Becker’s Healthcare Podcast

Episode: Carl Bergetz on Legal Strategy, Policy, and Patient-Centered Growth at Rush
Date: February 16, 2026
Host: Laura Dardo
Guest: Carl Bergetz, Chief Legal Officer and General Counsel, Rush University System for Health

Episode Overview

This episode delves into the legal, policy, and operational challenges facing Rush University System for Health. Carl Bergetz discusses the organization’s integrated approach to healthcare and education, recent government affairs initiatives, managing regulatory uncertainty, and opportunities—and cautions—for growth in a rapidly evolving landscape. The conversation also highlights patient-centered care, responses to immigration enforcement, and the promise and peril of new technologies like AI.

Key Discussion Points and Insights

1. Introduction to Rush and Bergetz’s Role

• [01:09] Carl Bergetz describes his dual legal role covering both the health system and its graduate-level university, highlighting the rare integration under a single corporate structure.
  • Quote: “We are really community focused, and we're an institution that is really mission driven... The diversity makes it a great place.”
  • Rush serves Chicago’s west side, western suburbs, and maintains both academic and community hospitals.

2. Integrated Legal and Government Affairs Strategy

• [04:05] In response to rapid policy and legislative shifts post-pandemic, Rush re-established an interdisciplinary Legal and Government Affairs (LGA) group, involving stakeholders from communications, clinical services, and finance.

  • Quote: “We always know that muscle [of policy interpretation] needs to be in shape and staying fit and growing.”
  • The LGA’s principal function: monitor, interpret, and operationalize new laws, court decisions, and executive orders across healthcare and higher education.

• [06:40] Ongoing communication is central, including audio briefings for staff, faculty, and students to explain volatile issues (e.g., ACA changes, budget acts, shutdowns).

3. Case Study: Responding to ICE Activity on Campus

• [09:26] Bergetz details a notable challenge: adapting policies and training for encounters with Immigration and Customs Enforcement (ICE) after federal protections shielding hospitals were rescinded.

  • Quote: “ICE was a different thing to deal with than we had customarily seen. Certainly just the size and scope of it hitting Chicago when it did, we knew that there would probably be more issues.”
  • Rush’s approach: reinforce the need for judicial (not administrative) warrants, educate staff—especially in the ER—and repeatedly train and debrief following incidents to cement protocols.
  • Quote: “No matter how well you write something down until you train on it and actually until you live it, it’s really hard to put into action.”

• [13:30] Wider social impacts: ICE encounters led to protests and inquiries from local officials. The need for de-escalation, clear priorities (patient care first), and transparent communication was emphasized.

4. Current and Forthcoming Challenges

• [15:36] Bergetz underscores ongoing pressures:

  • Tightening margins from Medicaid/Medicare cuts and unresolved ACA issues.
  • Greater numbers of uninsured patients as policy changes take effect.
  • Continued regulatory uncertainty with delayed fiscal impacts from federal legislation.
  • Quote: “It’s really hard to do that when... we’re not even sure if the funding is going to be there for certain types of programs, even something as big as Medicaid.”

• [18:58–21:23]

  • The main work ahead: translating legal/policy chaos into actionable, calming guidance for faculty, staff, and patients.
  • Active advocacy—working with associations and lawmakers—to protect healthcare delivery amid shifting government priorities.
  • Quote: “It is very hard. It’s hard for a lot of people out there. These days, this is not a pleasant time. But for healthcare in particular, some very specific risks... are actually being exacerbated by what’s going on in Washington.”

5. Opportunities for Growth and Efficiency

• [22:02] Despite adversity, opportunities exist:
  • Expanding care closer to patients via in-person services and community integration.
  • Judiciously leveraging AI and technology to create efficiencies—without losing the human touch.
  • Quote: “Healthcare is a human endeavor... the care should be delivered by people for patients.”
  • Caution towards technology: Bergetz is skeptical yet open to technological solutions where they enhance, not replace, patient-centered care.

Notable Quotes & Memorable Moments

• Mission-driven focus:
  “As big as we are, we are really community focused... and that's what's appealing to me and a lot of the people who work on my team.” — Carl Bergetz [01:09]

• On responding to ICE presence:
  “We had to make sure that our policies were well understood and train... [ICE] didn’t fit [the] description in terms of how they operated, and what it seemed to be, their training around those kinds of things.” [10:30]
  “Until you train on it and actually until you live it, it’s really hard to put into action when something emergent happens.” [12:15]

• On persistent uncertainty in healthcare:
  “Things are kind of uncertain. And it’s our job to try to create some sort of semblance of normalcy.” [16:56]

• On opportunities & role of technology:
  “I’m very leery of AI. I am a skeptic, if not worse. But I also understand that... it can be used to help grow and help create efficiencies.” [23:05]
  “Healthcare is a human endeavor... the care should be delivered by people for patients.” [24:15]

Timestamps for Key Segments

• Rush’s unique integrated structure: [01:09–03:39]
• Standing up the LGA workgroup: [04:05–08:40]
• ICE enforcement and adapting policies: [09:26–15:11]
• Biggest ongoing/regulatory challenges: [15:36–19:23]
• Growth, AI, and patient-centered care: [22:02–24:44]

Tone and Takeaways

The conversation steers a candid yet optimistic middle course: Bergetz acknowledges the weight of regulatory chaos and financial strain, but he and his team pull focus to their mission—adapting legal strategy, strengthening communication, and above all, ensuring patient care remains centered and humane, even as they explore new tools for efficiency and outreach.

For healthcare leaders and stakeholders, this episode provides a grounded, practical view of leading through uncertainty by prioritizing clear processes, agile legal strategy, robust internal communications, and a steadfast commitment to the communities served.