided a significant, uh, tax credit for,
for low income families.
Uh, national studies indicated that, uh, up to 40%
of children were lifted out of poverty were regrettably
that, uh, tax extension did not occur at the end
of 2022.
And it's back up, um, for consideration,
there actually is a bipartisan bill in front of Congress.
And so I've been actively lobbying on behalf
of the extension, uh, of this.
Uh, another thing that we're, uh, also talking about, Chris,
is protecting the food stamp program,
which is known as snap.
Um, that unfortunately is on the topping block, not
to be cut entirely, but to be cut back
significantly in the continuing resolution.
I, I note the fact that one out of seven children
or 11 million children nationally go
to bed hungry every night.
And so as the CEO and,
and working with our families here, I know
that food insecurity is a major problem.
And so I've been lobbying for those two things right now on,
on Capitol Hill.
So the last piece is we're ready
to tackle this home care nursing shortage
for medically complex kids.
Um, and what I'm doing right now is gathering a coalition
of hospitals, parent groups, child advocacy organizations,
home care agencies
before legislation could be written to more
specifically define the problem
and what the policy solutions should be at our state
government, which hopefully could be a model
for the rest of the nation.
That's what I'm working on right now.
- Larry, we certainly wish you continued.
Good luck in all these efforts.
And we also thank you for being so generous
with your time and insights today.
We cannot wait to share them with our audience,
and we look forward to connecting with you soon.
- Thanks so much, Chris.
I appreciate you having me on your program.
- It's so important for leaders at the top of organizations
to keep learning, stay sharp, grow their networks,
help our audience better do this in a more simplified,
personalized, and meaningful way.
Becker's Healthcare has launched my BHC,
it's your trusted Becker's healthcare experience
and more with content, connections, events
and learning opportunities.
Join the community free
of charge@www.my dot becker's hospital review.com
and we'll see you there.