5 questions hospital CEOs want answered — and why

Hospital and health system CEOs have a lot of issues dominating their thoughts, including questions about workforce challenges in today's economic environment.  

To gain more insight into executives' top concerns, Becker's asked hospital and health system CEOs to share the questions they need answered right now. Below are their responses, in listed alphabetical order of the respondents.

John Hennelly. President and CEO of Sonoma (Calif.) Valley Hospital

Question: How will hospitals keep up with rising costs while reimbursement constantly lags far behind?  

Why this question is important:
2022 has exasperated an already fragile financial system. For over 20 years I have watched reimbursement fail to keep pace with rising costs. 2022 has seen oversized increases on the expense side with modest advances in reimbursement. Stop gap measures, while helpful, do not address the fundamental disequilibrium. Hospitals are now dependent upon philanthropy for much of our investment in growth. We need change....

Question: When will healthcare entities be competitively reimbursed for much less costly and less invasive preventative care? 

Why this question is important: Caregivers got into healthcare to heal and promote health. And yet we are directed, through reimbursement, to focus on the fire and ignore the smoke. Fires certainly must be put out (heart attacks, strokes, etc.), but if we oriented more toward the smoke, obesity, diet, smoking(!), lack of exercise, how many fires could be avoided? The infrastructure to provide acute care can't go away, but the volume (and cost) could change dramatically if reimbursement supported more preventative activities.

Question: Where will I find staff as my workforce ages?   

Why this question is important: Labor shortages are only getting worse. Our population is aging. The proportion of the population who consumes the most healthcare, seniors, has grown from 13 percent to 17 percent over the past 20 years. That's a 30 percent increase. How do we find staff for nursing and technical areas as demand grows and the labor pool remains constantly deficient?  

Arthur Sampson. Interim President and CEO of Lifespan (Providence, R.I.)

Question: In light of the persistent labor shortage across many industries, what are some alternative models for providing quality care that can be operationalized with existing staff?

Why this question is important: Traditional recruitment and retention incentives have not been enough to fill the staff vacancies that grew exponentially during the COVID pandemic. Substantial hiring and referral bonuses, free on-the-job training programs, tuition remission, loan forgiveness have helped, but many healthcare human resource leaders will tell you that attrition is outpacing hiring. The solution that many hospitals implemented during the pandemic — to pause elective surgeries — is not a long-term sustainable model, nor is keeping hospital beds closed. There is an urgent need for immediate viable alternatives while we rebuild our workforce.

Mark Wallace. President and CEO of Texas Children's Hospital (Houston)  

Question: In the midst of the U.S. and global economies teetering on recession, combined with the highest inflation in decades, highly restrictive U.S. monetary policy, ongoing disruption from supply chain challenges, exceptionally low unemployment and a healthcare labor force that is exhausted from the pandemic, how do we further support our incredible workforce, while continuing to provide exceptional, platinum-level patient care to our patients and families with greater operational efficiency than ever before? 

Why this question is important: It is clear from our research that 2022 is turning out to be one of the most challenging operating environments for healthcare institutions in years. Margins for healthcare systems across the country are under pressure from rising costs resulting from persistently high inflation, ongoing supply chain disruptions, and a challenging labor market. We expect the macro environment will remain challenging, volatile and uncertain for the foreseeable future. As a result, it is imperative that we swiftly adapt to the current environment. We must continue to invest in our people, while constantly seeking opportunities to enhance operational efficiency as we deliver best in class, high quality care that our patients and their families expect from us. We must think differently and lead differently. 

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