Healthcare Delivery in the 21 st Century: An Environmental Assessment of Key Drivers of Change and Implications for Spiritual Care Alan E. Bowman, MDiv, MBA VP, Ministry Formation Catholic Health Initiatives

Healthcare Delivery in the 21 st Century: An Environmental Assessment of Key Drivers of Change and Implications for Spiritual Care Objectives At the end of the module, participants will be able to: Name the major shifts occurring in the structure and delivery of healthcare in the 21 st Century Comprehend what major trends will arise from this shifts Identify how these major shifts will affect spiritual care

CHI’s Environmental Assessment and Key Drivers of Change Aging Chronic Disease Physician Dynamics Payment / Financial Trends Catholic Identity Health Care Reform Treatment & Technology Talent Rural Challenges Consumerism 3

Environmental Assessment: Critical Planning Issues Health Care Reform Why is it needed? When did the Patient Protection and Affordable Care Act, ACA become law? What are the key benefits of the ACA? Catholic Health Care Organization “REALIZING OUR VISION FOR U.S. HEALTH CARE” “KEY BENEFITS OF THE AFFORDABLE CARE ACT” What happens if the Supreme court deems the ACA unconstitutional? 4

Environmental Assessment: Critical Planning Issues Payment/Financial Trends What is “Fee for Service”? How are chaplains services covered? CMS identifies up to 40% of “waste” in Medicare spending Transparency and Focus on Quality over “Fee for Service” and, Population Health Management 5

Environmental Assessment: Critical Planning Issues Treatment and Technology Virtual technologies extend access Technology will redesign care Data repository Electronic Health Records 6

Environmental Assessment: Critical Planning Issues Physician Dynamics Engagement and alignment of physicians Physician leadership formation Medicare Physician payment formula and cuts in Medicare and Medicaid reimbursement Expanding the numbers of employed physicians Clinical Integration 7

Environmental Assessment: Critical Planning Issues Catholic Identity Consolidation among providers Strengthening the relationships with Catholic Bishops is increasingly important Growth opportunities will challenge and redefine Catholic identity Some Catholic health care facilities are at risk Catholic systems becoming more innovative 8

Environmental Assessment: Critical Planning Issues Talent New business and clinical models Licensure legislation historically protects turf Shortages will challenge health care delivery systems, Catholic hospitals’ develop new formation opportunities 9

Environmental Assessment: Critical Planning Issues Consumerism Escalation of health care costs Consumers will change the health care landscape Increased demand for convenience and transparency Efficiency expectations 10

Environmental Assessment: Critical Planning Issues Implications for Spiritual Care Education and Formation: Changes in healthcare New payment models—where is spiritual care? Better utilize technology Better integrate into emerging markets Cultural competencies Pastoral Identity expansion Pastoral Role expansion (beyond comfort care and pastoral presence) 11

Environmental Assessment: Critical Planning Issues Implications for Spiritual Care Education and Formation (continued): Integration with Interdisciplinary teams Expansion of Scope of Service Researching, Documenting and Communicating value and purpose of Spiritual Care Expansion of Pastoral Skills Standards of Practice to meet changing needs 12

Environmental Assessment: Critical Planning Issues Implications for Spiritual Care Dialogue: What are your questions? 13

Environmental Assessment: Critical Planning Issues Resources Association for Clinical Pastoral Education: Association for Professional Chaplains: Catholic Health Association of the United States: Catholic Health World, April 1, 2012 volume 28, Number 6 Fierce Healthcare: Health Leaders: National Association for Catholic Chaplains: National Association of Jewish Chaplains: 14