Since the last time the American Hospital Association's members assembled, the country's priorities-and a good deal of the country's resources-have shifted to military readiness and antiterrorism efforts. That has put a damper on hospitals' efforts to boost Medicare and Medicaid spending at a time when they say they face declining reimbursement, rising drug costs, bioterrorism-preparedness expenses, workforce shortages and the constantly moving target of regulatory compliance.
Against this challenging backdrop, AHA officials said, the Chicago-based group is holding its annual meeting this week in Washington.
In large part the meeting will focus on "making sure Congress knows we are at a unique point in history where cumulative forces are jeopardizing the foundation of the healthcare system," said Richard Pollack, the AHA's executive vice president of advocacy and public policy. Among hospitals' concerns are the rising number of uninsured, competition from boutique providers, the possibility of $21 billion in upcoming Medicare and Medicaid reductions and rapidly rising liability premiums.
"We're very concerned we have all these things piling up at the same time," Pollack said. "We need to make sure policymakers understand that."
The AHA's annual membership meeting, scheduled for April 6-9 at the Hilton Washington & Towers, is expected to attract some 2,000 people, according to association officials, who said that's in line with previous years' attendance. Those who plan to attend said they hope the meeting will offer new ideas on how to address the series of challenges they face.
"Because of the increased focus on defense ... we're seeing a shift of dollars from healthcare to defense," said Thomas Royer, M.D., president and chief executive officer of Dallas-based Christus Health, a 27-hospital system with facilities in five states and Mexico. That priority shift, he said, has created "increased intensity about potential Medicare and Medicaid cuts, and what we might do about them."
Royer, who also is an AHA board member, said he hopes that a workforce shortage report the AHA has spent 12 months compiling will provide some new ideas on how to address rising vacancy rates among nurses and other healthcare professionals.
At the meeting the AHA plans to unveil details of that report, prepared by its 29-member Workforce Commission. The report, Pollack said, provides examples of hospitals that are successfully navigating staff shortages and includes actions hospitals and communities can take to solve the problem.
In the post-Sept. 11 environment, hospitals have found themselves on the front lines of bioterrorism threats and preparing to treat large numbers of injured in case of a new terrorist attack. Illustrating new priorities since the last AHA meeting, this year's panel of speakers is unprecedented in name recognition and the focus on bioterrorism, officials said.
Speakers at a federal relations forum include former New York City Mayor Rudolph Giuliani, Homeland Security Director Thomas Ridge, Rep. Richard Gephardt (D-Mo.), Centers for Medicare and Medicaid Services Administrator Thomas Scully and Sen. John Breaux (D-La.).