When American Hospital Association members go to Washington at the end of this month for their annual legislative pep rally, they'll be focused on two issues that don't offer much to cheer about: staffing shortages and the uninsured.
"We are going to be asking the members to take their story to the Hill, which is what we always ask them to do," said Richard Davidson, AHA president.
About 2,200 AHA members are expected to go to the nation's capital for the association's annual meeting April 28 to May 1 at the Hilton Washington Hotel.
The meeting, which formerly was held in January, was moved to the spring beginning this year because the legislative session would be further along and the healthcare issues more clearly defined.
During the meeting, Gary Meck-lenburg, president and chief executive officer of Chicago's Northwestern Memorial Hospital, will be formally installed as chairman of the AHA's 26-member board, although his appointment was effective in January.
For the AHA, its dual focus on alleviating staffing shortages and expanding coverage to the uninsured also encompasses a slate of payment issues and other big-ticket items. Some of those are regulatory relief to unburden providers from a sea of paperwork and a continued push for modifications in the massive medical-privacy regulations that went into effect April 14.
But when AHA members trek to Capitol Hill they'll find lawmakers and a White House focused on issues other than healthcare.
"I think it's really clear that taxes are the first and highest priority . . . there's just no question about that," said Richard Pollack, the AHA's executive vice president.
But positive signs have come out of the new administration. For example, Pollack said, President Bush's proposed fiscal 2002 budget recommends no new payment reductions to hospitals and also includes more than $70 billion for expanding coverage and access.
Unlike the past two years, when much of the AHA's attention was focused on securing payment relief from the Balanced Budget Act of 1997, this year "we have no BBA III plan," Davidson said. Relief bills passed in 1999 and 2000 gave hospitals more than $50 billion in additional funding over six years.
But that doesn't mean the AHA is giving up on trying to get more money for hospitals.
"Every year we are going to face pressure over money, and we'll always be fighting for fair and equitable payment," Davidson said.
In the fiscal 2002 budget battle, the AHA is focused on payment issues as they relate to workforce issues, such as getting full Medicare inflation updates to help hospitals keep up with rising labor costs and putting a floor under the wage index to raise Medicare labor-related compensation in low-wage areas.
The AHA said those changes require Medicare payment increases of $16.2 billion over five years.
"There is a clear message that our members are having difficulty in finding adequate numbers of workers," Mecklenburg said.
Making the business of running hospitals easier by easing regulatory burdens also is a key legislative objective for the AHA this year. One thing the association is looking for is money from the government to help hospitals comply with new regulations imposed under the Health Insurance Portability and Accountability Act of 1996.
"We continue to have new kinds of federal regulations . . . and they're not funded and that ultimately squeezes hospitals," Davidson said.