
美國(guó)醫(yī)院經(jīng)受住了疫情最艱難時(shí)期的考驗(yàn),但由于非急需施行的手術(shù)被取消,醫(yī)院遭遇了到目前為止最嚴(yán)重的財(cái)務(wù)危機(jī)。圖片來(lái)源:JEFFREY BASINGER- NEWSDAY - GETTY IMAGES
過(guò)去兩年,由于新冠疫情肆虐,醫(yī)療保健行業(yè)變得與所有人的生活都息息相關(guān)。在全民急需醫(yī)療服務(wù)的時(shí)刻,美國(guó)的醫(yī)療保健服務(wù)提供商們英勇無(wú)畏,而且即使又爆發(fā)了一波疫情,但至少?gòu)呐R床的角度,他們顯然已經(jīng)度過(guò)了最嚴(yán)重的時(shí)期。
了解醫(yī)療保健提供商目前的財(cái)務(wù)狀況同樣至關(guān)重要。醫(yī)療保健行業(yè)是美國(guó)經(jīng)濟(jì)規(guī)模最大的行業(yè),美國(guó)每年醫(yī)療保健支出超過(guò)4萬(wàn)億美元。其中超過(guò)一半支出需要由醫(yī)療保健提供商經(jīng)手。他們的財(cái)務(wù)健康狀況至關(guān)重要,因?yàn)橐环矫嫠麄優(yōu)槿藗兲峁┎豢苫蛉钡淖o(hù)理,另一方面大部分醫(yī)療保健提供商都是其所服務(wù)社區(qū)最大的雇主。
醫(yī)療保健行業(yè)遭遇了史上最嚴(yán)重的財(cái)務(wù)危機(jī),許多醫(yī)院因?yàn)榛颊邤?shù)量大幅減少而瀕臨倒閉。好消息是隨著我們逐步走出疫情的陰霾,該行業(yè)即將迎來(lái)強(qiáng)勢(shì)反彈。
為了更深入地了解美國(guó)醫(yī)療保健服務(wù)提供商的財(cái)務(wù)現(xiàn)狀,我于上周在第40屆摩根大通醫(yī)療健康年會(huì)(40th Annual JP Morgan Healthcare Conference)上了解了非營(yíng)利性醫(yī)療服務(wù)提供商的狀況。有20家美國(guó)最杰出的醫(yī)療系統(tǒng)的首席執(zhí)行官和首席財(cái)務(wù)官在此次大會(huì)上作了報(bào)告,這20家機(jī)構(gòu)代表了近2500億美元的年度醫(yī)療保健支出。
醫(yī)療保健行業(yè)的財(cái)務(wù)健康狀況
演講嘉賓明確指出,美國(guó)業(yè)內(nèi)領(lǐng)先的醫(yī)療系統(tǒng)經(jīng)過(guò)V字型復(fù)蘇,已經(jīng)完全恢復(fù)元?dú)狻?020年3月,由于非急需施行的手術(shù)被取消,美國(guó)醫(yī)院的患者數(shù)量減少了近30%。目前,患者數(shù)量已經(jīng)恢復(fù)到接近疫情之前的水平,收入和利潤(rùn)率均大幅回升。
但大醫(yī)院的情況并不適合社區(qū)醫(yī)療服務(wù)提供商。Strata與400多家醫(yī)療保健服務(wù)系統(tǒng)和2000家醫(yī)院合作。許多小型醫(yī)療保健服務(wù)提供商依舊利潤(rùn)微薄。
雖然未來(lái)依舊面臨著嚴(yán)峻挑戰(zhàn),但許多醫(yī)療系統(tǒng)的財(cái)務(wù)狀況已經(jīng)顯著好轉(zhuǎn)。長(zhǎng)期陷入困境的醫(yī)院終于迎來(lái)了喘息之機(jī)?,F(xiàn)在他們有精力著眼于未來(lái)進(jìn)行戰(zhàn)略思考。
未來(lái)的主要策略
通過(guò)收入多樣化推動(dòng)可持續(xù)增長(zhǎng)是此次會(huì)議的主題,未來(lái)策略主要涉及五個(gè)關(guān)鍵領(lǐng)域:
并購(gòu):并購(gòu)仍然是未來(lái)的策略之一。例如,猶他州的Intermountain Healthcare最近收購(gòu)了科羅拉多州的SCL Health,南卡羅來(lái)納州的Prisma Health正在評(píng)估在北卡羅來(lái)納州和田納西州的潛在發(fā)展機(jī)會(huì)。
創(chuàng)新投資:2021年,醫(yī)療創(chuàng)新融資規(guī)模翻了一番,達(dá)到440億美元,醫(yī)療系統(tǒng)在其中發(fā)揮了積極作用。例如,伊利諾伊州的Advocate Health Care在一家數(shù)字醫(yī)療公司擁有17%的股權(quán),并100%擁有一家老年人居家護(hù)理和健康解決方案提供商。此外,馬薩諸塞州的Mass General Brigham和Northwell Health旗下的營(yíng)利性子公司Northwell Holdings & Ventures發(fā)起了5億美元風(fēng)險(xiǎn)投資計(jì)劃。
基于價(jià)值與風(fēng)險(xiǎn)的合同:醫(yī)療保健行業(yè)繼續(xù)向“為價(jià)值付費(fèi)”的模式轉(zhuǎn)變。Intermountain基于價(jià)值的合同所帶來(lái)的收入,現(xiàn)在超過(guò)了傳統(tǒng)的“為服務(wù)付費(fèi)”業(yè)務(wù)的收入。賓夕法尼亞州的Jefferson Health公司30%的收入與完全基于風(fēng)險(xiǎn)的模式有關(guān),這種收入模式將醫(yī)療服務(wù)付費(fèi)與醫(yī)療服務(wù)的成本和質(zhì)量掛鉤。
打造目的地醫(yī)療中心:打造“目的地”專(zhuān)業(yè)醫(yī)療中心,是大型醫(yī)療系統(tǒng)目前正在探索的策略之一,涉及矯形外科等傳統(tǒng)領(lǐng)域以及行為和精神健康等較新的領(lǐng)域。比如,密歇根州的Henry Ford Health正在建設(shè)新醫(yī)療設(shè)施,預(yù)計(jì)將為其增加170萬(wàn)患者,創(chuàng)造22億美元收入。
部署虛擬護(hù)理平臺(tái):醫(yī)療系統(tǒng)著手?jǐn)U大市場(chǎng)的同時(shí),希望通過(guò)一種對(duì)人力資本要求較低的護(hù)理模式解決當(dāng)前人手不足的問(wèn)題。例如,費(fèi)城兒童醫(yī)院(Children’s Hospital of Philadelphia)在大會(huì)上表示,數(shù)字化將成為其增長(zhǎng)的關(guān)鍵驅(qū)動(dòng)因素,Mass General Brigham在2021年虛擬接診超過(guò)200萬(wàn)次。
無(wú)論從臨床還是財(cái)務(wù)的角度,美國(guó)的醫(yī)療保健服務(wù)提供商都已經(jīng)經(jīng)受住了疫情的考驗(yàn)。他們順利度過(guò)了一系列可怕的挑戰(zhàn),并且大多數(shù)提供商都能夠維持財(cái)務(wù)穩(wěn)定。現(xiàn)在,他們可以著手關(guān)注亟待解決的許多與美國(guó)人健康有關(guān)的其他問(wèn)題。
雖然過(guò)去兩年我們都?xì)v盡艱辛,但我們可以并且應(yīng)該為醫(yī)療保健行業(yè)史上最強(qiáng)勢(shì)的復(fù)蘇歡呼。(財(cái)富中文網(wǎng))
本文作者丹·米切爾森現(xiàn)任位于芝加哥的Strata Decision Technology公司的首席執(zhí)行官。該公司提供基于云的財(cái)務(wù)規(guī)劃、分析和績(jī)效平臺(tái),服務(wù)美國(guó)400個(gè)醫(yī)療系統(tǒng)旗下的2000多家醫(yī)院,其客戶涵蓋了美國(guó)一半以上的醫(yī)療保健服務(wù)提供商。
翻譯:劉進(jìn)龍
審校:汪皓
過(guò)去兩年,由于新冠疫情肆虐,醫(yī)療保健行業(yè)變得與所有人的生活都息息相關(guān)。在全民急需醫(yī)療服務(wù)的時(shí)刻,美國(guó)的醫(yī)療保健服務(wù)提供商們英勇無(wú)畏,而且即使又爆發(fā)了一波疫情,但至少?gòu)呐R床的角度,他們顯然已經(jīng)度過(guò)了最嚴(yán)重的時(shí)期。
了解醫(yī)療保健提供商目前的財(cái)務(wù)狀況同樣至關(guān)重要。醫(yī)療保健行業(yè)是美國(guó)經(jīng)濟(jì)規(guī)模最大的行業(yè),美國(guó)每年醫(yī)療保健支出超過(guò)4萬(wàn)億美元。其中超過(guò)一半支出需要由醫(yī)療保健提供商經(jīng)手。他們的財(cái)務(wù)健康狀況至關(guān)重要,因?yàn)橐环矫嫠麄優(yōu)槿藗兲峁┎豢苫蛉钡淖o(hù)理,另一方面大部分醫(yī)療保健提供商都是其所服務(wù)社區(qū)最大的雇主。
醫(yī)療保健行業(yè)遭遇了史上最嚴(yán)重的財(cái)務(wù)危機(jī),許多醫(yī)院因?yàn)榛颊邤?shù)量大幅減少而瀕臨倒閉。好消息是隨著我們逐步走出疫情的陰霾,該行業(yè)即將迎來(lái)強(qiáng)勢(shì)反彈。
為了更深入地了解美國(guó)醫(yī)療保健服務(wù)提供商的財(cái)務(wù)現(xiàn)狀,我于上周在第40屆摩根大通醫(yī)療健康年會(huì)(40th Annual JP Morgan Healthcare Conference)上了解了非營(yíng)利性醫(yī)療服務(wù)提供商的狀況。有20家美國(guó)最杰出的醫(yī)療系統(tǒng)的首席執(zhí)行官和首席財(cái)務(wù)官在此次大會(huì)上作了報(bào)告,這20家機(jī)構(gòu)代表了近2500億美元的年度醫(yī)療保健支出。
醫(yī)療保健行業(yè)的財(cái)務(wù)健康狀況
演講嘉賓明確指出,美國(guó)業(yè)內(nèi)領(lǐng)先的醫(yī)療系統(tǒng)經(jīng)過(guò)V字型復(fù)蘇,已經(jīng)完全恢復(fù)元?dú)狻?020年3月,由于非急需施行的手術(shù)被取消,美國(guó)醫(yī)院的患者數(shù)量減少了近30%。目前,患者數(shù)量已經(jīng)恢復(fù)到接近疫情之前的水平,收入和利潤(rùn)率均大幅回升。
但大醫(yī)院的情況并不適合社區(qū)醫(yī)療服務(wù)提供商。Strata與400多家醫(yī)療保健服務(wù)系統(tǒng)和2000家醫(yī)院合作。許多小型醫(yī)療保健服務(wù)提供商依舊利潤(rùn)微薄。
雖然未來(lái)依舊面臨著嚴(yán)峻挑戰(zhàn),但許多醫(yī)療系統(tǒng)的財(cái)務(wù)狀況已經(jīng)顯著好轉(zhuǎn)。長(zhǎng)期陷入困境的醫(yī)院終于迎來(lái)了喘息之機(jī)?,F(xiàn)在他們有精力著眼于未來(lái)進(jìn)行戰(zhàn)略思考。
未來(lái)的主要策略
通過(guò)收入多樣化推動(dòng)可持續(xù)增長(zhǎng)是此次會(huì)議的主題,未來(lái)策略主要涉及五個(gè)關(guān)鍵領(lǐng)域:
并購(gòu):并購(gòu)仍然是未來(lái)的策略之一。例如,猶他州的Intermountain Healthcare最近收購(gòu)了科羅拉多州的SCL Health,南卡羅來(lái)納州的Prisma Health正在評(píng)估在北卡羅來(lái)納州和田納西州的潛在發(fā)展機(jī)會(huì)。
創(chuàng)新投資:2021年,醫(yī)療創(chuàng)新融資規(guī)模翻了一番,達(dá)到440億美元,醫(yī)療系統(tǒng)在其中發(fā)揮了積極作用。例如,伊利諾伊州的Advocate Health Care在一家數(shù)字醫(yī)療公司擁有17%的股權(quán),并100%擁有一家老年人居家護(hù)理和健康解決方案提供商。此外,馬薩諸塞州的Mass General Brigham和Northwell Health旗下的營(yíng)利性子公司Northwell Holdings & Ventures發(fā)起了5億美元風(fēng)險(xiǎn)投資計(jì)劃。
基于價(jià)值與風(fēng)險(xiǎn)的合同:醫(yī)療保健行業(yè)繼續(xù)向“為價(jià)值付費(fèi)”的模式轉(zhuǎn)變。Intermountain基于價(jià)值的合同所帶來(lái)的收入,現(xiàn)在超過(guò)了傳統(tǒng)的“為服務(wù)付費(fèi)”業(yè)務(wù)的收入。賓夕法尼亞州的Jefferson Health公司30%的收入與完全基于風(fēng)險(xiǎn)的模式有關(guān),這種收入模式將醫(yī)療服務(wù)付費(fèi)與醫(yī)療服務(wù)的成本和質(zhì)量掛鉤。
打造目的地醫(yī)療中心:打造“目的地”專(zhuān)業(yè)醫(yī)療中心,是大型醫(yī)療系統(tǒng)目前正在探索的策略之一,涉及矯形外科等傳統(tǒng)領(lǐng)域以及行為和精神健康等較新的領(lǐng)域。比如,密歇根州的Henry Ford Health正在建設(shè)新醫(yī)療設(shè)施,預(yù)計(jì)將為其增加170萬(wàn)患者,創(chuàng)造22億美元收入。
部署虛擬護(hù)理平臺(tái):醫(yī)療系統(tǒng)著手?jǐn)U大市場(chǎng)的同時(shí),希望通過(guò)一種對(duì)人力資本要求較低的護(hù)理模式解決當(dāng)前人手不足的問(wèn)題。例如,費(fèi)城兒童醫(yī)院(Children’s Hospital of Philadelphia)在大會(huì)上表示,數(shù)字化將成為其增長(zhǎng)的關(guān)鍵驅(qū)動(dòng)因素,Mass General Brigham在2021年虛擬接診超過(guò)200萬(wàn)次。
無(wú)論從臨床還是財(cái)務(wù)的角度,美國(guó)的醫(yī)療保健服務(wù)提供商都已經(jīng)經(jīng)受住了疫情的考驗(yàn)。他們順利度過(guò)了一系列可怕的挑戰(zhàn),并且大多數(shù)提供商都能夠維持財(cái)務(wù)穩(wěn)定。現(xiàn)在,他們可以著手關(guān)注亟待解決的許多與美國(guó)人健康有關(guān)的其他問(wèn)題。
雖然過(guò)去兩年我們都?xì)v盡艱辛,但我們可以并且應(yīng)該為醫(yī)療保健行業(yè)史上最強(qiáng)勢(shì)的復(fù)蘇歡呼。(財(cái)富中文網(wǎng))
本文作者丹·米切爾森現(xiàn)任位于芝加哥的Strata Decision Technology公司的首席執(zhí)行官。該公司提供基于云的財(cái)務(wù)規(guī)劃、分析和績(jī)效平臺(tái),服務(wù)美國(guó)400個(gè)醫(yī)療系統(tǒng)旗下的2000多家醫(yī)院,其客戶涵蓋了美國(guó)一半以上的醫(yī)療保健服務(wù)提供商。
翻譯:劉進(jìn)龍
審校:汪皓
Over the last two years, health care has been at the center of our lives due to the COVID-19 pandemic. Our nation’s health care providers responded heroically in our time of need, and even as another wave hits, it’s clear they have weathered the worst of the storm, at least from a clinical perspective.
Understanding the current financial health of health care is also important. It's the biggest industry in our economy with over $4 trillion in annual spending. Over half of that spending?flows through our nation’s health care providers. Their financial health is critical, not only so that they can provide us with the care that we need, but also because most are the largest employer in the communities they serve.
Behind the scenes, this was the biggest financial crisis in the history of health care, with many hospitals running on life support due to the dramatic drop in patient volume. The good news? As we emerge from the pandemic, the stage has been set for what could be a stunning comeback.
To better understand the current financial condition of our nation’s health care providers, the place to go last week was the non-profit provider track at the 40th Annual JP Morgan Healthcare Conference, which featured presentations from CEOs and CFOs of 20 of the nation’s most prominent health systems, representing nearly $250 billion in collective annual spend.
The financial health of health care
Speakers were clear that our nation’s top health systems have completed their comeback with essentially a V-shaped recovery. Overall, patient volume dipped nearly 30% in March of 2020 as elective surgeries were canceled. Volume is now back closer to where it was pre-pandemic, with a strong recovery in revenue and margins.
However, the experience of large hospitals doesn’t necessarily extend to community providers. At Strata, we work with over 400 health care delivery systems and 2,000 hospitals. For many smaller providers, margins are still razor-thin.
While there are still major challenges ahead, many health systems have made a remarkable comeback from a financial perspective. The hospitals that fell below the surface for a long time are finally able to breathe again. They now have the bandwidth to think strategically and look to the future.
Top strategies going forward
Diversifying revenue streams to drive sustainable growth was the primary theme at the conference, with strategies falling into five key areas:
Mergers and acquisitions: M&A continues to be part of the playbook. For example, Intermountain Healthcare in Utah recently acquired of SCL Health in Colorado, and Prisma Health in South Carolina is evaluating potential opportunities in North Carolina and Tennessee.
Investing in Innovation: Health innovation funding doubled in 2021 to $44B, with health systems playing an active role. Advocate Health Care in Illinois, for example, has 17% ownership in a digital health company and 100% ownership in a homecare and wellness solution for seniors. There are other examples, such as the $500M VC initiative from Mass General Brigham in Massachusetts and Northwell Health’s for-profit subsidiary called Northwell Holdings & Ventures.
Value and risk-based contracts: Health care continues to move toward a fee-for-value model. Intermountain’s revenue from value-based contracts now exceeds traditional, fee-for-service revenue. About 30% of Pennsylvania-based Jefferson Health’s revenue is tied up in full, risk-based models, a form of reimbursement that ties payments for care delivery to both the cost and the quality of care provided.
Creating destination centers: Building “destination” specialty centers is another strategy large health systems are exploring, both in traditional areas like orthopedics and newer areas like behavioral and mental health. For example, Henry Ford Health in Michigan is building new facilities and expects to generate an incremental 1.7 million visits and $2.2 billion in revenue.
Deploying virtual care platforms: Health systems are looking to extend their market reach and simultaneously address the ongoing labor shortage through a care modality with a less intensive human capital requirement. Children’s Hospital of Philadelphia, for example, shared that digital will be the key enabler of their growth, and Mass General Brigham had over two million virtual visits in 2021.
Our nation’s health care providers stepped up and weathered the pandemic from both a clinical and financial perspective. They have been able to manage through a series of overwhelming challenges and most are on solid ground from a financial perspective. They can now start focusing on the many other issues we need to address relative to the health of the nation.
While the last two years have been hard on all of us, we can and should collectively celebrate the greatest comeback in the history of health care.
Dan Michelson is the CEO of Chicago-based Strata Decision Technology, which provides a cloud-based financial planning, analytics and performance platform supporting a customer base of over 2,000 hospitals in 400 health systems, representing over half of the health care providers in the U.S.