Creeping Toward Care Coordination

The survey shows that 48% of healthcare systems anticipate a major increase in HIT spending over the next two years, but 34% describe their approach to HIT spending as an operations investment, and 24% see it as a cost of doing business; only 23% see it as a clinical investment. In describing the ROI associated with HIT spending, 42% expect net cost to decrease over time, but 31% anticipate it would increase.

Improving IT systems is absolutely the cost of doing business, says Ray Chicoine, COO of Monarch HealthCare, in Irvine, Calif., a health system that includes 2,300 physicians who contract with 18 hospitals in Southern California. "You have to have a robust infrastructure, from A to Z. None of it fits easily and none of it is cheap," Chicoine says. "I think you can't escape that fact. To be an effective, integrated delivery model, you will have to spend more on technology, and that cost will continue to grow."

While 69% of healthcare leaders say greater transparency in healthcare will increase the quality of care, 35% say it would increase the cost of providing care.

The reason it's difficult is that so many health systems only have pieces of that care continuum, according to Julie Manas, president and CEO of the 349-licensed-bed Sacred Heart Hospital in Eau Clair, Wis., and division president of the Western Wisconsin division of Hospital Sisters Health System, which includes the 193-licensed-bed St. Joseph's Hospital in Chippewa Falls. "While there is discussion about moving that patient as seamlessly as we can, with incentives or lack of incentives, it's difficult because of the payment method and how we have been reimbursed. I'm embarrassed to say it drives some of our behaviors, but I think it does," she says.