Medicaid's future a top concern for 85% of healthcare CEOs

The future of Medicaid tops the list of concerns for healthcare CEOs, according to a report by accounting and consulting firm Deloitte.

For the report, Deloitte interviewed 20 healthcare CEOs last May. The CEOs came from various types of organizations, including nonprofit hospitals/health systems, academic medical centers, faith-based nonprofit hospitals/health systems and children's hospitals.

While the future of Medicaid tops the list (85 percent), the firm found healthcare CEOs also are concerned about the pace of the shift to value-based care, declining margins and challenges in finding, recruiting and retaining healthcare leaders that are "forward-thinking and adaptable." Other issues identified by CEOs include staying pace with new technology and the accompanying cybersecurity risks, as well as "adapting to evolving consumer expectations."

"CEOs note that effectively addressing the above challenges is compounded by uncertainty about the new administration and its healthcare policies," Deloitte added.

The firm said it plans to launch a series of short-form reports on the top concerns identified by healthcare CEOs. The first one focuses on preparing for potentially changing Medicaid reimbursement models, along with other policy issues.

"If Congress rolls back the Medicaid expansion authorized by the ACA, or otherwise reduces federal funding, CEOs are worried that they will see an increase in uninsured patients. Though the expansion of Medicaid reduced uncompensated care in expansion states, hospitals nationally still accrued $35.7 billion in uncompensated care costs in 2015," Deloitte wrote, citing a fact sheet from the American Hospital Association.

Deloitte also cites a Commonwealth Fund report, which projects hospitals in Washington, D.C., and the 31 Medicaid expansion states could see a 78 percent increase in uncompensated care costs over the next decade under the House-approved American Health Care Act.

Hospital CEOs shared their various focuses for addressing Medicaid concerns. These include "increasing government affairs/lobbying at both the federal and state levels" and "keeping apprised of the Medicare budget process." They also include "creating value-based contracts," "instating new strategies built around the core mission of delivering high-quality care," "emphasizing areas that transcend policy, such as quality, cost and customer experience," "implementing cost-reduction strategies," and "pursuing new revenue streams."

Access the full report here.


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