Economics Alone Drives Healthcare Reform

In other words, don't expect your Medicare reimbursements to keep pace.

Diaz says the strategies in place now in the for-profit hospital sector won't change much regardless of what happens in legal or political arenas. "There may be some tweaking of strategies here and there. But the focus on trying to operate more efficiently, having strong market position, those strategies will play either way," Diaz says.

"It will still be important to have a strong market position because you want to be in a position of strength in negotiations with commercial insurers," he says. "So at a local basis, market position is still going to be very important, and maybe even more important given the continued pressure on the growth in the commercial reimbursement."

Diaz says providers understand that they're going to be asked to do more and for less money. "Any efforts to continue to trim costs and operate more efficiently but still effectively clinically are going to remain a focus again no matter what happens in Washington. Especially on the government payers, the focus on the deficit and the spending levels for healthcare are absolutely going to pressure reimbursement from government payers," he says.

"It's already resulted in slower growth in recent periods and it's only going to become a bigger discussion as some of these proposals to trim the deficit come back to life."