If you had to choose one word to characterize what managing healthcare organizations is like currently, you might well pick uncertain. The Affordable Care Act is in, then out, then in again, then out, and now, who knows? Not even senators involved in the process are willing to give odds. Subsidies for premiums are up in the air, which means insurance companies are looking to double-digit increases. Insurance purchasers, both individuals and corporations, are concerned.
Payers are changing the rules on reimbursement for care provision. Things are moving toward new models that combine capitation, or fixed payments for cases, with incentives for high quality care that is effective. Hospitals try to head spiraling costs off through population care before they happen even as drug companies push up prices on long-available medicines.
Managers and executives at care providers must respond to all the changes, even though they often don’t know exactly what is going to happen.
Consulting firm BDC Advisors has tried to understand how providers are dealing with the uncertainty and the stress that accompanies trying to make the best decisions. The good news is that many of the tools providers can use aren’t all that different from the ones they’ve become accustomed to.
Uncertainty may be upsetting and stressful, but it doesn’t mean you should toss everything up into the air. If strategy has been sound, continue with it, recognizing that there will be unexpected shifts in the future. Plan on having less money available and scrutinize expansion plans and any other major capital investment.
Plan for the worst with Medicare and insurance marketplaces
Although no one knows exactly what will happen, use some scenario planning for potential cuts in Medicare and the number of people obtaining health insurance. Steer between “likely” and “pessimistic” scenarios so you can respond as needed in short time. If things go better than you planned, you can be thankful.
Efficiency is key
As Becker’s Hospital Review noted, at times of uncertainly, the only certain choice is to conserve resources. Labor optimization is never popular — no one wants to hear of cut-back hours or staff reductions — but actions taken too late may be useless. Not only will care providers of any type compete with direct rivals, but with other types of organizations — hospitals, clinics, specialty treatment providers, and provider networks. Everyone will look to see what other types of services they might offer. The point is to remain in existence. Also consider reinforcing performance-based payments by structuring compensation to reinforce strategic goals.
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