"How will we compensate? We, internally, have to continue to shift where services are provided, and how quickly and efficiently we can do that," Schneider says. "The pressure is going to be on delivering services for an additional volume into areas where it's less expensive to provide those services," such as in the home, small clinics, or outpatient ambulatory care settings.
I asked whether there is any more efficiency to be found, since hospitals have been working for a while at squeezing out excess costs.
"There has to be," Schneider says. "All organizations will continue on the path of asking how they can shorten stays and do more with existing staff. But the challenge is going to be, How can I do things more creatively?... What do I have to do that's much more creative in terms of becoming the type of organization that's more of a continuum? And where do we, with hospital and physician partnerships and with insurance and managed care organization partnerships... reign in some of the paperwork and other work from?"
Back in the nation's capital, membership of key Congressional health policy-making bodies—the Senate Finance Committee; the Senate Committee on Health, Education, Labor, and Pensions; and the House Committee on Ways and Means—will change.