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Hospital Review September 2014 • Vol. 2014 No. 9 INDEX Table of Contents p. 6 Clinical Integration & ACOs p. 22 Population Health p. 35 Financial Management p. 44 Community Hospital Affiliation Strategy p. 49 Hospital and Health System Transactions p. 53 Physician Compensation p. 57 CMIO Roundtable p. 65 Health IT p. 70 Health System Strategy p. 72 Leadership & Management p. 76 26 of the Most Controversial People in Healthcare Physicians, executives and politicians with some of the industry's most polarizing ideas, viewpoints and personalities. p. 60 The Problem With Population Health Why ACOs need a new term to describe the work they're doing. p. 22 Dr. Farzad Mostashari: New Startup, Same Neckwear The former National Coordinator for Health IT on Aledade, his new company to help primary care physicians form and join ACOs. p. 26 Health City Cayman Islands: Where Your Patients Might Be Headed For Healthcare By Ayla Ellison It's going to take some major changes for hospitals in the U.S. to compete with coral sand beaches and high-quality healthcare offered at a low price What if you could experience beautiful weather, relaxing beaches, fine dining and the amenities of a five-star resort at your hospital? If you think that is impossible, look less Does More Value Mean Less Profit? How to Keep Pay-for- Performance From Hurting Hospital Income By Helen Adamopoulos Downers Grove, Ill.-based Advocate Health Care and Advocate Physician Partners — a care management collaboration with Advocate that brings together more than 4,500 physicians — are trailblazers in the realm of value-based care, says APP President Mike Englehart. Hospitals and health systems are fac- ing a large assortment of pressures, challenges and threats. Depending on their size and market, some of these issues are highly concerning, whereas others are more promising. This article briefly discusses 10 con- cerns and trends facing hospitals and health systems at the moment. 1. The growth of high-deduct- ible plans. Between the movement of employer-sponsored plans to high- deductible plans and the growth of healthcare exchanges, consumers have more and more responsibility for their healthcare costs. The num- ber of people covered by an employer- sponsored high-deductible plan sky- rocketed from just 4 percent in 2005 to 31 percent in 2011, according to the Kaiser Family Foundation. Seventeen percent of employers in a 2013 PwC survey offered a high-deductible plan as the only option for employees, and more than 44 percent were consider- ing making it the only option. When consumers pay more for their healthcare, they often make more cost-conscious choices. This is leading patients to delay treatment and reduce procedures performed and hospital admissions. We have also reached the beginning of the point where patients price-shop for care. High-deductible health plans, insurance shopping through the exchanges and price trans- parency are prompting patients to look for more low-cost alternatives than their traditional hospitals, such as ur- gent care centers and retail clinics. continued on page 8 continued on page 10 continued on page 8 INSIDE: 100 Accountable Care Organizations to Know — p. 14 10 Concerns and Trends Facing Hospitals Right Now By Scott Becker, JD, CPA, and Molly Gamble REGISTER TODAY! Becker's Hospital Review CEO Strategy Roundtable November 5, 2014 Ritz-Carlton Chicago, Chicago 40 Hospital & Health System CEOs Speaking Co-chaired by Scott Becker, Publisher, Becker's Hospital Review, and Chuck Lauer, Former Publisher, Modern Healthcare To learn more visit www.BeckersHospitalReview.com To register, visit www.regonline.com/ceoroundtable2014