If there was a dominant theme at the American Hospital Association's most recent Board of Trustees meeting last week, it was this: health care in the United States is at a critical evolutionary juncture, and without a firm, proactive response to the myriad forces shaping this environment, hospitals could quickly be left behind.

 

That might sound a bit ominous, but that's because the stakes are so high - the changes underway are transformative and long-lasting. And hospitals are in a position to either shape their own destiny or become swept along as bit players in a larger movement.

 

Much of this change is focused on these buzzwords: "volume to value." We all know the underlying concept - that payers, providers and consumers are moving toward a system that rewards quality rather than quantity. But, very quickly, this phrase has become a cliché. Its presence is ubiquitous, but its meaning is diverse or, worse, undefined.

 

Maryland's hospitals are very much at the leading edge of the shift from volume to value under our all-payer agreement with the Centers for Medicare & Medicaid Services and hospitals' subsequent global budget contracts. Yet just two years into this five-year experiment, there is much debate about how to proceed. Are the early successes sustainable? What policies are needed to continue to improve? And, perhaps most important, what type of health care will consumers need and seek in the next few decades?

 

If these issues aren't concerning enough, here's one more: the longer it takes hospitals to create their own future by defining "value" to health care consumers, the greater the chance of disruptive enterprises encroaching on a domain that at one time belonged almost exclusively to hospitals. Already, a Tennessee-based company is developing comprehensive, data-driven care coordination capabilities; a New York-based insurance startup is marketing to millenials by offering simple, tech-based health solutions and consumer-friendly interfaces; and Wal-Mart, which operates more than 400 care clinics in 19 states, would be more than happy to provide services traditionally delivered by hospitals, like MRIs.

 

These challenges are serious, but in no way insurmountable. Hospitals have long histories with their communities and are consistently ranked among the most trusted institutions in the nation. Those are strong fundamentals on which to reinvent our work to meet the needs of a changing and demanding environment. And because Maryland's hospitals have a couple of years of experience with this new model, you're already beginning to develop a sense of what truly works and what resonates with your communities and patients. Those are great advantages going forward.