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52 Medical Construction & Design | SEPTEMBER /OCTOBER 2015 | MCDM AG.COM future, healthcare will be provided in different settings at different costs, and it is the location of care delivery that can increasingly help in the reduction of cost. As a consequence of these imperatives, AMCs will not remain islands. Many AMCs already have two or three affiliated regional and community hospitals comprising a health system with a primary service area and a secondary service area. They are leveraging resources and population health strategies to provide seamless care throughout a region. Strategic planning has enabled these institutions to focus care closer to the patients and shift care from the AMC campus to other hospitals within the system. This initiative requires investment in the development of an upgraded infrastructure across the network. AMCs are also increasing their partnerships with developers to provide upfront capital for new patient care of erings in strategic locations. These strategies allow AMCs to deliver care closer to home for more patients and in an environment that has lower overhead costs — that is, right care, right price, right time and right place. Increasingly, health systems also are seeking to leverage the resources and specialties each hospital brings to their health system in an integrated fashion. This trend is resulting in economies of scale in many areas, not only in facilities, systems, equipment, staff resources, functions and purchasing, but also in borrowing. Frederick Hessler, retired managing director of the Health Care Group at Citigroup, found that the larger a health system is, the better it performs — allowing greater ability to borrow and gain access to lower interest rates. In short, Hessler argues, "Scale matters." Given the financial, regulatory and operational pressures facing AMCs and the challenges ahead, leading institutions cannot remain solely rooted in the present "state-of-the-art;" they must also have eyes on the horizon and the "state-of-the-future." Through agility, efficiency and diversification, AMCs can navigate the changing landscape of an evolving industry. A comprehensive planning, design and construction strategy can support the institution's vision, mission and business objectives for the future. Louis A. Meilink Jr., AIA, ACHA, is a principal with Ballinger. He can be reached at lmeilink@ballinger.com. 1 Price Waterhouse Cooper Health Research Institute Analysis; "The Future of the academic medical center: Strategies to a void a margin meltdown;" http://healthsciences. utah.edu/hcr/2012/resources/ the-future-of-academic-medical- centers.pdf. Penn Medicine partnered with Liberty Property Trust to lease space in the new Walnut Tower creating an ambulatory care center as a strategic approach to expand reach into the community. Right: The new Golisano Children's Hospital takes patient- and family centered care to the next level, by placing the pediatric patient as the primary focus of every design element in the building.