Hospitals around the country are setting up shop in healthcare Emerald Cities. But will these mixed-use medical communities help realize reform or simply reveal the man behind the curtain?

Health Village. March LifeCare. Medical City. These are but a few of the mixed-use medical communities popping up across the country that put hospitals, research centers even residential and retail in one convenient place. Think of them as live-work-play developments with a healthcare twist.

One example is the March LifeCare campus, a healthcare complex in Riverside, Calif. that is being heralded as "the Mayo Clinic of the West." It would be home to a Catholic Healthcare West hospital, a medical group, an assisted living residence, a shopping center and other developments. In Orlando, both Nemours Children's Hospital and the VA are building in Medical City, a $1.5 billion development that is already home to the University of Central Florida med school, an M.D. Anderson Cancer Center and the Sanford-Burnham Research Institute.

Proponents see this proximity as a path to healthcare reform. In some ways, it is. Developers of the March LifeCare campus have proposed physician-sharing arrangements among facilities to better integrate care. An innovative campus could also attract new talent to Riverside, where the critical physician shortage will only get worse in 2014. Meanwhile in Medical City, Nemours hopes its patient care will be fueled by Sanford-Burnham discoveries a logical strategy given healthcare reform's focus on comparative effectiveness research, otherwise known as evidence-based medicine.

Threatening the yellow brick road is access to capital. Two projects in Medical City a dedicated M.D. Anderson Cancer Center facility and a full build-out of the University of Florida's Research and Academic Center have been delayed due to funding constraints. And down the coast in West Palm Beach, long-term plans for a medical-arts district could falter if the billions poured into biomedical research don't boost the regional economy. The same could be said of healthcare reform. Installing electronic medical records and forming accountable care organizations is expensive, and neither are guaranteed to save money or boost revenue. Failed debt-ceiling negotiations could further threaten healthcare reform and our fragile economic recovery.

Hospitals will always seek game-changing strategies, even where they dominate their markets. But will Emerald Cities be one of them. Let's hope the Great and Powerful Oz values 21st-century healthcare. Your thoughts are welcome...

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