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Both the payer and provider sides are consolidating, with bigger players picking off smaller players, he said. Many smaller players prefer the acquisition/consolidation route to having to modernize their IT and invest heavily in infrastructure upgrades they may not have the time or money for.
Nearly half the hospitals in the U.S. have fewer than 100 beds, Lundstrom said. Many "don't have the capital to achieve the change [needed] in the necessary amount of time."
That means, he said, that solution providers should focus on the larger accounts and determine who the consolidators are going to be. The top 15 national hospital systems, Lundstrom noted, account for 29.3 percent of the total hospitals in the country, and 27.4 percent of the total beds.
"Any hospital that isn't in economic distress right now is investing heavily in IT, starting at the data center," said Lundstrom, adding that application rationalizing, virtualization and data center consolidation are leading the way for projects.
Many providers, Lundstrom said, have been able to recover about 30 percent of their overall IT budgets by optimizing their data centers and infrastructure -- freeing up money to invest in the CPOE, EHR and analytics systems required of them.
"Anyone who wants to survive is actively engaged in spending big money on IT projects right now," he said, noting that 43 percent of providers are accelerating their investment in EMR to qualify in time for stimulus incentives.
Those investments are heavily core technology- and application-based, from PACS imaging systems to inpatient EHR, business analytics and practice management systems, Lundstrom added.
Some of the best opportunities will come from Integrated Delivery Systems (IDS), essentially networks of health care organizations under a single parent organization that can combine payers and providers. IDSes, Lundstrom said, will be the dominant model for health care organizations in 10 years, and should be in the crosshairs of health care solution providers.
"They do the best, they get the biggest and they live the longest," he said.
Payers, too, have new incentive to make themselves more efficient. Unless President Obama's Patient Protection and Affordable Care Act (PPACA) is repealed, an additional 32 million Americans will in theory have health insurance by 2019, and insurance companies are required to pay out 85 percent of the revenue they take in premiums to actual patient care.
"They need to capture every dollar of savings they can on these transactions," Lundstrom noted.
All of which adds up to a golden opportunity for solution providers: they know what will be required of their customers over the next several years, and therefore know what technologies they need to invest in and how soon they need to acquire those technologies.
More specifically, Lundstrom said, they will be investing in meaningful use technologies for ARRA, including EHR, CPOE and Health Information Exchange. They'll be looking at care management, analytics and clinical decision support technologies, and consume, at a tremendous rate, virtualization -- including server and client technologies -- and turning toward service-based delivery of applications and storage.
It's a powerfully clear sales opportunity, he emphasized.
"Make more money talking to fewer customers with less uncertainty about [what is being] offered to them?" Lundstrom said. "Sign me up!"
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