What’s Top of Mind for CEOs

A common question hospital and health system CEOs are asked is, “What keeps you up at night?” A better question would be, “What always keeps you up at night?” Based on the recent American College of Healthcare Executives (ACHE) annual survey, the answer is financial challenges.

The ACHE surveyed nearly 400 hospital and health system CEOs and their top concern was “financial challenges”, which was not surprising as it tops the list every year.

In the survey, the distant second to financial challenges listed as the CEOs’ top concern for 2019 was personnel shortages. That was followed by behavioral health issues, governmental mandates and patient safety/quality to round out the top five concerns, respectively.

The ACHE also asked CEOs to identify the specific financial challenges that they are concerned about. Here, in rank order by the percentage of respondents who cited it, are the Top 10 financial concerns:

Top 10 Financial Concerns
  1. Increasing costs for staff and supplies
  1. Medicaid reimbursement, including adequacy and timeliness of payment
  1. Bad debt, including uncollectable emergency department and other charges
  1. Reducing operating costs
  1. Managed-care and other commercial insurance payments
  1. Medicare reimbursement, including adequacy and timeliness of payments
  1. Competition from other providers of any type
  1. Transition from volume to value
  1. Government funding cuts other than reduced reimbursement for Medicaid or Medicare
  1. Revenue cycle management or converting charges to cash


Everything on the list boils down to two things: 1) Generating revenue and 2) Managing expenses. Achieving these two objectives is not going to get easier anytime soon in the new healthcare economy. Hospitals and health systems may not be able to cope by themselves. For many, it may be time to consider a third party expert or strategic partner that can help:

  • Reconfigure routine care
  • Increase productivity
  • Optimize revenue management
Let’s Talk
Share This Page