A fork in the road - changes in the Healthcare Financial Management Association

Healthcare Financial Management, April, 1999 by Richard L. Clarke

"When you reach a fork in the road, take it."

- Yogi Berra

In its history, HFMA has reached several significant forks in the road and taken them. Perhaps the most visible representation of the route we've traveled may be seen in changes in the Association's name over the years.

In 1968, the Association changed its name from the American Association of Hospital Accountants to the Hospital Financial Management Association. This change recognized two important changes for the Association and its members. First, the Association's focus was evolving from the simple recording and reporting of accounting transactions to encompass broader issues of hospital finance, including patient accounting, cost accounting, cash management, and so forth. And second, the responsibilities of Association members, the individuals who recorded accounting transactions in hospitals were becoming inextricably intertwined with the overall management process.

These changes were precipitated by a host of factors, including the advent of the Medicare and Medicaid, and required hospitals to improve their billing, cost allocation, cash management, and collection activities. They also resulted in significant increases in the complexity of the delivery of care. Simply put, hospitals needed more sophisticated management of their finances, not simply improvements in their accounting.

In 1982, the Association changed its name again - this time to the Healthcare Financial Management Association. In describing the need for this change, then HFMA Chairman, Raymond Cisneros, FHFMA, CPA, wrote:

"During the past several years, we have heard from Association members, chapters, committees, and councils that it is time for another change to reflect the industry of today, and to provide a better description of our function. It was suggested that the broader more comprehensive name of Healthcare Financial Management Association, more accurately describes who we are in the broader arena in which we operate."

Those HFMA leaders who guided the Association through these changes recognized that no organization can survive if it stagnates. That is as true today as it was in 1968 and 1982.

Certainly, the current healthcare environment is characterized by change. It is focusing less on acute care and more on ambulatory care. It is changing from a model of care that concentrates on the treatment of injury and disease to one that concentrates on the prevention of injury and disease. And the improvements in technology that are driving change in the flow of information and the delivery of care are occurring at such a rapid pace that the next five years will bring more change than occurred during the past 10 or 20 years.

The roles healthcare managers and executives must play also are changing - especially the roles of those in finance. Increasingly, these managers and executives are assuming broader responsibilities. They are adding value to their organizations by moving beyond simply being technical experts to becoming business advisors and strategic enterprise leaders.

In many organizations, healthcare finance professionals are responsible for many nonfinance areas - general healthcare business areas. Given these broader responsibilities, many of these individuals seek broader, more diverse professional development and information outlets. Unfortunately, the organizations that provide these services often are overly narrow in their focus.

As HFMA faces the new millennium, has the environment changed enough to require the Association to reexamine its vision, its mission...perhaps even its name?

To answer these questions, the HFMA Board of Directors has formed a Strategic Planning Committee. This committee will serve as the chief volunteer group to oversee a process that will help chart the Association's course for the next three to five years. This committee will facilitate a year-long look at the environment, HFMA's strengths and weaknesses, the changing roles of HFMA members, and the organization's potential to serve new members.

At the end of the process, the committee will recommend to the HFMA Board of Directors a new strategic direction that may include a new mission, vision, and perhaps a new name. HFMA has reached another fork in the road. And consistent with its history, the Association will take it.