Keys to Success

Out of the incredible complexity of health care reform, something resembling a consensus on how to run a hospital in the age of managed care seems to have emerged. Here it is.Out of the incredible complexity of health care reform, something resembling a consensus on how to run a hospital in the age of managed care seems to have emerged. Here it is.What to do: Remember, your hospital is making a flat amount of money for each person on your health plan. The more services you have to expend in treating a patient, the worse it is for your hospital. Think about treating patients in the following terms: Emphasize treating patients in doctors' offices or clinics before patients become seriously ill. Hospitalize patients only when it's really medically necessary; treat them as outpatients whenever possible. You may want to think about building an outpatient care center. Even if it costs a lot of money, it may just pay for itself in the long run. Johns Hopkins University just opened a new $140 million outpatient care facility. The University is also planning to build one, with plans to locate it where the Civic Center's Convention Hall now sits. What not to do: Sit out the managed care game, while hospitals in your area seem to be building networks of primary-care physicians and announcing comprehensive health plans. Doctors who affiliate with other hospitals will refer their patients to those other hospitals. This means your patient base might dwindle dangerously low, creating serious financial difficulties for your hospital. Not having patients also makes it hard to train medical students and nurses. A number of hospitals in the Midwest and West Coast, where managed care started catching on a few years ago, have reportedly experienced these problems. – Josh Goldwert