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Advisory Board: Shifting Concerns for Health System CEOs

April 7, 2017
by Rajiv Leventhal
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The top concerns for C-level hospital and health system executives have undergone a significant disruption over the past year, with a desire to improve ambulatory access and to come up with new approaches to expense reduction topping the list, according to Advisory Board’s Annual Health Care CEO Survey.

The nationwide survey of 183 C-suite executives was conducted in December 2016 and January 2017 from Washington, D.C.-based Advisory Board. The topic of improving patients’ access to care in ambulatory or outpatient settings ranked sixth just a year ago. A new topic for this year’s survey, finding innovative ways to reduce expenses, entered the ranks in second place. Just behind was boosting market share for outpatient surgical procedures, up from 10th a year ago. Overall, three new topics entered the top five.

Specifically, the survey asked executives about their level of concern for 26 topics, ranging from preparing for the Medicare Access and CHIP Reauthorization Act (MACRA) to non-merger partnership and affiliation models.  The top five areas of extreme interest to hospital and health system executives are:

1.   Improving ambulatory access (57 percent),

2.   Innovative approaches to expense reduction (57 percent),

3.   Boosting outpatient procedural market share (55 percent),

4.   Minimizing unwarranted clinical variation (54 percent), and

5.   Controlling avoidable utilization (49 percent).

“This shift in topic rankings reflects a change in hospital and health system priorities in part driven by current discussions on healthcare policy reform,” Chas Roades, chief research officer at Advisory Board, said in a statement.  “Improving cost-effective access for consumers, who are likely to bear more direct financial responsibility for the cost of care, will be a growing concern for healthcare providers in the coming decade. Our survey shows executives are considering new strategies to remake their cost structures to respond to the changing environment.”

The top four concerns each drew a higher percentage of extremely interested C-level executives than last year’s No. 1 topic. A year ago, minimizing unwanted variation in care cost and quality topped the field at 53 percent. This year, controlling avoidable utilization of care resources held steady at fifth.

Overall, the changes in interest point to hospitals and health systems increasingly seeing their relationships with physicians as potential points of differentiation from other providers in their markets, the researchers concluded.

“The uncertainty on timing and specifics of the repeal of the Affordable Care Act (ACA), as well as MACRA, are creating more momentum from physicians to seek support and alignment with health systems,” said Lisa Bielamowicz, M.D., chief medical officer and senior vice president, research at Advisory Board.  “While demand for physician employment is at a near-record high, hospitals should use this moment to refocus their physician strategies on building a network centered on delivering accessible, lower cost, and reliable healthcare. This will advantage systems regardless of the specifics of payment reform.”

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