Considerations that may be underappreciated by U.S. health system CEOs: A baker's dozen
pressures on inpatient demand are sustaining. Inpatient demand is
“morphing” to outpatient service demand. Is your health system’s strategy
designed to “re-capture” the shift?
systems are not likely to have internalized the operating competencies
required for the road ahead; especially competencies that are more “public
health practice” in nature; e.g. total cost of care evaluations,
epidemiology of populations, the
science of health behavior interventions, interprofessional team care and
looking for private practice investment opportunities are a dying breed.
movement of U.S. accounting methods closer to international standards will
favor applications of alternative financing methods; especially facilities. Alternative
financing models will provide for enhanced strategy flexibilities.
- Third party reimbursement methods will
be an “experimental science” for years to come. The system’s financial
structure must accommodate multiple payment options, including payments for
- Operative physician compensation models
may not square well with the need to deliver care from interprofessional,
collaborative teams. Health systems will need to re-define “compensable
- There are no published best practices on
interprofessional team care. Models are idiosyncratic and often driven by
philosophies and goals that misalign internal incentives.
- Hard asset capital structures have not
advanced as fast as care models; e.g. 60% clinical care delivery in the
outpatient arenas with 70% of hard asset investments on the inpatient side.
- Most I.T. platforms cannot readily
recognize, evaluate and report total costs of care for defined clinical
populations, nor are they geared to evaluate the performance of care teams over
- Care manufacturing and delivery models
rarely consider scalability at the point of service. “Scalability” is typically
a consideration for “corporate services” support only.
- “Speed to market” will become an increasingly
important factor in strategy; especially ambulatory care services.
- Collections of “doctor deals” won’t
serve health systems well into the future; well-organized, well-led and
well-incented professional services platforms are required.
- Physician leadership is an
under-developed asset for many health systems.