Impending Death of Hospitals

Physician Opportunity: Hospital CFOs Freak Out Over Failed Business Model

July 16, 2018

It’s not quite like life imitating art, but it’s probably as close to it as I’m going to see today.

I just read a puff piece sponsored by Bank of America, pricey click bait for hospital CFOs, that supposedly features a roundtable “conversation” among (oxymoron warning) forward-looking hospital CFOs.

Apparently, these CFOs have just realized that even the largest and, supposedly, best run hospitals and health systems are suffering from financial distress. The hospital-centric business model is broken. Ya think? [Read The Impending Death of Hospitals, on Amazon or, as a complimentary download.]

Their suggestion, after more than a decade of spending billions of dollars acquiring and otherwise “aligning” physicians, and then, as an industry group, blocking physician investment in hospitals, is that hospitals push into the outpatient/ASC world. (Attention hospital CFOs: this is not “forward-looking.” It is still looking into the rearview mirror to explain why hospitals are in decline.)

The problem of course, is that when hospitals thought that the future of healthcare would be hospital-centric, they convinced physicians that they needed the hospital. However, in the world as it’s become and is becoming even more so, that is, the outpatient, ASC (and not hospital outpatient department) centric world, physicians don’t need hospitals as partners. Oops.

For physicians, the unfolding world of independent outpatient care offers tremendous opportunity. Yes, it’s riddled with compliance landmines (and sure, the hospital industry will lobby for more restrictions faster than they can charge $15 for a single Tylenol), but most can be overcome. And, if I have to reverse social justice brainwashing, there’s nothing wrong with profiting legally from your referrals and healthcare investments.

Choose your partners wisely. Find those who’ll work with you, support common goals, and not seek to control you. Document deals properly up front — the expense will pale in comparison to that of undoing a poorly designed deal or of the first few months of litigation.

And, if you actually need a hospital partner for a joint venture, let the hospital compete for the deal. (Tell them you’re considering sending out an RFP. They used that ridiculous process to beat physicians down, and maybe I was wrong about their uselessness: I never considered them as a way to have fun.)

And, one final, free piece of advice for hospital CFOs: You should “forward look” back to elementary school: The time to ask Billy for an invitation to his party wasn’t after you stole his lunch.



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