After years of periodic pronouncements by the American Hospital Association and the American Medical Association that they're "finally" working together, the two healthcare trade group giants may really have gotten it together.
The top brass of each Chicago-based organization recently began a series of unpublicized quarterly meetings to discuss issues of common interest and to help coordinate educational and lobbying activities when possible, MODERN HEALTHCARE has learned.
The first meeting was held in March, and the second is set for next month.
Richard Wade, the AHA's senior vice president for communications, confirmed last week that the two sides are seeing each other again.
"This is an effort to put back together discussions that got off track during the debate over national healthcare reform," Wade said.
Wade described the quarterly gatherings as "informal" with open agendas. Initially, the AHA and AMA will focus on patient-care issues on which the two groups agree, he said.
Social issues will dominate the joint sessions, said Nancy Dickey, M.D., who chairs the AMA board. Dickey met last week in Chicago with the editorial staff of MODERN HEALTHCARE.
One of the first issues to be addressed by AHA and AMA executives will be the appropriate treatment of terminally ill patients, Dickey said. Other issues will include how hospitals and physicians can become better partners in improving the overall health status of communities, she said.
Dickey indicated that the joint sessions should bear fruit because political issues that historically have divided the AHA and AMA will be off the table and won't derail the discussions.
Relations between the nation's largest hospital and physician groups hit a low point in June 1992, when the AMA's House of Delegates, the association's highest policymaking body, voted to oppose the AHA's national healthcare reform plan.
The AMA delegates said the AHA's plan gave too much control of the healthcare delivery system to hospitals and could lead to a single-payer system, which the AMA vehemently opposed (June 29, 1992, p. 2). The AHA blamed the opposition on physician misunderstanding of the AHA's plan.
The AHA's plan promoted the idea of "community-care networks" of various providers to coordinate care in a given market and a "pay or play" plan of insurance coverage. Under the proposal, employers would have the option of providing insurance to employees or paying into a national program that would provide coverage like Medicare.
The AMA delegates' vote took the healthcare industry by surprise because up until that point both AHA and AMA executives had professed to be maintaining an ongoing dialogue on reform issues.
Shortly after the vote, the AHA and AMA said they were establishing three formal lines of communication between the two organizations: executive-to-executive, board-to-board and staff-to-staff. But less than six months later, the AMA delegates reaffirmed their opposition to the AHA's reform plan during a second vote.
Over the next four years, the two sides periodically would announce that their executives were launching collaborative talks. But certain events would belie their statements.
In October 1994, for example, the AHA and AMA issued a joint statement that proclaimed the two groups had developed a "framework for future collaboration" that would include the formation of joint work groups.
"The (AHA and AMA) leaders also agreed to continue to meet on a regular basis and to work on a process to address and, if possible, to resolve future policy differences," the groups said.
But just two months later, the AHA and AMA simultaneously yet independently launched initiatives aimed at correcting perceived operational problems at the Joint Commission on Accreditation of Healthcare Organizations. Neither side had alerted the other prior to the public announcements of their respective JCAHO initiatives. Representatives of both groups also sit on the JCAHO's governing board.
Previous attempts at collaborative talks never went very far because advocacy issues got in the way, Wade said. Dickey acknowledged that the announcement of new collaborative talks had as much to do with presenting a united front to hospitals and physicians as it did with actually working on common AHA-AMA objectives.
Things will be different this time, promised Dickey, because the joint AHA and AMA sessions involve fewer people. Typically, the meetings will involve each organization's top executive, board chairman and one or two senior-level executives.
The involvement of fewer people make the sessions easier to schedule and conduct, improving the odds of success, Dickey said.