The American Hospital Association's governing bodies made several historic decisions at last week's AHA convention in Dallas, including one to transform the group into an organization primarily dedicated to representing health systems, not individual hospitals.
At its Aug. 6 meeting, the 25-member board approved what it called a "framework for future strategic planning" that sets the course for the association to represent hospitals or other organizations that operate integrated healthcare delivery systems rather than individual hospitals.
"AHA's vision is to become an association that represents and serves hospi- tals and integrated healthcare delivery networks that are accountable to the community and oriented towards community improvement," the 11-page policy document said.
The AHA would represent individual hospitals primarily through a facility's participation in an integrated delivery system.
No timetable was set for the conversion, which the document suggested was a long-range objective.
To accomplish its goal, the association will have to be a leader in pushing for the creation of integrated delivery systems, as well as a provider of advocacy, educational and other services to start-up and established systems, the document said. The AHA also must foster collaboration among other associations and trade groups representing the interests of components of integrated delivery systems, such as physicians, it said.
In the document, the board acknowledged that moving in such a direction may put the association at odds with its traditional individual hospital membership, as well as state and local hospital associations that prefer to maintain their historic mission of individual hospital representation. To address this issue, the AHA "will develop a strategy that will enable it to relate to allied associations that are serving a traditional hospital membership as well as to those that are serving, or developing mechanisms to serve a broader-based integrator membership."
In other actions, the AHA's 218-member House of Delegates passed two significant bylaw changes at its Aug. 8 meeting. The changes previously were approved by the AHA board.
First, the house adopted a bylaws change that will allow up to two outside experts, dubbed "independents," to sit on the AHA's board. The move is designed to open up the board to outside interests, such as those of the business sector.
The AHA defined independents as "nationally prominent individuals from fields other than the practice of healthcare management or administration who demonstrated a significant interest in healthcare and health policy issues."
The house also adopted a bylaws change that permits the association to scrap its old membership dues system, which was a sliding fee scale based on hospital expenses, in favor of a new system that has yet to be determined. The old system resulted in double-digit dues increases for many AHA hospital members (June 13, p. 6).
Last year, total dues collected by the AHA from 5,692 paying hospital and individual members rose 14% to $60.9 million from about $53.5 million (See related story, p. 22).
In other policy actions at the Aug. 6 meeting, the board approved four principles of accountability that the AHA will use to develop policy on or respond to the accountability schemes contained in national and state healthcare reform plans and those pursued by private organizations, such as the Joint Commission on Accreditation of Healthcare Organizations and the National Committee for Quality Assurance.
The AHA said healthcare organizations should be accountable for delivering quality services, operating an internal performance improvement system, providing useful information to purchasers and consumers, and contributing to the health of their communities.
But in exchange, public or private organizations' accountability requirements must be flexible enough to satisfy their own needs while avoiding duplicative demands on providers. In fact, the AHA board recommended that all the organizations involved in developing accountability systems agree on common definitions for the data ele-ments they're seeking to collect and disseminate.
And, the AHA said, any information provided to the public must be "prepared and released in a fashion that enables the public to make valid observations."
The board's action comes less than two weeks after the JCAHO unveiled a five-star rating system to publicly release data on hospitals that undergo JCAHO accreditation surveys (Aug. 1, p. 6). The JCAHO's 28-member board, which has seven members representing the AHA, is expected to act on the rating system at its September meeting.
In his annual "town hall"-style presentation at the meeting, AHA President Richard Davidson didn't mention the star rating system, which has been panned by some state hospital association executives. But Mr. Davidson acknowledged that the AHA has been lax in giving the JCAHO clear views on accreditation and public accountability issues.
With the principles now in place, Mr. Davidson said he anticipated that the association would be preparing a position specifically on accreditation in a reformed national healthcare system. He said the AHA board may consider the position as soon as the panel's next meeting in December.
Finally, the board passed a resolution approving the sale of the association's longtime, two-building complex on Chicago's Near North Side. The AHA is relocating to leased office space in a building in Chicago's downtown area and is negotiating to sell the old building.
The AHA's treasurer's report, released at the Dallas meeting, indicated that the association expects to sell the building for $9 million.