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Kaiser Permanente makes a big deal, battles over 340B payments, and more: Our top management stories of 2023


From a big merger to a fight over federal funds to the nation’s largest healthcare worker walkout, these stories on management issues drew the most attention.

In a year filled with big stories, Kaiser Permanente managed to play a big role in two of the biggest of the year, and both touched on two big topics.

Image credit: Kaiser Permanente

Kaiser Permanente announced plans to acquire Geisinger Health in Pennsylvania, and form a new organization called Risant Health. (Image: Kaiser Permanente)

FIrst, Kaiser Permanente announced its plan to acquire Geisinger, the Pennsylvania-based health system. More hospitals and health systems announced mergers and acquisitions in 2023, and the Kaiser-Geisinger deal garnered widespread attention.

The California-based healthcare organization also found itself in the spotlight again when tens of thousands of workers went on strike.

In addition, hospitals and health systems continued a years-long battle with the federal government over the 340B program.

Continuing a look at the most popular Chief Healthcare Executive® stories of 2023, here are the five stories on management issues that garnered the most readership.

1. Kaiser Permanente’s acquisition of Geisinger: Billions committed to deal

Kaiser Permanente made it clear that it’s investing heavily in the acquisition of Geisinger.

Kaiser is forming a new organization called Risant Health, and plans to make Geisinger the first member of the new system. Kaiser Foundation Hospitals, a division of Kaiser Permanente, is designating up to $5 billion “to support core Risant Health capabilities, technologies, tools, and future investments,” the financial documents stated.

The agreement also calls for Risant Health to provide a minimum of $2 billion as needed through Dec. 31, 2028 to support hospital, ambulatory facility, technology and other capital needs.

2. Hospitals welcome billions in 340B payments, but decry ‘claw back’ of funds

Following a victory in a Supreme Court case in 2022, hospitals and health systems have been pressing the government to cough up billions in long-delayed payments from the 340B drug discount program.

The Centers for Medicare & Medicaid Services, a division of HHS, said in November that it plans to pay out $9 billion to 1,700 affected hospitals. However, health systems are protesting the government’s plans to recoup funds elsewhere.

“HHS made a grievous mistake in choosing to claw back billions of dollars from America’s hospitals, especially those that serve rural, low-income, and other vulnerable communities,” said Rick Pollack, president and CEO of the American Hospital Association.

The 340B program offers discounts on some outpatient drugs for hospitals that serve a high percentage of patients with low incomes and those in underserved communities.

3. More than 75,000 Kaiser Permanente workers will strike if they don’t get a deal

Union leaders said it was the biggest healthcare workers’ strike in American history.

More than 75,000 workers, including nurses, pharmacists, and radiology technologists, followed through on their warning and engaged in a 3-day strike in October.

Days later, members of the Coalition of Kaiser Permanente Unions approved a new, four-year contract.

The contract offers raises of 21% over the four years of the pact and concessions to improve staffing. Both union leaders and Kaiser officials said the contract was “historic.”

Officials on both sides also said Acting U.S. Labor Secretary Julie Su played a key role in reaching an agreement.

4. Kaiser Permanente’s acquisition of Geisinger could reveal ‘art of the possible’

After Kaiser Permanente announced its plans to acquire Geisinger, some healthcare leaders said the venture could help advance the expansion of value-based care.

Sachin Jain, president and CEO of the SCAN Group & Health Plan, said in the srping that Kaiser Permanente’s acquisition could yield some big dividends.

“I think there's an incredible opportunity here for both Geisinger and Kaiser to demonstrate the art of the possible,” Jain told Chief Healthcare Executive.

Kaiser Permanente operates 39 hospitals, hundreds of medical clinics, and a health plan with more than 12 million members. Geisinger operates 10 hospital campuses and a health plan with more than 500,000 members.

Linda Finkel, chief executive officer of AVIA, says she sees great promise in the deal. “The country is moving to value-based care far too slowly,” Finkel says.

5. Emergency Nurses Association president: Violence has reached level ‘I’ve never seen’

Terry Foster, the president of the Emergency Nurses Association, has been a nurse for 45 years. And he told Chief Healthcare Executive® that he doesn’t recall the level of violence that nurses are seeing in emergency departments.

“Violence in the emergency department for nurses is a tremendous problem,” Foster says. “It's something that I've never seen before at this level.”

Nurses and doctors say they have experienced assaults and abusive behavior with shocking regularity.

In the wake of so many attacks, Chief Healthcare Executive® has launched a new series, “Safer Hospitals,” examining what hospitals can do to reduce violence. To share ideas or suggestions, please send me a note: [email protected].

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