Author: ARHI

Regan Parker: Pennsylvania lawmakers can show how to put patients above politics

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Read the full op-ed, published in PennLive, here and below.

Pennsylvania lawmakers can show how to put patients above politics | Opinion

By Regan Parker

Pennsylvanians have a health care access problem. The state has lost 26 hospitals in the past five years – most recently, Crozer Health – leaving many rural and underserved communities scrambling for answers to meet demand.

These closures and the impact on local communities underscore the need for more oversight, transparency, and accountability in the Pennsylvania healthcare system to prevent future tragedies and access gaps. However, effective reforms must put patients over politics and avoid the unintended consequences that come from prioritizing punishment rather than prevention.

Unfortunately, Gov. Josh Shapiro’s proposed approach – which recently passed in the state’s House of Representatives and is now on its way to the Senate – falls short.

While well-intentioned, his proposal targets specific ownership structures instead of addressing the real issues: state and federal governments cannot be the sole solution to the healthcare access crisis. They already are stretched thin.

The governor’s response would pile on sweeping restrictions that would essentially create a system of political gatekeeping over who gets to operate a hospital. The increased regulatory burden would not improve access but instead stifle the infusion of private investment working to rescue systems on the verge of failing.

While it’s clear that some systems owned by private investors have failed due to mismanagement, many nonprofit and publicly traded hospital systems have experienced bad outcomes, as well. The governor’s approach focuses on punishment after the fact rather than on proactive ways to prevent hospital failures from the outset.

Legal frameworks that presume bad faith based on ownership structure alone risk deterring the very investment needed to keep struggling hospitals afloat and leave our healthcare system vulnerable to future closures. In many cases, responsible private investors have stepped up in situations where hospitals were already bankrupt or neglected by previous owners.

The real threat isn’t who owns the hospital; it’s whether there are clear guidelines to ensure patients come first and that the doctor-patient relationship is preserved. Without transparency and accountability, bad outcomes can—and do—occur under any ownership model.

In Pennsylvania and states across the country, there is a better, more constructive path forward that lawmakers should consider. The approach would strengthen oversight and raise standards for all types of hospital ownership while preserving the doctor-patient relationship and ensuring patients remain at the center. A more proactive strategy focuses on ensuring that clinical decisions stay in the hands of licensed providers. That would include banning quotas or incentivized treatment plans that put profits before patients.

In addition to keeping the focus on patients, legislators can create a framework that guides both nonprofit and for-profit investments to ensure they are done responsibly, especially for essential community hospitals. In cases where a hospital is the only facility serving a region, owners should commit to financial transparency and safeguards like annual solvency reporting, early warnings before closures, and community notice requirements. These safeguards can help spur necessary intervention before communities lose access to essential services, like those that Crozer Health was providing.

That is exactly what the organization I lead, the Association for Responsible Healthcare Investment (ARHI), is working to advance: common-sense reforms that encourage transparency, accountability, and clinical integrity. This approach would hold bad actors accountable. It also empowers responsible investors and providers who are doing the right thing.

It allows entry to those committed to patient-centered care and creates a system that is accessible, high quality, and responsive to community needs. That’s what every Pennsylvanian deserves. The Commonwealth has an opportunity to lead the nation in this area. Let’s partner to achieve that vision together.

Regan Parker serves as CEO of the Association for Responsible Healthcare Investment.

ARHI Provides Testimony on Oregon SB 951

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Testimony of Regan Parker
CEO, Association for Responsible Healthcare Investment
Before the Oregon Legislature – Expert Panel on SB 951
April 29, 2025

Chair Nosse, Members of the Committee:

Thank you for the opportunity to be with you today. My name is Regan Parker, and I serve as the CEO of the Association for Responsible Healthcare Investment. We are a coalition of responsible investors dedicated to supporting high-quality, patient-centered healthcare across the country. Every member of our organization agrees to a set of core principles that focus on ethical practices, transparency and patient centered care. 

Let me start by stating very clearly – we fully share your commitment to ensuring that clinical decisions remain with licensed medical professionals. Patients deserve care that is guided by doctors and nurses—not by business pressures.

The complexities of running a healthcare practice are becoming increasingly more difficult to navigate. There are pressures coming from a multitude of sources, and often private investment is what allows practices to remain open. In Oregon, and in other communities across the country, private investments have supported the opening of new urgent care centers, specialty clinics, and telehealth programs that provide access for patients who otherwise might have to wait months for care or drive hours to find a provider. 

Private investment plays a critical role in sustaining and improving healthcare, particularly at a time when workforce shortages, rising costs, and evolving patient needs are placing tremendous strain on healthcare organizations. Private capital enables practices—especially independent and community-based practices—to modernize their operations, invest in technology, expand access to underserved communities, and support healthcare workers through better training and development​.

We believe that there are ways to curtail the bad acts that lawmakers and communities are concerned about without stifling the critical investments that enable innovation and access that Oregon’s healthcare system desperately needs. 

The stated purpose of the bill makes sense, and we support keeping the doctor – patient relationship separate from business interests. The challenge is always in the details of how this is accomplished and the potential unintended consequences of the language. This bill has already undergone several rounds of amendments, trying to get it to a place where it balances the intention of the bill sponsors and the concerns from those in the industry. 

We are still concerned, however, that certain provisions in the amended version of SB 951 could unintentionally discourage responsible investments in Oregon’s healthcare system. In particular:

  • The restrictions on management arrangements could make it difficult for practices to access the administrative, technological, and financial support they need to stay viable—especially in rural and underserved areas. Doctors and nurses do this work to impact patients, not necessarily to run a business. If they have access to technology or processes that make operating their business easier, they can focus more on delivering patient care- which is what we all care most about.
  • The broad classification of violations under the Unlawful Trade Practices Act could create uncertainty and liability risks even for responsible investors acting in good faith. These measures would risk discouraging the partnerships and private sector support needed to expand access to care. Additional compliance costs and other requirements could especially impact independent practices, physician groups, and clinics that already face tight margins as they serve high-need populations. This could deter the types of partnerships that strengthen Oregon’s healthcare system.
  • Rather than fostering access and innovation, these kinds of proposals could create a chilling effect on responsible investments that help grow healthcare services and strengthen rural infrastructure.

We respectfully suggest that any reforms in this area balance two important goals:

  • First, preserving and reinforcing the autonomy of licensed medical professionals in clinical decision-making—which we strongly support.
  • Second, maintaining a framework that allows responsible investment to continue expanding access to care, improving infrastructure, and supporting innovation across Oregon.

Concerns about oversight are certainly justified. Recent examples of exploitation and mismanagement by bad actors have created reasonable questions around the influence of certain private capital investors in our healthcare system. However, private investment, done responsibly and transparently, can be a vital tool for enhancing—not undermining—patient care. We would welcome the opportunity to work with you on thoughtful approaches that protect patients and providers while allowing Oregon’s healthcare system to thrive.

Thank you again for the opportunity to appear today, and I am happy to answer any questions.

ARHI Submits Testimony on Texas HB 2747

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WRITTEN TESTIMONY ON HB 2747
Submitted by Regan Parker, CEO, Association for Responsible Healthcare Investment (ARHI)
Texas House Public Health Committee | April 2025

Members of the Committee:

Thank you for the opportunity to submit testimony regarding HB 2747.

My name is Regan Parker, and I am the CEO of the Association for Responsible Healthcare Investment (ARHI).

ARHI is a national coalition of organizations committed to strengthening healthcare through responsible private investment. Our members are deeply invested in the success of healthcare providers, the well-being of patients, and the resilience of the healthcare system as a whole.

At ARHI, we believe that when conducted responsibly, private investment can — and should — be a positive force in healthcare. Our members adhere to a set of core principles that guide all investment activity:

  • Patient-centered care, ensuring that every investment expands access, improves quality, and delivers better outcomes for patients, especially in underserved and rural communities;
  • Transparency and accountability, maintaining clear and ethical business practices, including governance disclosures and impacts on patient care;
  • Preservation of clinical independence, safeguarding the ability of licensed healthcare professionals to make decisions in the best interests of their patients, free from inappropriate financial influence;
  • Support for the healthcare workforce, including investments that promote fair compensation, training opportunities, and strategies to address burnout and shortages;
  • Innovation and modernization, enabling the deployment of new technologies and care models that improve system efficiency and patient outcomes; and
  • Long-term value creation, ensuring that investments strengthen the financial stability of healthcare organizations and create lasting benefits for communities.

These values reflect a commitment to building a healthcare system that is more equitable, more resilient, and more responsive to the needs of patients across Texas and the nation.

While we share the Committee’s interest in fostering a fair, competitive, and patient-centered healthcare marketplace, we must respectfully oppose HB 2747. As currently drafted, the bill would impose substantial new regulatory burdens on providers and investors without adequately targeting or fully understanding the root causes of rising healthcare costs in rural Texas.

Specifically, we are concerned that HB 2747 would:

  • Impose significant compliance and reporting burdens on independent practices, physician groups, clinics, and small facilities — organizations that are often already operating on tight margins and serving high-need populations;
  • Discourage investment in rural and underserved areas by creating uncertainty and new regulatory hurdles for prospective partners seeking to support healthcare expansion;
  • Fail to meaningfully address the true drivers of rural healthcare costs, such as geographic monopolies and market distortions that limit patient choice and inflate prices; and
  • Grant broad and undefined regulatory authority to the Attorney General’s office, without clear parameters or protections for sensitive, confidential business information, raising the risk of regulatory overreach.

Rather than achieving the intended goals of affordability and access, HB 2747 risks producing the opposite effect — making it harder for independent providers to thrive, harder for communities to attract investment, and ultimately harder for patients to access the care they need.

We respectfully urge policymakers to first understand more clearly the causes of the issues in Texas’ healthcare system, and to use those findings to create a data-driven approach to any proposed legislation. We encourage more research and dialogue to ensure that any legislation is focused on more effective, targeted strategies that directly address healthcare access and affordability challenges without imposing sweeping, costly burdens on responsible providers and innovators.

Such approaches could include:

  • Promoting competition and innovation through incentive structures that reward quality and value;
  • Expanding access to community-based healthcare models that bring services closer to patients in rural and underserved areas;
  • Strengthening enforcement of existing laws against anti-competitive behavior, rather than layering broad new reporting requirements across the entire healthcare system.

Transparency and oversight are important tools in ensuring a healthy healthcare marketplace, but they must be deployed carefully and thoughtfully, using a data-driven approach. Oversight efforts that are too broad, too costly, or too disconnected from the real sources of cost pressures risk chilling investment, undermining innovation, and reducing patient access — particularly in the communities that can least afford it.

At ARHI, we are committed to working with policymakers to find solutions that uphold accountability while also protecting the essential pillars of access, innovation, and clinical autonomy that Texas patients and providers depend on. For these reasons, we respectfully urge the Committee to reconsider HB 2747 and to work collaboratively with healthcare stakeholders to craft more targeted, effective solutions. Texas deserves policies that strengthen its healthcare system without inadvertently creating barriers to investment, modernization, or patient-centered growth.

Thank you for your time and consideration, and for your leadership in working to improve healthcare for all Texans.

Respectfully submitted,

Regan Parker

CEO, Association for Responsible Healthcare Investment (ARHI)