To say the rally staged at the American Hospital Association's Washington headquarters last week was a rare event would be like calling a snowstorm in Las Vegas out of the ordinary.
AHA officials said they found it difficult to recall the last time they unwillingly hosted a sizable group of protesters. Other industry observers called the walk-in by 70 members of an advocacy group for low- and moderate-income families a "strikingly different" approach.
The group, the Association of Community Organizations for Reform Now, or ACORN, wants the AHA to release a list of 4,000 member hospitals that signed a pledge to make free and discounted care available to patients. Lawmakers have told community groups that they will work on legislation that addresses the issue of discounted care. ACORN also has griped about the hospital industry's billing and collection practices for uninsured and underinsured patients.
The group already had many of its members in Washington to rally on behalf of other issues. The AHA protest was originally scheduled to be held outside the association's building, but bad weather pushed the activists inside.
"We got our message across, and that was the goal," ACORN spokeswoman Allison Conyers said. "We didn't get answers to our questions, but we hope to get them soon."
AHA officials described the visit as peaceful yet passionate and "not something we see, hardly ever." Others were just as surprised.
"This is pretty unusual in the healthcare industry trade association world," said Alwyn Cassil, spokeswoman for the Center for Studying Health System Change. "I think it's a sign of how much public scrutiny hospitals are facing these days. They are under a lot of pressure."
Susan Sherry, deputy director of Community Catalyst, an advocacy organization that works with community groups to improve healthcare access, said ACORN's efforts are part of a larger movement asking for greater transparency.
Community Catalyst was the organization behind the Free Care Monitoring Project, which released a national report titled Not There When You Need It: The Search for Free Hospital Care.
"ACORN, like a lot of community groups around the country, are asking hospitals for clarity in regard to the care they provide, how they give back to the community," Sherry said. "These rallies and protests are the result of that demand not being answered."
One industry insider said aggression by community groups against hospitals is likely to grow as low-income families grow more frustrated.
James Unland described the face-to-face encounters as "golden opportunities for hospitals to improve relations in their communities."
"The dialogue between hospitals and community groups doesn't have to be hostile," said Unland, president of Health Capital Group, a healthcare consultancy.
Lawsuits and bad press have prompted hospitals and hospital organizations, as well as the federal government, to publish guidelines designed to help hospitals navigate the billing maze.
"To be fair, hospitals are between a rock and a hard place," Cassil said. "They have to try and collect from people who are able to pay their bills; if not, they are blamed for being fiscally irresponsible."
AHA Executive Vice President Richard Pollack, who was called out of his office to discover the surprise visitors, told the group that hospitals are working hard to address the issues, but all stakeholders must cooperate to address the larger societal crisis of 45 million uninsured Americans. He said he agreed to meet with the group's leaders at a future date.