On the eve of its centennial, the American Hospital Association has approved a plan to allow integrated delivery systems to join as full-fledged AHA members for the first time.
The move recognizes the evolution of individual hospitals into hubs of complex delivery networks, but it also could generate needed revenues for the Chicago-based trade group, which has seen its financial situation sag along with several years of hospital industry consolidation.
At its meeting in Chicago last week, the AHA's 26-member board of trustees approved opening the organization to integrated delivery systems that include at least one licensed hospital. The change, effective in 1999, means physicians, insurers, long-term-care organizations and others will be accepted into the main fold of the AHA.
Historically, the AHA has allowed only individual hospitals or hospital-only systems in as members. The AHA has about 4,400 individual hospital members and 159 hospital system members.
The association has been working toward the membership change since 1994, when its board adopted a plan to move in that direction.
"Our view was we had to begin to restructure the AHA to acknowledge all the points our members were at on the road to integration," said Richard Wade, the association's senior vice president for communications.
The change means the AHA will be recognizing the entire integrated delivery system as a member, rather than only the hospital component.
"Welcome to the wonderful world of managed care," said Susan Pisano, a spokeswoman for the American Association of Health Plans, a 1,000-member trade association of health plans.
Both the AHA and the AAHP are trying to attract many of the same integrated delivery systems as members.
"We're clearly going to have some overlap," she said.
"It really, I think, is a very positive reflection of how the AHA continues to change as its membership changes," said John McMeekin, an AHA board member and chief executive officer of Crozer-Keystone Health System, an integrated delivery system in Springfield, Pa. The system includes five hospitals, four long-term-care facilities, a 200-physician network and a 2,300-enrollee HMO.
AHA President Richard Davidson and AHA Chairman Reginald Ballantyne III were unavailable for comment at deadline.
The new membership category means physician hospital organizations, along with staff- and group-model HMOs, which are connected to a hospital, can also be members, Wade said.
Half the AHA's members now consider themselves part of systems, compared with 11% in 1993, the association said.
Wade couldn't provide specific estimates of how many integrated delivery systems the association expects to capture as members or how much dues revenues they're expected to generate. A dues formula for system members hasn't been devised, he said. It should be in place after 2000.
Declining membership pushed the AHA's annual dues revenues down for the second consecutive year last year to about $56.4 million (Aug. 25, p. 2).
Also at the meeting, the AHA board of trustees voted to:
Push for legislation that would establish a minimum threshold of billing errors the government would have to find before it accused hospitals of violating the federal False Claims Act.
Pursue legal remedies to challenge the government's use of the False Claims Act. Wade said about half a dozen AHA hospital members are interested in taking on the government. Losing a False Claims challenge to the government can mean exclusion from federal healthcare programs, a death sentence for a hospital.