Community Business Resouce Council

Health Care Industry



Health Care Industry

Health Care Industry Critical Business Challenges

If you are experiencing any of these critical business challenges, then CBRC would like to help. Our Business Strategist has helped firms in the Health Care Industry overcome their frustrations by conducting a strategic growth analysis - then involving them with designing a business solution to generate revenue and solve their critical business challenges.


Here are a few of those business challenges that we have solutions:

  • Health Care Reform - The Patient Protection and Affordable Care Act of 2010 (PPACA) is changing how medical care is acquired and paid for in the US. The landmark law, which makes health coverage available to all Americans, predominantly concerns ways to keep health care costs low and affects how care is paid for. Several provisions of the law will kick in over the next several years, including health insurance exchanges and expansion of Medicaid and the State Children’s Health Insurance Program. In an effort to cut Medicare costs, the PPACA will require hospitals to decrease their hospital readmission rates, a key factor in high hospital bills. Hospitals that don’t succeed in cutting rates will be penalized. Other provisions of the law call for more medical training and the establishment of health care technology, such as electronic health records (EHR), that are expected to cut costs through efficiency.
  • Shortage of Physicians and Nurses - Nearly 40 percent of doctors are 55 years old or older, and approaching retirement age, according to a study by the Center for Workforce Studies of the Association of American Colleges. About 33 percent of nurses are 50 and older, and more than half have said they plan to retire in the next 10 years, according to a nursing study by the Bernard Hodes Group. Experts predict a shortage of 300,000 nurses and nearly 100,000 doctors. Other analyses, however, say that shortages are regional rather than countrywide, and may be met with incentives for providers to practice in rural and other underserved areas.
  • Containing Rising Costs - Prescription drug prices, an aging population which requires more care, and the increasing cost of medical technology have contributed to the rising cost of managed care in recent years. The new health care reform law is aimed at helping control costs. Proposals to manage costs include the adoption of electronic health records, more focus on quality and efficiency, emphasis on less expensive preventive care over more expensive services, and government regulation to keep insurance premiums and Medicare payments low.
  • Sustainable Growth Rate and Medicare - Medicare mandates successive fee cuts for physicians using a formula called the Sustainable Growth Rate (SGR). Congress has stopped the cuts with short-term fixes, but physicians say that Medicare does not reimburse doctors adequately for their services. Some physicians limit the number of Medicare patients they see, and others have opted out of the program entirely. Medicare’s fee schedule also keeps payments from private insurers low.
  • Medical Errors - The incidence of medical errors resulting in patient death is an issue of critical importance to the health care industry. A study by HealthGrades showed that between 2004 and 2006 medical errors caused more than 200,000 deaths and cost Medicare nearly $9 billion. In 2008, Medicare declared that it would not pay for treatment of eight preventable medical errors, including leaving surgical tools inside the patient and catheter-associated urinary tract infections. Hospitals are looking at ways to reduce patient deaths, including procedural checklists and safety training.
  • Malpractice Insurance - Malpractice insurance premiums rose sharply in recent years, sometimes such that doctors practice defensive medicine by ordering more tests or performing more C-sections. Many doctors support tort reform, which would reduce or limit jury awards for damages. Several states impose caps on awards, which state officials say help them retain and recruit physicians.
  • Questionable Results from High Costs - The US spends 18 percent of its GDP on health care, more than any other nation, yet the health of Americans, on average, is no better than in many countries that spend less. A WHO ranking of life expectancy lists the US as 34th in the world; among developed nations, the US has one of the highest infant mortalityrates, at about 6 per 1,000 live births. Adult and childhood obesity rates are among the highest in the world.