Leadership and affordability

An organization's success often comes down to leadership. And it's not just top executives who provide it — trustees have a pivotal role to play, too. Even as they fulfill their oversight obligations, board members can set direction, often with the help of lessons learned during their career.

For example, Nancy Agee, the new American Hospital Association board of trustees chair, is featured in our cover story on Page 8. Agee is president and CEO of Carilion Clinic in Virginia and has served on multiple boards in health care and other fields.

Of her new position at the AHA, Agee says: "What I would like to focus on is turning the dial a little bit to 'What are we for, what are we against?' And what we're for is affordable access to high-quality care. What can we do to be a part of that initiative, and how can we serve as a catalyst for change?" Agee wants to apply some of the leadership skills she's learned as CEO to the AHA board.

As Agee says, trustees can contribute to the growing push for affordability in health care. In this issue, starting on Page 19, Molly Smith and Paul Keckley analyze "total cost of care," a concept that's increasingly important in a landscape of new payment systems and performance measurement. Looking at the big picture, Nathan S. Kaufman discusses strategies for affordability in Viewpoint.

One area in which hospital trustees take a prominent leadership role is in the formation of partnerships. On Page 14, Jordan Shields and Ken Marlow go through the ins and outs of this process — specifically, as it applies to public or government-affiliated hospitals. In the case of public hospitals, questions of governance, regulation and fiduciary responsibility can be complicated, and politics often enter the picture. Boards need to navigate these waters to bring a partnership to fruition.

Some of you may have recently returned from the AHA's Rural Health Care Leadership Conference in Phoenix. If you did, and enjoyed the chance to hone your leadership skills with your peers, you may also want to register for the AHA Annual Membership Meeting. If you didn't, this meeting provides another great educational and networking opportunity. It's set for May 6-8 in Washington, D.C.