AHA chief: Industry needs to spread wings

Hospital cooperation with other providers key to post-reform, rate-cut success

The message from the leader of the nation's largest hospital group was clear: Reach out or be left behind.

Speaking to a Nashville Health Care Council luncheon Wednesday, American Hospital Association President and CEO Rich Umbdenstock said the industry needs to redefine its place in the spectrum of health care following the passage of health care reform and the specter of government rate cuts. Hospital operators, he said, should strive to have their facilities become a key part of a provider network that continuously improves the quality of care and prevents patients from acute episodes.

"If rates are being cut, you shouldn’t think of doing more of anything," Umbdenstock told the crowd at the Cool Spring Embassy Suites. "You should do things better and you should be doing fewer things. You’ll have to do less with less."

That, he added, means reaching "farther upstream" and partnering with others to provide more prevention and wellness services outside the hospital's walls. The overall goal — and one that is increasingly being reimbursed to a greater extent — is to keep chronic conditions in check or prevent people from becoming higher health risks.

"You’ll have to figure out how to lower the overall utilization," he said.

Umbdenstock's theme carried through to the question-and-answer section of Wednesday's event. Asked about the evolution of the primary care doctor's role, he said such physicians will have to get used to delegating some of their tasks — and via mergers into hospital systems, many of their costs — and being part of a broader team of caregivers. And speaking to the moratorium on physician ownership of hospitals, he said the AHA backs that measure because such facilities tend to pull profitable procedures out of the mainstream hospital system.

"We’ve got to point to a more connected and coordinated system, not pull the pieces farther apart," Umbdenstock said.