Hospital CEO rank concerns
Execs list financial challenges as biggest concern
Hospital executives’ daunting tasks ahead are well-reflected in a new survey showing that financial challenges, healthcare reform, safety and quality, and government mandates continue to be the biggest issues confronting hospitals.
The annual survey, conducted by the American College of Healthcare Executives, asked community hospital CEOS to rank 10 issues in order of relative concern, and the issue of financial challenges was by far the biggest concern with an average ranking of 2.5. “Everybody’s worried about what reimbursement’s going to be like from the government,” said Thomas Dolan, president and CEO of the ACHE.
The ACHE also asked about specific concerns within each of the 10 issues, producing a list of specific financial concerns that reflects fears about what lies ahead for major government payers Medicare and Medicaid (See chart).
The second biggest issue was healthcare reform implementation with an average ranking of 4.5, followed by patient safety and quality and then by governmental mandates, both of which had average scores that rounded to 4.6.
Behind those four issues in order were care for the uninsured (5.2); physician-hospital relations (5.3); patient satisfaction (5.6); technology (7.2); personnel shortages (7.4); and creating accountable care organizations (8.4).
Officials at Christiana Care Health System acknowledge the issues in the survey as important, including the financial concerns, but choose to tackle them in a top-down approach focused on improving the value of the care it provides, said Dr. Robert Laskowski, president and CEO of the two-hospital, Wilmington, Del.-based system.
As part of that, the system in July created the Christiana Care Value Institute to guide the system through the changes taking place in healthcare by trying to create a framework for creating and delivering value. “All these things are important, and if you don’t have resources, you can’t take care of people,” Laskowski said. “I wouldn’t put one higher than the other in terms of rank order. They all blend together,” he said. The issues are more amenable to a solution if a hospital is taking care of value in providing care, Laskowski added.
Dolan said he believes a sleeper problem found near the bottom of the list is personnel shortages, which could become more of a concern once the economy picks up some steam. “I’m predicting a workforce shortage like we’ve never had in the past once this (economic slowdown) is over,” Dolan said. Many hospital employees are working with the expectation that they will drop out of the workforce once their financial situation improves, he said.
The ACHE this year changed the way it conducted its survey, anticipating that the ordinal method used this time would provide better information than the approach used in previous years. “I just think this is a more accurate way to do it and this is how we’re going to do it in the future,” Dolan said.
The ACHE previously asked executives to rank the issues but reported on the percentage of respondents who listed a given concern in its top three. The new method for calculating the overall results takes a broader look at the CEOS’ concerns instead of targeting their three biggest concerns, he said.
The survey was sent to 1,294 community hospitals and received responses from 514, according to the ACHE. Previously, the survey was sent to all types of hospitals.