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P R O C E E D I N G S

Opening Remarks

            DR. GINSBURG: If you all could take your seats, I would like to welcome you all to HSC’s Sixth Annual Wall Street Comes to Washington roundtable.
            I know that many of you have made a special point of coming to this annual meeting to get a perspective that you don’t often hear in Washington, namely, how analysts working in the financial markets perceive the changes underway in the nation’s health care system.
            Briefly, the job of securities analysts is to predict the financial returns of companies, and this requires knowledge of the markets that these companies operate in, what their competitors are doing, what their customers are doing, and what their suppliers are doing.
            Some analysts work for those who underwrite and distribute securities or provide brokerage services, and these people are called sell-side analysts. Others work for those who are investing funds, such as mutual funds or institutional investors, and these are called buy-side analysts.
            For bonds, which are a key source of capital for nonprofit hospitals, some analysts work for agencies that rate bonds on the basis of the safety of their repayments.
            The perspectives of these analysts have been valuable to those in the policy world who are concerned not about the financial prospects of the companies, but on the implications of these developments for the public and for particular stakeholders.
            This year we have expanded the panel to include two highly regarded policy analysts, and since policy influences markets and in turn is influenced by them, the perspectives of the policy experts are likely to enhance our discussion.
            Policy analysts can help bring out the policy implications of developments in markets. Indeed, HSC sees it niche as the intersection between markets and public policy.
            Many of the questions today will be initially directed at the securities analysts, and I expect that the policy analysts will have reactions to what they hear from the securities analysts and will mix it up with them. Other questions will be directed at the policy analysts, and then the securities analysts will comment.
            Odd-numbered years, such as 2001, are my favorite years to hold this conference, and this is because HSC completes its site visits of 12 representative communities in March of those years and has the freshest perspectives on market developments to bring to this. And this gives us the ability to augment or refute what the analysts say, and Joy Grossman of the Center will be performing that function.
            To date, this year from our site visits we’ve published four issue briefs on major trends, and we have a lot more products, issues briefs, and journal articles in the pipeline coming from this round.
            Following this conference, HSC will provide a news release of the highlights of the discussion, and a searchable transcript will be placed on our Web site. Also, I’m very pleased that the Kaiser Family Foundation is webcasting the audio portion of this meeting. So it’s okay if you make faces, but speak clearly and I’ll try to identify you.
            Later in the summer, HSC will publish an issue brief summarizing the substance of this conference. And I want to thank The Robert Wood Johnson Foundation for its support of this meeting and its support of the HSC research and publication that goes into it.
            I’m supposed to introduce the speakers now, and my notes are over there.
            Okay. Going alphabetically, Bob Berenson, second from the left, is a senior policy adviser at the Academy for Health Services Research and Health Policy, and for the last two years, he was director of the Center for Health Plans and Providers at the Health Care Financing Administration, now known as the Centers for Medicare and Medicaid Services. Dr. Berenson is an internist and founder and former medical director of the National Capital Preferred Provider Organization.
            Sitting to his left, all the way on the left, is Dennis Farrell, who is the group managing director of Public Finance at Moody’s Investors Service, and in that capacity he heads a combined unit consisting of analytical teams in regional ratings and higher education, health care, and other nonprofit institutions.
            Closest to me is Normal Fidel, senior vice president of Alliance Capital, and he manages a slew of mutual funds, including Alliance Health Care, ACM International Health Care, Global Growth Trends, Universal Health Sciences, and the Epta Healthcare Funds.
            Roberta Walter Goodman, to his left, is the managing director at Merrill Lynch. She’s been there since 1997, and she covers managed care and a range of health care issues.
            Joy Grossman, sitting in the center, is associate director of the Center and plays a leading role in our site visit work.
            And Geoff Harris, who hasn’t arrived yet, is the managing director of UBS Warburg.
            And, finally, Robert Reischauer is the president of The Urban Institute, and he was previously the director of the Congressional Budget Office from 1989 to 1995, an also held senior positions at CBO earlier in his career.
            One thing that has contributed to the success of these meetings has been the willingness of the analysts to participate year after year. This is the sixth time, I think, for Geoff Harris, the fifth for Roberta Walter Goodman, and the fourth for Norm Fidel, and the second for Dennis Farrell. These people get numerous invitations to speak, and we are very grateful for the priority that they have given to these meetings.
            I also want to note that Joy Grossman has participated either behind the scenes or on the panel in all six of the meetings.
            If you look at the agenda, you see there are two sessions. We have a break in between, and we’ll have opportunities for questions and answers at the end of each of the segments.

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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.