Financial pressures remain the leading concern among hospital CEOs, according to the American College of Healthcare Executives’ annual survey of issues facing hospitals. Workforce challenges ranked No. 2, followed by governmental mandates.
The survey, conducted in October and shared with Becker’s, was sent to 1,185 community hospital CEOs — defined as leaders of nonfederal, short-term, nonspecialty hospitals — who are ACHE members. A total of 215 CEOs responded. Participants were asked to rank 11 issue areas by level of urgency and identify specific concerns within each category.
Since 2021, financial and workforce challenges have consistently ranked as the top two concerns in ACHE’s survey — a trend that continued in the latest results. Financial challenges received a mean score of 2.2, indicating the highest level of concern, while workforce challenges — including staffing shortages and burnout — had a mean score of 3.6.
Governmental mandates ranked third, with a mean score of 4.5. ACHE noted this marks the first time since 2018 that regulatory issues have returned to the top three, reflecting growing compliance demands.
Below are the ranked concerns, with lower mean scores indicating greater urgency:
- Financial challenges — 2.2
- Workforce challenges (e.g., personnel shortages) — 3.6
- Governmental mandates — 4.5
- Access to care — 5.3
- Behavioral health, addiction and mental health issues — 6.0
- Patient safety and quality — 6.2
- Technology — 6.4
- Patient satisfaction — 7.1
- Physician-hospital relations — 8.0
- Population health management — 8.8
- Reorganization (e.g., mergers, acquisitions, restructuring, partnerships) — 8.9
ACHE also outlined the most frequently cited concerns within each of the top issue areas.
For financial challenges, Medicaid reimbursement — including payment adequacy and timeliness — was the most commonly cited issue, noted by 75% of respondents.
Within workforce challenges, burnout among medical staff and shortages of technicians were each cited by 73% of respondents as primary concerns.
For governmental mandates, threats to the 340B Drug Pricing Program were identified most often, cited by 80% of respondents.
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