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For Strategists: 15 Key Factors Affecting Hospitals' Longer-Term Outlook

"Never make predictions, especially about the future." (Casey Stengel)

From Becker's Hospital Review, here's 15 Key Factors Affecting Hospitals' Longer-Term Outlook. (The parenthetical comments are mine.)
  • Promise fades for more paying patients. (You were expecting otherwise?)
  • Reimbursements lag further behind inflation. (Ditto.)
  • Number of paying patients in long-term decline. (Mega Ditto.)
  • Overcapacity of beds in some areas. ("But ours are shiny and new!")
  • Negotiating strength moves to insurers. (BOHICA)
  • Insurers may not need to be tough negotiators. (Yeah, but it's a tough habit to break.)
  • Patients continue shifting to high-deductible plans. (Get ready for "What's your price for an EKG?")
  • Hospitals forced to become more efficient. (As competition transitions to price and value.)
  • Payors move to bundled reimbursements. (Allocating the bundle among hospitals and physicians is, of course, the sticky wicket.)
  • Providers coalesce into integrated systems. (Deals hastily assembled by CEOs and painstakingly taken apart by attorneys.)
  • Physicians fall in with hospitals. (Sleeping with the enemy looks better than sleeping with the fishes.)
  • Small hospitals seek shelter with larger ones. (Small hospital CEOs: Be careful what you wish for.)
  • Capital needed for IT introductions. (Needed even more: a business case.)
  • Non-profits' debts stay comparatively small. (Compared to what?)
  • Discounts for construction become available. (Until the next bubble.)
So what's a strategist to do with a list like this? Lists abound and it's certainly possible to take issue with or refine each prediction. Still, when the arguments abate and in the spirit of "it's better to be roughly right than precisely wrong" smart planners use such forecasts to spark scenario-based discussions with leadership teams.

What if...? Why not...?

What if...the authors are right and small hospitals seek shelter with larger ones? Why not...offer smaller hospitals value-added services to improve their prospects while preserving their independence? Can we spread our overhead by offering our high-priced skills and talent to smaller hospitals on an as-needed basis?

And in the spirit of "We're not alone. These trends affect us and our competitors more or less equally." it's important to remember that the winners are those organizations responding most flexibly and aggressively. THAT'S a forecast not open to debate.

Time to thrive. Let me know if you agree.


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