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Six Predictions for Healthcare Strategy in 2010

Philip Betbeze, for HealthLeaders Media, December 18, 2009

4. The clinical staffing shortage will reassert itself.

For the past 18 months, physicians and nurses have been in the same economic boat as the rest of us. Retirement portfolios cut in half or worse, stagnant salaries. But over the past nine months, the stock market has come roaring back—not to pre-recession levels—but enough so that those who put off retirement may start thinking about it again. Add to that an influx of previously uninsured coming onto the rolls, and you have the makings of a staffing shortage that can't keep up with demand (see prediction 2). We've already seen this on a (relatively) small scale in Massachusetts. Nationwide, depending on the level of coverage the uninsured get in the final reform bill, the staffing shortage could quickly reach crisis levels.

5. Capital spending will remain recessed, just not depressed

This is one prediction for which I have to give at least partial credit to VHA Inc., which predicts that "hospitals will begin to experience a resurgence of spending for new and replacement capital equipment—a necessity as new technologies continue to force hospitals to upgrade."

While true, this prediction is more of a return to normalcy for healthcare. I don't share the optimism that capital spending will return to pre-recession levels anytime soon, however. Hospitals were burned by easy money once, as they invested in bricks and mortar as well as technology. Any bricks and mortar expansion will likely come outside the hospital, as more treatments move from inpatient to outpatient, but won't recover as quickly as spending for medical equipment, such as imaging, which many of my sources predict will become a larger piece of hospitals' income as reimbursement is ratcheted down for physician office-based imaging.

6. Hospitals will continue to acquire physician practices and increase hiring of physicians.

Anything that ties clinicians, especially physicians, closer to the hospital where they perform procedures on patients will continue to be hot (see prediction 4). That's why so-called “employment” of physicians—physicians don't like this term but that's what it is—will continue to be hot and will probably accelerate. Employment definitely ties them closer, and when structured correctly, allows physicians the level of autonomy they're looking for while moving toward accomplishing the goal of greater coordination of care and elimination of waste.

Take care, and let me know what you think of these predictions. I'd love to hear where you agree or disagree with my 2010 soothsaying. Corner office will be taking a break for the Christmas holiday next Friday (December 25), but will return the next week on New Year's Eve. Until then, Happy Holidays.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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