Eddie Soler, executive vice president and CFO at Florida Hospital Health System in Orlando echoes Bogen's concerns about finding the right strategy for dealing with physicians, both employed and independent.
>> Slideshow: HealthLeaders Media
"The cost associated with the physician enterprise is not sustainable in the long term, whether it is subsidies for physicians we employ or other fees to physicians we don't employ," Soler says. "The costs definitely outweigh the benefits. We need new models that create better alignment."
3.Health Insurance Exchanges
Bogen also says he is troubled by the uncertainty surrounding the potential financial effects of health insurance exchanges when they go live in New York.
"We don't know what the heck is going to happen in the first year. It's likely that it's going to take some time to develop. It may actually take several years to develop really the trends and the impact of what will ultimately occur under reform," he says, adding that it "remains to be seen if it will work."
Bogen believes that small business owners may opt to take the penalty rather than offer insurance coverage to employees and that most consumers who buy an insurance product through New York's health insurance exchange will choose the plans with high deductibles and co-pays. As a result, provider organizations may find themselves having to spend more time and resources collecting from this high-deductible patient population.