Tom Bell
Guest columnist
Health care is changing. For hospitals, the problem isn’t necessarily the change itself; it is the uncertainty. To make the best decisions for the communities they serve, hospitals must have an understanding of the environment.
The Kansas Hospital Association has released a new report identifying some of the most significant health care policy issues for the state’s hospitals. The report focuses on issues that are unknown but could affect the state’s hospitals, including the 2012 elections and the future of Medicaid expansion and health insurance exchanges.  It also addresses trends that are clearer, such as economic and demographic trends, consolidation in health care, the impact of technology, and performance improvement.
In broad terms, what the research indicates is that Kansas hospitals will be challenged by the confluence of state and national policy decisions, fundamental shifts in the way the health care system operates and the state’s demographic shifts and economic environment.
The 2012 election has moved the health care debate to the forefront, which is good. A robust debate about the direction of the health care system is important for designing the future health care delivery system to meet the needs and desires of patients and families. However, the ongoing nature of the debate complicates hospitals’ ability to make investments.  Cuts to entitlements, especially significant federal cuts to Medicare, could jeopardize hospitals and physicians — limiting access to care. The state’s pending decisions about Medicaid expansion also will have a substantial impact, at a time when hospitals have already surrendered significant Medicare revenue through the ACA with the expectation of expanded coverage.
The difficult financial climate has led to integration in health care. More hospitals are aligning through partnership, mergers and acquisitions. The number of physicians who are seeking hospital employment is increasing. Although these trends can bring additional assets for patient health, the sharing of technology and streamlining patient transitions are significant and costly investments.
Kansas has weathered the recession better than many states. However, many hospital margins remain at breakeven or below. This will present challenges to hospitals as emphasis is placed on improving the health of our communities and pay-for-performance initiatives.
Kansas ranks well on many performance measures in national surveys and ranks high in patient satisfaction. We are committed to continued improvement. Kansans deserve great hospitals. As turbulent and challenging as the present is for hospitals, Kansas hospitals are focused on delivering the best care to the communities they serve.
Health care policy is deservedly in the spotlight today because it is vitally important – especially because it affects the patients Kansas hospitals serve every day.
Tom Bell is the president and CEO of the Kansas Hospital Association in Topeka, Kan.