Percentage of community hospital CEOs who identified each issue as a specific concern for their hospital.
| Concern | Percent | |
|---|---|---|
| Increasing costs for staff, supplies, etc. | 70% | |
| Medicaid reimbursement (including adequacy and timeliness of payment, etc.) | 68% | |
| Reducing operating costs | 59% | |
| Bad debt (including uncollectable emergency department and other charges) | 56% | |
| Competition from other providers (of any type—inpatient, outpatient, ambulatory care, diagnostic, retail, etc.) | 50% | |
| Managed care and other commercial insurance payments | 50% | |
| Medicare reimbursement (including adequacy and timeliness of payment, etc.) | 49% | |
| Government funding cuts (other than reduced reimbursement for Medicaid or Medicare) | 48% | |
| Transition from volume to value | 48% | |
| Revenue cycle management (converting charges to cash) | 43% | |
| Inadequate funding for capital improvements | 37% | |
| Emergency department overuse | 31% | |
| Moving away from fee-for-service | 30% | |
| Pricing and price transparency | 29% | |
| Concern | Percent | |
|---|---|---|
| CMS regulations | 70% | |
| Regulatory/legislative uncertainty affecting strategic planning | 61% | |
| Cost of demonstrating compliance | 59% | |
| State and local regulations/mandates | 50% | |
| CMS audits (RAC, MAC, CERT) | 46% | |
| Concern | Percent | |
|---|---|---|
| High price/insufficient reimbursement for medications | 57% | |
| Engaging physicians in improving the culture of quality/safety | 56% | |
| Engaging physicians in reducing clinically unnecessary tests and procedures | 51% | |
| Redesigning care processes | 50% | |
| Lack of availability of medications | 45% | |
| Redesigning work environment to reduce errors | 40% | |
| Public reporting of outcomes data (including being transparent, fairness of measures, reporting burden) | 39% | |
| Compliance with accrediting organizations (e.g., Joint Commission, NCQA) | 37% | |
| Pay for performance | 32% | |
| Leapfrog demands (i.e., computerized physician order entry, ICU staffing by trained intensivists and evidence-based hospital referral) | 31% | |
| Medication errors | 14% | |
CEOs could choose as many issues as desired. Any specific concern with fewer than 50 responses was not included.