After the Advisory Board Company's 2015 CEO Special Sessions meeting, the organization outlined top concerns and items of importance for hospital and health system CEOs.
Here is a list of 10 things every healthcare CEO needs to know this year.
1. Medicare has a clear path to risk-based payment. Over half of a typical hospital's patient intake will be Medicare beneficiaries in the next five years. Because Medicare has become the biggest payer in healthcare, its payment models will be bound to change.
2. A population health strategy is necessary. A population health business model is no longer an optional facet for health systems. But the business model can't just involve Medicare. Health systems have to find ways into a commercial market, whether through an owned health plan or a partnership with a payer.
3. Consumer-driven healthcare is here to stay. With many patients paying higher deductibles, they want more control over their care. As consumers increasingly demand more decision-making capabilities, providers must cater to their needs.
4. Loyalty is the key to defining success. Due to patients' increasing financial obligations, they have begun to search for where they can get the best deal for their healthcare. To ensure patients return to a hospital for future care needs, systems must prioritize fulfilling the expectations and desires that contribute to patient loyalty.
5. Consumers want answers to day-to-day problems. Although health systems effectively solve acute care problems, patients also want care for other real-world problems, such as quitting smoking. To appeal to consumers, health systems must begin to offer such solutions and services.
6. Numerous commercial payers would rather "unbundle" the health system. Rather than using a single health system for healthcare, many employers prefer sending their employees to the highest-value providers at the point of care. By utilizing other methods of care, health systems are finding new approaches to manage costs.
7. The marketplace is becoming increasingly skeptical. Being a large health system in the Medicare ACO program is no longer enough. Purchasers are dubious of health systems' ability to provide value.
8. Hospitals can differentiate themselves with a coordinated, integrated care model. Many narrowly focused start-ups are sprouting up across the country. Because their prices are transparent, they're often preferred by consumers. But health systems have advantages the start-ups lack, such as access to comprehensive clinical service and care coordination. Health systems should use these assets to distinguish themselves.
9. Marketplace value concerns more than operational advantage. Today's market is dominated by consumerism and consumers are demanding a better population health model. To effectively respond to these demands, hospitals make decisions about standardizing quality, consolidating services and scaling back capacity.
10. The most successful health systems have four traits of "systemness." Thriving hospitals and health systems vary in size, payer mix and geographical location. But they share four hallmark qualities, according to the Advisory Board Company:
- Defined governance doing the right things at the right level
- Distinctive roles and responsibilities for key stakeholders
- Structures that support goals and don't encourage counterproductive behavior
- Utilize a free flow of information — including data, knowledge and experience — that enables smarter action