Academic medical centers (AMCs) are facing a changing health care landscape, and will have to make dramatic changes themselves to continue to be succesful, a new analysis from PWC said. The white paper, "America's future academic medical centers: Forging new identities in the New Health Economy,"was recently released by PWC's Health Research Institute. In it, the authors note that AMCs face challenges because they have a diverse, three-part role: education and training; research; and clinical care. This tripartite mission has become more difficult in today's health care marketplace as other facilities compete for patients, often leaving AMCs with sicker and poorer patients. In addition, their multiple roles and the size of their governing institutions make it difficult for AMCs to respond quickly to changes in technology and markets. Related: Consumer research, focus groups part of health systems' improvement plan In response, the PWC researchers found, AMCs are broadening their reach. "Many AMCs are expanding their clinical missions to address wellness and social determinants of health, such as access to affordable housing or transportation, food and employment," the report said. "They are broadening their research missions to include population health and personalized medicine, while stretching their educational missions to train their own workforces in emerging technologies and digital skills while emphasizing interprofessionalism."

Areas of growth, areas of change

The PWC researcher surveyed AMC executives and found some areas of agreement on where growth is expected. In the clinical care area, 73 percent of AMC executives said they planned to invest more in clinical care teams, including pharmacists, nutritionists, mental health professionals and physical and occupational therapists. In the area of research, 80 percent of executives said they were aligning their research pipeline with clinical and business strategies; 70 percent said they aim to improve population health. For education, 93 percent of AMC executives pointed to community health as an area of emphasis for training; 61 percent said their current workforce training included capabilities such as digital and data analytics. To grow and compete in the changing health care environment, the report said, AMCs are rethinking some traditional approaches. "AMC executives acknowledge that complacency from leadership could result in diminished stature," the report's authors write. "As competition intensifies and table stakes rise, AMCs need focused strategies that reflect the new realities of the market. With declining clinical margins and an expanding tripartite mission, they can't afford to do it all. They will need to invest in business models that have the best financial returns." With costs that are higher than other facilities, AMCs will have to streamline and become more efficient, the report said, quoting Mark Larmore, CFO of Columbus-based Ohio State University Wexner Medical Center. "AMCs will never be the lowest-cost provider," Larmore said. "The challenge is how do we become a lower-cost provider?" New models for the future According to the PWC report, the next generation of AMCs will become hybrids of four models of health care systems. Those models are: The Product Leader; The Experience Leader; The Innovator; and The Health Manager. (See slides above.) The report concludes with recommendations for AMCs as they evolve. These include listening to the market, telling the AMC's story, establishing new revenue streams, creating a more agile governing system, and making technology and data the common thread linking the other recommendations. Read more: 

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