by Alex Kacik in an exclusive interview for Modern Healthcare, June 6, 2025
Chip Kahn, president and CEO of the Federation of American Hospitals, will retire at the end of the year, ending his 24-year run at the helm of the trade association.
Kahn has worked in healthcare and politics for nearly 50 years, holding various roles on Capitol Hill and leading the Health Insurance Association of America before joining the Federation of American Hospitals. The Federation, which represents more than 1,000 for-profit hospitals and health systems, has yet to name a replacement and has tasked management consulting company Korn Ferry to help its search.
Kahn does not have any immediate post-retirement plans, but said it’s time for him to work on policy from another perspective as he looks for another platform to discuss healthcare affordability, coverage and quality improvement.
In an interview, Kahn said for the rest of the year he will focus on helping the hospital sector navigate the budget reconciliation process, push back against potential Medicaid cuts and work to extend enhanced tax credits that have boosted enrollment in the health insurance exchanges. The interview has been edited for length and clarity.
How do you view your 24 years at the Federation?
It has been an honor working on the side of those who provide care to patients every day. The sector I work for is one of the most effective providers of hospital care in the country.
We’ve come a long way over the last 24 years in areas like coverage. Quality has been better measured and improved. Innovation in care and the operation of hospitals has taken off. It has been important to help watch and guide the policy side of that for the great hospital operators I’ve had the good fortune to work for.
What accomplishments stand out?
It’s important to note that healthcare policymaking is a team sport. The Federation and its members have been most impactful because of collaboration.
Our “strange bedfellows” work with Families USA and the coalition put together by the Robert Wood Johnson Foundation made a tremendous contribution to forwarding the discussion around healthcare coverage. That blossomed into the Federation’s “health coverage passport,” a lot of which was reflected in the Affordable Care Act. We made a big contribution to the policy that led to the ACA.
On the quality front, we formed the Hospital Quality Alliance, which began promoting the use of clinical performance measures. The Centers for Medicare and Medicaid Services picked that up and it became part of the law. In the ACA, one of the features we pushed was looking at Medicare quality measures and making recommendations to Medicare through the National Quality Forum.
We’ve also made sure that Medicare and Medicaid payments were fair, and that payments were neutral across whatever kind of provider you were — nonprofit, tax-paying or public. We showed that our hospitals are providing as much uncompensated care as other comparable hospitals.
What keeps you up at night?
The budget reconciliation legislation keeps me up at night. Medicaid cuts will affect coverage and access to care for millions of Americans. We have to provide care for those people, whether or not the government determines they’re eligible for services, and find a way to pay for it.
The problem with the legislative process is you just never know whether plans are going to come to fruition. We’ll be very focused on the enhanced tax credits in the exchanges. Those are not going to be dealt with in the next few weeks, and we hope we can get those extended.
The major thing that’s happening in Medicare and Medicaid is managed care. We’re above 54% in Medicare and it’s going up. We’re above 70% in Medicaid and that’s probably going to continue to go up.
Medicare Advantage provides beneficiaries with the opportunity to get extra benefits. On the other hand, beneficiaries face prior authorization and claim denials when they need care. We think those managed care principles have been overdone and need reform.
What are some potential managed care policy reforms?
We have research that shows that fee-for-service Medicare patients tend to have more hospitalizations than Medicare Advantage patients. MA patients have an average length of stay that is two days longer because health plans prefer to see the patient in the hospital rather than getting released to some kind of post-acute care, which may be more appropriate than hospitalization. They’d prefer to release patients to their homes rather than going to another setting where the managed care company would have to pay another fee.
The policymakers at CMS want to see the numbers there, so we have spent a lot of time and effort on that.
What’s next for you after the Federation?
One of the projects I have been thinking about is policy processes that have been readjudicated in some form. We need to find a way to quickly educate everyone that’s working now on the fact that many current issues have been discussed before. Frequently, a policy was enacted and it didn’t work because of various aspects — there are better ways to craft it. I’d like to take policy vignettes that you could tie together to see the story line.
I’d like to do some writing. I’ve really enjoyed the podcast I have here at the Federation. I’m looking at the freedom of taking my almost 50 years of experience and turning it into something that helps inform the people that will come after me.
