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    Council of Academic Health System Executives (CAHSE): Frequently Asked Questions

    Last Updated: December 01, 2023

    The following provides an overview and answers to frequently asked questions about the AAMC’s new Council of Academic Health System Executives (CAHSE), which will officially launch on July 1, 2024. The new council will replace the Council of Teaching Hospitals and Health Systems (COTH). The AAMC Board of Directors and AAMC Assembly approved the change in September and November 2023, respectively. As noted below, all current COTH members will be eligible to remain in CAHSE.

    Moving from COTH to CAHSE

    What change will occur?

    Effective July 1, 2024, COTH will become CAHSE. CAHSE is the AAMC’s membership council for academic health systems (AHSs) and teaching hospitals (THs). As was the case for COTH, CAHSE will be led by an elected Administrative Board, and its chair and chair-elect will have seats on the AAMC Board of Directors. The chair and chair-elect will bring their experiences as CAHSE members in AAMC Board discussions and keep the Board updated on all CAHSE activities.

    What can I expect from CAHSE? What does this mean for COTH?

    Through CAHSE, the AAMC will continue to offer membership for academic health systems and teaching hospitals. It will also enable the AAMC to shift how we serve the rapidly evolving needs of executive leaders at these institutions. All member benefits will remain in place—and they will better reflect the demands placed on today’s executives.

    CAHSE will focus on the unique challenges faced by system-level leaders who oversee the highly complex clinical enterprises that improve health care outcomes while supporting medical education, research, and community collaboration. While you can expect to see CAHSE use new ways to engage these leaders, the AAMC will also continue to offer the same core tools and resources you and your teams need to succeed. The AAMC remains a premier source for operational, financial, quality, and other benchmarking data and reports. We are a united and respected voice for academic medicine. We offer the professional networking and development groups your teams rely upon—from late-breaking news and information to specialized listservs, webinars, and national meetings. And we will mobilize around the topics of greatest importance to you.

    Why is the AAMC making this change?

    Establishing CAHSE will enable the AAMC and our members to keep pace with the significant transformation of health care delivery systems in academic medicine, which have evolved from 2 © 2023 Association of American Medical Colleges traditional THs to highly integrated and diversified AHSs that comprise multiple inpatient and outpatient locations throughout large regions, including multiple hospitals (some with formal residency programs and some without) and physician practices. Many also have accountable care organizations and other delivery/payment models, provide post-acute care and other community-based services, run their own major health plans, and more.

    Which institutions are eligible for CAHSE membership?

    AAMC Academic Health System membership will be available to health care delivery systems and their affiliated THs, as well as independent THs, located within the United States that advance the missions of medical education, research, community collaboration, and other activities that are vital to academic medicine. CAHSE participation will be open to the chief executives (and other individuals with comparable executive-level leadership roles) at these member AHSs and THs. Because AHSs and THs may have several individuals serving in these executive leadership roles, we will not limit the number of CAHSE participants to only one representative from each institution.

    Why change the current COTH structure?

    The purpose and objective in replacing COTH with CAHSE is to:

    • Recognize the monumental shift that has occurred in the structure of health care delivery over the last 60 years and acknowledge AAMC’s commitment to supporting the clinical care delivery mission of academic health care.
    • Provide an institutional membership option that best reflects and serves the current needs and structures of AHS and individual teaching hospitals.
    • Serve as the centralized go-to resource for AHS and teaching hospital executives on matters related to their organizations’ unique missions, roles, and partnerships. This will include improvements in the ways we engage and serve these leaders and their teams.
    • Encourage greater (not restricted) participation by the leaders who oversee and run AHSs. This includes expanding the types of leaders who can serve on the CAHSE administrative board to include AHS leaders who were previously not eligible, other than Federal or corresponding member representatives. The Chair and Chair-elect of the administrative board will also serve on the AAMC Board of Directors. Teaching hospital leaders who were eligible to serve under COTH will remain eligible under CAHSE.

    Who will participate in CAHSE?

    The AAMC recognizes that an AHS might have several individuals serving in senior executive roles—whereas in the past those roles were the responsibility of a single person. With that in mind, the AAMC will expand (not limit) the types of senior executives who participate in CAHSE.

    • AHS members with multiple individuals who share comparable executive leadership roles across the enterprise have the option of designating several members to participate in the 3 © 2023 Association of American Medical Colleges new Council. For example, a university’s AHS might have their health system chancellor, health system leader, and the leaders of their affiliated teaching hospital members participate in the CAHSE council.
    • Similarly, individual TH members with more than one person in a chief executive role can designate more than one CAHSE council participant.
    • The AAMC’s Federal members (such as VA medical centers and the NIH Clinical Center) are also vital to the future of academic medicine, given their unique clinical care, education, and research programs. We continue to welcome their directors and other executive leaders as CAHSE members so they can add their critical perspectives.
    • We will continue to offer Corresponding Memberships for teaching hospitals and other institutions that are not eligible for other types of AHS and TH membership. Their executive leaders will be able to participate in CAHSE, as well.

    What CAHSE Means for Alliance Membership

    What does this mean for my Alliance membership?

    Alliance members who have executive leadership responsibilities for the clinical care enterprise at an AAMC-member AHS or TH are invited and encouraged to participate in CAHSE. They will be able to access CAHSE member benefits, resources, and services previously limited to COTH members. In addition, these senior leaders will become eligible to serve on the new CAHSE Administrative Board, AAMC Board of Directors, and in other governance roles.

    Alliance members who do not lead clinical care delivery systems will be able to continue to participate in the Alliance and, if appropriate for that individual, the AAMC Council of Deans (COD).

    The AAMC remains committed to the integration of the Alliance, and we will continue to work with the Alliance Steering Committee over time. The move to CAHSE is one important step.

    What does this mean for my AAHCI membership?

    AAHCI membership currently is separate from Alliance membership and will remain so in this new membership category.

    What does this mean for my VA or NIH membership?

    As noted above (see “What does this mean for my COTH membership?”), VA members will continue to be welcome as CAHSE members. This recognizes the fact that VA medical centers are part of larger, well-established academic health systems (VISNs) that have UME and GME affiliation agreements, active bench and clinical research programs, and comprehensive patient services, including innovative care often unavailable elsewhere in their communities. In accordance with federal budget policies and practices, the AAMC and VA will continue to negotiate multi-year agreements for annual federal membership dues.

    Similarly, NIH clinical care centers may continue to participate as members in CAHSE, under agreed-upon conditions.

    Membership Dues and Benefits

    How will this affect my membership dues?

    Teaching hospital and health system members will continue to pay AAMC membership dues. The formation of CAHSE will not result in a change to the current dues structure. Starting in FY 2025, Alliance organizations with an AAMC membership (either through CAHSE or COD) will not pay separate Alliance membership dues.

    How will this affect my membership benefits?

    This change will strengthen the value of your AAMC membership (see newly created Values and Membership Benefits linked below):

    • Better Serve the Changing Needs Academic Health Systems and Their Leaders
      • Provide a membership option that better reflects and serves the current (and everevolving) structures and needs of AHSs and individual teaching hospitals.
      • Offer a centralized go-to resource for AHS and teaching hospital executives on matters related to their organizations’ unique missions, roles, and partnerships.
      • Make membership available to the diversity of health systems and teaching hospitals that support the missions of academic medicine—including a Corresponding Membership for institutions that are not eligible for other types of membership, but still fulfill an important role.
      • Reimagine how we convene and engage AHS and teaching hospital leaders, including the development of more efficient, rich, and targeted programming and services.
    • Further Elevate the Voice and Influence of Academic Health Systems and Their Leaders
      • Further enhance the breadth, reputation, and influence of the AAMC by engaging a wider range of organizations who actively support the missions of academic medicine.
      • Encourage greater (not restricted) participation by the influential senior leaders who oversee and run CAHSE institutions.
      • Enhance the ability to speak and engage as a collective voice, whether we are speaking to our communities or national policymakers.
    • Expand Access to Member Benefits
      • COTH and Alliance member benefits will be combined and made available to all CAHSE members. All CAHSE members will be able to access the same advocacy resources, data and reports, AAMC affinity groups, leadership development opportunities, etc.
      • CAHSE members will be able to work with the CAHSE Administrative Board and AAMC staff to identify potential new offerings that will help sustain the missions of academic medicine in a rapidly changing (and challenging) environment.
      • CAHSE will continue to partner with COD and AAHCI in exploring and tackling the new challenges facing academic medicine through shared programming and other collaborations.
      • A more extensive list of CAHSE member benefits is available.

    Timelines, Next Steps, and Providing Feedback

    When will these changes take effect?

    The new Council will become effective on July 1, 2024, which is the start of the AAMC’s next fiscal year.

    What happens next?

    Now that CAHSE has been approved by the AAMC Board of Directors and the Assembly, a core team of AAMC staff is working to prepare for the launch of the new council in July 2024. Current COTH members should see no interruption in their access to member benefits during the current membership year (July 1, 2023 – June 30, 2024). They will be receiving more information about converting their membership to CAHSE in advance of the new membership year. Our expectation is that the process will require minimal action on the part of current COTH members.

    How can I provide input on the changes underway?

    You can share your thoughts and questions by email at NewAAMCCouncil@aamc.org.

    We will update these FAQs periodically in response to our continued process and your input.

    Download the FAQs (PDF)