Hospital Chiefs Still Grappling With Reform

The program cover for the annual American College of Healthcare Executives meeting in Chicago this week portrays a driver's view over the steering wheel as the car ascends a scenic mountain.

But the navigation screen on the dashboard shows danger: an abrupt turn a few yards up and a fall to oblivion for anyone not paying attention.

This year, many of the nearly 5,000 attendees at the ACHE said they are indeed paying a lot more attention to this road, waking up to the fact that the way they operate must dramatically change.

On the first anniversary of the Affordable Care Act's passage, many attendees confided that they have gone through mood swings much like stages of grief: shock and denial, anger and bargaining, depression and reflection and are starting to take that upward turn. Perhaps, some of them are starting to have hope.

"We'd been thinking maybe the law would be reversed in the courts; that maybe we [wouldn't] need to change things that much," says Nick Neuman, MD, of Bismarck, ND, a member of the governing board of 306-bed St. Alexius Medical Center. "Our hospital has been, I'm afraid to say, complacent. But now, after listening to some of these sessions, I'm more convinced that is a dangerous assumption."

So as soon as he gets back to Bismarck, Neuman said he will be "meeting with physician leaders to get them to understand how we have to partner and to change strategies. The future of our survival is at stake."