Since the Affordable Care Act was enacted in 2010, there has been much speculation and many opinions as to how this sweeping law will impact the American healthcare system. Now, four years later, as the first open enrollment deadline of March 31 passes, uncertainty still exists, but we now have a better grasp on the enormous change that is, and will be, taking place throughout the healthcare system.

Approximately 7 million Americans have enrolled in the new insurance coverage, but the total impact on hospitals and the healthcare system remains to be seen. For healthcare providers, what we do know is that major change is underway. Increased patient volume (but a yet-to-be determined mix) and reduced reimbursements is a double-edged sword pushing healthcare through a huge paradigm shift – a shift, however, that ultimately and positively aims to push value over volume.

In the face of this continued uncertainty, but with the need to move forward, how do healthcare systems respond? There is no time to “wait and see”. We’ve seen record attendance at numerous state healthcare association conferences in 2013 and to-date in 2014, with healthcare executives and administrators seeking information, clarification and consensus with their peers.

Discussions of budget cuts and consolidation abound, with some healthcare systems cutting costs by as much as 20-30%. Mergers and acquisitions within healthcare are continuing to increase – from hospitals buying hospitals, to hospitals buying home care, wellness and other services. Hospitals are seeking methods of both vertical and horizontal integration – actions that seek to increase collaboration, prioritize programs, cut costs and also become ‘total healthcare’ providers.

With these changes, there is often a need to update hospital facilities to optimize these strategies. Otherwise, they may never reach their fullest potential. Whether building new or renovating existing facilities, the highest priorities are implementing new technologies, creating new efficiencies, driving value, and establishing greater flexibility – all within a reduced budget while minimizing risks. However, with today’s challenges, not every project delivery method can produce these results on all fronts. Therefore, just as everything else is being questioned and scrutinized, so should the way the project is actually delivered. It’s not just about having a great team, it’s also about having a great process.

In the end, by creating ‘hospitals of the future’, we can not only survive these changes, but also become stronger, more efficient and better healthcare providers.