Healthcare Reform Then, and Now

But the question is when that is going to happen and whether those executives have any control over the timing.

"Our team has been dealing with that question with the payers in this area," he says. "When we set out a timeline over the next few years, the first step for us is the goal of
having all hospital payments be DRG [diagnosis related group] payments—no discounted fee-for-service."

The biggest hesitancy is timing, says Wallace, adding that making the determination is difficult because, on one hand, executives might drive their organization toward doing everything right for population-based payment but still getting reimbursed on a fee-for-service basis. The flip side is, if you don't do enough and suddenly the payment system is flipped, then you can't make it happen.

"My personal guess is it's going to happen faster than most people think," says Wallace. "There's enough wheels in motion that it will happen in next two to five years."