>> biness s news from the capital region. this is "washington business report" with abc7 national correspondent rebecca cooper. >> thanks for joining us fofor a look at businesess anfinance issues and the washington region. this week, two sides who rarely work togetether manage to d do just that in washington. not talking about republicansns and democrats in congress but we did see the afl-cio and the chamber of commerce come together a immigrationon. the coalition is promoting a new system to bring lower skilled workers the u u.s. on wall street, a week that flirted with historic highs and like a bad boyfriend, doused the hopes with the biggest evidencee that loss in 2013.

manucturing where reece european woes d slow sales for housg and wal-marart contbuting to nowhere e res. then the gulf -- boyfriend came back whispering promises about hewlett-packard's potential on more a on friday w we saw the dow rebound. but a warning of catastrophe e -- not o overseas but here at home as an agreement -- if an agreement is not reached to avoid sequestration. those topics and more in our roundtable. but first, we want to check up on one of the biggest industries in the washington region. dstar health is theistrict's second-largest nonfederal employerer and the largest not- for-profit health-care delivery system in the region. annual revenunues now $4.44 billion. but there are challengesacing the healthcare indtry, providers, and mor hospital etty joining us today is kennetethamet, president and ceo of medstar health, in charge of managing 10 hospipitals, tens o of thousands of physicians and serving 500,000 paties for your. welcomeo "washingtoton busisiness

report." >> nice to be here. > i love reading your background. u went to old dominion to study medicine but it was running the concession stand and organizing your fraternity brothers made you realize yo really h have a a feel f for bususiness, so you pivoted and now you are on the business side of health care. what are the biggest challenges you're facing right now? >> contitinuing to provide the highest quality and safety to residents across the region. and to d do that and a set of very changing health-carere policy times. with more and more changes to economics -- challenges to economics.s. but stilill very much h focused on what we do at the point of f care for every individual who comes to us for care.e. >> youou were with their original company that ler evolves. you stayed the old-fashioned road and staying with one company. but it is really a company thatt changed dramaticay in the ticket you have been t there.. what are some of the biggest changes? >> i cam -- state of washington

hospital center 3030 years ago. i woke up and it is hard to believe all the years went by. the company changed so significant. you mtioned 10 hospils, 100 different ce sitetes. the challenge for us is to connect all of us and to what we call a dispute it care divery network. have to take the care out to where people live -- access matttters, conveence matters and cost matters. to the eyes of the p patient doess not look like one connenected o of it -- delivery system. so o our challenge is have one standard of quality say, and service. to that information that i ubiquitous syou as a patient only has to register once acrososs all e sites. >> you are a leader in the field you know alall the benefits that come with the qntity and size of delive of health care that can come wiwith being able to have all the resources at yo dispos. you have also heard ctics -- patients who say whehen they go away medstar hospital they almost feel overwhelmed by the size. how do you manage quantity and

quality? >> you need quantity because it has been proven when you do more of a particular kind of care the outcomes are actually better. of the b business side, size matters because we can purchase at cheaper prices. we can bring in efficiency and ecomy. all that matters. but having said that, right and our tagline we put "focused on you." if we forget every single patient care is that momoment -- moment with the care is like, it is all for nothing. it is the most important thing. to your point, how do we balance a system and infrastcture that let us provide the bebest care, provididing value, but have the patient feel like we are focused on them. >> you have a businessss mind but you did not take an easyy industry decing to keep your focus medicine. it is a chahallenging iustry where you have to constantly stay ahead of your competition. you have found innovative new partnerships. tell us about the cleveland clinic f for a ship. >> we are very excited about our relationship with them. it started severeral years ago whwhen we came together with a

dstar institute for innovation and the cleveland clinic institute. no matter our size, no matter how proud we are, we have e to as a leader have no approaches to health care. in the hrt space medst washington hospitacenter has been the clear l leader for many years. the regional leader -- with the clinic -- cleveland clinic heart and vascular, the national leader for 17 and 18 y years, we bring strength d strurung together. focused on research, fifindingg the best new approhes to cardiac care, focused on linkingng eye doctors and thr doctctors toto think about howardiac car should be provided. from a business standpoint, demand of the cleveland c clinic has had national contacting activities. lowe's contract t to sell all of their employees to the cleveland clininic. this will bring medstar i into a national network. >> johns hopkins had done it with pepsi but the cleveland c clinic c has

do it in a lot of differt areas. that w not part of the original collaboration, but you think it will be part of the future? >> it is absolutely what the cleveland clinic leadership an i intend to happen. a good o opportunity for the cleveland clinic to have an e east coast se. >> your employer makes a contract so if their employees go exclusively to medstar you can bypass the middleman and bring in morore affordabl pricing. >> for certain kinds of care you will see large employersrs contractct directly with healthth providerers. >> hospitals are under fire right now with the advent of the affordable health ca act. prproviders really being blamed almost for the rise of alth ca coststs. some of that blame unfair and is unwarranted? >> i think both. i think as a country, the u u.s. health-care system is very complex. but rmember, so much of whatt ds up on the balalance sheet of cost relative thealth care is driven by societal issues.s. whwhat dwe do to aually

provide healthcare long before somebody shohows up in the emergency y department? it is expensive by the time you come to the emeency department andd we do an inteention. what weo it around managiging chronic care. what i is the societal policy rerelative to homomeless? in washington, it was cold last night. there were thousands sleeping on the grate. and number will end up with a respiratory issue. they will end up on somebody's -- in somebody's emergency department. it is a cost that goes to the healthcare ledger and societal fabric costs. we need a bigger, more thougghtful comprehensive discussion. having said that the business of health care has grown up -- as we intended. ge philips -- we sell a lot of imaging, we sell pducts. so amazing inventions and happen and that is what t the american public wants. if you have something bothering u, you want to be treated today. you do not want to be told, like the canada gillett in canada, theris a t threeeek wait for an mri.

it is n not the most efficient system of care to be set up. >> we hearbout the downside of obamacare, e even e president lling it ththere, which is cuts in payments to providers. you alluded to possib upsidide. more health insurance, more peopople coming inthospitals? >> the fact that we know as a country we will take care of everyone -- we think everyone should coverage, so we can be more thoughtful and how we take caref them. th is a good fit. some of the nsurance reform imimportanant. so you are not tied to your employer to kp your insurance.. so that pre-exisisting conditions cannot keep you from getting coverage because we will stillll take care of those people. that is a good thing. is it the ultimatate piece of gislation? we all know it is not. it will have to can take -- have to of all. but from medstar''s standpoint restructured our strategy, medstar 2020 around the possssibility of the a accountable care act. we want to as a leader think through hohow to provide.

>> so many questions but i i could spend a wholole hour with you. i have have you babackn. but we were talking beforehe show started some ofhe ways with the size and d growth of medsr, you were ablble to partner up. you were talking about your georgegetown university cacancer treatment being ablee to team up with montgtgomery county. give us examples of that for people to know more about huizar bridgette now. >> 12 years ago we brought medstar -- georgetown university hospital in the network and we have a partnership with orgetown university. the lombardi cancer ceer. when you think about cancer ceer, there are certain kinds of care that should be provided at lombardi cancer at -- buto much o of the follow-up, the chemotherapypy, specialistst for routine follow-up, can and should have been closer to the patient and community. momontgomery medical center, one of the community h hospils, we have ann infusion center set up connected to the mbardi cancer center specialist from

lombardy and the medststar cancer institute rotate out to medstar mogomery. so the patient canome for tempore and care. >> you get to see marcus welby and get the best the best. a plan for growth. ank you souch, kenneth samet. stay with us. a political's jonathan allen and brian coester, right after the number of the week, coming up

>> well, if youou of a a tiger woodss r underdogs maybe the number of the week is n not foror y you but ifif you are from fairirfax county it is. 8400 is the number of jobs

regional powerhouse fairfax county says it attractive in 2012. the fairfax county econonomic devevelopmt authority says it works with 186 businesseso add those bs. jerry gdon, president and ceo of the aututhority says the gains are a testament of fairfax county's economy and thehe result of the strategy of diviversifying its economic base. borden says the new jobs come from companies in many differerent fields and all sizes and backgrounds. stay with us. we will be talking sequestration and other topics when our roundtable joins u us after thee eak.

i got it when we could download an hd movie in like two minutes. [

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>> well, it is t q question w keep aing g -- how badly will be across-theoard spending cuts known as sequestration damage our gionon'ss economy. seququesation topsur round table to do list thihis weekend we got a pro to talk about it. jonathan a allen politico'o's senior washington correspopondent and briacoester, , coester valuation management services. he is a big fish in a realistic appraisal sector. welcome to y both. briaian, and newbie to the show -- jonathan, , an old pro. i sound like a broken record asking will we or will we notn the sequestration? >> we will. there is always a chance of a last-mute deal but it does not seem like there is interest on either side, the president of the house republicans, to yield any ground. if i were in a government agcy or bring a government contra in office i would vy much expected to take effect and

hopefully have been planning for it to take effect for some time. > it is anan unusual alliance of different people coming forward saying they support sequestration. ward dean this week said i don't like what the impact will be, but i think it is the right thing to do. how much is the momentugrowing on both sides? >> on the republican side, there isefinitely a desire to make sure the spending cuts happen. ththe alternative is to have fewer spending cuts and more revenue. that isot what these guys in the house republican caucus signed ufor and not what a lot of the senate republicans signed up for. they wou rather see sequestration, even if it is imperfect, which is all spending cuts in some mix. on the democratic side, there is a concernhe pentagon w will escape and a domestic agencies will be the ones who end bearing thburden. if there were to be some fix thpentagon wouould get fixed first. i think that is why we are hearing some of that left sang this is not the worst thing in the world of all goes into

effect. of course, it is not as that -- i know paul krugman in "the new york times" wrote today that it is not as bad as the fiscal cliff would have been or thee governor shot back -- government shut dow >> b brian we are seeill kinds of estimates. most agree that while there will set up -- certnly the impact if sequestration goes into effect the engaging anywhere - gdp has grown to 0 0.6% in the coming year. they are sing it will probably grow in the range m more of 2.1%. not castrophic, but certainly in our region it wilbe felt. ta a about the housing industry. how are things going right now and the washingt region? >> the thing is, the d.c. market kind of an anomaly. you have a a very y defined geographicrea. a huge mber of high-iome earners. if you look at the top income areas, it is aays in the top d.c. nevever really had a huge downturn if you look at areas like vegas

a house wasorth 600,000 and now 100 -- in d.c worth 600,000, now 500,000.. anything that affects jobs, anything that affects employment obviously would have a negative effect. but i think there have been so much people e on the sidelines right now. what we're seeing is there'a lo of build up demand and people are ready to go. wewe have clients who are seeing ge increases in purcse demand, huge amounts of increase in inquiries for purchases. being on the sideline for the past three or fofour years. i thinink sequestration obviously would be a negative but i still think k it w would b a good d.c. housing market overall. >> how do you keep adapting thehe appraisals? i know you a are known in the industry has been a high-th leaders in bringing kind of a home town appach, but using high-tech. but it seems like with prices being all overr a plot ---- the plplace, how do you adapt? >> we do it nationally. so it is very difficult.

it is as complicated as yo would think. a a loof technology. we have to rely on our appraisers communicate with clients. it has been really a fast run race. we're dealing with all the adoption of new l legislation techchnology requirements. cfpb comes out w with a lot of stuff and the state comes out the leer c comes out, the tent -- and a lot of ople have not been able to adapt. the thing preventing, so many changes going on that it is very difficult to keep up. i meet with all the regulators, the mortgagege banking -- mortgage banker associations and aba, and you have to almlmost meet with the weekly and ty did not even know what to go -- what is going on. >> this is what we e keep hearing from the bususiness community. you talk to any business, and especially someone i in the housing industry, people are very anxious whether o or not to buy a home with all of the

uncertaiainty due to washington. tell us what is goin on at leasbehind the scenes. are there any talks going on to try to avoid sequestration or is anything on hold? >> there a no talks going on for sequestration, but you do have a couple of phone calls the president to repubublican leaders on the hill yesterday momoseley so the president can say he has talked to them rather than actually. the president wants to beat the republicans up for wanting to cut spending on various things -- whether police or fire services or the militar and the republicans want to be the president up for wanting to spend more money. this is a situation where there is a lot of political interest on both sisidesf nohaving something done. th think the stakes are aot smaller. >> that is their interest, they are accomplishing it. we will take a part break and come back with both of you. stay with us. look, every day we're using more and more energy. the world needs

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>> we a are back w witholitico jonathan allen's senior jonatn allen and coesterer valuation management servivices c bri coester. brian, you a and i were talkingg ring the bak about the changes in thehe houng industry -- cfpfpb, consumer financial

protection board. some good and s some bad. "the wall street journal l " -- "the wall street journal" does not like it much but use it for consumer there is so good -- some good and some debt. >> what the house and people ---- industry, yet so many people involved. state regulators the banking regulators at the federal level. you've got the investors and have an overlay. so many things involved. just tryg to figure out what to do. and youave oveapping regulations that conflict each other. one says he wantso disclose this and the other says you cannot disclose that. what they're really trying to do is get consistency. >> is it working? >> it is starting to work. it started to go in the general direction. qrm mcculloch by residents of mortgage, and mortgage servicing roles. qrdefine what is considered qualifiemortgage. as long as you make a loan in those parameters, you could not be at risk of predatory lding.

ey're obviousus caveat. but at least it qualifies -- if i make this loan, a year from now i willll not be sued by the state attorney genereral saying you messed up the borrowing. also, mortgage servicing rules came out that says, here is the proper way to go aboutt servicing the loan interest the borrower goes to default. here are the borrowers rights, lenders right, and t proper way to do it. it provides clarity. what the mortgtgage industry is loing for right now is clarity on the wave of regulations coming aboard. all the dodd-frank stuff the wave of regulations coming on board and how to deal with them proply in a compmplaint with. technology companies and a mortgage origination system doing a decent job trying to adadapt to these changes. it is one of the things, ok, what changes now? ththen the comeback and sa well, it will be modified a little bit. >> businesses, jonatn allen looking for clarity. let me bring up other word likeke sequestration that has --

cer, continug resolution, congress working in those roles funding agencies the same level asas last year. that is have an impact. explain where we are in the process. >> contiing resolution from last year, basically a six- month fixed and then kicking it to march so later in march after we have sequestration. they have to either continue funding the government or let it expire and have a government shutdown. i think the thinking on capitol hill and the white house is it will happen n in. >> that what will happen? >> no, nono -- an agreement and move forward with the continuing resoluon. look, there was a huge -- you are not able to adjust the pocy year-overer-year and we have been doing continuing resolution several years. >> getting a little tiresome. jonathan allen covering congress, not always an eaeasy be, d briaian coester bring us insight from housing. thank yoyou for joining us. i got

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