Non-Catholic, private, for-profit physician practices and HMOs could join the Catholic Health Association under the organization's proposed new-membership guidelines.
If the guidelines are approved, it will mark the first time membership has been extended to non-Catholic groups affiliated with, but not controlled by, Catholic systems or facilities. Their membership would fall under a new affiliate category, one that wouldn't be open to publicly traded, investor-owned companies. Affiliate members could not vote.
The CHA's president, the Rev. Michael Place, has been an outspoken critic of investor-owned hospital chains (Dec. 8, 1997, p. 2).
For the CHA, the inclusion of non-Catholic private for-profit and not-for-profit affiliates recognizes what already is happening in Catholic healthcare.
"We are, in fact, as a ministry, in many complex sets of relationships," Place said.
Based in St. Louis, the CHA has more than 1,200 members, including freestanding hospitals, sponsors and systems.
"To my mind, this is a change but not a revolutionary change," Place said.
Affiliate members will not be able to apply to the CHA on their own. Instead, they must be recommended by a voting, or representative, member.
The proposed changes still need the approval of CHA members, who will meet June 7-10 in New Orleans for the 83rd Catholic Health Assembly. If approved, the changes will take effect July 1, 1999.
A 12-member CHA task force worked on the changes for more than two years, and they were approved by the CHA's 25-member board last month.
The addition of non-Catholic affiliates is only one of several membership changes, including revamping the organization's dues structure to recognize the evolution of freestanding hospitals into systems.
But the attention being paid to systems "is not to diminish the role of any other element in the ministry," said David Lincoln, chairman of the CHA board and head of Covenant Health Systems, Lexington, Mass.
The proposed dues change places payment responsibility at health system headquarters rather than at each component of the system.
A new dues rate hasn't been set, but it will be a fixed percentage of a system's or freestanding hospital's operating expenses.
The new dues structure is not intended to boost the CHA's almost $13 million annual budget, officials said.
However, the CHA's total revenues and dues collections have declined.
According to the CHA's 1996 federal tax filing, its total revenues were almost $15.2 million and membership dues and assessments were about $11 million. That's a decrease from its 1995 filing, which showed almost $15.5 million in total revenues and dues of more than $11.5 million (March 9, p. 16).
The CHA also is considering a proportional system of voting. Religious sponsors and stand-alone hospitals would have one vote, while systems' votes would be based on their total operating expenses. Those votes could be delegated to people in the systems, such as hospital CEOs. The parent organization and delegates would represent the entire system.
The number of votes a system now gets is based on the number of entities, such as hospitals, that it controls.