One of the blessings-and curses-of being a healthcare executive in the last half of the 20th century has been a lack of boredom.
From the postwar construction boom to Medicare to managed care, the times have been interesting. And in 1998, they stand to get even more intriguing as some trends of recent years are altered.
We asked our reporters to take a look at the new year and what it may hold. Their collective advice can be summed up this way: Don't get comfortable. Several major shifts in the status quo became visible in 1997. They likely will change the perceptions and behavior of providers, payers, consumers and government officials.
For example, one of the most prominent events of the past year was the unraveling of Columbia/HCA Healthcare Corp. As Columbia is whittled down in a restructuring, the not-for-profit hospital sector and other for-profit companies are expected to pick up the slack in mergers and acquisitions.
While most hospitals have enjoyed healthy balance sheets, they will face restricted Medicare payment growth and other pressures. They may have to turn to creative financing techniques to maintain fiscal strength.
The managed-care industry, as exemplified by Oxford Health Plans and PacifiCare Health Systems, faces troubled times. Managed care has squeezed out most of the easy cost reduction in healthcare. Now plans are caught between higher medical costs and competitive prices. Payers, in turn, will have to cope with rising premiums.
For these and a variety of other reasons outlined by our staff on the following pages, 1998 promises to be a year in which the rules of the game will be rewritten. The year may be fulfilling, frightening or frustrating, but it certainly will not be dull.