In the Spring 2013 Economic Outlook from provider alliance Premier Inc. that included surveying 530 hospitals and health systems, 43 percent of respondents expect health information technology and telecommunications to be its largest capital investment during the next year.

That’s up 21 percent from two years ago, according to Premier, and reflects the need for increased health information exchange. Thirty-two percent of respondents are unable to share data across the continuum of care.

That care increasingly is being targeted on the ambulatory side with only 35 percent of respondents expecting an increase in inpatient volume this year, down 30 percent from last year. Sixty-nine percent expect an increase in outpatient volume during 2013 as the industry moves toward more efficient and accountable value-based treatment and payment models.

Other survey results include:

* Nearly 22 percent of respondents were in an accountable care organization with 55 percent planning to be in one by the end of 2014. Twenty-seven percent currently do not plan to join an ACO but may join another value-based program such as bundled payments or pay-for-performance.

* The biggest drivers of health care costs are overutilization of products and services and lack of clinical care coordination.

* Forty-eight percent report reimbursement cuts as having the greatest effect on their organizations.

* Forty percent expect capital spending during the next year to increase, down from 43 percent a year ago, and 37 percent expect a decrease, up two points from last year.

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