Cost-containment and cost-management strategies.

The leadership and boards of trustees of all healthcare organizations are the ultimate stewards of the limited resources available to best meet community needs. The strategic planning process leads the organization down a clear path of setting priorities, making choices, and taking action. The day a new cancer center opens or the latest technology arrives is an exciting one for the community. After the ribbon cutting, these new programs become the responsibility of the hospital’s service line directors or clinical managers. Their staffing is based on projections and other assumptions that may or may not be on point but have a direct impact on the operations and finances of the organization. As part of normal decision making for a hospital’s new initiatives, a payer mix and revenue stream were predicted. Now two significant environmental events have made projections more uncertain and put aggressive cost management on center stage: the economic downturn and payment reform. The economic downturn affecting hospitals began in the fall of 2008. Its broad impact on the organization was described by Goldberg and Petasnick (2010):