Will medical centers be able to change leadership structure to conform to the PPACA “ObamaCare”?

June 30, 2012, by Steven Greer, MD

The Supreme Court ruled that the PPACA “ObamaCare” law was constitutional in most aspects. With the law proceeding forward, provisions within it to change the leadership structure of medical centers will have to be adopted by academic medical centers accustomed for decades to being reimbursed under the fee-for-service hierarchical divisional leadership style.

The Cleveland Clinic (CCF) is one of the few medical centers to organize leadership by “institutes” comprised of different medical and surgical subspecialties with the faculty paid a flat salary. The Accountable Care Organizations (ACO’s) created by the PPACA are an attempt to nudge the American healthcare system more toward the CCF and away from the fee-for-service systems that reward volume over outcome.

To understand the basics of the different leadership structures of medical centers, we interviewed Dr. John Kastor of the University of Maryland. He has published extensively on the topics of leadership in medicine.

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