Healthcare Strategy Development and Planning in a Dynamic Environment: Successfully Obtaining Planning, Design, and Construction Business While In The Midst of Change
Authors: Tom Testerman, ACHA, EDAC, NCARB; Kyle Kramer, FAAMA; Andrew Collignon, JD, AIA, GGP; James G. Easter, Jr., ACHE, FAAMA, MArch
The healthcare landscape is evolving through mergers, acquisitions, and tenuous federal legislation. The Patient Protection and Affordable Care Act (PPACA) was signed into law by the US Congress in 2010. The status of this law is changing as key components are being modified to reduce federal budget obligations. Without a back-up plan to the PPACA, these actions will continue to confuse consumers, frighten the underserved, and financially distress providers. The Certificate of Need (CON) laws and the Critical Access Hospital (CAH) programs in tandem with the Federally Qualified Health Clinics (FQHC) remain in flux without strategic vision, budgetary compliance, and continuity of effort. Cuts in reimbursement, insurance premiums, and the elimination of programs supporting underserved populations continue. The greatest impact occurs in the chronic disease, senior care, mentally ill, substance abuse, and emergency care arenas. Herein resides the future opportunities for healthcare planners and architects. Methods to improve the delivery processes and growth in demand continue with the roll out of free standing emergency departments (FSED), urgent care centers, and satellite micro hospitals (all these are efforts by developers and providers to improve access, reduce cost and gain market share). Reductions in hospital stays and recidivism continue to aid in cost reductions. This paper explores four key sectors of these market dynamics:
Mergers and Acquisitions
Realistic Needs Assessment
Emerging Models of Care
Consumer Expectations
Traditional planning will be redefined in light of these factors and the need for collaboration between industry experts working in partnership with the client to change processes, adjust operations, and A/E design solutions. We are witnessing how this disruption can be harnessed and directed toward improving the delivery of care while reducing fear, risk aversion, and “analysis paralysis” from numerous perspectives. Without vision with action, we lose our ability to change these external forces. To be effective, a methodology for owner-driven collaboration is required. The architecture of the future will be informed primarily by defining the strategies of service integration, population health, partnerships, and action-oriented service. This new service model will embrace a mutually beneficial philosophy of vision plus asset and operational planning. Capital dollars will be measured over time to demonstrate the optimum ROI and added value to the consumer. The recommendations will need to be feasible, flexible, sustainable, and transformable.
