Changing with the Times

Author: Anthony Shih, MD, MPH 

Anthony Shih, MD, will step down as president of United Hospital Fund after five years at the helm, effective August 1, 2022. Chad Shearer, UHF’s senior vice president for policy and program, will serve as interim president. The Board and staff of UHF are deeply grateful for Dr. Shih's outstanding leadership. 

It has been my absolute privilege to serve at the helm of this esteemed organization over the past five years. In the context of United Hospital Fund’s 143-year history, my tenure has been brief. However, given the transformative events of the past few years, this period feels so much longer. These have been challenging times to say the least. But I believe that UHF has not only weathered the storms—we have emerged stronger and with a renewed sense of purpose and determination. 

Foremost on my mind is how the COVID-19 pandemic has forced all of us to challenge our assumptions and revise our perspectives. In health care, how we structure the delivery system and provision of care, how we finance and pay for services, and how much of a role is played by public health were all put to the test. This led to some notable successes but also laid bare clear areas of weakness. 

For United Hospital Fund, the fundamental way we carry out our mission was also challenged, forcing us to quickly adapt. We shifted from targeting our work almost exclusively to policymakers and health care leaders to taking on the additional responsibility of direct outreach to communities. For example, we provided education about options for the newly uninsured as well as resources on parenting during the pandemic. The rapidly evolving health care landscape spurred a change from our historic focus on long and detailed analytic reports, leading to the addition of shorter and more frequent commentaries from both internal and external experts; these pieces allowed us to quickly highlight emerging issues on COVID-19 that were not otherwise addressed by the broader media or trade press. And of course, while maintaining momentum in our core program and policy areas, we scrambled to address new problems specific to COVID-19. We were the first organization to examine and highlight the impact on children who have either lost a parent or guardian or who entered poverty during the pandemic

Secondly, the re-energized social justice movement ignited by the very public murders of Black Americans and other Americans of color, intersecting with the long-standing and wide racial health disparities exacerbated by the pandemic, gave UHF a renewed urgency to tackle health inequities. This has now become a central theme across all our programs. It appears in obvious places—like helping the Medicaid program to drive equity—to less obvious, such as some work in progress on how private insurers can also support health equity. We’re not only embedding the topic of health equity in all our existing projects and events but have also developed new projects that are completely focused on advancing equity. These include our Pediatrics for an Equitable Developmental Start Learning Network and a task force we just launched in July on Bridging Quality and Equity with experts from across the New York City metropolitan area. And of course, any work on addressing disparate health outcomes must go beyond the health care system, and so we have increased our focus on major drivers of poor health, such as food insecurity and housing instability.  

The social justice movement also accelerated the hard journey of working toward a diverse, equitable, and inclusive environment within UHF. While we have made much progress, we acknowledge there is much more work to be done.

Finally, the political unrest coupled with the precipitous degradation of public discourse over the past few years has reaffirmed the importance of entities that provide credible, independent research to inform public policy. Facts do still matter, and it is vital that there remain organizations like UHF that serve as respected voices and as conveners bringing together diverse stakeholders to find solutions to critical challenges in health care. Tackling issues such as price transparency in health care requires entities like UHF to bridge the divide between consumers, providers, and payers, all of whom have different interests and perspectives, and all of whom are critically important in a well-functioning system.

As United Hospital Fund moves forward under new leadership, there will almost certainly be changes to the specific program and policy areas the organization chooses to work on. There are numerous unanswered questions: Can we agree on whether and how to reach the remaining uninsured in New York? As health care costs continue to rise, what is the tipping point before wholesale restructuring is needed and/or forced upon us? As health systems increasingly engage in the social determinants of health, where do their responsibilities begin and end? What is the most effective strategy for reducing health care disparities?

Despite any coming changes, however, I am confident there will also be continuity in our guiding values. Throughout our history, from our founding in 1879 as a federated charity dedicated to raising funds to care for the poor to our current structure as an independent nonprofit, our commitment to the historically disadvantaged and medically vulnerable endures. There is no other way to fulfill our mission to build an effective and equitable health care system for all New Yorkers.

A sincere thanks to all of you—our friends and partners as well as the board and staff of United Hospital Fund. Together, we can make continued progress toward better health for all.