An Economic Perspective

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Presentation transcript:

An Economic Perspective Health Policy Issues An Economic Perspective Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

The Future Role of Hospitals Chapter 16 The Future Role of Hospitals Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

LEARNING OUTCOME Examine the changing role of the hospital and developments affecting the hospital’s future role in the delivery of medical services Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Lecture From Medicare to the Present Exhibit 16.1 Exhibit 16.2 Exhibit 16.3 Hospital Costs: The Public and Private Sectors Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Lecture (Continued) Hospital Revenues Hospital Utilization Hospital Payment Exhibit 16.4 Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Lecture (Continued) The Current Hospital Outlook Hospital Consolidation Expansion of Medicaid and Enrollment on State Health Insurance Exchanges Changing Payment Systems Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Lecture (continued) Hospital Strategies Status Quo Scenario A New Role For Hospitals continue to discussion Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

US Community Hospital Capacity and Utilization, 1975–2012 Exhibit 16.1 US Community Hospital Capacity and Utilization, 1975–2012 return to lecture Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Exhibit 16.2 Aggregate Total Margins and Operating Margins for US Hospitals, 1980–2012 return to lecture Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Exhibit 16.3 Annual Rate of Increase in Hospital Expenditures, Actual and Trend, GDP Price Deflated, 1961–2012 return to lecture Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Sources of Hospital Revenues, by Payer, Selected Years, Exhibit 16.4 Sources of Hospital Revenues, by Payer, Selected Years, 1965–2012 return to lecture Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Discussion What is the outlook for hospital cost increases? What are the likely economic assumptions hospitals should consider in developing their future strategies? Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Summary Managed care and Medicare DRG payment greatly reduced hospital utilization, created excess capacity, and weakened hospitals’ bargaining power with insurers. Over time, hospital capacity decreased, mergers occurred, managed care broadened its provider networks; hospitals consolidated and raised prices and profitability. Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Summary (Continued) The future presents threats and opportunities: Technological developments have enabled a greater number of complex procedures to be performed in an outpatient setting. Payment systems have given incentives for performing more services in outpatient settings. Over time, the ACA will lower hospital rates for Medicare patients. Growing reliance on government payment is likely to result in a lower growth rate in hospital expenditures. Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Summary (continued) As the number of publicly insured increases, hospital competition for a diminishing pool of privately insured patients will intensify. Changes in payment systems offer the potential for greater revenues, but will also result in disruptive innovations in the delivery of medical services; many hospitals will experience difficulty adjusting. Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.

Summary (continued) Huge financial rewards are available to those who are able to cut costs while improving patient outcomes and satisfaction. The future of hospitals will be determined by how well they are able to work with physicians and deliver coordinated care while reducing rising medical costs and improving patient outcomes. Copyright © 2015 Foundation of the American College of Healthcare Executives. Not for sale.