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How will reform affect patient demand?

What effect will health care reform have on demand for inpatient and outpatient services?  What are the implications for hospitals?  The forecasting firm Sg2 has quantified the expected change in service utilization between 2010 and 2020: inpatient utilization will decrease by 1.9%, while outpatient utilization will increase by 30%.  During the same period, emergency department utilization will increase by 15% for minor to moderate severity patients and there will be a lot more of a new type of care — ‘e-visits’ or online care.  Thomson Reutersa health care data vendor,  forecasts that there will be increases in all types of service delivery, especially for preventive and diagnostic services.  The Thomson Reuters white paper (Dunn et al., 2010) provides a breakdown of the anticipated impact of the phase-in of the reform provisions through 2018.  Demand for outpatient services will grow and ambulatory care will be prioritized — “closer to the center of care delivery within hospital systems,” (Johnson, 2010).  Other implications of the implementation of the reform law will be an uptick in health facility construction, according to an executive with a health care real estate firm (Taylor, 2010), and the potential for an increase in security concerns in the emergency department (Sweeney, 2010).  These security concerns may arise not just from more ED patients, but also from a potential clash between their sense of immediate entitlement and the fact that the provisions of the law will be phased in over a period of several years.


Dunn, D., Lewandowski, D., and Pickens, G.  The Influence of Reform on Local Coverage and Utilization: White Paper.  Thomson Reuters, Sept. 2010.  http://img.en25.com/Web/ThomsonReuters/InfluenceReformLocalCoverageUtilization_090110.pdf

Johnson, T.K.  Ambulatory care stands out under reform.  HFM. Healthcare Financial Management;64(5):56-63, May 2010.

Sg2 forecasts inpatient services to decline 1.9% and outpatient services to grow 30% over the next decade.  Press Release, June 9, 2010.

Sweeney, E.  Healthcare reform: increased demand intensifies safety concerns.  HealthLeaders Media, May 20, 2010.

Taylor: reform will drive demand for health care facilities.  Indianapolis Business Journal, May 8, 2010.

One Response

  1. […] Improving care for patients in this country will mean relying more on primary care physicians and medical homes to treat conditions and manage chronic illness ahead of time, before a patient's health ever requires hospitalization. Better care will mean treating health issues in a timely fashion, providing comprehensive follow-up care and doing all we can to keep patients healthy and out of the hospital. This is what changes could look like – in theory – and as a result, we very likely will see some hospitals close due to a decrease in demand for certain healthcare services. […]

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