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AHA chairman says hospitals must take on broader responsibility for their communities

January 11, 2013
   As group president of Southern California and Hawaii for Kaiser Foundation’s Hospitals and Health Plans in Pasadena, AHA Chairman Benjamin Chu, M.D., comes from an integrated health care world, where he says value-based payment and accountable care structures – coupled with good information – enable hospitals to deliver better patient care at lower cost.

But, as more hospitals move closer to that integrated world, he worries that government cutbacks in funding for their Medicare and Medicaid services could hinder the journey for many of them.

“The cuts to fee-for-service reimbursement are like one little amputation after another until finally the entire limb is gone,” Chu says. “This is not the way to make sound financial decisions about health care for the country.” The AHA is committed to protecting hospitals from arbitrary budget cuts in Washington, DC, and is working to “preserve what we can so hospitals can live to
fight another day,” Chu says. But he says the AHA also is “taking the longer view” – beyond this year’s federal budget battles – because, “if hospitals want to make sure their patients and communities stay as healthy as possible, then the things that we can do to make that happen are bigger than just providing hospital care.”

To Chu, that means advocating “for a better way of doing things … working to deliver care in a more cohesive, integrated way, where we create a common view of a patient across the continuum and where we align incentives.”

Chu became AHA chairman on Jan. 1, succeeding Teri Fontenot, president and CEO of Woman’s Hospital in Baton Rouge, LA. He was appointed
regional president of Kaiser Permanente Southern California in 2005 and named group vice president six years later, with additional accountability for Kaiser Permanente’s Hawaii region. He oversees 14 hospitals and 168 medical offices, which serve more than 3.6 million of Kaiser’s 8.8 million members.

“I like larger bundled capitated payments and being the deliverer of care that is organized in a way that makes sense for the patient,” Chu says. “I know not everyone believes in capitation, but prepayment and capitation at Kaiser are really the key for how we do things.”

As a large organization representing some “5,000 absolutely diverse hospitals across the country, the AHA is doing an amazing amount right to help facilitate the change” toward a more integrated world, he says. As an example, he cites the AHA’s work around the Health for Life framework, which took place as Chu was complet­ing his first term as an AHA board member in 2007.

“The AHA showed incredible leadership” on Health for Life, says Chu. He believes it continues to serve as a valuable roadmap to the future, with its emphasis on coordination across the continuum of care; wellness and prevention and equity of care. “The knock on big organizations is that they are lumbering and are not nimble,” Chu observes. “But the AHA is a special organization. It is hard to get that many diverse views to come together and support a single position. We did that in 2007 with the Health for Life framework.”

He also is quick to note the work of the AHA’s Health Research & Educational Trust, its Hospitals in Pursuit of Excellence initiative and collaboration on quality and patient safety efforts, like the Hospital Engagement Network program, which are getting AHA members the tools they need to make change happen at the local level. “Our work with patient safety is moving the field down a pathway that gets everybody to embrace this larger view of [the Institute of Medicine’s] Triple Aim: improving the individual care experience; improving the health of the population and doing it on a cost-efficient basis,” he says.

Chu enjoys the camaraderie on the AHA board and on the regional policy boards and “the fact that so many great people around the country are thinking about how the hospital world is changing and are working hard to do the right thing for their communities and patients.”

Hospital and health system leaders “know that we are about trying to keep our communities as healthy as possible,” Chu says. “With the new tools coming our way … the information technology and metrics, we can look into the mirror and see whether we are doing the best job we can for our patients … and see how we can do better.”

By Pete Davis