As the healthcare system shifts toward paying for patient outcomes, hospitals will focus on reducing cost, improving quality, and boosting consumer experience.
If you want to know what hospitals will look like in the near future, take a peek at UF Health’s recently opened Heart & Vascular Hospital and Neuromedicine Hospital in Gainesville, Florida.
The use of green space and large windows opens these hospitals to the outside, rather than closing them off like the institutionalized brick-faced boxes of the past.
And the buildings have two front doors — rather than a front and a back — to allow easy access for visitors.
Inside the hospitals, private patient rooms have wall-to-wall windows, furniture built for family members’ comfort, a wide flat-screen TV monitor, and bedside tablets for patient communication.
You might expect features like these in a four- or five-star hotel. But as hospitals’ “customers” shift from insurer to patients, more medical buildings will be designed to enhance the experience of patients and their families.
Still, expect more than just a makeover.
You will also see a change in what services hospitals provide and where they fit into the overall healthcare ecosystem.
Driving many of these changes is the rise in value-based healthcare, where hospitals and other providers are paid based on patient health outcomes, not how many services they provide.
“The overall trend is moving from volume to value-based payment mechanisms,” said Michael Rovinsky, a director of Veralon, a Philadelphia-based healthcare consulting firm.
Rovinsky told Healthline that as a result of this, hospitals will focus more on reducing costs, improving the quality of care, and boosting consumer experience.
You’ll also see hospitals catching up with the on-demand access we already enjoy in other areas of our lives.
If you need to make a restaurant reservation, you can check out reviews online and make a reservation right from your phone. If you need a ride to a party, you can use a ridesharing app for a pickup.
So why expect anything less from your hospital?
Hospitals’ online patient portals will allow you to check in before you show up for your procedure or hospital stay. And see your medical records and test results wherever you are — even from the bedside tablet in your hospital room.
You’ll also be able to consult with a doctor or nurse by video or online chat — before you drive to the emergency department or urgent care center.
And apps will proliferate — guiding you to the best parking spot and to your destination inside the hospital. Or updating family members on your status so they don’t have to wait around at the hospital.
But even as hospitals make it more convenient for you to show up and more comfortable once you’re there, the patient experience will extend more beyond the walls of the facility.
“Part of the consumer focus,” said Rovinsky, “is having accessibility, and that is not just bricks and mortar.”
He thinks that at some point telehealth — also known as telemedicine — will become a “significant” part of the healthcare system.
This is partially for the convenience of patients and family members. But also for hospitals’ bottom lines.
“It will be in their best interest to provide services by telehealth mechanisms, even if there’s no direct payment,” said Rovinsky, “because it will reduce their overall cost of care.”
Hospitals spend a lot of money to take care of a patient admitted to the hospital. With value-based payments, there’s less incentive for hospitals to keep patients long term.
Telehealth will enable hospitals to monitor patients once they’ve gone home, allowing them to be discharged earlier.
While at home, patients will check in regularly with a nurse or doctor by video. If their health changes, or an in-person visit is needed, a mobile health team can visit the patient’s home.
Telehealth, though, isn’t just for outside the hospital. Remote monitoring will keep an eye on patients’ vitals from the moment they check in. If there’s a problem, nurses or doctors can be dispatched immediately.
Your location may even be monitored inside the hospital, so you can sit peacefully in the outdoor garden until it’s time for your procedure.
Technology will also help doctors diagnose patients, free staff from administrative burdens, and manage operating costs more tightly. Big data analysis and artificial intelligence will shine in these areas.
Does that mean hospitals will be expendable?
Not at all.
“Most hospitals aren’t going anywhere,” said Rovinsky. “There will continue to be a need for hospitals to provide acute, complex care.”
This includes handling emergencies and performing complicated surgeries such as triple bypass heart surgery or brain surgery.
Some health experts see two main types of hospitals in the near future.
One type of hospital will treat sicker or more acute care patients. These will probably be located at academic medical centers or at well-established hospitals in an urban area.
Suburban and community hospitals will focus on preventing illness, providing primary care services, taking care of patients with chronic illnesses, and performing common procedures.
Rovinsky thinks that in the future hospitals will specialize more, especially within large health systems where this can save money.
“Instead of every hospital in a health system having cardiology,” he said, “maybe there will be two or three that specialize in this field, and they will be geographically dispersed across the entire market area.”
Hospitals will no longer try to provide all services but will be known for a few specialties, such as neurology or high-risk pregnancies.
As medical technology advances, though, more procedures will be done in outpatient settings. This will give rise to ambulatory care facilities, like the multispecialty “hub” model of Kaiser Permanente, Mid-Atlantic States.
At Kaiser’s hub hospital, patients can stay for up to 23 hours, but there are no beds available for multi-night stays.
The facility can handle urgent and complex problems, minor medical care, and outpatient surgeries. If a patient’s condition is more severe, they can be admitted to a partner hospital.
“These ambulatory care hubs will become valuable,” said Rovinsky, “but they won’t replace the hospital. They’ll just diminish the number of beds needed in a market.”
Rovinsky thinks both of these hospitals have thrived in the current fee-for-service environment, where they can make money for each service they provide.
But they may not work going forward.
“In the long term, as we move toward value-based payments, these are both higher-cost settings that healthcare companies will probably want to avoid,” said Rovinsky.
Keith Mueller, PhD, director of the RUPRI Center for Rural Health Policy Analysis, said that so far stand-alone emergency departments have shown up mainly in urban areas.
But in the future, they could be a way to “maintain essential services in a rural community — such as emergency and outpatient services — but not the inpatient component.”
The Rural Emergency Acute Care Hospital (REACH) Act, introduced last year in the U.S. Senate, would allow for this kind of rural hospital designation under Medicare.
Mueller told Healthline that he also expects smaller hospitals — both rural and urban — to continue to affiliate with other hospitals. This gives them the larger scale they need for greater purchasing power, delivery of services, and negotiating with insurers.
Rural hospitals sometimes affiliate with urban health centers. But they also partner with other rural hospitals and rural community health centers — what’s known as federally qualified health centers (FQHCs).
This type of consolidation has been going on for some time in urban areas and will continue.
But Mueller said that even large regional centers — like UnityPoint Health in Iowa and the Mayo Clinic system in Minnesota — are increasing their size through affiliations with rural providers.
“They’re all making moves to expand their ‘geographic footprint’ so that they have more scale and more people covered,” said Mueller.
Rovinsky said that as hospitals and health systems are called on to manage patients’ health both inside and outside the hospital, they will partner with a wider range of businesses — communications, mobile health, biotech, and genomic companies.
While hospitals aren’t going away anytime soon, the self-contained facility that dominated U.S. healthcare for so many decades will lose some of its prominence.
“Historically, health systems have been very hospital-centric. That’s really what’s going to change,” said Rovinsky. “There will still be hospitals, but the health system will be much more broadly focused on managing patients’ health.”