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Hospitals, physicians, and payers will connect like never before.

 

Three major groups are at play in the healthcare system today: hospitals, physicians, and payers. By virtue of who they are and what they do, these forces have always been interconnected. However, the push to contain costs in health care is bringing these groups together more intensively than ever. 

Containing costs requires a focus on wellness, better care coordination, and elimination of unnecessary utilization. It also merits special consideration of patients with chronic conditions, who use up the bulk of the healthcare premium dollar. None of these changes will happen without close alignment of hospitals, physicians, and payers. As a result, these groups’ spheres of influence are becoming mixed, and their boundaries are blurring. Furthermore, as the push toward alignment continues, the market will continue to drive one into the territory that traditionally belonged to another, and vice versa. HFMA and our members should be leaders in this transformation. 

Since 1946, HFMA has been at the forefront of healthcare finance thought leadership, and our biggest sphere of influence has always been hospitals and hospital-based systems. Yet as hospitals align with physicians and payers, we will need to increase our affinity with those other groups to maintain our leadership role. In the days to come, the changes that affect one will increasingly be felt by the others. 

I don’t expect physicians or payers to have the same type of affinity for HFMA as, say, hospital CFOs do. And we’re not simply trying to connect with physicians and payers within the traditional membership model. We must take innovative, meaningful steps into these new spheres. For example, one way HFMA is entering new territory is with the nomination of two physicians to our national board of directors. One of these physicians is employed by a payer, which doubles the number of payers currently represented on our board. These new perspectives will strengthen HFMA’s ability to reach out to physicians and payers, and increase our ability to stay attuned to their issues. 

More than ever before, the entire industry can benefit from HFMA’s perspective. After all, who better than financial people to speak the hard truths about costs and value? Financial issues are top concerns for every aspect of the industry. We can’t function in a silo. Everyone needs to hear what we have to say: hospitals, physicians, payers, and, perhaps most important, patients. 

At our 2010 annual conference, physician and former U.S. Senate Majority Leader William H. Frist, MD, spoke about the need for HFMA members to address the underlying challenges facing health care, and to make the tough calls needed to stay on track. 

As Frist put it, “Somebody has to do something, and it’s going to be—and it has to be—you.”I couldn’t have said it better myself. We stand at a time of unparalleled change, challenge, and opportunity. I’m confident that HFMA and its members have the knowledge and experience that can help all segments of the industry move forward in the challenging days to come.

Publication Date: Friday, March 01, 2013

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