Christopher (Chris) S. Dunn and David M. Johnston, Members of the Firm, in the Health Care & Life Sciences practice, co-authored an article in Nashville Medical News, titled “‘Getting the Cart Before the Horse’ – Failing to Integrate Federal Reimbursement Requirements into the Programing and Schematic Design Phases of Modern Healthcare Facilities.”

Following is an excerpt:

As reported by the U.S. Census Bureau, in the last decade the value of put in place private healthcare construction in the U.S. has ranged from a low of 29 billion in 2014, to close to 39 billion in 2021.  Only the energy and manufacturing sectors involve greater spending, and with demographic shifts and trends in the U.S., and the need for greater energy efficiency to combat climate change multiple macro factors point to continued growth in healthcare spending in the next decade.

It is given that healthcare construction is technically complex.  The sector attracts top tier design and construction professionals to develop facilities with unique systems involving operating suites, medical gas, imaging, resilient power, pharmacies, laboratories, decontamination facilities, complex fire and smoke protection, and intensive care units, many of which are often operated on a 24/7, 365 days a year basis through a variety of extreme weather conditions.  As a result of the technological complexity, these same design professionals and building contractors contend with an array of national standards and state and local codes apply to the technical design and construction aspects to acute care facilities, in addition to requirements imposed by accreditation agencies. 

What is less commonly understood or appreciated is that Federal regulations regarding reimbursement for medical services can have a profound impact on the successful operation of a facility and are often neglected in the design process.  While top tier architects and engineers can be trusted to manage the technical codes and requirements associated with various building systems, the reality is that many healthcare providers do not gather the necessary Federal reimbursement advice and counsel early in the design process in what are known as the “programing” or schematic stages of design process to convey to their design teams.

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