Potential compromises to Medicare reimbursements, CMS audits and reduced operating costs rank among the top concerns for community hospitals in a new survey of more than 330 hospital CEOs. Leaders are in “challenging times,” as they try to do more with less, according to the report scheduled to be released Monday by the American College of Healthcare Executives.
Trying to simultaneously reduce costs and improve quality is proving to be a complicated task, says Deborah Bowen, ACHE president and CEO. Taking care of patients is a top priority, but CEOs must do so in “a climate of complex payment reform, dwindling reimbursement and government mandates,” she said.
Financial challenges, healthcare reform implementation, government mandates and patient quality and safety topped the list of woes hospital leaders faced in the list of 10 areas of concerns.
When it came to finances, 69% of the respondents said adequate and timely Medicare reimbursement was a major concern, while 67% reported they were worried about bad debt. Another 63% said they were struggling with decreases in patient volumes.
Other concerns stemmed from changes brought about through the Patient Protection and Affordable Care Act. Indeed, 78% said they were concerned about or facing reduced operating costs, and 66% said they were focusing attention on the shift to value-based purchasing. Another 65% said the alignment of provider and payer incentives was on their list.
Government mandates were third on the list of 10 issues, which also included areas of focus like caring for the uninsured or underinsured, patient satisfaction, technology transitions and personnel shortages. In the mandates category, 80% said their attention was focused on CMS audits, such as the recovery audit program and the Comprehensive Error Rate Testing evaluation. Implementation of the ICD-10 coding system was a top issue for 68% of the respondents.
The top priorities for respondents within the area of patient safety and quality, included: the engagement of physicians in improving the culture (73%); redesigning care processes (61%) and the shift from fee-for-service to value-payment structures (56%).
The recurring theme among all 10 issues was the focus on improving quality and reducing costs, Bowen said. “These are real problems that everybody has to deal with, and I think there's a tremendous amount of opportunity for leadership.”
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