Morrison says changes in the healthcare delivery model will be facilitated and accelerated by technology, and the compensation principle will shift from actions to outcomes. "Patients don't want health services, they want outcomes," he said. "We tend to give them health services rather than deliver what it is they want. We also tend not to persuade them to do less. We persuade them to do more."
He also sees – and supports – further consolidation of the healthcare industry, because larger integrated healthcare systems are simply more efficient. "A lot of these smaller institutions need to be swept up into larger networks of care," Morrison says.
"I see large hospital systems rapidly consolidating and integrating and expanding their base but they need a payment signal from CMS that that is a good thing to do," he continued. "If you are going from volume to value you are going from 'fill the hospital' to 'empty the hospital'. That is a different mindset."
Morrison says every hospital should be planning to integrate health services for accountable care – even if they have no plans to join the ACO pilot. "That means prepare to take financial risk for the patients, maybe not full capitation, but certainly bundled payment. Integrate with your medical staff and dedicate those staff to higher performance," he says. "The only way I know to be in the forefront 20 years from now is make it better, faster, cheaper. Make it cheaper care. Learn to live on Medicare. Make it better. Continuously improve performance and focus on outcome not just processes."
Even with the uncertainty and upheaval in the healthcare sector, Morrison reminded the ASHHRA crowd that it is an "exciting time in healthcare." He cited a recent Centers for Medicare & Medicaid Services estimate that healthcare spending could hit $4.6 trillion by 2020. "This is a great business to be in. Do not be depressed. Go home uplifted," he says. "You do not want to get a job in commodity textiles. This is the business you want to be in."