Financial challenges have ranked as hospital CEOs' number one concern for the past decade, according to the American College of Healthcare Executives' most recent annual survey on issues facing hospitals.
Survey findings reflect 388 community hospital CEOs' top concerns from 2013. The latest edition marks the 10th year "financial challenges" took the number one spot. The 2013 rankings were steady from those of 2011 and 2012, with a couple of exceptions. Governmental mandates and patient safety reversed spots this year, for instance, as they were the fourth and third most concerning issues in 2012, respectively.
1. Financial challenges
2. Healthcare reform implementation
3. Governmental mandates
4. Patient safety and quality
5. Care for the uninsured
6. Patient satisfaction
7. Physician-hospital relations
8. Population health management
9. Technology
10. Personnel shortages
11. Creating an accountable care organization
CEOs also ranked specific aspects of the top three categories they found most pressing. CEOs could select as many as desired. Here are the top five for each.
Within "financial challenges"
1. Government funding cuts — 85 percent
2. Medicaid reimbursement (including adequacy and timeliness) — 81 percent
3. Medicare reimbursement (including adequacy and timeliness) — 71 percent
4. Bad debt — 67 percent
5. Decreasing inpatient volume — 64 percent
Within "healthcare reform implementation"
1. Reduce operating costs — 72 percent
2. Alignment of provider and payer incentives — 66 percent
3. Shift to value-based purchasing — 60 percent
4. Align with physicians more closely — 53 percent
5. Regulatory/legislative uncertainty affecting strategic planning — 50 percent
Within "governmental mandates"
1. CMS audits (RAC, MAC, CERT) — 83 percent
2. ICD-10 implementation — 79 percent
3. CMS regulations — 65 percent
4. State regulations — 33 percent
5. Increased government scrutiny — 32 percent
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