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Hospital CEOs list financial concerns as top worry, point to value-based care, study finds

American College of Healthcare Executives report says patient safety and quality, governmental mandates rank 2nd and 3rd among the leaders.

Beth Jones Sanborn, Managing Editor

Financial challenges once again ranked as the top concern for hospital chief executive officers in 2015, according to a new study by the American College of Healthcare Executives. Patient safety and quality, and governmental mandates came in as the 2nd and 3rd highest concerns.

Not surprisingly, CEOs cited the transition from volume to value-based reimbursement as a big concern. Medicare is already tying many payments to quality and only plans to shift more away from fee-for-service.

Issues with Medicaid reimbursement like adequacy and timeliness of payment, as well as bad debt, also worry CEOs, the study found.

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[Also: Healthcare providers must weigh high value vs. high prices, revenue cycle pros say]

ACHE found 65 percent of respondents cited volume to value as a top financial challenge, and 62 percent pointed to Medicaid as a top financial concern. More than 57 percent of respondents said bad debt was a noteworthy financial challenge, data showed.

Aside from financial issues, worker shortages ranked as the 4th biggest concern among healthcare execs, which was a big jump from 2014, when staff shortages ranked lower as the 10th most pressing concern. Patient satisfaction as the 5th biggest concern, the study showed.

"The rise in rank of personnel shortages as a top concern for hospital CEOs -- from the 10th-ranked concern last year to the fourth-ranked concern this year -- is noteworthy, indicating organizations are also concerned about recruiting and retaining the right talent," said Deborah J. Bowen, FACHE, CAE, president and CEO of ACHE.

[Also: With nonprofit health, the more the CEO earns, the better the hospital, survey finds]

For the survey, ACHE said they asked respondents to rank 10 challenges their hospitals face in order of how pressing each was, and then also to find specific areas of concern within each of those broader issues. The survey was sent 1,054 community hospital CEOs. 33.2 percent, or 350 responded.

When it came to patient safety and quality, 66 percent of responding CEOs said engaging physicians in improving the culture of quality and safety was an issue, and 60 percent said engaging physicians in reducing unnecessary tests and procedures was a challenge.

Finally, ICD-10 remains top of mind for healthcare CEOs when it came to governmental challenges, with 71 percent citing it as a top concern with the government-mandate category, the study said.

The American College of Healthcare Executives is an international society made up of 40,000 executives who lead hospitals, healthcare systems and other related organizations. 

Twitter: @BethJSanborn