Regional and state hospital associations are examining their roles-and sometimes their reasons for being-as healthcare mergers shrink their memberships and transform their members.
Earlier this month, the 18-member board of the Hospital Association of Metropolitan St. Louis unanimously voted to dissolve the 58-year-old group at the end of the year. Area hospitals instead will seek a contract in which the Missouri Hospital Association will operate a St. Louis office. MHA's board and HAMSTL's 43 members must approve the decision. Votes haven't been scheduled yet.
HAMSTL President and Chief Executive Officer Stephen Dorn said he will retire Jan. 1, 1995. Mr. Dorn, 62, became the first African American to hold a CEO position at a healthcare association when he joined HAMSTL in 1980.
"This is a time when healthcare providers are making difficult decisions on how to better consolidate services, avoid unnecessary duplication and reduce expenses," HAMSTL Board Chairman John Farrell said in a written statement. Mr. Farrell is president and CEO of 871-bed St. John's Mercy Medical Center in St. Louis.
"Contracting with MHA will reduce the operational expenses of a metropolitan association and save members dues," Mr. Farrell said.
HAMSTL employs 25 people and has a $2.6 million budget. An estimate on the cost of contracting with MHA wasn't available.
In the past year in St. Louis, Christian Health Services and Barnes-Jewish Hospital merged into the BJC Health System. Missouri Baptist Healthcare System and St. Louis Children's Hospital later joined BJC. Three St. Louis hospitals formed the AJL network to develop a managed-care product. And, eight other area hospitals linked up in another network.
"The healthcare delivery system is rapidly changing," said Cheryl Jernigan, chairman of the Conference of Metropolitan Hospital Associations. "The bottom line is that all the associations, be they metro or state, are evaluating what their futures will be. I think you'll see a variety of actions taken."
In fact, four new metropolitan associations were created last year by hospitals in Oklahoma City, San Antonio, Trenton, N.J., and Tulsa, Okla., Ms. Jernigan said. After HAMSTL announced its decision, the board of Ms. Jernigan's association, the 42-member Kansas City Area Hospital Association, affirmed its commitment to keeping the association as an independent organization.
In California, the three regional hospital associations and the state association are discussing the possibility of forming a federation or other organization between them, said J. Michael Gallagher, president of the Hospital Council of Northern and Central California, based in Pleasanton. The group would carry out some joint activities to eliminate duplication, but the associations still would be separate entities, Mr. Gallagher said.
"We may find that this doesn't work for all of the organizations because of geography," he said. "I am confident that our association is going to be doing more with the state association."
Mr. Gallagher's group, which represents 210 hospitals, is itself the product of consolidation. It was formed in 1990 through a merger of 15 metropolitan and rural hospital councils.
It's now building a separate association for hospitals, health systems, managed-care organizations, other payers and medical groups in its territory. The group will start operations this year, Mr. Gallagher said.
"The formation of a new integrated healthcare association will provide a transitional forum for the future healthcare leadership," he said. "The hospital council, while closely affiliated with the new association, will continue to have our principal focus on acute-care hospitals."