What the hospitals of the future could look like
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Illustration: Sarah Grillo/Axios
Economists say in an ideal world, different hospitals will specialize in different forms of care while others — particularly in rural areas — will focus on providing basic services.
Why it matters: The hospital of the future will likely mean a significantly different patient experience, in ways both obvious (it'll have better technology) and potentially disruptive (it could require more travel).
- "My own view of what it's going to look like in the longer run is much, much fewer hospitals that are much, much bigger," said Yale economist Zack Cooper.
Where it stands: Many health systems are already cutting service lines — maternity care is a common one — or closing altogether, especially rural hospitals.
- To some extent, that may be OK, some experts say. The reality created by shifting demographics is that some places just don't have the population necessary to support certain services.
- Not only do the economics not work, but a handful of specialized procedures every year probably isn't enough to keep providers well-trained.
Between the lines: Instead of consolidation, there should be more of a divergence between hospitals that provide basic care to local communities and those that specialize in more complex care, Cooper said.
- That model, of course, would mean many patients would have to travel for certain care instead of receiving it at their local hospital.
And as technology broadly changes the consumer experience, patients will have similar expectations for their care.
- "People's gold standard is buying stuff on Amazon at 2 in the morning, and when they compare their health care experience, they say, 'Why can't my health care experience be more like that?'" said Ken Kaufman, co-founder of consulting agency Kaufman Hall.
- Emerging medical technologies will also impact the care that people receive, and hospitals are positioning themselves at the forefront of that change.
- "Patients right now — and in the future — can expect more care delivery that is driven by 3D modeling; predictive analytics; advanced robotics for surgeries and treatments; and personalized therapies based on genomics," American Hospital Association president and CEO Rick Pollack wrote in a blog post last year.
Yes, but: Hospitals that serve higher populations of vulnerable people, who are more likely to have lower-paying government insurance, are the most financially exposed.
- That means if they don't adapt, care could become even less accessible for these patients.
Some economists' ideal version of the future may mean lower profits for health systems.
- Hospitals "should do what they do best, which is inpatient care and emergency care … and other people should do things that they do best, like the physicians working together as a multi-specialty group but not part of the hospital," said Johns Hopkins professor Gerard Anderson.
- "They wouldn't make the substantial profits they're making, but for the nonprofits, that's not the goal," he added.
The bottom line: "Is there going to be disruption? Yes," Cooper said. "I think there's a romanticism about local hospitals. They're where our kids were born and where our parents spent their final days."
- "But I firmly believe the local hospital of the future is not doing everything for everyone."
