IHA's History Through the Decades

For more than 90 years, IHA has helped Indiana hospitals adapt to a rapidly changing environment. The following are highlights from each decade. 90yearsquarefinal.jpg

The 1920s

In 1921, IHA was formed as a section of the American Hospital Association with 34 charter members. Dr. George Keiper, a Lafayette physician, spearheaded the initiative. Issues of the day included the need for standardized patient charts, hospital/physician and hospital/board relationships, employee training, dietetics, and fire safety.

1928:  Albert G. Hahn, business manager of Deaconess Hospital, Evansville, is elected the first president of IHA in recognition of his leadership to increase association membership and revenue. During this time, IHA adopted its first mission statement, acquired its first corporate sponsors,​ and addressed the issue of providing information to patients about their hospitalizations.

The 1930s

As the country struggled under the burden of the Great Depression, the U.S. shifted its attention toward providing relief for the poor and the elderly. In 1932, the findings of the Federal Committee on the Costs of Medical Care were published. The report raised concerns about the cost and accessibility of health care. In 1935, President Franklin Delano Roosevelt signed the Social Security Act into law. The bill provided pensions and other benefits to the elderly. However, national health insurance was omitted from the final bill. The American Medical Association strongly opposed national health insurance because they believed it would limit doctors' freedom and complicate doctor-patient relationships.

1938:  Indiana Hospital Association is incorporated under the laws of the state. Its constitution by-laws were revised to conform with the by-laws of AHA. The financial devastation of the Great Depression highlighted the need for public health insurance.

 The 1940s

The outbreak of war with Japan and Germany in 1941 presented Indiana hospitals with a new set of challenges. As the war effort demanded more resources, hospitals were required to make do with less. Hospitals all over Indiana faced shortages of food, rubber, fuel and medical instruments. One issue of Harmony asked hospitals to "Make one tool do what two used to." Hospitals also faced severe manpower shortages, as many doctors and nurses left to serve their country overseas. In 1943, the National War Labor Board declared employer contributions for health insurance "tax free." This encouraged hospitals to compete for an increasingly scarce workforce by offering health benefits. In 1944, enrollment in the Indiana Blue Cross plan began. Two years later, the passing of the Hill-Burton Act paid for the construction of hospitals across the country, especially in rural areas. It also prohibited hospitals from discriminating on the basis of race, religion, or national origin.

1944:  IHA leads the launch of Indiana’s first hospital insurance plan, Indiana Blue Cross. The late wartime era initiatives sponsored by IHA also included passages of a state hospital licensing law, as well as one to exempt non-profit hospitals from the intangibles of tax.

The 1950s

In 1949, IHA officially came out against "compulsory health insurance," a stance it would maintain as a debate over national health insurance continued throughout the 1950s. By September of 1950, Indiana led the nation in a number of resolutions against socialized medicine. With the outbreak of the Korean War, the nation's attention shifted away from health care reform. Hospitals were once again burdened with personnel shortages and were forced to ration valuable resources. Throughout the decade, enrollment in private insurance plans increased drastically. Several different approaches to national insurance made their way onto the legislative agenda, but none of them became law.

1951:  The creating of the Joint Commission on Accreditation of Hospitals makes the development of professional standards a national issue.
1958:  After a dozen years of baby boom births, hospitals’ services are in high demand. This year, the Indiana State Board of Health reported 4,399,122 patient days in the state’s hospitals, drawing interest from government.

The 1960s

By the 1960s, hospital costs had risen dramatically. In 1965, President Lyndon B. Johnson signed into law legislation creating the Medicare and Medicaid programs, providing comprehensive health care coverage for people 65 and older, as well as the poor and the disabled. A continued shortage of doctors and nurses led to federal measures to expand education in health care professions.

1960:  In response to the new environment of regulatory bureaucracy, IHA elects Elton TeKolste, a former accountant for AHA, as its first salaried president. “Tek’s” background was well suited to a focus on finance, efficiency, and productivity. Under his leadership, IHA helped develop a national rate control plan.
1961:  IHA launches statewide insurance program.
1964:   Members of Indiana Hospital Association begin the process of drafting rules and regulations that would allow hospital pharmacies in hospitals throughout the state (Feb. 1964)
1965:  Hospital reimbursement methods change dramatically with the establishment of the Medicare and Medicaid programs.
1967:  William S. Hall is appointed IHA’s general counsel in response to hospitals’ growing need for legal guidance. His firm, now Hall, Render, Killian, Heath & Lyman, continues to serve IHA and its members’ legal needs.

The 1970s

With millions more Americans insured under Medicare and Medicaid, health spending and health care costs both increased. Much like today, the cost of health care became a hot-button political issue. Facing economic government regulations, IHA worked with the American Hospital Association to fight President Gerald Ford's proposed cap Medicare payments to hospitals, believing they would force hospitals to cut services. In addition to the struggling economy, the energy crisis forced Indiana hospitals to operate with limited access to resources, such as gas.

1971:  John Render joins Bill Hall’s law firm to help with the increasing burdens of regulation and advocacy. The 1970s saw the passage of the nation’s first medical malpractice act, the launch of the Voluntary Effort to Reduce Health Costs in an era of high inflation and the purchase of IHA’s new headquarters building at 39th & Meridian streets in Indianapolis.

The 1980s

The 1980s saw a change in the landscape of the health care industry. Corporations began integrating into hospitals and other health care fields. By 1985, more than 130 business and health coalitions had formed nationwide, marking an overall shift towards the privatization of hospitals and health care. As this shift took place, new threats from infectious diseases such as AIDS also began to surface. By the end of the decade, more than 100,000 people in the U.S. had HIV/AIDS, with a 60 percent mortality rate. This new threat meant hospitals had to make unprecedented adjustments to the way they dealt with patient safety and confidentiality, staff safety, and public relations.

1983:  This year of dramatic change, the first in a long recovery from a deep recession, is the year that hospitals see the first major departure from fee-for-service medicine when Medicare introduces prospective fixed-rate payments. That move initiated a shift away from inpatient to other forms of delivery and reimbursement. For IHA in particular, 1983 marks the year it lost its president, Elton TeKolste, to a shockingly sudden death.
1984:  IHA selects Kenneth G. Stella, the administrator of Morgan County Hospital in Martinsville, as its new president. Under his leadership, the association went through many changes. In keeping with Ken’s focus on a more business-like demeanor, IHA moved its headquarters to the OneAmerica Tower in downtown Indianapolis and developed a long-term strategic plan that emphasized public policy and new collaborative relationships.

The 1990s

In the 1990s, organizations merged and consolidated more rapidly than at any other time in the nation's history up to that time. Technological advances provided hospitals with new opportunities and methods for providing quality care. President Bill Clinton made health care reform a major part of his campaign and presidency. The 1993 Clinton health plan required every U.S. citizen to enroll in a qualified health plan and allowed people under a certain income level to pay nothing. However, the plan was not enacted into law.

1990:  Reflecting the changing times and the shift into the digital era, IHA began its efforts to implement a financial data collection system. This gave IHA a more reliable way to evaluate member hospital performance and to determine the overall health of the state.
1991:  In fulfillment of its new plan goals, IHA organizes Concerned Hospital Advocates Information Network (CHAIN) to supplement its PAC, Friends of Indiana Hospitals, and opens a formal data department, expanding the existing member services of advocacy, education, and communications.
1994:  During this time period, focus of strategic planning shifts to community health status.
1996:  IHA celebrates its 75th anniversary with a new name and corporate identity that reflect its focus on partnerships: “Indiana Hospital & Health Association.”
1997:  Law enforcement declares "War on health care."

The 2000s

The 9/11 terrorist attacks changed national priorities and hospitals were placed on the backburner as attention shifted from health care legislation to homeland defense. However, with health care costs rapidly rising and the world's economy in recession, it was not long before health care again became the nation's primary focus.

2000:  The association begins to transition to establishing its presence on the Internet. A public/private website, digital documents, electronic data submission and dissemination, and email all begin the process of development.
2005:  IHHA led the charge to improve patient safety in Indiana hospitals by advocating for a medical error reporting system based on a list of 27 events that should never happen, which later became known as the 27 never events list. This initiative was a response to a 1999 report from the Institute of Medicine titled To Err is Human, which claimed that medical errors killed between 44,000 and 98,000 people each year in the U.S., suggesting that medical errors may be the eighth leading cause of death in the country.
2006:  The first of the baby boom generation turns 60. The high demand for health care services, in addition to expensive technological advancements, drives these costs as a percentage of government budgets and personal expenditures ever-upward. There is a renewed focus on patient safety and quality of care, especially as they relate to hospital reimbursement.
2006:  The Indiana Patient Safety Center is launched under the direction of IHHA.
2007:  Ken Stella retires after 23 years of leading the association. Douglas J. Leonard, IHHA’s past two-term chairman and CEO of Indiana’s Columbus Regional Hospital, is elected as the association’s new president. Leonard recognizes the need to refocus the association‘s efforts on hospital-specific issues, and IHHA once again becomes IHA, Indiana Hospital Association.

The 2010s

Decades of debate over universal health insurance and health care reform came to a head in March 2010 when President Obama signed the Affordable Care Act--the most significant overhaul of the health care system since the passage of Medicare and Medicaid--into law.

2010:  President Barack Obama succeeds in passing his signature legislation, the Patient Protection and Affordable Care Act. This act, and the Health Care and Education Reconciliation Act of 2010, comprise what is commonly referred to as “health care reform.” The implications of these new statues are complicated and far-reaching, affecting insurance, Medicaid and Medicare, among many other hospital interests.
2011:  IHA celebrates its 90th anniversary with the slogan, “Stability Through Decades of Change.” IHA continues to find strength through association in the common best interests of its members.
2012:  The U.S. Supreme Court handed down its 5-4 ruling upholding the most major provisions in the Patient Protection and Affordable Care Act, including the individual mandate that compels individuals to obtain and maintain health insurance. The Supreme Court did however strike down the ACA’s mandatory Medicaid expansion, which gives states the option to participate or opt out.
2014:  This was the year of patient safety improvements. Hospitals worked together to create new best cultures and reliable systems of care to prevent harm to patients and developed strategies and tools to reduce health care related harm. There was a large focus on the reduction of early elective deliveries and pressure ulcers. This was also the year when Ebola became a frontline issue in health. Indiana hospitals prepared for this epidemic to make sure that no Hoosiers would go untreated.
2015:  This was a big year for health care and IHA. On January 27, 2015, the Healthy Indiana Plan was expanded through the approval of the HIP 2.0 waiver. Since then, HIP has grown to serve more than 356,000 Hoosiers and the number is only expected to increase in the years to come. Harmony was combined with the trustee magazine to give our members a single platform for information. This was also the last year the IHA team spent in the OneAmerican Tower after 30 years in their office space.
2016:  IHA begins its first year in its new office at 500 N. Meridian in Indianapolis, IN.