Budgeting for a more likely future

"The future isn't what it used to be!" Medical group managers must take this humorous truth as gospel. Managed care and capitation are rapidly changing everything about medical group planning and budgeting. Profit centers will cease to exist and instead, all departments will become cost centers. Specialists and primary care physicians will find themselves in very different--and much less comfortable--roles. Administrators must strive to keep the whole team working together even in the face of unprecedented stress. Incentives may change, but quality of care and patient satisfaction will need to stay high and even improve to ensure survival. The budgeting process can be an important tool for helping to prepare for the evolution of medical groups, but first the implications of medical marketplace reform must be understood and accepted. This task will be emotionally and intellectually challenging. Accepting the shape of our future is painful but necessary. The choice is clear: rapidly evolve or disappear.