Noblis highlights 15 trends in provider healthcare delivery for 2008
During 2008, healthcare providers will continue to face mounting pressures from multiple fronts, including thin operating margins; physician recruitment challenges; decreased access to capital; increased competition; rising medical costs; and the growing number of uninsured, according to Noblis, a nonprofit strategy, technology and decision sciences organization.

The Noblis Center for Health Innovation projects that healthcare providers will need to adapt to the continuously changing and challenging healthcare environment by addressing the issues directly, while continuing to focus on improving quality of care, customer service and provider effectiveness.

The Noblis Center for Health Innovation has highlighted 15 significant issues impacting provider healthcare delivery this year:

1. The next wave of payment pressures: The increasing utilization and costs of healthcare cannot and will not be sustained over the long-term. Government, business and primary payers have begun initiating reforms to pay for services based on value. To reign in healthcare spending will present challenges for many providers with already thin margins.

2. Re-emergence of the ambulatory care imperative: In 2008, there will be noticeable changes in the trend lines for the use of expensive inpatient hospital care and, as a result, the ambulatory care arena will again become a large growth market to healthcare providers.

3. Consolidation within the hospital industry will accelerate: As economic pressures force stronger systems to acquire vulnerable organizations to solidify market position, some hospital closures may occur. Other merged entities will streamline service lines, improve operations and reduce cost.

4. Popularity of medical tourism will continue to grow: More U.S. healthcare organizations are opening offshore hospitals to compete and capture this market segment, resulting in the need to address issues related to patient confidentiality and global availability of patient data.

5. Individual states will continue to pick up the mantle of health reform: Although healthcare will be the major domestic issue in the next presidential election, actual healthcare reform in 2008 will be most evident at the state level rather than nationally.

6. Access to capital will become more strained and expensive: The overall condition of the capital markets will change access to capital for even established organizations. Providers will have to make serious choices about what functions and programs they are able to fund over others.

7. Increased scrutiny on the tax-exempt status of hospitals and health systems: It will force organizations to better document, and in some situations, to increase levels of charity care and community benefit.

8. The need to redefine relationships with physicians – partner, competitor or employee: Like hospitals, physician groups are more concerned with future costs, and proposed Medicare payment reductions in 2008 will only increase their incentive to compete in the ambulatory care market.

9. Physician employment by hospitals will increase: The trend will persist as physicians question the economic viability of the private practice model. More physician activity will be split into an inpatient medicine component and an office-based practice component.

10. No payment for mistakes: Hospitals will stop receiving payment for “never events,” requiring them to continue existing efforts aimed at improving the quality of care and eliminating “never events.”

11. Healthcare facility investments will continue: High population growth areas will experience an increase in the building of new facilities, while low growth areas will concentrate on upgrading existing facilities.

12. Construction of free-standing specialty hospitals will reach a tipping point: This is due to their limited ability to serve complex patients and public scrutiny. Yet, specialty boutiques within hospitals will flourish.

13. Organizations of all types will increasingly establish institutional-centric health-related web portals: For internal and external purposes, these portals will be designed so that they provide support for the individual organizations and consider integration with the community.

14. Community and regional data sharing organizations will continue to struggle: The ultimate goal of a National Health Information Network appears unlikely by the target of 2014. There are a handful of successful organizations, but defining sustainable business models and governance issues remain difficult challenges, even as technology is progressing.  Failed attempts will cause new models to emerge.

15. Operational strains and the continued fast pace of change in healthcare delivery will place significant stress on the workforce: The impact on employee morale, coupled with a reduction in available employees will cause hospitals and other healthcare providers to redouble efforts relative to managing organizational change, building stronger internal cultures and attracting and retaining top-notch healthcare workers.