Healthcare Hunger Games #1: This Week in Washington and Your State Capital

‘-by Ryan Sprinkle, Stroudwater Associates

Like most folks who operate at the grassroots level, hospital board members and leaders understand that decisions made in Washington, D.C. eventually impact their communities and the hospitals that serve those communities. Our team at Stroudwater understands this reality, too. Since 2010, more than 190 hospitals across the country have closed and, by my count, at least 85 hospitals have filed for bankruptcy. Most hospitals collect over 50 percent of revenue from government healthcare programs, so the decisions made by federal and state governments play a significant role in shaping longer-term strategic decisions for hospital board members and leaders.

My appreciation for how government policy affects communities started with attending local political functions as a ten-year old in rural Alabama. Over time, I developed a deep interest in U.S. fiscal policy and matters relating to the national debt. I came to realize that improving the nation’s fiscal policy challenges in any meaningful way requires lawmakers to address the looming liabilities associated with the nation’s healthcare programs. In law school, I studied the nuances of federal healthcare law and how they affect the strategic and operational decisions of local hospitals and physicians.

For hospital leadership, knowing what is in a proposed bill like the American Health Care Act, the Trump Administration 2018 federal budget, or a given state’s section 1115 Medicaid waiver or section 1334 innovation waiver is only half the challenge. Even more critical is understanding how these federal and state legislative proposals should inform the strategic planning and decision-making of your hospital or health system.

This blog post is the launch of a new series of posts that I’ll write over the next several months. In these posts, I’ll provide an overview of selected state or federal legislation or other health policy issues and will discuss how that legislation or policy would impact the strategic activities that hospital boards and leaders undertake.

Most importantly, I want to hear from you, the reader at the grassroots level. Is your state considering pursuing reforms in its Medicaid program? What aspects of the latest GOP healthcare reform proposal keep you up at night as a hospital board member or leader? How is your board reconsidering its strategic plan given the increased focus on HSAs, patient self-pay responsibilities and healthcare consumerism? Send me your questions (or anxieties). Let’s make this blog a conversation and learn from one another.

Ryan Sprinkle is a consultant at Stroudwater and a licensed (but recovering) attorney. He can be reached via email at or by phone at (770) 913-9046.