CHICAGO, March 2, 2020—Financial challenges again ranked No. 1 on the list of hospital CEOs’ concerns in 2019, according to the American College of Healthcare Executives’ annual survey of top issues confronting hospitals. Personnel shortages ranked second. Behavioral health/addiction issues ranked third in only its second year on the survey, up from fifth last year.
“While the financial climate continues to be a challenge, leaders remain dedicated to ensuring an expert workforce is well prepared to meet the expanded needs of patients and communities,” says Deborah J. Bowen, FACHE, CAE, president and CEO of ACHE.
In the survey, ACHE asked respondents to rank 11 issues affecting their hospitals in order of how pressing they are and to identify specific areas of concern within each of those issues. Following are some key results from the survey, which was sent to 1,481 community hospital CEOs who are ACHE members, of whom 395, or 27 percent, responded. The issues cited by survey respondents are those of immediate concern and do not necessarily reflect ongoing hospital priorities.
|
Issue |
2019 |
2018 |
2017 |
|
Financial challenges |
2.7 |
2.8 |
2.0 |
|
Personnel shortages |
4.6 |
5.2 |
4.5 |
|
Behavioral health/addiction issues |
5.0 |
5.3 |
--- |
|
Governmental mandates |
5.2 |
5.1 |
4.2 |
|
Patient safety and quality |
5.3 |
5.1 |
4.9 |
|
Access to care |
5.9 |
6.2 |
5.9 |
|
Patient satisfaction |
6.3 |
6.1 |
5.5 |
|
Physician-hospital relations |
7.1 |
6.6 |
5.9 |
|
Technology |
7.7 |
7.7 |
7.0 |
|
Population health management |
8.1 |
8.1 |
7.3 |
|
Reorganization (e.g., mergers, acquisitions, restructuring, partnerships) |
8.7 |
8.3 |
7.5 |
|
The average rank given to each issue was used to place the issue in order of how pressing they are to hospital CEOs, with the lowest numbers indicating the highest concerns. The survey was confined to CEOs of community hospitals (nonfederal, short-term, nonspecialty hospitals). |
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Within each of these 11 issues, respondents identified specific concerns facing their hospitals. Following are those concerns in order of mention for the top three issues identified in the survey. (Respondents could check as many as desired.)
|
Financial Challenges (n=395)1 |
|
|
Increasing costs for staff, supplies, etc. |
76% |
|
Medicaid reimbursement (including adequacy and timeliness of payment, etc.) |
71% |
|
Bad debt (including uncollectable emergency department and other charges) |
60% |
|
Reducing operating costs |
56% |
|
Managed care and other commercial insurance payments |
54% |
|
Medicare reimbursement (including adequacy and timeliness of payment, etc.) |
54% |
|
Competition from other providers (of any type—inpatient, outpatient, ambulatory care, diagnostic, retail, etc.) |
51% |
|
Transition from volume to value |
48% |
|
Government funding cuts (other than reduced reimbursement for Medicaid or Medicare) |
47% |
|
Revenue cycle management (converting charges to cash) |
45% |
|
Inadequate funding for capital improvements |
42% |
|
Pricing and price transparency |
37% |
|
Moving away from fee-for-service |
32% |
|
Emergency department overuse |
24% |
|
Other |
N=27 |
|
1 If number of respondents is fewer than 50, only numbers are provided. |
|
|
Personnel shortages (n=395)1 |
|
|
Registered nurses |
73% |
|
Primary care physicians |
61% |
|
Technicians (e.g., medical technicians, lab technicians) |
61% |
|
Physician specialists |
55% |
|
Therapists (e.g., physical therapists, respiratory therapists) |
39% |
|
Physician extenders and specially certified nurses (physician assistants, nurse practitioners, certified nurse midwives, etc.) |
24% |
|
Other |
N=66 |
|
1 If number of respondents is fewer than 50, only numbers are provided. |
|
|
Behavioral health/addiction issues (n=395)1 |
|
|
Lack of appropriate facilities/programs in community |
81% |
|
Lack of funding for addressing behavioral health/addiction issues |
73% |
|
Insufficient reimbursement specifically for behavioral health/addiction services |
67% |
|
High volume of opioid addiction and related conditions |
56% |
|
Legal/regulatory framework limiting treatment options |
35% |
|
Other |
N=9 |
|
1 If number of respondents is fewer than 50, only numbers are provided. |
|
About the American College of Healthcare Executives
The American College of Healthcare Executives is an international professional society of more than 48,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE’s mission is to advance our members and healthcare management excellence. ACHE offers its prestigious FACHE® credential, signifying board certification in healthcare management. ACHE's established network of 77 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its career development and public policy programs. Through such efforts, ACHE works toward its vision of being the preeminent professional society for leaders dedicated to improving health. The Foundation of the American College of Healthcare Executives was established to further advance healthcare management excellence through education and research. The Foundation of ACHE is known for its educational programs—including the annual Congress on Healthcare Leadership, which draws more than 4,000 participants—and groundbreaking research. Its publishing division, Health Administration Press, is one of the largest publishers of books and journals on health services management including textbooks for college and university courses.
Contact:
Frank Austin
Senior Vice President
Department of Marketing
American College of Healthcare Executives
300 S. Riverside Plaza, Suite 1900
Chicago, IL 60606
faustin@ache.org