The Earth is Moving Under Our Feet

February 2014

The tectonic plates beneath the ground we walk on constantly move, but we often do not notice unless the shift is a major one and causes an earthquake. As it has over the past decade, the healthcare industry continues to experience underlying shifts. However, we do not always immediately understand the changes because we cannot see or feel the movement while standing in the middle of it. But if we look at the larger picture, just as we can see the Earth’s plates from space, we gain a better understanding of the changes.

Examples of movement in the healthcare industry include:

  • Increased use of new, expensive therapies, procedures and technology.
  • Rapid expansion of healthcare facilities.
  • The aging of America and the associated costs.
  • Employers shifting healthcare costs to employees.
  • Growing numbers of uninsured and underinsured.
  • Growth in federal and state spending for Medicare and Medicaid.

Instead of feeling minimal tremors, the realization that the healthcare landscape underwent drastic changes hit us like an earthquake. We face a daunting transformation that continues to accelerate. Here are some examples of the continuing changes:

  • Healthcare marketplaces enrolling hundreds of thousands in high-deductible plans.
  • Medicaid expansion.
  • Narrow networks that exclude high-cost providers.
  • Various groups (insurance companies, physician groups, health systems, etc.) struggling to integrate care with employers, commercial payers, patients and the government.

The question for us is this: in the aftermath of these “healthcare earthquakes,” will we remain burrowed in our basement, hunkered down, trying to hang on to what’s familiar? Or will we view this movement of tectonic plates as an opportunity to significantly re-shape who we are and what we can become?

We should view the Affordable Care Act as an exciting opportunity to be a beacon of what the healthcare ministry should be.

We can:

  • Rapidly expand our continuum of care services, like our home care programs.
  • Create new partnerships with providers and payers.
  • Expand our person-centered approach to care, shifting services to community-based instead of institutional based.
  • Use technology to engage with patients as members of our health system.
  • Redesign our care delivery around best practices and provide it at a lower cost.

As these shifts continue, they will reveal new opportunities and we will remap our territory as a result.


Michael A. Slubowski, FACHE, FACMPE
President and Chief Executive Officer
SCL Health