Healthcare reform and the hospital industry: what can we expect?

Healthcare costs continue to increase dramatically, while quality remains a significant problem. Reform measures adopted by Congress will fuel expansion of these costs, further stressing taxpayers and employers and forcing hospitals to adopt transformational changes as they adjust to increased demands for services and shrinking reimbursement. Cost control and quality improvement can be achieved through increased competition or greater government intervention. Competition will require unpalatable changes to the healthcare system to decrease costs without further restricting access or decreasing quality. Increased government intervention will result in changes to reimbursement and hospital-physician relations and increased demands for improved care. To improve cost and quality while preserving increased access, we advocate for a universal standard coverage of Americans; accountable healthcare system leadership; leverage of information resources to make utilization decisions and evaluate performance; alignment of physician, hospital, and payer incentives to focus on care outcomes rather than profit maximization; and the use of quasicompetition to allow for consumer choice within this system.