Transcript Governmental Relations Update and Strategies

The Health Care Environment
Now and in the Future
Hospital Name
Date, 2012
Name
When asked what made him a great
hockey player, Wayne Gretsky observed:
“I skate to where the puck is
going to be,
not where it has been.”
Hospitals anticipate changes, predict their
impacts and adapt appropriately.
2
Hospital and health system leaders
are working to manage
complex institutions and
professional relationships
in a time of multiple changes
with great turbulence
and limited resources.
Introduction
• The Health Alliance of Mid America
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–
•
•
•
•
On behalf of MHA and KHA
Environmental Assessment: addresses
selected issues and challenges facing
hospitals and health systems across the
country and in Kansas
KHA and MHA member polling
Final Written Report
Tools for Hospitals
Targeted Communication to the Public
• The best outcome is achieved by
thoughtful consideration and the
recognition that good leadership beats
good plans every time.
• Good hospital leadership requires a
knowledge of:
–
the community,
–
the clinical staff, and
–
developing trends and issues.
Trends and Issues
• 6 areas with an uncertain timeline or
outcome
• 9 areas where trends are already
underway
Major but Uncertain Trends
1. The election outcome
2. Supreme Court’s decision that health
reform is constitutional and
Medicaid expansion is optional
3. Insurer responses to Supreme Court
decision
4. Entitlement reform
5. Balance of conflicting societal values
6. Recalculating prospective payment
Major but Uncertain Trends
1.
The election outcome

Political conflict reflects a divided public.

Small numbers of elected officials can have major
impact.
2.
Outcome of the Supreme Court’s decision
3.
Insurer response to Supreme Court decision

How will insurers respond to insurance
exchanges?
Major but Uncertain Trends
4.
Entitlement reform

Federal spending is financed 60% by taxes and
40% by loans

Entitlements are 60% of total tax revenues
5.
Balance of conflicting societal values
6.
Recalculating prospective payment

More accurate information will lead to increases
or decreases in PPS revenue
Trends Already Underway
1. State of the economy
2. Population changes
3. Slow workforce growth
4. Government debt
5. Consolidation
6. Increasing electronic information
7. Integration/coordination across silos
8. Increasing performance information
9. Increased financial risk shifting to
providers
Trends Already Underway
1.
State of the economy

Uncertain

Spending cuts likely
2.
Population changes: aging

3.
More Medicare patients increase entitlement spending
Slow workforce growth

4.
From 2% to 0.1%
Government debt:

The Catch 22s
–
Reducing taxes or cutting spending both increase the risk
of recession
–
Low interest rates undermine financial market discipline
Trends Already Underway
5.
Consolidation

Of both caregivers and institutions

Consolidations change both cultures
6.
Increasing electronic information

7.
Integration/coordination across silos

8.
coordination of care
Increasing performance information

9.
What does “all health care is local” mean when
patient information is digital?
Publicly visible and always dated
Increased financial risk shifting to providers
Final Thoughts
• Health care change is obvious, as episodic,
acute care provided in uncoordinated silos
is overtaken by longitudinal, chronic care in
a coordinated or integrated health system.
• While hospitals need to adapt to this
change, episodic, acute care is not going to
disappear.
• The challenge to hospitals is not to move
from one paradigm to another; it is to be
effective in both paradigms simultaneously.
Final Thoughts
 As the financial risk faced by
providers and practitioners increases,
and as some variety of “bundled
payments” advances, hospitals need to
assess the scale necessary to prosper.
 Scale includes the geographic reach,
scope and volume of services, and
internal staff capabilities.
Final Thoughts
• Change is the order of the day for all of
the components in the health care
system.
• Each hospital needs to determine if its
board and staff have the
entrepreneurial orientation necessary to
rapidly adapt to a changing
environment.
The Bottom Lines
• The best outcome is achieved by
thoughtful consideration and the
recognition that good leadership beats
good plans every time.
• Good hospital leadership requires a
knowledge of:
–
the community,
–
the clinical staff, and
–
developing trends and issues.
Questions
Contact Information