Access to Care at Risk: 5 Key Quotes from Pa. Hospital Community Leaders

May 07, 2025

Pennsylvania’s hospitals and health systems face significant and persistent challenges that jeopardize communities’ access to health care, HAP and hospital leaders told a state Senate panel today.

During the hearing, hosted by the Senate Institutional Sustainability & Innovation Committee, leaders outlined policy solutions to protect the care Pennsylvania communities rely on. Here are five quotes from hospital community leaders that illustrate the challenges hospitals face, and the policy solutions to address them.

• Communities at risk:  HAP President and CEO Nicole Stallings emphasized that everyone should be invested in hospital stability. “The challenges that we're talking about today aren't just hospital challenges,” Stallings said. “They are community challenges because we cannot have healthy, vibrant communities in Pennsylvania without strong, viable, and stable hospitals.”
• Underpayment drives instability:  Mark Rubino, MD, president of Allegheny Health Network Forbes and Allegheny Valley hospitals and HAP Board chair-elect, said that hospitals’ ability to carry out their missions is jeopardized by chronic underpayment from government payors. “For too long, we have operated under a system that inadequately reimburses us for the essential services we provide,” Rubino said. “The combination of persistently low Medicare and Medicaid reimbursement rates, coupled with rising operational costs—it creates a perfect storm of financial instability.”
• Critical to rural health:  Ed Sabanegh, MD, CEO of The Guthrie Clinic and a HAP Board member, noted that hospital closures and service cuts are felt especially strongly in rural communities. “When a rural hospital scales back services or eliminates departments, often due to a combination of financial, workforce and systemic challenges, there is a ripple effect that extends far beyond the hospital itself,” Sabanegh said. “Patients must travel further for care, and some choose to delay treatment or go without it altogether. Nearby hospitals are forced to absorb volume and often experience significant strain, including longer wait times for patients, larger workloads for staff, and further financial instability. If the hospital fails, the entire region could lose essential services, jobs, and economic stability. Lives are put at risk and the fabric of the community begins to erode.”
• Unsustainable trajectory:  Steven Fontaine, CEO of Penn Highlands Healthcare, said the system has been operating in the red for the past three years. Without increased support, he said, rural hospitals are “on the brink of disaster.” “Without immediate and sustained support, the services we provide are at risk,” Fontaine said. “The financial pressures, workforce shortages, regulatory burdens, and policy challenges we face are not just numbers on a balance sheet—they represent real people, families, and communities that depend on us.”
• Financial stability crucial to mission:  Katherine Levins, vice president, public policy and government affairs for Temple University Health System, said that remaining financially solvent is necessary for the hospital to continue to serve its critical role as a community safety net in the nation’s largest city without a public hospital. “A hospital must be a responsible steward of its funding in order to remain financially stable and capable of sustaining its mission,” Levins said. “This requires fair and adequate reimbursement from all payers. At a time when hospitals are struggling, however, there is no question that proposed cuts to Medicaid at the federal level will have an adverse effect on access to healthcare in Pennsylvania among the most vulnerable patient populations.”

Watch the hearing, read hospital community leaders’ full testimony, and learn more about HAP’s advocacy to protect access to care online.