Last summer's bitter debate over raising the nation's debt ceiling and how to control our growing deficit spilled over into the fall as the special congressional committee worked to devise a way forward. Because committee members failed to reach a bipartisan agreement, Medicare providers, including hospitals, now face reductions in payments of 2 percent per year over nine years beginning in 2013. This is in addition to reductions hospitals already are absorbing as a result of state belt-tightening and recent federal legislative and regulatory changes.

As Congress returns this month, it is more important than ever for hospital leaders to build and nurture relationships with their legislators. They need to understand the real-world implications of the decisions made in Washington, and there is no better advocate for your hospital than you.

As a trustee or commissioner, you are in the best position to help legislators understand all that your hospital does for the community 24 hours a day, 365 days a year, and the challenges it faces as it strives to continue to deliver those services.

Successful advocacy translates the needs of your hospital and community into messages policymakers can understand and on which they can act. You can paint a vivid picture of the impact that your organization has not only on your community's physical health, but on its economic health as well. The health care sector represents nearly 18 percent of the U.S. economy and is one of the few bright spots in terms of job growth. Hospitals are the largest component of this sector, employing more than 5.4 million people. As hospitals and hospital employees buy goods and services from other businesses, they create additional jobs and economic impact throughout the community.

As you think of ways to reach out to your legislators, remember that it's important to work with your hospital administrators to coordinate any contact with legislators to make sure you're speaking off the same page and not working at cross purposes, thereby confusing your legislators.

For more information on ways to become involved, and information on the most pressing issues, visit

Kimberly McNally ( is COG chair and a trustee of Harborview Medical Center/UW Medicine in Seattle.