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AHA Health Care Transformation Fellowship Application

Thank you for applying for the AHA Health Care Transformation Fellowship. Please be sure you have the following information on hand to complete the application process:
- Resume or curriculum vitae
- Letter of organizational support
- Individual photo
- Project proposal
- Organizational information.
Applicants need to fill out the application in its entirety. You will not be able to save and return to the semi-completed application at another time.

If you have questions or need assistance, please email HCTfellowship@aha.org or call (877) 243-0027.
Demographic/Contact Information

*First Name:

*Last Name:

Title:

Organization Name:

Organization Address:

City:

State:

Zip:

Phone:

Fax:

*Email:

Assistant Name:

Assistant Phone:

Assistant Email:

Organization Information

What is the percent of employed versus affiliated/non-employed physicians in your hospital or care system?

On a scale of 1 (low) to 10 (high), please assess your organization's abilities on the following items:

Clinical integration

Risk management

Population health management

Health information technology integration

Project Proposal
Please submit a 250-word proposal describing how your project will support payment or care delivery model transformation at your organization. Think strategically and align your project with your current role or organization’s existing initiatives. Make sure your project has clear objectives, a way to measure progress and is something that you can realistically achieve during the 9-month fellowship. Please include the following items.
1. Describe your organization’s overall initiative (e.g. pursue clinical integration, bundled payment arrangement, population health management).
2. What are you specific goals for the fellowship project? What will you accomplish over the course of the fellowship? How does your project align with organizational goals?
Examples from previous fellowship classes include:
- Developing a perioperative surgical home
- Creating a comprehensive population health management strategy
- Developing a structure for clinical integration
Please note: It is understood that all projects are works in progress, but should have realistic goals and include actionable measures, milestones and objectives to be completed by the end of the fellowship program. Projects may undergo modification to ensure they fully meet program objectives.
Application Material

Total file upload size must be less than 7 MB. If your files are larger, please email them directly to HCTfellowship@aha.org with your name and the subject line: HCT Fellowship Attachments

Please attach the following information below:
- Resume or curriculum vitae
- Letter of organizational support
- Individual photo
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Recaptcha:

This system will not allow you to save or make changes once this form is submitted. You will receive email notification shortly that your application was received. Thank you for your interest in the AHA Health Care Transformation Fellowship.

Hospitals in pursuit of excellence

AHA Health Care Transformation Fellowship Application

Demographic/Contact Information

Organization Information

Project Proposal

Application Material