Episode 324- Independent Hospitals And Local Power. with Bill Manns

This episode of The Common Bridge is part of a special 21‑part series of interviews recorded with healthcare leaders from across Michigan during the 2026 Mackinac Policy Conference, in partnership with the Michigan Health and Hospital Association

Healthcare costs keep climbing, but the most frustrating part might be how much of the system’s pain is self-inflicted. I sit down with Bill Manns, President and CEO of Bronson Healthcare Group in Kalamazoo and chair of the Michigan Health and Hospital Association board, to get specific about what’s driving affordability concerns for Michigan hospitals and the people they serve.

We talk about what independence really changes for a local health system: local governance, faster feedback from the community, and the freedom to focus on “local care for local people.” From there, we zoom out to the policy environment and why legislative volatility can be just as damaging as a bad bill. When the rules swing back and forth, hospitals cannot plan staffing, investments, or long-term community health work with confidence.

Then we tackle the heart of the affordability debate. Bill makes the case that hospitals often do not “set prices” the way people assume, because rates are typically locked in through insurance contracts or driven by government payment. We also dig into the administrative burden that quietly inflates costs, especially prior authorization, where clinicians and patients jump through hoops for services that are frequently approved anyway. If we want real healthcare cost reduction, reducing unnecessary paperwork and delays is one of the most practical places to start.

The most hopeful part of the conversation is Kalamazoo County’s progress on Black infant mortality, achieved through community collaboration, listening to moms, and a clear focus on health equity and trust. If you care about Michigan healthcare, hospital regulation, prior authorization reform, preventive care, and community health outcomes, this one delivers. Subscribe, share this conversation with a friend, and leave a review so more people can find it.

Transcript

This episode of *The Common Bridge* is part of a special 21‑part series of interviews recorded with healthcare leaders from across Michigan during the 2026 Mackinac Policy Conference, in partnership with the Michigan Health and Hospital Association. In these short conversations, Rich explores regulation, cost pressures, workforce challenges, and the future of health care in Michigan and across the country.

Rich Helppie  

We’re at the Mackinac Policy Conference today on behalf of the Michigan Health and Hospital Association, and of course *The Common Bridge* podcast and Substack page. We have with us today Bill Manns. He is the president and chief executive officer of the Bronson Healthcare Group in Kalamazoo, Michigan, and chair of the Michigan Health and Hospital Association Board of Trustees. Bill, it’s great to see you.

Bill Manns  

It’s great to see you as well.

Rich Helppie  

How have you been?

Bill Manns  

I’ve been good. Life’s good—very busy, but good.

Rich Helppie  

That’s good. You’re in a unique position. You lead a substantial independent health system in Michigan, and that has to create some differences from some of your peers. Would you talk about that a little bit?

Bill Manns  

I absolutely love it. Bronson is independent. We’re a four‑hospital system serving nine counties in southwest Michigan. We are by far the largest employer—9,444 employees the last time I checked—so the independence allows us to do things I couldn’t do when I was part of larger health systems. We can focus on delivering local care. Our board is entirely local, and they receive their care at Bronson facilities, so I get direct feedback from board members and from their neighbors. I absolutely love that.

Rich Helppie  

That’s a very unique perspective. In your role as chair of the MHA, what’s top of mind for Michigan hospitals?

Bill Manns  

Where do we start? Affordability—what it really means, and how we ensure that hospitals aren’t automatically blamed. There’s also volatility in some of the legislative actions that keep us moving. When you understand where the Legislature is headed, you can plan and adjust. When it’s up and down and really volatile, it’s much harder to plan effectively.

Rich Helppie  

Are there any bills moving through the Legislature that are causing you concern, or maybe giving you hope?

Bill Manns  

Both, actually. I have healthy doses of concern and healthy doses of hope. At the end of the day, I’d like to believe we all want the same thing for Michiganders: top‑quality health care at an affordable price that’s easy to access. As long as we all want that, we have common ground.

Rich Helppie  

When I think about affordability, it’s easy to say everybody’s getting paid too much, so we’ll all reduce our prices or compensation—and then the answer is always, “You go first.” What parts of the system could operate just as efficiently while spending less money? Every enterprise has to look at where it can take out costs. If you step back and look at the entire ecosystem, where could costs come out?

Bill Manns  

You’re absolutely reading my mind. It’s not just hospitals, not just insurers, not just big pharma—it’s the collective ecosystem. There’s a lot of administrative work that’s totally unnecessary. I understand fraud, waste, and abuse concerns, but prior authorizations are a good example. If a physician says you need something, why do we have to jump through several hoops for something that’s almost always approved? There’s a lot of waste in that process.

On prices, I have to remind people that hospitals don’t set prices like gas stations do. We don’t just raise prices when inflation hits. Our prices are usually set through insurance contracts negotiated years earlier, and by the federal government, which is often the majority payer. We’re actually price takers. Michigan hospitals in particular have been incredibly efficient. Many of us use lean methods and kaizen events to improve efficiency. I think the untapped opportunity is in the administrative component tied to “prove this patient needs that service,” which is often unnecessary.

Rich Helppie  

I strongly agree. Hospitals are the only industry where, if you get more efficient and better at something, your revenue goes down—and the economic benefit accrues to a third party.

I understand that in Kalamazoo County there’s work underway to reduce Black infant mortality. This was an issue I hadn’t heard much about. Tell us what’s going on.

Bill Manns  

Thanks for bringing it to light. It’s an issue that’s near and dear to my heart. Before I took the job in Kalamazoo, I’d heard a lot about how high the Black infant mortality rate was. The community had been working on it for years. Bringing it to light was huge for the state.

We’ve now achieved the lowest Black infant mortality rate in the entire state and the lowest since Kalamazoo County began tracking it. It’s the result of a collective community effort. Bronson is one part of it, but the whole community wants everyone to start on more equal ground. The question is how to deliver care equitably so that women and children who need services receive them.

It’s not just about what happens within the four walls of the hospital. I often talk about Bronson as a health care provider without walls. How do we reach into the community, especially Black communities that historically have not trusted hospitals, and build trust? If you can do that with one cohort of the community, you can do it with all. What did we learn from reducing Black infant mortality?

Bill Manns  

We learned that we need to listen to moms. We need to be more compassionate in how we deliver care. We need to truly understand the difference between equality and equity—what this particular patient needs that another patient may not, and how to deliver those services respectfully.

It’s been fascinating to watch the community come together and say, “This is an important health issue, and collectively we’re going to solve it,” rather than saying, “That’s the hospital’s problem,” or “That’s the health department’s problem,” or “That’s someone else’s problem.” We’re all in this together.

Rich Helppie  

I’m sensing a theme. These issues may manifest in the hospital, but they’re really broader, systemic issues. They’re part of that ecosystem—whether we’re talking about denials or infant mortality, in this case Black infant mortality—and they have to be addressed everywhere. Otherwise, people end up in the hospital as patients who never received prenatal care, for example.

A lot of good has happened over the years. You’ve been at this a long time. When you think about where you started your career and where we are today in medical care and what we can do, is there anything that jumps out?

Bill Manns  

A lot. I was thinking about this as I was walking through here. I started my career over 30 years ago. It’s not only the technological advances; it’s also how we interface with the community differently.

Again, I go back to outside the four walls of the hospital. The electronic health record, for example—now I can pick up my phone and check any test result. That’s a huge advancement. When I was in graduate school, a professor said health care was 10 to 15 years behind the rest of industry in IT. Seeing how far we’ve come is remarkable.

Preventive care also stands out. Historically, people waited until they were sick. Now you’re seeing more efforts to reach into communities so people can live healthier lives and thrive, instead of hospitals just waiting until they get sick and only inviting them inside then. That idea of being a health care delivery system without walls is crucial.

Rich Helppie  

Wonderful. Any final comments?

Bill Manns  

I just really appreciate this opportunity.

Rich Helppie  

It’s great to see you again. Thank you for what you’re doing, and keep it up. We’ve been talking with Bill Manns, president and chief executive officer of Bronson Healthcare Group. On behalf of the Michigan Health and Hospital Association and *The Common Bridge* podcast and Substack, this is your host, Rich Helppie, signing off.