Hospitals and healthcare systems faced an Ebola crisis, a rise in competition from retail clinics and urgent care centers, and millions of newly insured patients as a result of the Affordable Care Act in 2014. Organizations will continue to deal with those challenges in 2015, but other trends are emerging as well. FierceHealthcare asked hospital chief executive officers their predictions for challenges and focus areas they'll experience this year.
Here's a snapshot of what they say their colleagues should watch out for in 2015:
Greater hospital-physician integration: Raymond Hino, CEO of the California-based Palm Drive Health Care Foundation and a member of Fierce's editoral advisory board, expects to see a re-emergence of physician provider involvement, with a new generation of physician leaders in hospitals and health systems helping to drive healthcare in the United States
Hospitals and providers will continue to develop models of integrated organizational design, in which both will participate in shared savings, shared risk and shared gain, says Hino, pictured left.
"These new models of shared risk and reward will motivate many physicians to reverse the trend of employment in large medical groups and hospitals, and to partner with hospitals to create centers of excellence in which the physician providers themselves will have a seat at the table and a say in the design of new programs and services," he says. These new organizations will be patient-centric and physician led.
Continued shift to value-based care delivery: Nicholas Tejeda, pictured right, CEO of Doctors Hospital of Manteca (Calif.), a 73-bed facility affiliated with the Tenet Healthcare Corporation, expects to see an ongoing shift of reimbursement from fee-for-service to fee-for-value, pushing more risk to providers.
To stay on top of the trend, he suggests leaders consider questions such as, "What clinical services, organizational structure, operational competencies and external relationships are necessary to thrive in this environment?"
Barry Ronan, president and CEO of Western Maryland Health System, agrees that value-based care delivery will continue to gain momentum throughout the rest of the country. His organization was one of 10 hospitals in Maryland to take part in a demonstration project that focused total patient revenue on value-based care. The state is rolling out a similar program focused on global budget revenue to the remaining Maryland hospitals. In the meantime, the 10 original hospitals involved in the pilot have formed a collaborative.
Although the shift wasn't easy, Ronan, says he couldn't imagine the system returning to the old fee-for service environment. In a post on his blog, The Ronan Report, he notes that the system has exceeded its net revenue over expense for two consecutive years, which has enabled the organization to re-invest savings into programs and services that support the new care delivery model.
Consolidation with former competitors: Mergers and acquisitions aren't necessarily the only way to survive. Ronan, pictured left, says his organization has had great success consolidating some of its high-cost services through its Trivergent Health Alliance with Frederick Memorial Hospital and Meritus Health, all while remaining independent entities.
The organization has consolidated pharmacy, information technology and laboratory services. The alliance estimates by its third year it will save $20 million--a figure that West Maryland Health System could not achieve as a stand-alone health system, according to Ronan.
"It's very challenging for small-to medium-sized independent health systems and hospitals to continue to go it alone," he says. "I'm hearing more and more interest in strategic regional organizations and alliances, and I expect a greater momentum during 2015."