Last week, while attending Modern Healthcare's Women Leaders in Healthcare Conference in Nashville, I had the opportunity to discuss recent healthcare spending trends with the executives in attendance, as well as with some of the top leaders of the nation's for-profit hospital chains, which cluster around Music City.
When asked for their analysis of the slowdown—overall healthcare costs have increased no faster than the rest of the economy the past three years—those officials offered similar reasons and usually in the same order. First, the lingering anxieties from the Great Recession are still leading many people to eliminate discretionary healthcare spending from their household budgets.
Second, employers' accelerating shift to high-deductible and high-copayment insurance plans are forcing healthcare consumers to be more cost-conscious because they are spending more of their own money. Third, there has been a structural shift in the locus of healthcare delivery with more being delivered in outpatient settings and less in more expensive hospital settings.
Finally, and this is often said with a shrug, the delivery system reforms encouraged by the Patient Protection and Affordable Care Act and the increasing emphasis on quality and safety are starting to have an impact on overall costs. Suffice it to say that there is a high degree of skepticism about that latter claim.