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Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable.

From reading recent headlines, one might easily get the impression that hospitals are resistant — or at least ambivalent — in their pursuit and adoption of accountable care initiatives.

Are Hospitals Dragging their Feet on Accountable Care?

Commonwealth Fund: “only 13 percent of hospital respondents reported participating in an ACO or planning to participate within a year”

KPMG Survey: “(only) 27 percent of [health system] respondents said current business models were either not very or not at all sustainable over the next five years”

Health Affairs: “Medicare’s New Hospital Value-Based Purchasing Program Is Likely To Have Only A Small Impact On Hospital Payments”

The Bigger Picture

Do hospitals today perceive their current business model on the metaphorical “burning platform” — when the status quo is no longer an alternative?

The answer from the headlines above might suggest “no”, but I believe the correct answer is “not yet, but it’s inevitable”.  Hospitals are feeling the heat, but it’s just not yet hot enough to jump off the platform and abandon existing business models.

Fiscal forces are in play to continue to turn up the temperature to the point where change is inevitable. Modern Healthcare reported:

The AHA estimates that about 10% of Medicare revenue will be at risk in 2017 as a result of:

  • Value-based purchasing
  • Penalties for high rates of readmissions and hospital-acquired conditions
  • Incentives for participation in the inpatient quality-reporting program
  • Incentive payments tied to achieving meaningful-use standards in the use of electronic health-record systems.

None of these initiatives are dependent on the Accountable Care Act (ACA) legislation. The first three of these date back to the Bush administration.

With 10% of your revenues inevitably at risk in the near future, what’s a hospital CFO or CEO to do? While you might believe you can hold out for a year or two, the conclusion is inescapable: We must change.

Yes, I’m frustrated that more hospitals are not yet leading or engaging in accountable care initiatives. But, I’ll be patient. It’s just a matter of time.

This work is licensed under a Creative Commons Attribution-Share Alike 3.0 Unported License. Feel free to republish this post with attribution.

26 Comments

  1. Paul Sonnier on September 5, 2012 at 5:44 pm

    Vince,
    Great insights! While I’m also patient, I hope we’re not patients before the major changes take place, e.g. inpatient quality.
    Paul



  2. Vince Kuraitis on September 5, 2012 at 11:36 pm

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/1IEgbjXx #ACO #HCR



  3. Paul Sonnier on September 5, 2012 at 11:42 pm

    RT @VinceKuraitis: Are #Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/4iHTNjgu #ACO #HCR



  4. Bob Climko on September 5, 2012 at 11:45 pm

    Are Hospital Business Models on a Burning Platform? http://t.co/XOgysfSF via @sharethis



  5. Stephanie Gaffin on September 5, 2012 at 11:56 pm

    RT @VinceKuraitis: Are #Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/4iHTNjgu #ACO #HCR



  6. PointClear Solutions on September 6, 2012 at 12:07 am

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/A2G3oIJc



  7. Netspective Health on September 6, 2012 at 12:25 am

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s… http://t.co/vrqKbguc #HIT #HealthIT



  8. Michael Stanton on September 6, 2012 at 12:25 am

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. | e-CareManagement Blog: From… http://t.co/yLczlOHc



  9. Aparna M K on September 6, 2012 at 12:26 am

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. | e-CareManagement Blog http://t.co/TCZCJBmB



  10. Aparna M K on September 6, 2012 at 12:26 am

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. | e-CareManagement Blog http://t.co/OMXlgiDX



  11. Michael Stanton on September 6, 2012 at 7:36 am

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable.: From reading recent headlines… http://t.co/cQn9kxcu



  12. Healthcare Valuation on September 6, 2012 at 12:52 pm

    Are Hospital Business Models on a Burning Platform? Not Yet, But …: Health Affairs: “Medi… http://t.co/YkKRTd3j #HealthcareValuation



  13. Vince Kuraitis on September 6, 2012 at 3:19 pm

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/1IEgbjXx #ACO #HITPol



  14. Charlene Marietti on September 6, 2012 at 3:29 pm

    RT @vincekuraitis: Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/ZxHGVYZ9 #ACO #HITPol



  15. Mark Browne on September 6, 2012 at 3:39 pm

    RT @VinceKuraitis: Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/baV4J8Ml #ACO #HITPol



  16. Donna Scott on September 6, 2012 at 3:43 pm

    10% Medicare rev at risk 2017 RT @vincekuraitis: Are #Hospital Business Models on Burning Platform? http://t.co/ANJ8Zl38 #ACO #relayhealth



  17. Amit Dhabalia on September 6, 2012 at 3:57 pm

    Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/1IEgbjXx #ACO #HITPol



  18. Mediprocity on September 6, 2012 at 4:08 pm

    Sparks and embers around revenue…when will #hospital feet start burning? @VinceKuraitis http://t.co/WVM9jKYY #HIT #health



  19. Doug Della Pietra on September 7, 2012 at 12:55 pm

    Are #Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/7LhwSpuE #hospitals #healthcare #reform



  20. Randall Oates, MD on September 7, 2012 at 1:58 pm

    RT @VinceKuraitis: Are Hospital Business Models on a Burning Platform? Not Yet, But It’s Inevitable. http://t.co/ikYFsU2A



  21. Vince Kuraitis on September 11, 2012 at 7:24 pm

    This post was republished on The Health Care Blog. There are some great reader comments and disagreements at http://thehealthcareblog.com/blog/2012/09/06/are-hospital-business-models-on-a-burning-platform-not-yet-but-it%e2%80%99s-inevitabl/



  22. Phil C. Solomon on September 19, 2012 at 10:43 am

    Are Hospital Business Models on a Burning Platform? e-Care Management http://t.co/kBofvRlt



  23. Jon Mertz on October 25, 2012 at 3:30 pm

    Call for action by @VinceKuraitis > Are #Hospital Bus Models on a Burning Platform? Not Yet…Inevitable. http://t.co/YT5k30FW #ACO #HITsm



  24. Vince Kuraitis on October 26, 2012 at 7:12 pm

    .@healthblawg Yes, payers are on burning platform re: acceptance of #ACO; providers not yet, but inevitable http://t.co/1IEgbjXx



  25. Erik Pupo on October 27, 2012 at 1:54 pm

    .@healthblawg Yes, payers are on burning platform re: acceptance of #ACO; providers not yet, but inevitable http://t.co/1IEgbjXx



  26. Kevin Bower on October 27, 2012 at 2:12 pm

    .@healthblawg Yes, payers are on burning platform re: acceptance of #ACO; providers not yet, but inevitable http://t.co/1IEgbjXx