Noblis Predicts Hospital Trends, Sees Vulnerability

The Falls Church, Va.-based Noblis Center for Health Innovation says that due to the combined factors of access to capital becoming more restricted, a significant decline in philanthropic giving, dwindling investment income, increasing bad debt and growing charity care, many hospitals and health systems are extremely vulnerable. The Center predicts five trends that will impact provider delivery in 2009:

• Consumer demands will continue to change and utilization will be stable or even decline as consumers delay in seeking routine care; consumers will seek medical information/knowledge via Web resources; and medical travel will increase.
• Budgets will be trimmed and capital investments delayed; margins will decline, negatively affecting investment income, philanthropy, interest payments, unemployment, cash flow, bad debt, and charity care and most hospitals will trim their operating budgets, resulting in hiring freezes and lay-offs. The healthcare construction boom will continue, but at a much slower rate.
• The health care industry will consolidate even further as hospitals experience an increase in bankruptcies, program closures, and/or hospital closures. Small hospitals and rural hospitals will be the most at risk in today’s economy.
• The workforce will be in transition. Physician responses will include slowed/delayed retirements, seeking employment/practice purchase, and decreased acceptance of no pay/slow pay. Innovative staffing alternatives will be explored by hospitals and physicians and nursing vacancies may lessen.
• Health reform will not be universal, but will be a high priority on the national level although significant national system reform is unlikely in the short term. Hospitals will increase efforts to fund care for their uninsured patients.