Last month I attended the Annual Congress of the American College of Healthcare Executives (ACHE) in Chicago. The ACHE represents executives in hospitals and health systems: CEOs, COOs, CFOs, as well as nursing and physician executives and more junior executives on the leadership track. The annual Congress is a great place to get a sense of the ideas and concerns on which hospital leaders are focusing. Let me share some of my observations of this year’s Congress and hot topics of conversation.
Congress this year had many familiar themes. Most prominent were the ongoing changes in payment models, the transition from “volume” (fee-for-service) to “value” (quality metrics and outcomes) and fully at-risk models. There continues to be huge variation in these models regionally in the U.S., with different dominant payers, and generally there is some mix of models. This may continue to be the case, as some services continue to fit better within a fee-for-service model.
Uncertainty regarding regulatory frameworks and the Affordable Care Act continues to be on attendees’ minds. There was much discussion not only around regulations, but also about the political environment, the unpredictability of the current administration, and how policies might shift if control of the House or Senate changes this year.
Mergers and acquisitions continue to be a hot topic, as independent hospitals get pulled into local and regional systems, as well as into national networks. The increased complexity and burden of regulatory and payer compliance, as well as the move towards value, have driven this rollup. Diversity and inclusion also continues to be a prominent theme in the healthcare industry, as it has across virtually every other business.
Some of this year’s newer topics included a focus on information technology security, with one featured speaker emphasizing the diverse range of threats facing the healthcare industry and the need to move away from point solutions and towards a comprehensive data protection strategy. There were some gasps in the audience as the speaker pointed out just how many attacks are routinely defended every day by most hospitals.
One of my personal observations from the Q&As and other discussions at the conference was the degree to which hospitals and systems are still overwhelmingly local in their outlooks. Yes, there are national quality metrics. Yes, US News and World Report and other organizations give national rankings. However, there is an intense focus upon local competitors, relationships with local payers, local referral patterns, and local political and regulatory concerns. Local geography and demography are the chess board on which most strategic moves are made. Of course, national institutions such as ACHE help everyone get beyond the local fray.
There were some promising examples of ways hospitals and health systems are lifting their gaze beyond the local. For decades, healthcare leaders have talked about adopting best practices from other industries. Some of the richest opportunities lie in adopting advanced, technology-driven operations management practices: for instance, the technologies that allow airlines to match supply to demand and keep flights full; that allow theme parks to have the right number of staff at the right locations to handle the flows of visitors; that allow hotels to forecast volume and adjust operations accordingly. I’m happy to report there were several impressive presentations on adopting these approaches in hospital settings. In my role with Hospital IQ, I know firsthand how much potential these solutions can unlock in healthcare. I’m encouraged to see technology playing a more strategic and prominent role in how hospitals optimize the efficiency of their operations, and fully expect next year’s ACHE Congress to reflect the progress our industry is making in this critical area.