Pendulum swings on a number of health care issues

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The new millennium has arrived. Representatives of every part of our society have commented on what lies ahead as the next century begins. I want to share what I think lies ahead for health care systems such as Cox. |ret||ret||tab|

|bold_on|Health care cost|ret||ret||tab|

Over the next few years, health care costs are probably going to rise more rapidly than the cost of living. Insurance companies and the government have significantly reduced payments to hospitals and physicians. Reductions have been exacerbated by the unintended consequences of the Balanced Budget Act of 1997. |ret||ret||tab|

Originally it was estimated this act would reduce federal health care expenditures by $101 billion. Now it is estimated the reductions will be closer to $180 billion. |ret||ret||tab|

Beginning in the 1970s there certainly began a trend to lower the out-of-pocket costs borne by employees. This trend will be reversed as more and more employers shift a larger part of the cost back to their employees.|ret||ret||tab|

Health information management|ret||ret||tab|

Patient information will continue to be consolidated into databases creating more efficient retrieval of data. A tremendous amount of spending to build appropriate data-retrieval systems has taken place. Because of the complexity of merging health information, implementation of these new applications has been slow. |ret||ret||tab|

However, the potential is now there to reduce the time to obtain referrals from other physicians, streamline complicated billing practices, and share meaningful health information to improve the care we provide. Health information already available through the Internet will rapidly become more sophisticated in content.|ret||ret||tab|

|bold_on|Medical technology|ret||ret||tab|

There will continue to be enhanced medical technology. With better clinical information available it will be easier to assess the enhanced value of new technology vs. the increased cost. |ret||ret||tab|

The impact of genetic research will begin to come to the forefront. Such research has the potential to revolutionize diagnostic testing, medicine selections, as well as short-term and long-term care plans. Drug costs will continue to be a larger portion of health care expenditures as drug research continues and more new drugs are approved for use.|ret||ret||tab|

|bold_on|Health care construction|ret||ret||tab|

We will see a slowdown in health care construction. The tremendous capital costs for new construction, along with the reduction in reimbursements for treating Medicare, Medicaid and managed care patients, is causing most organizations to maximize the use of existing structures. Expenditures in the future will incorporate designs that are more user friendly and address the growth in new alternative-treatment modalities embraced by health care providers.|ret||ret||tab|

Health care financing|ret||ret||tab|

The financing of health care is the greatest wild card in predicting what lies ahead. The majority of our health care dollars will be spent on Medicare and Medicaid patients, primarily because of our aging population. |ret||ret||tab|

Because of existing federal government budget surpluses, this issue has become a political football, kicked back and forth between using surpluses to reduce the deficit, returning the money to taxpayers, or to finance Medicare and Medicaid. A compromise will likely be reached.|ret||ret||tab|

|bold_on|Managed care|ret||ret||tab|

The premise of managed care is that competition lowers health care costs, principally by being more efficient in health care expenditures per patient. This has led to the restriction of choice in the selection of health care providers, which has not been well-received by most people. |ret||ret||tab|

The pendulum will now swing back toward a system that provides patients more choice. As individuals assume greater financial responsibility for their own health care, they will expect more personalized care with a greater amount of information concerning their care shared with them by their selected physician.|ret||ret||tab|

|bold_on|Physician relations|ret||ret||tab|

Many physicians feel their professional lives were turned upside down in the last decade of this past century. They were asked to provide more service for less payment. One method used to protect their income was to affiliate with health care systems, however this did not always accomplish their goals. I believe many physicians will return to the independent practice patterns that were most common until just a few years ago.|ret||ret||tab|

|bold_on|New programs |ret||ret||tab|

If payments to health systems and physicians continue to decline, there will be fewer new health-related programs. |ret||ret||tab|

Standardization within health care will continue to grow and create efficiencies. |ret||ret||tab|

Such standardization will be based on new clinical information available to assist in such areas as treatment planning, drug selection and home treatment options.|ret||ret||tab|

The traditional aspects of health care such as compassion, competency and accessibility will be preserved to appropriately manage the changes in our industry.|ret||ret||tab|

|bold_on|(Larry D. Wallis is president and CEO of Cox Health Systems.)|ret||ret||tab|

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