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The Journey Ahead

Edward Prewitt, for HealthLeaders Media, May 13, 2014
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This article appears in the May 2014 issue of HealthLeaders magazine.

The phrase hospital of the future may conjure images of gleaming new buildings and ever-advancing medical equipment. And in fact, in August 2012 HealthLeaders Media profiled just such a hospital, the $1 billion Palomar Medical Center in a San Diego suburb. But today, the future of hospitals is tilting toward outpatient centers, while future hospital leaders will have different titles and roles than before.

This month, we take stock of hospitals and their leadership at a critical moment—as the shift to value-based care takes hold, and the number of insured expands even as their insurance benefits contract. It's perilous in such a market to park cash in expensive hospitals. As related in our Leadership section feature on "The Hospital of the Future" (page 30), many healthcare providers are instead pursuing an outpatient and population health strategy. "Our measures of success or market share for the past 50 years have always been things like admissions or births or surgeries or ER visits, but our mind-set is shifting now," says Keith Alexander, president of Memorial Hermann Medical City in Houston. "Over time, our number of covered lives will become our most commonly used measure of market share."

Different metrics of success call for different types of leaders and organizational structure. Our cover story, "Presidents, CEOs, and the New Leadership Model" (page 10), is an inside look into the shift that many health systems are making from serving as holding companies—with hospitals operating mostly independently—to integrating into operating companies. For Catholic Health Initiatives, the Englewood, Colo.–based giant, this sea change means "we have to bring in new people, for instance with a plan development and insurance background. ... So that becomes a shared resource and you see integration there," says Michael Rowan, the system's chief operating officer.

Rowan recently added the title of president of health system delivery to his COO role. That's a statement by the board that he, like other top executives at CHI, is expected to bring the health system's 87 hospitals together—in other words, to work to get the organization to function as a true system.

Local autonomy is lost in this change. Some executives may feel demoted. But as noted by David Brooks, a former hospital CEO who is now president of St. John Hospital & Medical Center in Detroit, "If it's about turf, that will all feel very antagonistic. Our role is to create great systems of care. Not great hospitals or great doctor's offices or great home care. It all has to fit together."

Both of these articles were reported and written by Philip Betbeze, our longtime leadership editor. Look to him and all of the HealthLeaders Media team to figure out the future of your healthcare organization.


This article appears in the May 2014 issue of HealthLeaders magazine.


Edward Prewitt is the Editorial Director of HealthLeaders Media.
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