Volatility and opportunity: industry forecast

Although hospitals have grown and prospered by "doing good," that purpose no longer is the only consideration in health care decisions. Business and the federal government now play key roles in controlling costs, and the once orderly prepayment industry is now a tangle of competitive interests. For the next few years, economic considerations will force quality-of-care issues to the background. In fact, until the current malpractice crisis, which causes physicians to practice defensive medicine, is resolved, it is unlikely that "doing good" will be the dominant concern. The future does not, however, hold greater and stiffer economic competition as far as one can see. Payers will be able to wring concessions from hospitals for only so long. When patient care is jeopardized, payers then will loosen the purse strings, and hospitals will return to a balance between "doing good" and "at what price".