Day 1: Top 10 Health Care Issues in 2011

Frequently I am asked to name some of the top things I expect to see in health care over the next year. 

I thought it might be a good starting point for me to start the list and see what you think. 

I have to say that my list will be biased related to the immediate issues that The Henry Ford Hospital faces, and I view the list as broadly related to health care. 

I’m going to begin posting my Top 10 for 2011 list today, and continue adding other items to the list throughout the rest of the week.

Join in if you wish to add, delete or create a more specific list of your own, such as the top discoveries or the top trends that you see.

Top 10 List: Day 1

1.     Fight Over Health Care Reform. The politics and positioning may be as interesting to watch as the Super Bowl, but the stakes for all are much higher. Increasing challenges will come from all arenas, including judicial challenges, leading to a possible Supreme Court ruling on the constitutionality of health reform.

The dominant issue looming is the continued high costs of health care and the national deficit concern. The outcome of health care reform will more likely be predicated on finances and health care expense, competing priorities with other social programs, and state budgets and entitlements.

Best advice on how to individually deal with health care reform: Commit to staying as healthy as possible. If you are a health care worker, commit to being a solution to the high cost of health care.

2.  Transparency: Moving Toward Reporting Performance & Outcomes in Health Care. This is already occurring in hospitals, but all of us are gearing up to report our physician and hospital performance of specific measures of health care outcomes, quality, and safety.

The push to create transparency, comparative performance and improvement in outcomes is not new.

The important understanding is that this is leading to increasing pay for performance or, more likely, non-pay for adverse outcomes, as well as payment for value (outcomes). The movement is well on it’s way to transforming how providers and organizations are paid. This will occur with or without full health care reform.

It is interesting to note that consumers often are uncertain what to do with this data. They may increasingly make decisions about hospitals and health care providers based on it, but the current effect on consumer choice is not clear. What is clear is that when data is reported, health care institutions gets far more serious about improving their performance.

3.  Organized Physician Practices (Can You Say Accountable Care Organizations?). The predominant practice model in this country is small groups of physicians (less than five) in independent, self-owned practices.

The demands on these practices are enormous, with high cost of operations, high capital outlays for information technology and other equipment, and difficulties in accessing support for the care of patients, especially those with chronic care. 

Physicians are organizing in a variety of integrated models from financially integrated structures to clinically integrated networks, in order to achieve some of the scale, practice supports and access to contracting. Others are seeking full employment by hospitals or large group practices, such as the Henry Ford Medical Group.

Look for physicians to increasingly seek employment models.

Tomorrow I’ll discuss No. 4, No. 5, No. 6 and No. 7 on my list.

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