Financial challenges were the second-most pressing concern for hospital CEOs in 2023, according to the American College of Healthcare Executives's annual survey of top issues confronting hospitals.
The latest survey, published in January, marked the second consecutive year that hospital CEOs have ranked workforce challenges, financial challenges, and behavioral health and addiction issues as the top three concerns, and the third consecutive year that workforce or personnel challenges have been the top-ranked issue.
Workforce challenges, which include personnel shortages, as well as staff burnout, among other workforce issues, had an average score of 2.3 on an 11-point scale of how pressing CEOs find each issue. Financial challenges, which held the top spot for 16 consecutive years prior to 2022, were listed the second-most pressing concern, with an average score of 2.6. The lower the number, the more concerning the issue for CEOs.
Here are the specific concerns within financial challenges that hospital CEOs identified, according to the survey:
Note: CEOs could check as many options as they wanted. The survey is based on responses from 241 CEOs of community hospitals (nonfederal, short-term, nonspecialty hospitals) who are ACHE members.
Increasing costs for staff, supplies, etc.: 94%
Managed care and other commercial insurance payments: 66%
Medicaid reimbursement (including adequacy and timeliness of payment, etc.): 61%
Reducing operating costs: 58%
Revenue cycle management (converting charges to cash): 52%
Medicare reimbursement (including adequacy and timeliness of payment, etc.): 51%
Inadequate funding for capital improvements: 50%
Government funding cuts (other than reduced reimbursement for Medicaid or Medicare): 46%
Bad debt (including uncollectable emergency department and other charges): 45%
Competition from other providers (of any type — inpatient, outpatient, ambulatory care, diagnostic, retail, etc.): 36%
Transition from volume to value: 26%
Emergency department overuse: 25%
Pricing and price transparency: 21%
Moving away from fee-for-service: 18%