Trinity Health's Letter to President Trump Urges Consideration of Health Care Industry Realities

Livonia, Michigan, May 7, 2020 — Trinity Health President and CEO Mike Slubowski and Board Chair David Southwell sent a letter to the White House this week, asking that the Administrationconsider three tenets related to the nation's health system as it continues with the Opening Up America Again initiative. The letter follows.

May 5, 2020.

Dear President Trump,

As you continue with Opening Up America Again efforts, we offer three tenets for your consideration: the health care delivery system is essential to broader economic recovery; rebuilding the health care delivery system will take time and a laser-like focus on safety; and the rebuilt health care delivery system must be able to flex.

First: The Health Care Delivery System is Essential to Broader Economic Recovery

We all share the desire for a return to a strong national economy. A viable, high-functioning health care delivery system is critical to a strong recovery. The delivery system must be capable of addressing all needs for a potential surge to care for sick patients in all communities. Without a strong health care delivery system, many sectors of the economy will not be able to be restored, and the American public will lack the confidence to consume goods and services that are vital to full economic recovery.

Investments in the health care delivery system make strong economic sense. Hospitals, physicians, home health care and senior care represent approximately 12 percent of the U.S. economy, and the workforce is comprised of 100 percent U.S. domestic labor. Hospitals are among the largest employers in most communities and have excellent-paying jobs with benefits – so when hospitals thrive, the impact on the entire community is immediate.

The coronavirus pandemic has been brutal for the health care delivery system. Providers have spent tremendous amounts of resources on preparedness efforts while, at the same time, seeing a sharp drop in physician patient visits, surgical volume and outpatient diagnostic and treatment services that are the financial lifeline of hospitals.

Trinity Health, a faith-based system with more than 90 hospitals in 22 states, has responded with sweeping cost-savings measures that include workforce and salary reductions, suspension of almost all capital spend, and a pause on several strategic initiatives. Unfortunately, we cannot cut our way out of this crisis and still offer the vital services our communities need. Furthermore, we would like to bring all of our employees on furloughs and reduced hours back to work!

The health care system needs an infusion of additional relief to assist in the recovery. Your administration will be critical to providing this relief.

Second: Rebuilding the Health Care Delivery System Will Take Time and Will Require Laser-Like Focus on Safety and Patient Concerns

Consumer research suggests that at least 60 percent of patients are fearful of returning to the doctor or hospital while coronavirus is still active. Optimistically, we expect a vaccine sometime in mid-2021. The virus could resurge at any hospital at any time, so we must be thoroughly prepared. At the same time, people are struggling with, and dying from, unmet health needs not related to the coronavirus because they are too fearful to seek treatment for chronic conditions or urgent needs.

At Trinity Health, clinical leaders from across our 22-state footprint developed a recovery plan that includes a safe care environment for patients needing outpatient and elective surgery services, diagnostic and treatment services, expansion of telehealth and home care services, and optimization of the use of our ambulatory facilities. It will require a massive amount of capital to redesign all clinical services, facility ingress/egress, staging to create social distancing, additional personal protective equipment (PPE) and universal precautions, and patient interfaces to address concerns and promote communication. This bullish commitment to safety is necessary to restore patient confidence.

Success of this plan depends upon a significant amount of available testing for the virus and for antibodies, and testing will remain critical to the recovery until a vaccine is developed and readily available. Testing capacity is still limited, largely to available reagents and test kits. Your administration could develop national strategies to ensure the testing supply becomes and remains stable. This could include federal tax incentives to expand domestic testing capacity, an effort to push manufacturers to increase production of reagents, and public-private solutions to address supply chain deficiencies, particularly over reliance on foreign country manufacturing.

Third: The Rebuilt Health Care Delivery System Must Be Able to Pivot Quickly to Changing Health Care Imperatives

For as long as the coronavirus continues to circulate in the environment without a wide-spread vaccine, providers and public health leaders must remain vigilant. To contain new infections from spreading, we need broad, ongoing testing, capability to trace and alert those who have been exposed to an infected person, and opportunity for exposed and infected persons to self-isolate.

We know social distancing is effective. If public health efforts fail to contain new infections before a new outbreak begins to surge, local and state leaders must be equipped to reinstate stricter social distancing measures.

Rural communities and racially and ethnically diverse communities are particularly vulnerable to the coronavirus. A rebuilt health care delivery system must adequately address the needs of rural America as well as the elimination of health disparities.

A comprehensive public health infrastructure will financially reward primary care providers for their focus on social influencers of health and contributions to improving the health of communities.

Responses to public health threats should be data-driven. America needs a national digital health system. This will include an information technology infrastructure that consistently pulls data from varying health system electronic health records (EHRs) to provide our public health infrastructure data on effectiveness of clinical interventions and patient trends. Similarly, recent advancements in the delivery of, and reimbursement for, telehealth must be preserved and expanded.

Trinity Health seeks to be a positive disruptor. Recognizing the volatility of our pharmaceutical supply chain, we collaborated with other national health systems to start our own generic drug company. Today, Civica Rx is supplying drugs, including many that are in short supply, to treat patients with COVID-19. Similarly, we started our own nursing pool, allowing us to move nurses anywhere in our national footprint to support a surge. Finally, we’re laying telehealth tracks across our 22-state presence to build a care model that protects vulnerable populations.

While disruption is a key component of the solution, it alone will not get health systems to a desired future state. Your administration can proffer needed infrastructure advancements in public health, digital health, and health facility redesign that will be critical to ensuring tomorrow’s health care delivery system has the needed flex to meet future preparedness needs.

A companion document that expounds upon our policy recommendations is included with this letter. We hope that these comments are helpful as you develop a plan to reopen and restore America. We thank you for your continued efforts.

Sincerely,

Michael A. Slubowski, FACHE, FACMPE


President and Chief Executive Officer


Trinity Health

And

David Southwell


Board Chair


Trinity Health