A lot can happen in five years. Coincidentally, that's roughly when nearly all major provisions of the Affordable Care Act (ACA) will take effect.

With the election now past, so is much of the uncertainty about the ACA's future. What this means to our readers is clear. Regardless of your hospital or system size, care delivery will continue to be reshaped at a torrid pace.

That laser focus you've seen from the executive suite on reducing costs, improving efficiency, raising patient satisfaction scores, reducing readmissions and eliminating health care-associated conditions? It will continue.

Your organization likely will forge new or greater alliances with other health systems, physician groups and health plans. In other words, get used to change at a pace few have known.

To help connect the dots about how all this likely will impact you, we've devoted this Trends in Health Care report to exploring what may happen by 2018.

Looking into the future, even in a time frame as short as this, can be difficult. So we've scoured research literature, interviewed futurists, designers, builders and leaders in the supply chain, infection prevention and sustainability fields to provide you with valuable insights.

Let's face it. It's sometimes easy to feel disconnected from the big-picture issues driving health care and seeing how to drive improved performance. Take this opportunity to step back and take a fresh look at where you're headed. It will help you prepare for the journey.

Managing change
Reengineered care delivery and payment models will have a huge impact on hospitals
by Bob Kehoe

Building for tomorrow
Decentralized care provides model for hospital planning, design and construction
by Mike Hrickiewicz

Infection Prevention
Stressing science
Evidence-based cleaning practices and technology advances will drive safety improvements
by Bob Kehoe

Sustainable benefits
The incentives continue to grow for hospitals to reduce their impact on the environment
by Jeff Ferenc

Supply Chain
Mission critical
Linking supply chain to organizational objectives and patient outcomes once seemed a distant goal. Not any more.
by Bob Kehoe