Claudia Gourdon, chief marketing officer and senior vice president of business development at Healthcare Finance Group, has been involved in the finance industry for about 35 years.
She's seen the healthcare system change during her career, which has included stints in investment banking, corporate banking and specialty lending. Here, she gives three observations she thinks will define healthcare finance in 2014.
1. Consolidation will remain prevalent among all healthcare providers. Much of the merger and acquisition chatter within healthcare focuses on hospitals and health systems. It's not surprising, as hospitals typically are the largest facilities within a given community.
However, consolidation is also accelerating among post-acute providers. For example, Louisville, Ky.-based Kindred Healthcare has acquired almost 20 different sites of care in the past two years, including long-term acute-care hospitals, inpatient rehab units and other post-acute providers.
"Originally, I think people were focusing on the consolidation trend among hospitals. That remains true," Ms. Gourdon says. "But that has expanded to include skilled nursing, home health, hospice and the other main provider segments. And the overall trend is accelerating."
2. High inpatient utilization may never return. In November, Citi Research analysts found that only 5 percent of hospitals reported year-over-year growth in their overall admissions — the weakest level of growth in more than a decade. Ms. Gourdon believes the age of high admissions has simply passed.
"You're not going to have the kind of utilization you had before. Hospitals lower costs in the outpatient setting," Ms. Gourdon says.
Some within healthcare have said the industry is "overbedded," and a surplus of beds combined with declining inpatient utilization means one basic conclusion. "I think the first wave is going to be shutting programs or repurposing parts of a hospital," Ms. Gourdon says. "If [executives] can rent or lease out part of a hospital so you get hospital within a hospital, or an outpatient facility within what used to be a hospital, that'll be the first step."
"If that doesn't work well, they will consolidate buildings and sell off excess capacity," she adds. "It's a continuation of what's already happening, but it will continue with accelerated energy."
3. Consumerism is reshaping healthcare. Employers and providers have fought the rising costs of healthcare, in part, by putting more financial responsibility on patients. These types of strategies include high-deductible health plans and health savings accounts.
Consequently, consumers have had to be more proactive and pragmatic when they need care. They now want to discuss the costs of care, and providers have to engage them, Ms. Gourdon says. Further, some healthcare analysts have said that not giving financial details of treatments can be just as harmful to a patient as not explaining the side effects of medication.
Consumers are "willing to pay for treatments they think will have a clear impact on their health," she says.
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