By Charlie Evans, President, International Health Services Group; Senior Advisor and Board Member, Jackson Healthcare; Past Chair ACHE

Since the passage of the Patient Protection and Affordable Care Act (PPACA), I have had the opportunity to engage a wide variety of colleagues, policymakers, and noted health care thinkers about the effects of health care reform on hospitals.  With the hindsight of over 30 years managing hospital operations, I have developed the strong belief that if hospitals are to improve significantly the systemic delivery of care we must commit to making bigger changes than may seem reasonable.  Moreover, hospital administrators entering the field will do well to consider changes of this scale as the "new norm" that will likely govern the industry for the next several decades.

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