The American Hospital Association's annual advocacy agenda is designed to help hospitals continue to provide the high-quality care their communities need 24 hours a day, seven days a week, 365 days a year, particularly in these uncertain economic times. The agenda is formulated by the association's policy staff with input from its state, metropolitan and regional hospital association partners, regional policy boards and governing councils, as well as the governing trustees.

This year, the AHA's advocacy efforts will focus largely on ensuring that hospitals continue to have the resources they need to care for their patients and communities effectively. Rather than work toward long-term solutions to overcome the flaws in our current Medicare and Medicaid payment systems, policymakers continue to seek short-term remedies by reducing payments to hospitals and other providers. At the same time, hospitals are under enormous pressure to improve and transform how they deliver care through the use of new technology, revamped facilities and new care processes. They also face an increasing regulatory burden.

Hospitals cannot continue to do more with less. Knee-jerk payment reductions compromise hospitals' ability to improve and, thereby, to improve the health of their communities. These reductions also threaten the economic health of those communities because hospitals play a critical role in every local community as a source of jobs and a consumer of goods and services.

But sensible alternatives exist. The AHA this year will take a hard look at the question of how to modernize the Medicare and Medicaid programs thoughtfully to ensure that they can continue to provide access to high-quality health care for future generations, and to put a stop to the continuous ratcheting of provider payments.

But the AHA can't do it alone. The effectiveness of the AHA's policy development and advocacy efforts relies on input and participation from health care leaders across the country. Watch for more from the AHA in the coming months about how you can add your input, and visit regularly to learn how you can play a role in policy development and advocacy efforts.

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