Five Questions With: Howard Dulude

In December, Howard Dulude was named the new finance director for the Hospital Association of Rhode Island, where he will work with staff and hospital members to develop and evaluate hospital finance policy information to support advocacy efforts. 

Dulude is the former vice president of human resource operations and Lifespan Health at Lifespan Corp. He recently spoke with Providence Business News about his new job. 

PBN: Kayla Mudge, communications coordinator at HARI, noted you were hired in part for your knowledge in finance, human resources and health care policy, specifically Medicaid policy. Can you describe which of these have come in handy the most since you began?

DULUDE: At HARI, my role primarily focuses on hospital finance/payment policy. Often, it is easy to get focused on the numbers; however, it is extremely important to remember that the payments to hospitals support the health care needs of every Rhode Islander. Additionally, these payments support one of Rhode Island’s top workforces.

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Hospitals provide well-paying jobs to individuals in and around Rhode Island. Hospitals directly employ more than 30,000 health care professionals and indirectly support an additional 20,000 jobs in other sectors of the economy. In total, hospitals are responsible for generating more than 50,000 jobs for Rhode Island.

Over the past few years, the federal Affordable Care Act provided needed access to health care coverage for many Rhode Islanders. Unfortunately, hospitals have and will continue to experience reductions in Medicare and Medicaid payments to help fund the provisions of the ACA. My role at HARI supports the analysis of the reductions, identifying the implications of the reductions on health care/hospital services and jobs, and identifying solutions to assure that hospitals receive all of the payments they are entitled to under the federal laws and regulations so they can continue to provide great care to their patients.

PBN: Please tell us a little about how your other two areas of expertise have figured into the last few months.

DULUDE: In today’s economy, many businesses are struggling to retain and recruit high-performing staff. Hospitals employ some of the most highly educated and trained staff of any industry, including doctors, nurse practitioners, physician’s assistants, nurse midwifes, registered nurses, physical therapists, pharmacists, radiology and many other technicians and health care workers in addition to information services, finance and other administrative staff.

My background in human resources and health care policy helps me interpret the impact of new state and federal regulations and laws on the hospital industry to develop information to educate state and federal decision-makers. I will also be relying on this experience to help hospitals understand and implement related regulatory and legislative changes.

PBN: Can you describe your recent work to develop and evaluate hospital finance policy information in support of advocacy efforts?

DULUDE: I’ve been at HARI for a little over three months. So far, I’ve been focusing on several hospital payment issues, including:

Understanding the implications of the governor’s proposed budget for 2020 that includes several articles that impact hospital payments by about $24.5 million.

The Affordable Care Act includes reductions to Medicaid Disproportionate Share Payments to hospitals. The payments are used to maximize federal dollars coming to the state of Rhode Island. Reductions will impact hospitals and the state of Rhode Island budget.

Last fall, the Centers for Medicare & Medicaid Services finalized regulations that reduced the component of hospital Medicare payments related to wage costs by over $28 million for 2019.  We are working with our congressional delegation to restore these payments.

PBN: Part of your new post, according to HARI, was to monitor and analyze the financial impact of federal and state legislative and regulatory activities. What have your discovered so far?

DULUDE: Hospitals provide a critical service to all Rhode Islanders. Our federal delegation, state leaders and legislators are supportive of the patient care needs and work closely with hospitals to address issues. We may not always agree on issues, but our elected officials and leaders understand the importance of the hospital industry.

PBN: What would most surprise most people about your work with HARI?

DULUDE: Director of finance for the Hospital Association of Rhode Island sounds like a numbers or accounting job. While numbers are involved, the role is more about understanding the implications of federal and state health care policy, regulations and legislation on the health care services provided to Rhode Islanders.

Rob Borkowski is a PBN contributing writer.