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Industry Survey: Certainty on Reform Helpful, but Challenges Remain

Philip Betbeze, for HealthLeaders Media, February 13, 2013
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This article appears in the January/February 2013 issue of HealthLeaders magazine.

Editor's note: This piece is excerpted from the CEO report, Optimism on the Upswing, which features data and analysis based on the responses of CEOs who participated in the annual HealthLeaders Media Industry Survey. The report is available online at www.healthleadersmedia.com/industry_survey/.

Healthcare CEOs showed a renewed—though restrained—level of optimism about the future of the industry, according to more than 100 CEOs who responded to the annual HealthLeaders Media Industry Survey. In fact, only 44% of CEOs said healthcare is on the wrong track this year, compared to 56% last year. Also, 33% said healthcare is on the right track this year, compared to only 19% last year. Of course, one in three hardly makes for a resounding endorsement of the state of the industry.

While the CEOs' opinions about the prospects for their own organizations are roughly the same (78% right track this year vs. 74% last year), the marked improvement in attitude about the industry in general could have a lot to do with the removal of uncertainty surrounding the implementation of the Patient Protection and Affordable Care Act, which the Supreme Court ruled on in June 2012.

"It's a realization that the ACA is the law of the land and here to stay," says Bruce M. Elegant, president and CEO of Rush Oak Park Hospital, a 176-licensed-bed hospital near Chicago that is part of Rush Health Systems.

Still, while there may be some comfort in the PPACA becoming a largely settled matter, industry CEOs are nearly evenly divided on whether healthcare reform represents a threat (47%) or an opportunity (48%). Indeed, Elegant says that the gain in optimism is tenuous because hospitals and other healthcare providers have yet to realize the transfer of risk that they're about to experience due not only to the implementation of the PPACA but also to employer and health plan demands for better quality, safety, and other performance measures.

"The end result is that there will be greater risk shifted to providers at a time when providers are really not that good at accepting risk," he says. "That is generating a lot of anxiety and worry because we're being asked to do something that has traditionally been the role of insurance companies."

Elegant says increased scrutiny and penalties associated with satisfaction and readmissions may swing the optimism pendulum back toward the negative as hospitals dive deeper into areas they have previously not had to worry about.