Hospital Chiefs Still Grappling With Reform

They have heard, and hopefully understand, how important it now is. They are going to have to change their organizations in major, cataclysmic ways especially if they haven't started to do so already.

Tom Dolan, president and chief executive officer of ACHE, says leadership in general is now "much more knowledgeable" about the steps they have to take. "They know they need to reduce costs. They understand they have to adopt Toyota and Lean manufacturing strategies. They know they have to reduce errors, medication mistakes, reduce readmissions and improve quality measures for specific diseases."

"They know they have to dramatically re-engineer the way we provide care and can't tinker the way they have in the past." That's why, he says, attendance at this year's meeting is dramatically up.

I gleaned from speaking with many C-suite executives over the last few days that for months they've felt stymied, not knowing where to turn or what to do first, or even what the phrases "medical home," or "accountable care organization" might mean for their neck of the woods. Only the first of many critical federal regulations – that for inpatient value-based purchasing incentives – has been released.  Everyone I spoke with is anxiously awaiting the government's ACO regulations, which are expected by month's end.

In one of the most well-attended talks of the week, Richard Pollack, executive vice president with the American Hospital Association, summed up a dizzying assortment of political gear grinding affecting healthcare reform inside the Beltway. But in the end, he says, hospital executives should already know what their course should now be, regardless of whether the Affordable Care Act is reversed.