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John is in San Antonio to speak to the Association of Imaging Management’s spring conference.

SAN ANTONIO, Texas – If you had a blank sheet of paper and a pen:

  • How would you redesign America’s healthcare system to ensure high quality, lower costs and increased patient satisfaction?
  • How would you redesign your career – your area(s) of interest, education and skill sets necessary to be successful in that new model?

I am someone, perhaps in the minority, who believes this exercise may have more real value than just a writer’s prop inserted to make a point, which is that the early stages of what promises to be a transformation of the healthcare business model – how care is delivered and paid for – has started down the tracks.  There is ample evidence:

  • Trends reflecting continuing declines in inpatient admissions and lower revenue
  • The shift from fee-for-service and the emergence of value-based reimbursement models
  • Introduction of Accountable Care Organizations
  • The rise of palliative care programs, some of which incorporate physician house calls
  • Use of reimbursement penalties to reduce “never events” and to cut the frequency of readmissions inside of 30 days of discharge
  • Innovative house call programs using EMS and other resources to cut down on the number of unnecessary ED admissions
  • Increased usage of less costly care settings, including primary care clinics in retail places like Target, or the development of acute care protocols for a new type of nursing home as well as private residences
  • Creation of new technologies, models and services to support existing infrastructure such as telemedicine networks.  These technologies will be increasingly important with the anticipated shortages in primary care physicians.  For some communities, this will become the family doctor, minus the house call
  • Development of population health management networks that will apply the concepts of hospital case management to the entire community
  • Continued industry consolidation and a reduction in the number of “big box” hospitals, as predicted by an increasing number of industry analysts

[Tweet “Healthcare costs are still increasing at three times the rate of inflation. “]
Healthcare costs, although lower over the past two years, are still increasing at three times the rate of inflation.  Even at this lower rate, compared with 9 percent as late as 2008 and as high as 17 percent in the 1980s, we are high tailing it to a fiscal crisis within 10 years given the record number of new Medicare beneficiaries – one every 8 seconds.  The Obama administration and Congress, at the expense of their victims, the American voters, are more interested in ideological purity and/or re-election.  In kid-speak, it is called kicking the can down the road.  This impending crisis will drive transformation, whether we like it or not.

While we are not always able to influence the politicians, we can exert more control over our professional development.  I think executives who begin to think about their careers in terms of adapting to transformation will be far better off than those who sit back, hope for the best and then react.

So, how would you redesign the American healthcare model?  More importantly, how will you alter your current career track given these trends?