AHA Annual Meeting, 
Advocacy/Trustee Luncheon,
October 7-9
The Arkansas Hospital Association will host its 71 Annual Meeting and Trade Show October 7-9 in Little Rock’s remodeled and enlarged Statehouse Convention Center with housing at the Excelsior Hotel, which is undergoing renovations to become the Peabody Hotel — Little Rock.

To accommodate increasing demands on time, the AHA’ s annual meeting has been streamlined. The Sunday through Tuesday schedule will feature a golf tournament, learning sessions with prominent speakers, dedicated time to visit exhibits, a dinner honoring past AHA chairmen, and the annual awards dinner.

Political strategist Mark Allen will discuss President Bush’s first year in office and how his presidency has affected healthcare during the Advocacy/Trustee Luncheon on Monday, October 8.

Other speakers scheduled to appear include keynoter Ken Schmidt, former director of communications for Harley-Davidson Motor Company who tells a fascinating story of building an entirely new corporate culture, of rekindling relationships with customers, and reaching out to new ones in completely untraditional ways; and Terry Andrus, president of East Alabama Medical Center, who steered his hospital towards becoming one of Fortune magazine’s “100 Best Companies to Work For.”

Attorney Lynda Johnson will present “Mr. Smith’s Incredible Journey,” an entertaining story that describes HIPAA’s affect on a patient as he journeys from hospital admission to discharge; air safety analyst John Nance will discuss comparisons between airline safety and patient safety; and author James Bradley (Flags ofOur Fat hers) will close the annual meeting with a motivational message, “Doing the Impossible.”

Included with this issue of The Arkansas Trustee is the program and registration information for the AHA Annual Meeting. We hope you will join us.

AAHT Regional Meetings Successful
Over 140 hospital trustees and executives attended the Arkansas Association of Hospital Trustees 2001 Regional Dinner Series presented in five Arkansas cities in April and May. Participants heard governance consultant Larry Walker challenge them to educate their community about the serious financial effects of the Balanced Budget Act (BBA), and its implications for the hospital’s future.

Walker said hospitals need to engage their communities in a variety of ways to both share information about the impact of reduced federal reimbursement, and to gain community understanding and support to successfully weather future problems. He said the key to success is to involve the community as a partner in designing healthcare direction for the future, and put the hospital’s current financial challenges in perspective as part of the overall equation, rather than a singular issue of its own.

Five key steps are involved in successfully engaging in a community-based dialogue about the challenges and future of local healthcare. They are:

• Perform a strategic assessment of your organization, and its readiness for future success

• Create a plan for engaging the community

• Involve internal resources and stakeholders

• Have a broad-based, multi-faceted dialogue with the community that covers a broad range of issues

• Continually refine and hone key messages and their relationship

If you were unable to attend the workshops, but would like a copy of the educational materials, please call Beth Ingram at 501-224-7878 or email bingram@arkhospitals.org.

In a related story, Don Wilson, president of the Kansas Hospital Association, wrote the following commentary included in the July 9,2001 AHA News.

We’ve all read the headlines. We’ve all read the gloomy assessments and forecasts about the nation’s healthcare delivery system. Nurses dissatisfied with their jobs.. .serious medical errors... workforce problems... skyrocketing increases in prescription drug costs.

Our first reaction to such negative publicity about healthcare is, understandably, regret — if not dismay or even some anger. But we can’t dispute any of these stories. As Rick Wade, the AHA ‘s senior VP for strategic communications, recently noted, “The cold, hard fact remains that you have one-third of the hospitals in this country on their knees financially. The more we talk about these problems in public, the more they ‘Il serve as a catalyst for improvement.”

I can honestly say that I’ve never met a healthcare provider at any level who wanted to give substandard care, or have a stressful working environment, or not be able to meet the healthcare needs of the community. Other factors are driving this dilemma~ and, while we can’t blame the lack of adequate reimbursement for all these issues, they're exacerbated by financial pressures.

While none of us likes airing our dirty laundry in public, I can’t help but think that increased public awareness is a crucial step toward public understanding and support. And public understanding and support are essential to our advocacy strategies for improving healthcare.

However~ it's also important— in fact, an absolute necessity — that we remember all that is good about healthcare in America. We have problems to address quickly and creatively. But we also have incredible strengths, which we can’t neglect, and upon which we must build a new and improved future for healthcare delivery.

Candid public acknowledgement of hospitals’ challenges and attributes is a much better scenario than the counterproductivity of the inevitable defensive posturing that comes from public denials that our problems exist. We need to sustain our commitment to improve because our patients, communities and employees deserve that commitment. But let’s not be shy about making sure they know about the good news as well.

HIPAA Privacy Guidance
On July 6, the Department of Health and Human Services (HHS) issued its first guidance to address questions and concerns regarding implementation of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 privacy regulations finalized on April 6, 2001. 

On three of the American Hospital Association’s most significant issues — the minimum necessary standard, oral communications, and consent— it appears that HHS has taken a first step towards easing some of the rules’ unnecessary burdens on hospitals and patients. 

In addition, HHS promised in the guidance to take further steps to address other troublesome problems with the oral communications and consent requirements. The full document can be accessed at www. aha. org.

Hospitals Face Lost Income
America’s largest companies have become so successful at exerting price pressure on health carriers that carriers are responding by cutting their fees to hospitals. But, carriers may not be able to continue cutting payments to hospitals without compromising the quality of patient care, according to a study released by Health Affairs.

The study’s authors report that because the nation’s largest companies have virtually completed their transition to managed care coverage and are searching for new ways to cut escalating health costs, they have dramatically altered their purchasing strategies. These strategies include adopting aggressive purchasing techniques, raising premiums or co­payments and abandoning the existing employer-based system for a defined contribution approach. For more, go to www.healthaffairs.org/archives library.htm.

Leadership Transition Process
According to American Governance Leader, few changes have the potential to upset hospital operations more significantly than a change in an organization’s chief executive. Ensuring a smooth, orderly transition should be on the short list of priorities for most boards.

Elements of the leadership transition process should include:

• Initial fact finding to review the organization’s strategic imperatives and compensation philosophy.

• Conducting interviews with board members, selected executives and internal and external stakeholders to identify the CEO characteristics, skills and expertise needed.

• Determining whether an internal, external or combination succession process is needed and/or desired by the board.

• Developing the transition plan to identify timetables and relative roles and responsibilities of the incumbent CEO, the successor and the board.

• Putting into place executive retention plans and severance plans to reflect the incoming CEO’s vision for the executive team.

• Developing employment and compensation agreements to specify responsibilities and associated compensation and incentives for both the incumbent CEO and successor throughout the transition and negotiating an appropriate retirement package for the incumbent CEO.

• Establishing a communications plan that delivers a clear, consistent and coordinated message to all constituencies.

Resolution on Workforce Relief
Hospital governing boards are being asked to play a pivotal role in the American Hospital Association’s push for workforce relief legislation to help America’s hospitals. Each hospital CEO and board chair will receive (if you haven’t already) a draft resolution for your board’s action.

The resolution tells your lawmakers that you are grappling with the serious challenges brought on by workforce shortages. And it urges them to support and pass three important bipartisan legislative initiatives to bring some relief to your hospital:

• The “American Hospital Preservation Act” (H.R. 1556/ S. 839) increases Medicare inpatient and outpatient payments by providing full prospective payment system market basket updates for fiscal years 2002-2003.

• The “Area Wage and Base Payment Improvement Act” (H.R. 1609/5.885) standardizes reimbursement rates for Medicare inpatient hospital services and eliminates wage index differences between large urban and rural or community hospitals.

• “The Nurse Reinvestment Act” (H.R. 1436/S. 706) establishes a national nursing service corps and expands Medicare/Medicaid funding for nurse education.

Make your voices heard by passing the resolution. It will send your legislators a strong message on the need for immediate workforce relief.

HCFA Becomes CMS
HHS Secretary Tommy Thompson, acting on his pledge to reform HCFA, announced on June 14 that the agency has been renamed the Centers for Medicare and Medicaid Services (CMS), and will be reorganized into three divisions to promote greater responsiveness to states, providers and patients.

The Center for Medicare Management will deal with traditional Medicare. The Center for Beneficiary Choices will focus on Medicare+Choice and providing beneficiaries with information about various supplemental Medicare options. And the Center for Medicaid and State Operations will be left unchanged and will continue to focus on state-federal programs, including Medicaid and CHIP.

Governance Update Online
If you would like to receive Governance Update, a free publication for trustees by the American Hospital Association’s governance section, please email your contact information, including mailing address, telephone number, email, and hospital affiliation, to: yblackburn@aha.org Your email address will be considered confidential and will be used only for the transmittal of AHA information. It will not be shared with others without your permission.

Healthcare Notes and Quotes
Less than half of the people in key targeted populations for preventive health services receive services that would be most valuable to them, according to a recent joint survey.

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Data from The Centers for Disease Control and Prevention show a decline in mortality from some leading causes of death, including cancer and heart disease.

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A survey from the American Hospital Association of7 15 hospitals found significant shortages of personnel in several disciplines outside of nursing. Another study found that the shortages are beginning to affect operating margins.

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JCAHO’s new patient safety standards address leadership’s responsibility for medical error reduction and developing systems for improvement.

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There were about 103 million visits to U.S. hospital emergency rooms in 1999, up 14% from the 90 million visits recorded in 1992.

Joint Leadership Conference September 14-16, Nashville
The Arkansas Hospital Association will join other southern hospital associations in presenting the 12th Annual Southeast Joint Leadership Conference, “Rekindling the Spirit — Remembering Why We Went Into This Business,” September 14-16 at the Opryland Hotel in Nashville, Tennessee. The conference is designed for hospital chief executive officers, trustees, and medical staff leaders.

Conference program topics include healthcare trends in our future, spirituality in healthcare, quality and value, workforce challenges, and more. In addition to the educational workshops, participants and guests may enjoy golf, Opry Mills factory outlets, and Bass Pro Shop’s Outdoor World, as well as other Nashville attractions.

Program and registration materials will be mailed to all members of the Arkansas Association of Hospital Trustees, as well as to Arkansas hospital CEOs this week. Early hotel reservations are encouraged. Call 615-883-2211, referring to code S-TENHA.

Trustee Orientation Workshop November 7 — Little Rock
In response to numerous requests from trustees and Arkansas hospital CEOs, the Arkansas Association of Hospital Trustees will host a Trustee Orientation Workshop Wednesday, November 7 at the Holiday Inn Select in Little Rock. The workshop is designed not only for trustees new to their governance position, but also for those who’ve been “in the trenches’ for quite some time. It’s never too late to learn and share new ideas and techniques, concerns, and strategies.

Larry Walker, governance consultant and facilitator, will be the featured speaker presenting topics recommended by Arkansas hospital CEOs. Topics will include the challenge of healthcare governance and why excellence in trustee leadership is more critical than ever; lessons from the trenches; preparations for the future; boardroom basics (medical staff development, credentialing, QA, finance, accreditation. payment systems, CEO performance, etc.); the ideal strategic board; effective board meetings; and error-proofing hospital governance.

In addition, participants will receive an extensive notebook with supporting materials, including executive briefings on issues, trends, governance processes; the language of healthcare; Trustee KnowledgePLACE (which includes websites and reports useful to trustees), and other relevant tools and resources developed by The Walker Company.

Mark your calendar and save November 7 for the Trustee Orientation Workshop. You won’t want to miss this educational opportunity

AAHT Calendar of Events

September 14-16, Nashville, TN
Joint Leadership Conference

October 7-9, Little Rock
AHA Annual Meeting and Trade Show 
Advocacy/Trustee Luncheon

November 7, Little Rock
AAHT Trustee Orientation Workshop