While nothing can match the drama of last year's presidential election, 2001 still promises to be eventful for not-for-profit healthcare systems.
Some of the potential hot-button issues:
* The National Conference of Catholic Bishops may revise the church's rules governing some partnerships between Catholic and non-Catholic hospitals.
* Consolidation activity by not-for-profit healthcare systems will continue at a pace much slower than the industry experienced in the late 1990s.
* And contentious labor organizing and contract bargaining at some hospitals -- both for-profit and not-for-profit -- will continue, as will the militant activities of some unions.
Let's take these issues one at a time.
For Roman Catholic hospitals, the first half of this year will be a period of waiting and watching, says the Rev. Dennis Brodeur, senior vice president of stewardship at SSM Health Care, St. Louis.
What hospitals are waiting to see is what action the bishops will take on a proposal to revise the Ethical and Religious Directives for Catholic Health Care Services when they meet in June in Atlanta.
The proposed revisions are aimed at those partnership deals between Catholic and non-Catholic providers where special business arrangements are made so the non-Catholic partner can continue providing contraceptive sterilizations, such as elective tubal ligations, without the Catholic partner running afoul of church rules. Contraceptive sterilizations are prohibited by the Catholic Church.
Talk about the revisions was prompted by concern from the Vatican that church rules were being misapplied in some partnerships where the Catholic partner was not sufficiently distanced from the provision of services prohibited by the church.
The most recent text of the proposed revisions the bishops are considering calls for partnership deals that involve such services to undergo moral analysis using reliable theological experts. The proposal reminds providers that Catholic partners "should avoid entering into partnerships that would involve them in cooperation with the wrongdoing of other providers."
Catholic healthcare leaders are striving to inform the bishops about "the realities of the Catholic health ministries in the United States today," says Diana Bader, senior vice president of mission and ministry at Catholic Health Initiatives, Denver.
That, Bader says, includes talking about Catholic providers' need to collaborate with partners, including non-Catholic ones, in today's healthcare environment.
Because it's unclear how the bishops may revise the rules, it will make potential not-for-profit partners "slower (and) much more cautious" when it comes to doing deals with Catholic hospitals, Brodeur says.
A second issue regarding the not-for-profits revolves around consolidation.
Gone are the days of rapid consolidation, says Stephen Monroe, a partner at Irving Levin Associates, a New Canaan, Conn.-based firm that tracks merger and acquisition activity in the healthcare industry.
Monroe says that while a number of not-for-profit systems and hospitals have merged in recent years, "no one's really proved that mergers have been beneficial."
A third issue facing all hospitals -- regardless of ownership status -- is ever-increasing contentious labor negotiations and union organizing.
That's not likely to let up, especially as some of the more militant unions wage war against what they see as the corporatization of healthcare at the expense of patient care.