A Sea Change in Health Care Delivery in the U.S.
Even if the U.S. Supreme Court unwinds part of health care reform law, the changes occurring now aren't likely to recede because all of the dominant players in the health care industry are staking out new ground. The driving forces are: cost cuts, care improvement and federal health-care overhaul preparation. In many cases, this has blurred the lines between businesses that have historically been separated. Hospitals are slowly bulking up into huge systems, merging with one another and building extensive new physician work forces. This reflects a continuing trend that dates back to the 1990s. Hospital capacity in the United States has steadily shifted away from independent hospitals and towards multi-hospital systems. Hospitals are getting into insurance-like setups (e.g., ACOs), including direct approaches to employers that cut out the health insurer. Insurers certainly aren’t dormant. They are buying health-care providers, or s