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Is Health Reform a Disaster or Opportunity for Hospitals?

Cheryl Clark, for HealthLeaders Media, March 24, 2010

Blair Childs, senior vice president of public affairs for Premier, had similar view on ACOs. "ACOs are by their very nature disruptive to hospitals," Childs says. "Their design concept is to shift care out of hospitals, and that's not good for hospitals."

To get in front of that, Childs says hospitals are going to have to realign their physicians on quality and cost issues, and on efforts to reduce hospital-acquired infections and conditions. "It's going to become a greater imperative, whether it's contracts or joint ventures or whatever it might be, or standardizing the devices you use or reducing readmissions."

Chris Van Gorder, president and CEO of the five-hospital Scripps Health system in San Diego, was in Chicago this week as the newly elected ACHE chairman, and he too heard the negative concerns from his colleagues.

But, he says, "This is not time for panic. Hospitals have been impacted by government changes, mandates, and laws many times in the past. This will require us to change and we will, and many of the changes will be positive, albeit challenging."

Van Gorder agrees that forging close affiliations with physicians is imperative. Health reform could be a "disaster" if hospitals, physicians, and affiliated medical groups don't work together to integrate care.

Hospital administrators will have to realize they now operate within "systems of care," not just hospital care and not just within hospital buildings "and for physicians to do the same," Van Gorder says. "We need to integrate our electronic health records and make sure our patients receive care in the appropriate setting and that we not duplicate unnecessary care.

"We also have to reduce unexplained variation in care. This improvement in care process will reduce costs while improving care—and that's what will be required," he says.

Van Gorder acknowledges the next few years may be upsetting for many hospitals and physician groups.

"As providers—physicians, nurses, technicians, even administrators—we resist change," he says. "But change will be required. The hospitals and systems who embrace change and work well with their physicians will survive—maybe even thrive. Those who don't, or struggle, will have a difficult road ahead."

Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.

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