The Future of Healthcare, as we know it, is changing at an explosive rate especially in conjunction with the economy as well as the introduction of the Patient Protection and Affordable Care Act (PPACA). The PPACA was enacted in 2010 and has provisions and standards which will become effective through 2015 adding to the evolution of healthcare. Additionally, the state of the economy is affecting all Americans, requiring all of us to do more with less

DPR Construction surveyed 42 leaders in the healthcare industry as to what they predicted the future holds for the healthcare industry. Following are the results of the survey which focus upon wellness, integration, and community embeddedness:

1. There is a care shift to prevention and wellness, services which may be performed in a primary care setting or other non-hospital setting, which may shift hospital emphasis to high acuity patients and services. Hospitals may become smaller in size due to shift in scope and the treatment of fewer lower acuity patients.
2. Healthcare systems are continuing to merge together creating fewer systems, each consisting of more facilities. This merging trend may decrease the number of not-for-profit facilities as some of these are merging with for profits. Additionally, the trend is toward physician practices becoming a part of healthcare systems rather than operating independently.
3. Outpatient services will become more of an emphasis due to a shift toward patient centered healthcare and the creation of Medical Homes and Affordable Care Organizations, again supporting the transition to focusing upon prevention and wellness.
4. Specialty areas will continue to focus upon the aging population and will center on services which are most profitable such as cardiac, oncology, and arthritis.
5.  Health Information Technology will continue to become a primary interest which will require facilities to increase spending for things such as electronic medical records, telemedicine, home monitoring systems, and point of care. Increased costs may be due to implementing or upgrading these systems as well as possible facility changes to accommodate these systems and perhaps the addition of staff to implement and manage these systems.
6. The economy will continue to be an issue. Facilities have less cash on hand necessitating the need for external funding, also calling into question the ability to repay amounts borrowed. Lending institutions are beginning to delay funding decisions making it more difficult to obtain the funding requested and in a timely manner.
7. Renovation and re-purposing of facilities will become more important. Generally, it is much more cost effective to renovate an existing building than to start over fresh with a brand new building. The condition of the facility is something that affects patient satisfaction and is therefore an item of interest. Patients are gravitating toward state-of-the art facilities requiring each facility to “keep up with the Joneses”.
8. There is shift toward being “green” as patients are beginning to value organizations which are actively moving toward saving operational costs through “green” measures.
9. Delivery methods are changing in order to provide reduced costs, collaborative efforts to reduce wastes and increase efficiencies.
10. Demographics are changing and care will need to accommodate the aging population, including both aging illnesses, increased numbers of patients, and sufficient number of physicians to treat the increased number of patients.

These predictions, along with healthcare legislation slated and pending and changes in the economy, provide additional challenges for the healthcare industry. Competitive advantage will be much more difficult to obtain.