Health care is undergoing enormous change again and it’s far from complete.

Industry senior executives who led their hospitals through the transition to the Federal DRG system in 1982 acknowledge that change from the Affordable Care Act is substantially greater. The full impact of the employer and individual mandates is still evolving and the Cadillac insurance plans will not be taxed until 2018. CMS continues to roll-out new initiatives (mandates) for hospital providers in an attempt to “improve patient outcomes and reduce costs”.

One given is that hospitals will still provide charity care to millions of patients each year despite the premise the ACA would provide insurance for the ”uninsured”. State allocation of charity care reimbursement to hospitals varies and is subject to the overall health of each state’s economy (tax revenues).

Streamlining operations, including physician alignment, implementing a patient engagement culture to optimize patient satisfaction, data mining to identify a special treatment plan for ‘frequent fliers’ who use ER services, identifying and expanding your more profitable service lines, investing in more IT data capability, securing greater buy-in from physicians, and positioning the hospital or system to generate more net revenue are vital to be successful in the new health care arena.