Another election has come and gone and done little to change the partisan tone in Washington, D.C. As I'm writing, congressional leaders are trying to strike a deal to avoid the "fiscal cliff" of tax increases and budget cuts. By the time you read this, I hope they will have reached a compromise.

To help the American Hospital Association solidify its position headed into the election and the critical lame-duck congressional session, in 2012, the COG, like all AHA governance committees, took a hard look at the sustainability of the Medicare and Medicaid programs and how to modernize them. Discussion started in the spring and continued through the fall as we worked through various proposals and what they would mean for hospitals and the communities they serve.

We also examined how delivery system transformation and health care reform have handed boards huge responsibilities to reposition their organizations for the future and how the COG could help prepare trustees for these responsibilities. Part of those discussions included working with other parts of the AHA to identify a national metric for gauging the AHA's impact on improving governance across the field.

In addition, we discussed and provided feedback to the AHA on principles for redesigning the overall primary care workforce. We identified the skills new physicians need to provide high-value care. We also looked at new strategies in advanced illness management, engaging health care consumers and improving overall community health.

Regardless of politics, the hospital field must be prepared for the changes coming its way in 2013 and beyond as deficit-reduction continues to be a focus and the Affordable Care Act takes effect. I'm honored to serve as COG chair this year and to play a small role in helping to prepare trustees for the road ahead. You, too, can play a role by becoming involved in the AHA governance process. See the article on page 27 for ways you can become involved, determine which is right for you and apply.

Katherine Keene (klinnkeene@comcast.net), is COG chair and a trustee of Salem (Ore.) Hospital.