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January 12, 2017

Trump taps former Beth Israel CEO David Shulkin to lead VA

Daily Briefing

    President-elect Donald Trump during a press conference on Wednesday said he will nominate Veterans Affairs (VA) Undersecretary for Health David Shulkin to take over as VA secretary under his administration.

    Trump said his transition team "looked long and hard" and interviewed "at least 100 people" when considering candidates to lead VA.

    Trump called Shulkin a "fantastic" choice to take over VA who "will do a truly great job." Trump said, "I have no doubt [Shulkin] will be able to lead the turnaround [VA] needs," adding that Shulkin "has the experience and the vision to ensure we will meet the health care needs of every veteran."

    Read the Q&A: How David Shulkin runs America's largest health care system

    Background on Shulkin

    Shulkin is a physician who previously served in C-suite roles for various hospitals and health systems, including as president and CEO of Beth Israel Medical Center. Shulkin has been VA's undersecretary for health since June 2015. As VA undersecretary for health, Shulkin directs the Veterans Health Administration (VHA), which oversees the care of about nine million veterans at nearly 1,000 VA clinics nationwide.

    Shulkin took over VHA following a scandal that emerged in 2014 over long wait times for veterans seeking health care and subsequent cover-up efforts.

    According to USA Today, Shulkin has favored moving VA toward a hybrid public-private model, under which VA would continue to provide specialized care for veterans—including treatment for post-traumatic stress disorder, loss of limbs, and traumatic brain injuries—and discontinue services that the private sector might be better suited to provide, such as obstetrics and gynecology.

    Currently, VA will cover only private health care for veterans in certain circumstance under the VA Choice Program.

    However, Shulkin has spoken out against drastically reducing the federal government's role in VA health care, the Washington Post's "PowerPost" reports. According to "PowerPost," Shulkin previously said it "would be a terrible mistake, a terrible direction for veterans and for the country, to essentially systematically implement recommendations that would lead to the end of the VA health care system."

    If the Senate confirms his nomination, Shulkin will be the first non-veteran to head VA.

    Study: VA, non-VA hospitals have similar patient outcomes

    Shulkin, others react

    Shulkin in a statement released by Trump's transition team said he was honored to be Trump's pick for VA secretary. He added that he and Trump "are both eager to begin reforming the areas in our [VA health care] system that need critical attention, and do it in a swift, thoughtful, and responsible way."

    House Veterans' Affairs Committee Chair Phil Roe (R-Tenn.) praised Trump's decision to nominate Shulkin as VA secretary. "I am pleased ... Trump has chosen a physician to lead [VA], especially one familiar with the integrating of private practitioners into the VA's network of health care providers," he said.

    Brian Duffy, national commander of the Veterans of Foreign Wars, said the group "is proud to support [Shulkin's] nomination ... and [is] most appreciative of [Shulkin's] willingness to continue serving veterans and making the VA better."

    Phil Carter—director of the Center for a New American Security's Military, Veterans, and Society Program—said, "Picking Shulkin shows both a focus on veterans health reform, and a desire to largely continue much of the good work done since" the VA wait-time scandal emerged in 2014. He added, "Under Shulkin, VA has slowly and quietly shifted more of its patient load to the private sector, and that has helped VA handle much greater demand. That trend will likely continue, and work better than outright privatization of the VA."

    However, Paul Rieckhoff, CEO of the Iraq and Afghanistan Veterans of America (IAVA), in a statement criticized Shulkin's coming nomination because Shulkin is not a veteran. He said the group's "membership overwhelmingly supported the selection of a veteran for this critical leadership position." Still, Rieckhoff said the group is "optimistic" about Shulkin's nomination, adding that Shulkin "has been a trusted partner of IAVA at VA" (O'Brien, Politico, 1/11; Slack, USA Today, 1/11; Lovelace, CNBC, 1/11; Domonoske, "The Two-Way," NPR, 1/11; Rein, "PowerPost," Washington Post, 1/11; Shane, Military Times, 1/11; Bradner/Diamond, CNN, 1/11; Small, FierceHealthcare, 1/11).

    12 things CEOs need to know in 2017

    12 things CEOs need to know in 2017

    The continued growth of the consumer-driven health care market threatens the durability of patient-provider relationships—and, at the same time, the push toward population health management and risk-based payment is greater than ever.

    Hospitals and health systems must adopt a two-pronged strategy to respond to these pressures and serve both public payers and the private sector.

    At the core of that strategy? A formula of accessible, reliable, and affordable care that wins consumer preferences and drives loyalty over time. Below, we share 12 key insights for senior executives working to create a consumer-focused health system.

    Download the research brief

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