Healthcare reform was on the mind of many healthcare finance executives gathered in Las Vegas Sunday for the start of the Healthcare Financial Management Association's annual ANI conference.
Author Ian Morrison told the audience at his keynote speech that providers should expect everything to change.
As the new law is put into play, he said, changes in the healthcare payment and delivery systems would require providers to respond with speed, agility, flexibility and innovation.
HFMA President and CEO Richard L. Clarke struck the same note in his remarks at the opening session of the group's conference.
"Clearly, we're in a new environment," he told attendees on Monday. "This year's ANI is a great opportunity to network with people from around the country and talk with them about what is this law, and how will it affect me?"
In an era of healthcare reform, Clarke said, "We need education like ANI. We need support from each other and from firms such as our exhibitors. And we're going to need to drive for excellence."
In his talk "The Future of the Healthcare Marketplace: The Quest for Value for All Americans," Morrison said the nation's healthcare delivery system is in critical condition.
"It's going to bankrupt the country," he said.
Morrison noted that the United States spends 17 percent of its gross national product on healthcare, compared with 10 percent to 12 percent of the GNP in most countries. The value of the care Americans receive is not as high as in countries that spend less, he added.
For example, in the category of "mortality amenable to health care," which relates to the effect that medical care has on improving the rate of mortality in a nation, "We rank 19th out of 19 countries," he said. "It's not exactly a stunning performance."
Morrison cited four reasons why the United States spends more:
- The salaries of workers ranging from healthcare nurses to consultants are much higher in the United States than in other nations.
- The level of bureaucracy in American healthcare contributes to administrative waste.
- The intense and expensive use of technology in U.S. healthcare drives up costs.
- The country under-invests in primary care and over-invests in specialty care.
Morrison said these problems are fixable – but not without changes in culture, policy, management and the healthcare payment system.
"We are on an unprecedented reform roller coaster," Morrison said.
Although the immediate effects of reform will be minimal until all provisions of the law have been implemented in 2014 and beyond, he said, they will result in a massive expansion in coverage that will lead to an increased demand for services.
"Reimbursement reform will become the imperative," he said.
Morrison predicted that the era of reform would require better management of costs and risks.
"I think you're also going to see greater transparency, and a focus on outcomes, not just indicators or process measures," he said.