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Mixing politics with pleasure. An AHA vice president organizes a fund-raiser for the Bush-Cheney campaign. Does this constitute a conflict of interest?

An American Hospital Association lobbyist's fund-raiser for the Bush-Cheney re-election campaign last week at Washington's Capitol Hill Club raised eyebrows, along with questions about the gray area between personal advocacy and the industry's political agenda. The AHA was not involved in the event, association officials say, but some observers remain skeptical.

American Hospital Association↗

Trustees: indispensable to hospitals' political thrust.

Because of trustees' unique role in the hospital and the community, they are a vital part of health care's political thrust. The American Hospital Association and the allied state and metropolitan hospital associations have responded to trustees' increased commitment to political action by stepping up their own commitment to trustee political involvement.

American Hospital Association↗

Q & A: AHA's Dick Davidson.

Alabama hospitals face an array of complex challenges and questions as the nation moves toward health care reform. We recently asked Dick Davidson, president of American Hospital Association, to explain some key aspects of AHA's position on reform and how it relates to the Clinton administration's proposal.

American Hospital Association↗

Government officials redefine use of False Claims Act to combat fraudulent hospital bills.

The Dept. of Justice and the Dept. of Health and Human Services Office of Inspector General have issued new guidelines for using the False Claims Act to prosecute hospitals that fraudulently bill Medicare. Ellen Beck explains the changes and why the American Hospital Association calls the more lenient use of the FCA a "positive first step" toward acknowledging that the act is being used improperly.

American Hospital Association↗

AHA meeting focuses on federal budget: "the only game in town".

The Gramm-Rudman-Hollings budget balancing law still casts a long shadow over this year's Symposium on Federal Relations sponsored by the American Hospital Association. However with more Democrats in Congress, bills on catastrophic coverage and indigent care might have a chance to see the light of day.

American Hospital Association↗

AHA blasts federal policy on home health ownership.

A month after the Health Care Financing Administration implemented its new transfer payment policy, the American Hospital Association has blasted federal investigators for unfairly targeting hospital discharge planners. According to the association, recent actions by investigators suggest that the government is set to crack down on hospitals that own home health agencies, and particularly on discharge planners, who remain under suspicion for allegedly limiting patient choice in steering patients to hospital-owned agencies. The AHA's senior associate director of policy development stresses the importance of reviewing and correcting all discharge policies to make sure financial incentives aren't driving discharge decisions.

American Hospital Association↗

Regulating managed care plans: is the telecommunications industry a possible model?

Merger mania has been a striking trend in the health and managed care fields during the last decade, promising to improve integration of services, decrease excess capacity, enhance price competition, and increase the ability of providers and insurers to handle risk-based payment. In view of these promises, our first argument in this paper is that undoubtedly strong, well-financed managed care plans and health networks will continue to utilize the merger concept to acquire additional insurers and providers, eventually gaining more control over the organization and the financing of a region's health care delivery system. Our second thesis is that the quasicompetitive, quasiregulatory authority inherent in the Telecommunications Act of 1996, somewhat similar in concept to the American Hospital Association's earlier Ameriplan (1970), might serve as an appropriate model for Congress to use in designing future managed care, health field, and federal/state governmental interrelationships.

American Hospital Association↗

Specialties and the specialty boards.

As specialism has developed in the United States, multiple specialty societies and specialty boards have been created. Although they, in a very realistic fashion, have established the general standards for the delivery of specialty care and for graduate medical education, they, with other national medical organizations such as the American Medical Association, the Association of American Medical Colleges, and the American Hospital Association, function with a considerable degree of independence. There is lacking a cohesive and integrated effort to develop unified attitudes, postures, and policies that represent the medical profession and the health care industry in general. Recently the Coordinating Council on Medical Education and the Liaison Committee on Graduate Medical Education have been established. These two agencies represent a significant attempt to integrate policies for medical education and to identify a single accrediting agency that will apply uniform standards to the process of accrediting programs of graduate medical education. The federal government for the past several years has had an increasing interest in the health care industry and medical education. Many legislative bills have been passed which have imposed more and more regulations on medicine and have established more bureaucratic control over the professional activities of physicians. Insidiously the medical profession is being socialized. If accountability for the public welfare cannot be exercised by medicine, at least in the perspective of the federal government, more and more legislation and regulation are inevitable. The pluralistic structure of organized medicine will ultimately be self defeating. Cohesive policies on behalf of the medical profession must be developed if leadership in medicine is to remain in the private sector. The Coordinating Council on Medical Education is unquestionably a significant attempt to demonstrate public accountability. It is, however, only the first step in the long and difficult process of developing cohesive national policies on behalf of organized medicine.

Humans↗

Hospital-level performance improvement: beta-blocker use after acute myocardial infarction.

BACKGROUND: National surveys indicate improvement in beta-blocker use after acute myocardial infarction (AMI) over time; however, these data could obscure important variation in improvement at individual hospitals. Our objective was to characterize the hospital-level variation in the improvements in beta-blocker prescription rates after AMI and to identify hospital characteristics that were associated with hospital improvement rates after adjustment for patient demographic and clinical characteristics. METHODS AND RESULTS: We used data (n = 335,244 patients with AMI discharged from 682 hospitals) from the National Registry of Myocardial Infarction (NRMI) and from the American Hospital Association Annual Survey of Hospitals and hierarchical modeling to examine the associations between hospital characteristics and hospital-level rates of change in beta-blocker use during 1996-1999. On average, hospital rates of beta-blocker use for patients with AMI increased 5.9 percentage points (standard deviation, 9.7 percentage points) from the premidpoint time period (April 1996-February 1998) to the postmidpoint time period (March 1998-September 1999) of the study. The range in hospital-level changes in beta-blocker rates was substantial, from a decline of -50.0 percentage points to an increase of +35.7 percentage points. AMI volume and teaching status, geographic region, and initial beta-blocker use rates were associated with rate of improvement, but the magnitude of these effects was modest. CONCLUSIONS: The study reveals marked hospital-level variation in improvement in beta-blocker use after AMI. Several hospital characteristics were associated with this improvement, but they are weak predictors of hospital-based improvement in the use of beta-blockers.

Adrenergic beta-Antagonists↗

AHA responds to proposals on medical waste incineration.

Roger Olson, chairman of facilities operations for the Mayo Clinic, Rochester, MN, testified on behalf of the American Hospital Association before the U.S. Environmental Protection Agency's Office of Air Quality Planning and Standards on the EPA's proposed rules on medical waste incinerators. Here's what he had to say.

American Hospital Association↗

A worthy challenge. Interview by Mary Grayson.

Dennis R. Barry, president and chief executive officer of Moses Cone Health System and chair-elect of the American Hospital Association, describes the challenges facing health care. Change is clearly necessary, he says, and one of the keys is collaboration among health care professionals, the government and other stakeholders in the field.

American Hospital Association↗