The hospital industry has been in a self-proclaimed state of crisis during the past three years, but it didn't affect the annual turnover rate of hospital chief executive officers.
"When you're looking at turnover of 5,000 hospitals, it's generally going to be stable, barring a huge cut in reimbursement or other catastrophe," said Thomas Dolan, president and CEO of the American College of Healthcare Executives. "Things certainly haven't gotten any easier out there, but contemporary CEOs are getting more used to dealing with those issues."
Some 17% of all hospital CEO positions turned over last year, or about the same rate in each of the previous five years, according to data released exclusively to Modern Healthcare by the ACHE last week.
Last year, the ACHE reported that hospital CEO turnover in 1999 had fallen to 10.6%, a sharp decline from 16.9% in 1998. The ACHE subsequently "caught some data anomalies" and adjusted the 10.6% figure up to 18%, Dolan said (See chart).
The ACHE, which uses American Hospital Association data to conduct its analysis, attributed the anomalies to a delay-prone reporting process that can skew results by providing incomplete data for a given time period, said Peter Weil, the ACHE's vice president of research and development.
Of the CEOs who left their positions last year, about two-thirds resigned voluntarily. Of those, about 20% retired and the remainder accepted new positions at other hospitals, Dolan said. Only 4% to 8% of CEOs who voluntarily left their posts also left the healthcare industry.
The District of Columbia and states in the Southwest reported the highest rates of hospital CEO turnover: 54% in D.C. and 31% each in Arizona, Nevada and New Mexico.
Although 33% of top administrators at Las Vegas-area hospitals left their jobs last year, CEO turnover is not considered a problem in Nevada, said Mark Howard, president and CEO of 200-bed Mountainview Hospital in Las Vegas and former chairman of the ACHE. He said it hasn't even reached the agenda of state hospital association meetings.
In New Mexico, even though 25% of the state's residents lack health insurance and hospitals suffer from reimbursement rates that are as much as 30% lower than other parts of the country, the CEOs who left their jobs last year were not escaping from increased economic pressure, said Maureen Boshier, president of the New Mexico Hospitals and Health Systems Association, Albuquerque.
"I don't know of anybody who left because they can't do this anymore," Boshier said. Instead, she said, they left to retire or because of organizational changes in their health systems.
In the District of Columbia, the high turnover figure may be skewed by the small number of hospitals there and the fact that one hospital-250-bed District of Columbia General Hospital-is shutting down inpatient care, and two others changed ownership last year, said Joan Lewis, spokeswoman for the D.C. Hospital Association.