HASC Taps Head of Healthcare Association Of Hawaii As New President

As the healthcare sector enters what could be some of its most turbulent years ever, the Hospital Association of Southern California has turned to an outsider with extensive political experience to fill its top post.

The appointment of George W. Greene, currently president of the Healthcare Association of Hawaii, was announced by the HASC board of directors on Dec. 1. He takes over the reins at HASC in February.

"We are very pleased that George Greene has agreed to accept this important position.  He is a relationship-driven leader with a successful track record working through strategic policy and advocacy issues with diverse stakeholder groups,” said HASC Chairman Richard Afable, M.D., chief executive officer of St. Joseph Hoag Health in Newport Beach, in a statement.

The hiring of Greene, a 46-year-old attorney by training who has been leading Hawaii's leading hospital lobby for the past seven years, is a significant departure from how HASC has traditionally filled its top ranks, customarily with Southern California natives who had previous hospital management experience. Greene will replace James Barber, who has held the post since 1993 and recently announced his retirement. Barber had been with HASC virtually his entire career, having briefly worked as a hospital administrator before joining the organization in 1989.

Greene beat out some HASC insiders for the job, including Chief Operating Officer Mark Gamble, whose father Stephen Gamble headed HASC's predecessor, the Hospital Council of Southern California, in the 1970s and 80s.

“HASC is one of the greatest metro associations in the nation with an incredibly talented staff and reputation for success,” Greene said via an email. “I saw this as a tremendous opportunity to work on healthcare issues on a large scale and to hopefully have a bigger impact by helping more hospitals improve the health of the communities they serve.”

A native of South Carolina who obtained an undergraduate degree from Clemson University and a law degree from the University of Tennessee, Greene has had a career almost entirely in politics and lobbying. He began his career working as an aide to Robert Inglis, a South Carolina Republican who served six terms in Congress between 1993 and 2011. Greene then served as director of government relations for the National Association of Homebuilders and as senior policy director for former San Diego Mayor Susan Golding before entering healthcare in 2001 as director of government affairs for Sharp HealthCare in 2001. He served as a regional executive for the American Hospital Association between 2005 and 2009 before moving to Hawaii.

Greene noted his political experience was crucial to how he would perform his job. “In order to be an effective advocate the ability to work with politicians from different parties is crucial,” he said. “Having an in-depth knowledge of the policy implications to stakeholders on both sides of the aisle is certainly critical in negotiating and implementing meaningful reform.”

Greene is likely to be more high-profile than the publicity-shy Barber. He appeared on the cover of Hawaii Business Magazine in 2014, named one of the state's top 20 visionary executives – a level of publicity bestowed to few hospital lobbyists.

“I do enjoy interfacing with the media and key stakeholders and plan to maintain that role as HASC President /CEO,” Greene said. “That being said, we do work in a team environment and there will be times when we will engage the person with the most relevant subject knowledge.”

During his tenure, Greene has focused on obtaining extra funding for Hawaii's hospitals, which before his arrival received among the lowest rates of Medicaid reimbursement in the country. A 2012 waiver obtained from the Centers for Medicare & Medicaid Services boosted payments by more than $30 million a year. The change increased the proportion the federal government paid for the state's Medicaid patients from 70% to 83%.

However, Greene observed that he would have a different role at HASC, which collaborates with the parent California Hospital Association – and also defers to its leadership on many issues.

“As a metro association executive, my role will be different than it was as a state association president,” Greene said. “CHA provides terrific leadership and we will work collaboratively to advance the needs of hospitals.”

When Greene was appointed to the Hawaii job in September 2009, he was the first person of color to lead a state hospital association in the nation. He takes over the reins at HASC at a time when two of its major constituents – Kaiser Permanente and Dignity Health – are headed by African-Americans.

Greene will also be taking over at a time of enormous uncertainty for hospitals in both California and nationally. Less than a month ago, it was assumed that the Affordable Care Act would remain intact. The surprise election of Donald Trump as President has meant the law could be repealed as soon as 2017, potentially taking with it the insurance for tens of millions of Americans – and hundreds of billions of dollars in additional funding related to the ACA that has gone to hospitals.

The results of the election have raised grave concerns among the nation's leading hospital lobbyists. The American Hospital Association and the Federation of American Hospitals issued a letter earlier this week to Congress and the incoming Trump Administration. “According to reports, it appears that the Congress is moving to reconsider the ACA in the early days of the new year without enacting accompanying legislation specifically guaranteeing similar coverage for those who will lose it,” wrote AHA CEO Rick Pollack and FAH CEO Charles “Chip” Kahn. “If that approach is taken, we respectfully urge you to also include in such legislation the prospective repeal of funding reductions for Medicare and Medicaid hospital services for patient care that were included in the ACA for purposes of helping fund coverage for the insured.”

The AHA/FAH letter was accompanied by a report from the health economic firm Dobson/DaVanzo concluding that a full repeal of the ACA would lead to a staggering $558.4 billion loss of revenue to hospitals between 2018 and 2026. That would a $166 billion loss in revenue directly related to the loss of insurance coverage for individual patients; $289.5 billion in Medicare inflation updates currently contained in the ACA; and $102.9 billion in reductions to Medicaid Disproportionate Share Hospital payments.

“Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care, decimate hospitals’ and health systems’ ability to provide services, weaken local economies that hospitals help sustain and grow, and result in massive job losses,” Kahn and Pollack's letter said.

Greene said bluntly that “it is not (HASC's) role to ensure that the ACA remains intact,” but that as “a metropolitan association, we will work in partnership with others to ensure that a replacement package provides the needed access and coverage for patients in our communities, and adequate funding for hospitals.”