Don't Even Count Your Eggs Yet...

Requests from speaker bureaus give me a pretty good indication of our industry’s current expectations. Inquiries over the past week suggest a perception that ARRA/HITECH requirements and health reform are finally final—or sufficiently close to closure that health care executives will want to attend meetings this spring to learn how to qualify for new government funding.

In my opinion, many people are overacting to last week’s stories about stimulus and reform. We’re not close to a final definition of “meaningful use,” a statutory prerequisite for HITECH payments. The publication of proposed requirements in the Federal Register, expected for January 13, will start a 60-day period for public comment. (Ironically, the comment period would end on the Ides of March—a date forever associated with betrayal by a false friend.)

The final rules would presumably be issued later in the year, but such deadlines are routinely missed. Even in the most optimistic scenario, the gap between passage of the law and distribution of the bulk of authorized HITECH funds will be nearly three years. Delays in subsidies for expanding health insurance coverage will be even longer if a reform bill passes in early 2010. Progress on programs may be in the news right now, but checks will not be in the mail for years to come.

Speaker bureaus apparently aren’t being deluged with requests for presentations on last week’s news that will affect the survival of health care organizations this year—unemployment staying above 10% and government tax revenues falling far short of already gloomy expectations. Consumers, employers, and governments simply do not have money to pay more for health care. Help from Washington cannot come fast enough to fill the void created by economic stagnation.

The wisdom of not counting chickens before they hatch brings to mind a French saying, “To make an omelet, you must break eggs,” that also provides important perspective on the current news. We’ve got to break out of our shells and change the way we do business because customers cannot pay us to keep doing what we’ve done in the past. Supply-side enterprises in the medical marketplace cannot count on getting any more nest eggs than they’ve got right now. I think we must scramble—move quickly and stir things up—by putting top priority on business process transformation in 2010. Do you agree, or do you think I’ll have egg on my face by the end of the year?