American Hospital Association restructures to focus on advocacy

In his more than two years as leader of the American Hospital Association, CEO Rick Pollack has transformed the look and approach of the lobbying organization.

Much of its senior management has turned over, departments have been revamped and this month its 90-plus year-old flagship magazine will print its last issue.

Over the past two years, divisions focused on governance, diversity and physicians have been retooled. Health Forum, a for-profit subsidiary that sells hospital data to the industry, has also been restructured, including the shuttering of Hospitals & Health Networks. Pollack said the latter move is intended to deliver a more succinct, cohesive message to AHA members.

"We are not backing off from providing the content, insight and analysis, we are just delivering it in a different form in a more streamlined, consolidated fashion," Pollack said.

There have also been sweeping leadership changes. Neil Jesuele, former CEO of Health Forum and AHA executive vice president; John Evans, the former CFO; John Combes, former president of AHA affiliate the Center for Healthcare Governance; and former American Organization of Nurse Executives CEO Pamela Thompson, all retired.

Tomas Leon, former CEO of the Institute for Diversity in Health Management, relocated to Arizona for a new job closer to home; Maulik Joshi, former president of Health Research and Educational Trust, went to work for Anne Arundel Health System as COO; and Amy Mosser, former COO of Health Forum, took on the COO position at consulting firm LaunchPoint.

Pollack said that in redefining the association, the goal is to more closely align operations with advocacy at the forefront, followed by thought leadership, knowledge exchange, and being an agent for performance and quality improvement. Some of the structural changes have allowed the association to invest in its advocacy role.

The AHA has had to adapt to the break-neck speed of policy changes as well as the ambush of natural and man-made disasters. From threats to the Affordable Care Act and Medicare and Medicaid coverage to the latest tax bill that affects tax-exempt private equity bonds to the hurricanes and wildfires, this has been the most challenging advocacy environment over the past 30 years, said Carmela Coyle, president of the California Hospital Association, and a former AHA staffer who now serves on the AHA board.

Each legislative or regulatory change now requires a multifaceted campaign that includes advertising, grassroots marketing and lobbying to push reports and data, Pollack said. "There is more of an interest in what the hospital of the future is going to look like," he said.

Pollack highlighted lobbying efforts that helped defeat major insurance mergers like Humana-Aetna and maintain Medicare and Medicaid coverage—for now.

"Anything we are doing internally has helped make the AHA's advocacy effort more effective," said Jim Skogsbergh, Advocate Health Care's CEO and immediate past chair of the AHA board.

The AHA trailed only the Blue Cross and Blue Shield Association and the American Medical Association in lobbying expenditures through the first nine months of 2017.

"Lobbying is the part that has the spotlight on it," Coyle said. "But what's going on behind the scenes is preparing everything else that needs to ready—the financial side, member services data analytics side—so that it's ready to carry a unified message to the hospital field."

The AHA hired a chief data officer who is tasked with helping build a database to collect information across the industry and increase its utility and accessibility.

The association also plans to expand the reach of some of its services. Some of the AHA's platforms like its governance and diversity arms have required that users sign up; they're now open to everyone.

One of the biggest challenges the AHA continues to face is providing equal representation to the diverse needs of hospitals from large systems to rural providers, Skogsbergh said.

The association will strive to continue to break down silos within the organization to ensure that legal, lobbying, business and policy perspectives are brought together to resolve particular problems, Coyle said.

Updated, Dec. 11.