By Rose O. Sherman, EdD, RN, FAAN
Each year the American Hospital Association surveys members and does an environment scan to identify key trends that have a high probability of affecting the healthcare team. This report 2015EnvironmentalScan.pdf0 is full of valuable information for nurse leaders to better understand the critical issues that their organizations are likely to face. I have selected five of these to highlight in this blog but encourage you to read the whole report.
1. More Americans are insured but are choosing high deductible health care plans.
The good news with the affordable healthcare act (ACA) is that more Americans than ever before are now insured. The not so good news in these numbers is that a large number of these individuals are choosing health plans with high deductibles. The number of Americans choosing these high deductible plans increased from 4% in 2006 to 20% in 2013. This trend has serious implications for individuals and families when they develop serious illnesses. While the plans do a great job of covering low cost preventable care – when individuals have extensive healthcare needs, their deductibles exceed their savings. For healthcare systems, this could mean the level of bad debt might not decrease over time as was expected with more Americans insured. It also means that it is very likely that healthcare costs will continue to be the number one cause of bankruptcy in the US even for those with insurance.
2. One 10-15% of an individual’s health status is attributable to the health services that he/she receive.
Current research according to AHA indicates that an individual’s behavior is by far the biggest contributor to his/her overall health followed by genetics and social determinants. This creates challenges for health systems who are now being hit with ever increasing penalties for hospital readmission and poor discharge outcomes. It is expected that in the future, we will see stronger incentives and penalties put in place to encourage individuals to adopt more health oriented behaviors.
3. The demand for Mental Health Services is outstripping the supply.
Acute care environments such as emergency departments are confronting an increase in patients who seek mental health services that may not be readily available in their community. Nationally, a staggering 42.5 million adults (18.5% of the population) over 18 years of age experienced a mental illness in the past year. Only 62.9% of those needing services actually received them. The healthcare system is seriously under equipped to manage the problem and acute care clinicians find themselves providing care to these patients despite lacking the competency.
4. A continued movement from independent community-based hospitals to integrated health systems.
The days of the stand alone community hospital are likely to be numbered. Many of these hospitals are under considerable financial stress because they lack the economies of scale and negotiation abilities of larger systems. We increasing see what is called “horizontal integration” across the care continuum. Hospitals are being acquired along with physician practices, ambulatory centers, diagnostic centers, homecare and durable medical equipment companies. It is estimated that by the end of this decade, 75% of physicians will be employees of hospitals or healthcare companies.
5. The healthcare workforce needs a different skill set.
Healthcare CEOs recognize that they will need to build a workforce to address what is needed in tomorrow’s healthcare market. The challenge will be finding staff with the right skill sets as healthcare becomes less hospital centric and more community-based. 53% of CEOs want to hire more staff in the next 12 months but 63% are concerned about finding people with the right skills.
Monitoring future trends in healthcare is important for nurse leaders. You will be expected to assist both your organization and staff to adapt to the changes and maintain a competitive advantage. Executive recruiters have repeatedly told me that strategic planning is now a key skill which nurse leaders need to have in their toolbox. Take the time to read this important report and consider what the implications are for your work setting and organization.
Read to Lead
American Hospital Association (2015). Environment Scan. 2015EnvironmentalScan.pdf0
© emergingrnleader.com 2015
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