The No. 1 problem keeping hospital CEOs up at night

Workforce problems in U.S. hospitals are troublesome enough for the American College of Healthcare Executives to devote a new category to them in its annual survey on hospital CEOs' concerns. In the latest survey, executives identified "workforce challenges" as the No. 1 concern for the second year in a row.

Financial challenges, which consistently held the top spot for 16 years in a row until 2021, were listed the second-most pressing concern in the American College of Healthcare Executives' annual survey.

Although workforce challenges were not seen as the most pressing concern for 16 years, they rocketed to the top quickly and rather universally for healthcare organizations in the past two years. Most CEOs (90 percent) ranked shortages of registered nurses as the most pressing within the category of workforce challenges, followed by shortages of technicians (83 percent) and burnout among non-physician staff (80 percent). 

Here are the most concerning issues hospital CEOs ranked in 2022, along with the score of how pressing CEOs find each issue. 

1. Workforce challenges (includes personnel shortages and staff burnout, among other issues) — 1.8 

2. Financial challenges — 2.8

3. Behavioral health and addiction issues — 5.2 

4. Patient safety and quality — 5.9

5. Governmental mandates — 5.9

6. Access to care — 6.0  

7. Patient satisfaction — 6.6

8. Physician-hospital relations — 7.6

9. Technology — 7.7 

10. Population health management — 8.6

11. Reorganization (mergers and acquisitions, partnerships and restructuring) — 8.7 

Within financial challenges, most CEOs (89 percent) ranked increasing costs for staff and supplies as the most pressing, followed by operating costs (66 percent) and Medicaid reimbursement (63 percent). CEOs are less concerned about price transparency and moving away from fee-for-service.

Seventy-eight percent of CEOs ranked lack of appropriate facilities/programs as most pressing within the category of behavioral health and addiction issues. That was followed by lack of funding for addressing behavioral health and addiction issues (77 percent).

The results are based on a survey administered to CEOs of community hospitals (non-federal, short-term, non-specialty hospitals). ACHE asked respondents to rank 11 issues affecting their hospitals in order of how pressing they are. Results are based on responses from 281 executives.





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