8 Key Issues for Hospitals and Health Systems — 2013

This article explores eight of the most challenging and interesting issues that hospital leaders are facing as they move into 2013. It is written within the context of health care consolidation that is occurring at all levels.

At the hospital level, hospitals are merging into other hospitals and independent hospitals are finding it more challenging to thrive on their own. At the hospital–physician level, the system has shifted toward one in which nearly 50 percent of all physicians are employed by hospitals and health systems, and nearly 80 percent of all physicians have some sort of financial relationship with hospitals. There is also increased consolidation among payors (although a great deal of this consolidation has already happened over the last 10 years). This has resulted in only several key payors existing in most markets. Finally, payors are increasingly re-entering the healthcare provider business, either as a hedge against provider market power in certain markets or in an effort to attempt investment in areas outside of insurance.

The eight issues are:

• Physician alignment
  • Other physician financial relationships
  • Decreasing technical fees
  • Hospital-owned practices
  • Physician shortages
  • Physician referrals/leakage
• Sustainability of independent hospitals
• ACOs
• Physician leadership burnout
• CEO concerns, per ACHE study
• Orthopedics
• Population health
• Information technology