While Congress works to reconcile the five healthcare reform bills that have been reported out of committees, health economists say they have at least this in common: All imply major changes in healthcare delivery down the road.
A glance in the crystal ball suggests greater healthcare delivery integration, more physician employment by hospitals, and fundamental changes to primary care.
"There's likely to be another three months of healthcare reform on the front pages (of the newspaper)," says Paul Keckley, executive director of the Deloitte Center for Health Solutions. "Scenario planing will be key ... and it will not be business as usual."
Keckley and R. Lawrence Van Horn, a healthcare economist at Vanderbilt University, will assess the likely impact of reform on healthcare providers in a educational session from 12:15-1:15 p.m. Eastern Time Thursday at the Healthcare Finance News Virtual Conference. Access to the virtual conference is at http://www.himssvirtual.org/hfn/index.asp.
Previewing the session, Van Horn said much of the debate to date has focused on insurance access and cost. "But delivery side reforms are likely to follow payment side reforms," he warned, so it's critical that CFOs and other healthcare administrators focus on the key trends in all the current bills.
Keckley agreed, identifying four of those trends – episode-based payments, a major shift to primary care, a comparative effectiveness platform available to the public, and expanded scope of practice for mid-levels, specifically nurses and allied health professionals.
"There will be a major redesign of the workforce," he predicted, given that the current delivery system can't provide enough doctors to manage the expected influx of patients and the greater emphasis on primary care.
But the changes are likely to go beyond operating budgets and human resources.
"Capital budgets will have to be rethought as well," he said.
Van Horn says the Obama Administration's goals of reducing costs and universal coverage are fundamentally incompatible. "To solve this problem, someone's going to have to be hurt," he said.
The Keckley and Van Horn session is part of the two-day Healthcare Finance News Virtual Conference and Exhibition. In addition to a full schedule of educational sessions, the virtual conference includes an exhibit hall and provides attendees with opportunities to interact with colleagues from their own desk.