Editor's note: H&HN Managing Editor Bill Santamour will be blogging through Wednesday from the American Hospital Association Annual Membership Meeting.


WASHINGTON, D.C. — This may be the most opportune moment hospital leaders have ever had to make their voices heard in the debate over health care reform, the American Hospital Association's top two executives declared yesterday.

"You have stories to tell," President and CEO Rich Umbdenstock told those gathered in Washington, D.C., for the second day of the AHA's Annual Membership Meeting. "And this is the best of all possible times for your elected representatives to listen."

In addition to the presidential race, 435 U.S. House seats, 33 U.S. Senate seats and 11 gubernatorial seats are up for grabs, as well as seats in 86 of the country's 99 state legislative chambers.

AHA Executive Vice President Rick Pollack pointed out that reducing the federal budget will be a top priority for whomever wins in November. "Just think about it for a moment," he said. "On Dec. 31, the moratorium preventing the Medicare physician cuts will expire, and fixing them could increase the deficit. Remember, several Medicare extenders will also expire over the course of this year, and extending them could increase the deficit. The payroll tax cut expires on Dec. 31, and extending it could increase the deficit. The so-called Bush tax cuts expire on Dec. 31, and extending them could increase the deficit by more than $4 trillion. And just four days later, on Jan. 3, the sequester — those automatic budget cuts — kick in, and stopping them would increase the deficit by $1.2 trillion."

At roughly the same time, Pollack said, the country will face the need to extend the debt limit again, as it did last August. If not, the United States will default on its financial obligations.

"We have the opportunity — right now — to lay the foundation for this discussion," Pollack said. "Our challenge: how do we ensure Medicare and Medicaid patients will have access to care?" Legislators "must hear loud and clear that if they go down the same old road of cutting payments to caregivers, that raises the real serious question: Will the care be there?"

At the same time, hospital leaders must impress upon their legislators what they are doing to improve quality and patient safety, reduce inappropriate admissions and hospital-acquired conditions, implement electronic health care records, develop strategic alliances for clinical integration, reduce practice variation, find new efficiencies to take cost out of the system, and address diversity and disparities in care.

Finally, the field must address the budget deficit and offer "creative solutions that reform the delivery system." They include: eliminating barriers to developing integrated models of care; providing "more powerful" payment incentives to encourage providers to participate in coordinated care approaches; and doing a better job of caring for individuals suffering from multiple chronic conditions, starting with Medicare and Medicaid dual eligibles.

That's not all. "We need to reform medical liability laws once and for all, don't you think?" Pollack said. "We need to consider raising additional revenue to ensure the viability of the Medicare trust funds, and taxing products that encourage bad health behaviors. We need to look at retirement ages, and make Medicare consistent with Social Security."

The debate over health care "is without a doubt one of the most critical conversations of our lifetime," Umbdenstock said. "If those of us who know health care inside out aren't speaking up loudly and clearly, frequently and with one voice, where does that leave our patients, our communities and our nation?

"You are re-inventing your organizations every day. You are providing patients with better care than ever. You are driving costs out of the system like never before. You have a positive story to tell, and we are ready to help you tell it."