by Tom aka Rusty Rustbelt
Health Care Thoughts: Hospitals Rising
One of the key operational themes of PPACA (Obamacare) is integration. Almost all models of integration have a hospitals or hospital networks as the hub. Some networks are already highly integrated, others are headed in that direction. (There was a big push for integration at the time of the Clinton-care proposals, some of the integration stuck and some of it unwound as a result of operational disasters.)
This gives hospitals and hospital networks an immense amount of new power, whether it is used for good or ill is yet to be seen (I have often encountered a “not-for-profits give better care and are more ethical” theme, but as NFP merge into networks with billions of dollars this does not appear to me to be correct).
In regions with competing networks there are stampedes for “market share,” with a great deal of money often thrown into new facilities and new services. There are also bidding wars for employed physicians and battles for favorable affiliations with practice groups.
This also creates a “talent war” for quick and nimble executives, and I fear the ascendency of “slick-and-useless” MBAs in the hospital industry.
This is a little “inside baseball” but beyond politicals, law and economics there are details with consequences.