When I wrote my predictions column at the beginning of 2009, surprise and uncertainty were the themes for the year. Some of my prognostications—that healthcare reform would be a priority and the EHR adoption rates would jump, for instance—seem rather obvious in hindsight. But I wasn't so sure at the time. Many thought the economic crisis would force a young administration to push reform to another year.
Although some uncertainty persists, particularly with one major obstacle remaining for healthcare reform legislation, in 2010 providers should start getting a clearer picture about the future of healthcare. Reform will likely pass, the economy will hopefully recover, and the tea leaves will be a little easier to read.
Adapting and preparing for these changes will be the big challenge for the coming year. I'm reminded of the Charles Darwin quote: "It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change."
That will hold true for physicians and hospitals as today's theoretical healthcare system changes become reality very soon. Today's biggest and most profitable medical groups aren't guaranteed success in the future; the best clinicians in today's system won't necessarily be the best in tomorrow's. But providers and organizations that anticipate structural changes and make adjustments early will find themselves ahead of the pack as others struggle to keep up.
Here are a few steps physicians can take in 2010 to prepare:
1. Get close to hospitals. This has been sound advice for a while, and physician employment and tighter alignment aren't exactly new trends. But if the federal government moves forward with plans to bundle payments and shift toward accountable care organizations, closer relationships will become an absolute necessity. Building those ties now will benefit both physicians and hospitals. Even though healthcare reform didn't include the promised realignment of incentives through a new payment system, the powers that be have been pretty explicit about the models they're considering. The days of fee for service are numbered.