In today’s news…the announcement that total enrollments for the Affordable Care Act have hit 7.1 million – which was roughly the original expectation. This represents a significant milestone on the healthcare landscape.

Indeed, healthcare in our country is changing. Change is taking place in areas of Medicare coverage, healthcare coverage for families, and structurally — that is, where and how medical care is delivered. Have you noticed local physician practices opening their doors in your neighborhood? This is medical foot traffic which is by-passing the traditional services of a hospital.

There has been a slow, but steady, transformation of how consumers seek medical care. The role of local hospitals is changing. Most of you have probably witnessed, or heard, of hospitals closing their doors. They are financially bankrupt. The cost of care is too high; the volume of patients able to pay such costs is decreasing.

Over the past 25 years, hospital usage has dropped. More than 200,000 hospital beds have been closed in the United States. Not coincidentally, outpatient visits have risen by 200 percent over the same period. It’s not to say people no longer need hospitals; rather, the purpose of these structures is changing. The one-size-fits-all hospital is morphing into an integrated healthcare system – combining high-volume specialty centers with more accessible primary care services. But the notable change in the medical landscape is characterized by the increase in smaller patient care centers, staffed by a team of physicians, which have opened their office doors in suburbs or in high commuter traffic areas. Patients can walk-in, receive prompt professional attention, and eliminate the time spent (for many) sitting in the hospital emergency room.

– John D. Miller is the founder/owner of Home Care Partners, LLC, a Massachusetts business providing private duty, personalized in-home assistance and companion care services to those needing help in daily activities and household functions. He can be reached at: (781) 378-2164; email: ; or online at: