Two years ago, the last time I attended the American College of Healthcare Executives' annual Congress on Healthcare Leadership (I had a son being born during last year's event), hospitals were getting their first gander at healthcare reform.
In fact, days prior to the event, the Patient Protection and Affordable Care Act had finally passed amidst much rancor. In the political realm, that fight has hardly diminished, with Republican primary candidates uniformly are promising to repeal it (something they certainly can't deliver on their own) if they are elected President. But where reform really matters, where it's operational, leaders at hospitals and health systems are getting on with the work to transform healthcare's business model.
Back in 2010, attendees at the world's largest annual event featuring healthcare leaders (that's how ACHE bills it, at least) seemed almost uniformly dispirited. Wringing every last dollar out of a fee-for-service business model wasn't why most of them had chosen a career in healthcare, but it's all they knew. And as a reimbursement system, fee-for-service was pretty clearly on the way out, if slowly.
Unsurprisingly, initial impressions of the PPACA bill were negative in 2010. The prevailing opinion was that the legislation was terrible for hospitals and addressed only one of the many problems plaguing healthcare—coverage for the uninsured. Many executives said the bill did very little to address a rapidly steepening cost curve in an industry that was already guzzling down nearly 20% of the nation's annual gross domestic product.