Today. 15 concepts that Scott Becker's keeping an eye on and I think are important to keep an eye on as well.

 My name is Bill Russell. I'm a former CIO for our 16 hospital system and creator of this week Health. A set of channels dedicated to keeping health IT staff current and engaged. We want to thank our show sponsors who are investing in developing the next generation of health.

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 All right. So Scott Becker posted a LinkedIn post that I think is really interesting and worth, , taking a look at. And he captures 16, did I say 15? I said 15 earlier. It's 16. 16 concepts that he is keeping an eye on. Based on some of the interviews and conversations that he, he's having, and I was reading these and I thought, this is worth sharing with y'all, so I'm gonna do that.

Number one, the era of cross subsidization is coming to an end. Health systems and providers were traditionally paid more by commercial payers and less by government payers, so they made margin via commercial business. Now the commercial payers don't pay nearly as much and have more. further, government payers comprise more of the revenues, but at lower reimbursement rates.

Further services used to subsidize poorly paying services. Are often moving out of the health system. Wow, there's an awful lot in that. One is, hey, your commercial payers are more powerful. They're giving you less money. Your commercial book of business, or I'm sorry, your government book of business is growing and they're paying less money and the things that you used to make money on is now getting cannibalized and people are taking it outside your health system.

Definitely worth, worth keeping an eye on. Number two, health systems are seeing leak. Of better paying businesses to all kinds of sites and competitors, and we've been talking about that for quite some time, that the competition's heating up and we have to be better. And I'm just gonna keep commenting on these as we go along.

We have to be better at the consumer aspect of our business. And we've known this for the better part of almost a decade, and now it's time to put up or shut up. We have to be good. The consumer aspect, knowing our consumer, , creating convenience, access, , you know, digital experiences, it, it all matters, right?

, number three, there's a massive competition for doctors and nurses and staff and not enough of these people. 1 million plus doctors against a quickly growing population in aging population, i e 330 million and growing. Number four, Medicare Advantage has become usually financially helpful for huge.

And a few health systems that got out in front of this. It's not so helpful to the others. There's also a huge increase in Medicaid managed care. All right, so again, , we've been talking about this for a little bit and the, , the systems that got out in front of this, the systems that are getting first dollar, and I don't think it's too late to get into this game.

I think you have to get into this game. In fact, , you have to. Offering products to your market, and a lot of health systems have shied away from this or get very strong partnerships with local players if they exist. Number five, systems are looking at how to redefine how they do work to be more efficient.

, I think Mark Zuckerberg and the year of efficiency, right? So health systems are hyper vigilant on efficiency. Number six, health systems need to often decide if investing in tech people or capital project. Tech people or capital projects. There's no commas in this because it's social media. Health systems need number six.

Health systems need to often decide if investing in tech people or capital projects and what mix. That's always been the case. Not sure that's new. I'm gonna skip number seven cuz it's an ad. Number eight. All systems are working hard to automate as well as retain and. and need to invest in technology to make the delivery of care a great mix of people and technology.

Absolutely. , let's see. Number nine. Value-based care keeps evolving largely because systems and payers can make money that way.

The actual benefit to the healthcare system as a whole, as it actually works today is a great question. Form follows finance as much as follows function. Thank you, bill Hercules for this concept. Number 10. Because health systems remain the backbone of our safety net, we will see a concept evolved of too big to fail in healthcare.

Health systems are the backbone of the safety net.

That is likely true and brings up a whole host of questions. . , are they gonna help this health system or that health system? Are they gonna help rural health systems? They gonna help academic medical centers?

Who are they gonna help? , becomes an interesting question. The Intertrust authorities are misguided in taking aim at hospitals. Interesting. Number 12, inflation in staff and other costs remain very serious and. He notes Michael Dowling's work to stem gun violence. And , let's see.

I'll skip a couple of these. Go to the last one. Overall health systems are incredibly mission driven and face often an exhausted and dedicated workforce and numerous challenges as costs go up, reimbursements stay flat, and goods business moves out. There. It is in a nutshell that right there. One is we have great people, we're mission driven, and these are good things.

, the people are exhausted, the workforce is exhausted, and they're facing many challenge. And that's one of the challenges we have in front of us. And the main crux of the challenge is our costs are going up, our reimbursements are not, and we have business that continues to move out. As, you know, new and alternative options pop up.

So I thought I would share those. Those are worth putting in your head. These, these are a result of his interviews. I have similar lists from the interviews that I do. He interviews a little different group of people than I do, and , I think this is. Just I, if you are in the, the conversations which require you to understand the business of healthcare, this is a great list to have in your head.

Again, it was, , Scott Becker's post on LinkedIn Worth taking a look at. I.

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