WASHINGTON, D.C. — Some people might have arrived at the American Hospital Association's Annual Membership Meeting this week still clinging to one last shred of hope that the pressure to implement the Affordable Care Act had eased and that perhaps health care reform was stalled indefinitely, especially in light of the political gridlock gripping the federal government.

AHA President and CEO Rich Umbdenstock put any such hopes quickly to rest in his remarks at yesterday's opening plenary session. "A few years ago, I spoke about hospitals being in transition, with one foot on the dock and the other in the boat," Umbdenstock told hospital leaders assembled at the Washington Hilton. "Well, my friends, that ship has sailed. We've left port, and there is no going back."

But in a meeting whose theme is "Journey to Excellence," Umbdenstock struck an optimistic tone, declaring that providers have taken control of health care's transformation and are improving the system from the inside out. "We are where we need to be — in the cockpit, hands firmly grasping the wheel, eyes keenly focused on the horizon."

He cited several examples of the progress providers are making, both in improving quality and controlling costs. Hospitals are "resolutely moving toward zero preventable infections" and from "shifting costs to bending them, contributing mightily to the goal of lowering health costs over time," Umbdenstock said.

To support those claims, the AHA yesterday released data showing results so far from the Health Research and Educational Trust's Hospital Engagement Network project. The HRET project, the biggest of several HENs funded by the Centers for Medicare & Medicaid Services, involves more than 1,600 hospitals in 31 states. Yesterday's data show that early elective deliveries among HRET HEN participants have dropped 42 percent, resulting in $10 million in health care savings. In addition, readmissions are down 14 percent, for a savings of $100 million.

In other encouraging news, Umbdenstock said overall "hospital cost growth is at the lowest level in a decade. Medicare spending per beneficiary increased only 0.4 percent in 2012, far below per capita GDP."

Umbdenstock outlined the next areas hospitals and health systems must concentrate on to build on the momentum. I'll discuss those in an upcoming blog post.

Meanwhile, colleague Marty Stempniak caught up with John Combes, M.D., AHA senior vice president and COO of the Center for Healthcare Governance, to discuss the board’s role in guiding their institutions through these challenging times. It’s a compelling interview. Combes discusses how prepared boards are to tolerate risk. Importantly, he says, boards must answer some critical questions: “What are we here to do? What’s our purpose? What do we want to be when we grow up?”

Also at yesterday's session, AHA Executive Vice President Rick Pollack noted that if the federal budget impasse isn't resolved soon, the debt ceiling will again become an issue, maybe as early as July, putting still more pressure on Medicare and Medicaid. He reiterated that AHA members should urge their members of Congress to:

  1. Reject arbitrary cuts to Medicare and Medicaid funding for hospital services.
  2. Delay disproportionate share payment cuts in the ACA. Those cuts were passed with the expectation that coverage would increase through Medicaid expansion and the establishment of state insurance exchanges, neither of which is happening as smoothly or quickly as predicted.
  3. Support passage of the Medicare Audit Improvement Act of 2013, which seeks to reform the RAC program. Pollack said RAC "has run amok," calling the auditors "bounty hunters" who sit in cubicles second-guessing physicians. He noted that two-thirds of RAC reviews are later found to have no validity.

"It's not about being against change," Pollack said. "No sector is experiencing as much change as we are. It's about being reasonable and thoughtful about the changes" so that health care transformation is effective and successful."

In the afternoon plenary, journalist Bob Woodward, of Watergate fame, placed the blame for government paralysis firmly on President Obama for not spending more time and energy building relationships with members of Congress. Afterward, a hospital leader wondered if any Obama outreach would have succeeded. She recalled that as soon as the president was elected the first time, Senate Minority Leader Mitch McConnell (R-Ky.) declared his party's single objective was to make sure Obama did not win a second term. It was a question moderator Frank Sesno chose not to ask.