"To sit back now, and say 'This won't happen, we'll be fine,' will just get them into trouble," Childs said.
Chris Van Gorder, immediate past chairman of the American College of Healthcare Executives and President and CEO of San Diego's Scripps Health, says he had predicted the panel's failure ever since it was formed. But it doesn't really matter, he says.
"What does this mean to healthcare and for the C-suite? It means more uncertainty for another year and more challenges as we try to plan for future changes and reimbursement reductions—but beyond that, our task is clear," he says. It shouldn't change the tasks ahead for healthcare leaders, who must reduce costs while improving quality.
"In the end, we know we are going to be paid less for the work we do—while expectations are that we will improve quality, safety and patient satisfaction at the same time."
Van Gorder says the way to do this is to reduce "non-value-added variation in quality and costs of care...to continue our movement to become health care systems rather than hospital-based organizations (and)...to continue our work in aligning more closely with our physicians in getting this work done in a way that ultimately benefits our patients."
The only real question remaining is how much of a cut will come, he says, "especially when we combine the reductions we are seeing and anticipating from Medicare, Medicaid, and commercial insurance companies driven by the development of state insurance exchanges...and more bad debt" driven by laws in California and other states that require Medicaid patients to make co-pays and absorb deductibles, even for emergency care.