In the midst of this uncertainty, a few things are clear. Over the next few decades, the typical hospital patient will be older and will have multiple chronic medical conditions. At least in the near term, our members will see more patients who have put their healthcare on the back burner because of the economic recession.
And while we as a nation strive for consensus on how to address our very real budget problems, patients will continue to look for the care they need at a cost they can afford.
We can wring our hands or, preferably, we can roll up our sleeves and harness the strengths we have as the world's best patient-care providers while we reinvent ourselves as a true system, oriented toward health.
The first challenge for hospitals is counterintuitive: We want to keep patients, especially those with multiple chronic medical conditions, out of the hospital by making it easier for them to remain healthy.
A small percentage of patients, many of whom are uninsured and underinsured, represent a very high percentage of hospital costs. Helping these patients to improve their own health through collaborative approaches and good records practices can vastly improve the quality of their lives, and many hospitals are coordinating these kinds of efforts.
Other organizations are actively sharing comparative data to encourage practitioners to adhere to evidence-based management and therapies and are also stepping up their leadership of community-based health interventions.
We can't keep everyone out of the hospital, of course, but we can learn from hospitals that have simultaneously reduced utilization, cut costs and improved care and who have partnered with payers and purchasers to soften the changes in revenue.
Some are borrowing lessons from manufacturing to provide better care at lower cost and make optimal use of their staff and facilities. They now share the savings with purchasers and payers, progressing toward a system of accountable care while effectively managing system capacity.