Massachusetts health care outlook for 2014

The health care marketplace has been consolidating in Massachusetts for decades, with few standalone community hospitals remaining and a handful of players vying for dominant roles in Greater Boston.

In a rush of intense hour-long phone interviews, I recently produced four stories for MD News that included the 2014 prognostications of top executives at Greater Boston health care organizations. With the notable exception of a hospice and serious-illness care CEO who is grappling with falling Medicare reimbursement rates, the outlook these business leaders have for the year ahead is bright. All of them are keenly aware of the rapid and far-reaching change sweeping through U.S. health care.

The parade of presidents, founders and CEOs was a perfect introspective and prospective finish to a year of producing freelance stories for the Greater Boston edition of MD News. Here are some observations from the CEO series that will publish in early 2014 and the dozen other projects I produced for MD News this past year:

• The Greater Boston health care marketplace is a bubbling cauldron of innovation that is ahead of the reform curve. Romneycare is a mirror image of Obamacare, giving the health care establishment in Massachusetts about a five-year head start on the rest of the country.
• A major driver of consolidation in Massachusetts health care has been gaining efficiency to provide convenient services to patients while containing costs. The consolidated players are able to provide a wide spectrum of "integrated care" including urgent care, primary care, specialty care, surgical procedures, chronic disease management and rehabilitation services. A couple of recurring buzzwords among CEOs and health care providers are "seamless care" and "good hand-offs."
• The Greater Boston health care marketplace is fortunate to have a deep pool of intellectual talent. With several academic medical centers and dozens of other world-class medical facilities, the state is fortunate to have a relatively large number of highly trained health care providers. The region also has excellent medical administration leadership. The men and women running Greater Boston's health care organizations appear well-equipped to tackle the changing landscape ahead.
• In Massachusetts, health care reform is working. The marketplace is competitive, which is fueling innovation. Nearly all children and about 90 percent of the adult population have health insurance. With increased insurance rolls, access to care is as challenging as ever, but the increase in patients has created opportunities such as the explosive growth in primary care practices and urgent care facilities.
• On a compassionate note, the growth in patients coupled with a heightened emphasis on wellness programs has created opportunities to improve the health level of the entire state.
• Providing access to high-quality health care at an affordable cost is a challenge that can be met in a state such as Massachusetts, which has an enviable talent pool and medical infrastructure. Making health care reform work in every state in America is going to be a daunting challenge.