Health Care Group

Health Care Community Breakfast Comments, June 9, 2005

What trends will affect the way you do business in 5 years?

Economy	Financial challenges: as expenses rise faster than revenues, budgets are squeezed; capital projects get delayed or canceled. We must emphasize efficiencies. Inability of hospital management to change/become more creative (trend to greater management conservatism) More retirees in Traverse City means more demand for specialized medicine and a need to operate more efficiently - especially with Medicare as their primary payer. Greater need for long-term care units and home therapy services Soft economy in Michigan creates growing unemployment and uninsured As more uninsured delay treatment, hospitals are required to provide more acute levels of care Increased pressure on the community regarding homeland security Emerging need for training and equipment for bioterrorism preparedness Growth brings "big city" problems such as crime, safety needs, traffic, and environmental pollution, all of which increase health risks. Agricultural/tourist economy in region means lower wages and fewer benefits for many residents. Rising cost of healthcare Increasing competition for market share of profitable services from large downstate agencies/systems and national chain medicine. Decrease in government funding and insurance reimbursement rates (e.g. Medicare, Medicaid, mental healthcare). Burden of providing services to under/un-insured More emphasis on emergent & critical care Improved awareness of end-of-life care Higher demand for a larger variety of healthcare programs and services Public demand to become more involved and knowledgeable in their own healthcare Quantum leap in applying genomic discoveries to hospital environments Pandemic of new infections and increased cost of medicines More emphasis on conservation of environmental resources (e.g. clean air and water) Fewer family practices Limited clinical experience opportunities for students Recruitment/Retention of healthcare professionals - Physicians, RN, RT, PT, OT, X-ray, EMS, etc. Decreasing reimbursement (both hospital & physician) while increasing demands (regulatory & consumer) Reimbursement affects business and consumer; elective surgeries limited, increased out-of-pocket expense for consumer Shortage of trained staffing: assistants, office personnel, tech. equipment repair, nursing, automation/computer support Increased cost of training due to hiring inexperienced staff Inadequate support from community
Government	Government creates more mandates but provides no funding for them. Governmental/Insurance regulations change/impact clinical practice (e.g. less autonomy for physicians) Increased EMR regulation and respective program (maritime & law enforcement) requirements Increased requirements from accrediting agencies New codes (e.g. air balance, fire ratings) Nursing care - change in acuity levels (care levels) Inadequate funding of government insurance programs (e.g. Medicare, Medicaid) Stricter regulations for home health (e.g. paperwork required by Medicare & Medicaid)
Technology	Increasingly expensive technology needed to provide state-of-the-art care (but limited capital) Expanding technology increases patient knowledge and demand for cutting edge systems. Heavy reliance on electronic documentation Challenge of keeping all workers at all levels competent and aware of new technologies. New technology requires new information communication techniques. Building functions are controlled by automation (e.g. HVAC). Changes in technical advances occur faster, making equipment, facilities and some procedures obsolete. Patients may have to travel to another area for treatment. More advanced technology in nursing homes and home healthcare More uninsured people with increased acuity, requiring more technically advanced care Increase in wireless devices Increased public access to internal data
Demographics	Declining volunteerism Aging population growth puts strain on pre-hospital resources in the region. Decline in volunteerism in outlying areas necessitates increased Government spending on emergency services. Recruitment & retention of paramedics Geriatric population has increased interest in maintaining wellness, requiring more geriatric specialists and therapists. Seniors - how to manage their health & healthcare costs (e.g. Medicare) Aging workforce, particularly nurses (average age: 47) Young adults leaving the area Insufficient workforce to meet entry level needs Increasing population and development
Education	Increasing educational requirements for entry & completion in healthcare professions Increased continuing education requirements Increase in tuition; lower reimbursement Adult learners entering healthcare fields (non-traditional students) Transportation costs for lower income residents outside Traverse City creates barrier to training/education Lack of instructors (e.g. EMS) Higher education needs of nurses in teaching roles Shortage of trained workers (e.g. medical assistants, physical, occupational, and speech therapists), especially with more of the Medicare population requiring rehab services. Will get worse with PT program moving to Doctorate, OT & Sp masters. Need for more highly trained techs for diagnostic purposes K-12 students entering health education programs are weak in basic math and writing skills. Need for greater involvement from high schools educating students on health career choices. Local health occupations courses at high school level shifts burden to facilities Staff development - hands-on Less money for education travel Health literacy/wellness programs; move from the current model of a "sick care" system to one of prevention through health education

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