During the U.S. News & World Hospital of Tomorrow conference, panelists in the health care reform break-out session discussed the changes underway in the health care system and if they represent incremental change or a fundamental shift.

[More Hospital of Tomorrow Forum coverage: usnews.com/hospitaloftomorrow]

Panelists included David Burik, the Managing Director who co-leads Navigant's Healthcare Strategy, Dr. Gene Lindsey, M.D. CEO Emeritus and Vice Chair of Atrius Health, and David W. Johnson, Managing Director and Sector Head for Healthcare and Higher Education at the Public Finance and Infrastructure Group.

Burik began by asking about lessons can we learn from the Massachusetts health exchange and apply to a national model. Some of the findings of the Navigant study indicate that there are no national players, yet, in the healthcare system.

"So, if we're not national, what are we?" Burik asked. "The principal consolidation in this industry is local."

Burik also wondered: "Who is going to have primary care models?" He predicted the answer is in the "Walmarts, the Walgreens," and also in the clinics which are expanding their affiliate care centers, including The Cleveland Clinic (27 Affiliates), MD Anderson Cancer Center (9 affiliates), the Mayo Clinic (14 affiliates) and Duke Lifepoint Healthcare (4 affiliates).

Here are a few additional highlights of the Navigant study.

"In 2011, the Top 20 (by admissions) health systems operated 20 percent of the hospitals and captured 26 percent of total U.S admissions," he said. "In 2003, the Top 20 operated 18 percent of US hospitals and captured 23 percent of admissions."

"Will the market or government have a larger hand in the result?" The short answer, Burik offered, is yes. We are seeing that change through exchanges that are introducing health insurance plans with narrow networks.

Dr. Gene Lindsey, of Altrius Health, began by asking "Why are organizations consolidating?" and specifically addressed why Altrius came to be. The short answer was "to create capitol."

Originally posted here:

Health Care Reform: Incremental Change or Fundamental Shift?