Healthcare management is always in a state of change. Seemingly more so in the recent years than ever before. More particularly, the business models are changing and how someone may get the healthcare they need or desire.  Having had a couple of opportunities lately to fly, of course I had to look at what was for sale in sky mall these days (unbelievable collection of “stuff”) and the airline magazine. To my surprise, I found 4 full page ads for a kidney transplant destination that boasted less wait time for a kidney, a cancer center who claimed to have decoded cancer, a heart center whose ad stated,” it’s about getting your life back” and a pulmonology destination touting a different way of treating lung cancer. Predictably, there were also several lasik surgery ads and the top 10 plastic surgeons in the country.

What struck me most about these ads were that they come at a time when healthcare dominates the news. The ads which obviously appeal to those with money and can travel to get their healthcare needs met are the ultimate opposite of what’s in the healthcare news these days; stories about people who can’t afford to get their dying relative care for their terminal disease.

While there will always be a market for healthcare, disease and death is predictable, there are emerging more and more alternatives for healthcare at both ends of the healthcare spectrum. The very rich and the very poor all have unprecedented opportunities for getting their healthcare needs met in ways not even comprehended 50 years ago.

“When people say, ‘why should I care about undocumented immigrants’ health? They are undocumented.’ You know what the problem is? You can go to the nicest restaurant in New York City, have a great steak and you pay $100 for the steak and you have a great time and you go home. If you look behind the door, the guy who cooks the steak is probably one of the guys who is undocumented. If that guy is sick, it doesn’t matter that you paid $100 or not. You are going home sick.”
-Ram Raja, new president of HHC, Chicago

In an attempt to turn around a massive system, the Health and Hospital Corporation in NYC is looking to bring health and revenue to the system by caring for newly eligible Medicaid recipients and insured persons who now have insurance under ACA. While you may not agree with Dr. Raja’s statement, he does make you think!

The healthcare industry is probably more diverse today than it has ever been. There are models for payment from cash only concierge practices with 24/7 access to their provider to medical tourism destinations; hospital owned practices to stand-alone single doc practices. It seems like there is a place for every kind of payment model and practice.

These are amazing times and as ICD-10 makes its way slowly but surely into practice realities, those in healthcare management, whether providers, nurses, practitioners, or business persons, all will feel the impact of new variations of business models.