I recently read an article in Becker’s Hospital Review that shed some light on the challenges facing hospitals across America.

Financial challenges have ranked as hospital CEOs’ number one concern for the past decade, according to the American College of Healthcare Executives’ most recent annual survey on issues facing hospitals.

Survey findings reflect 388 community hospital CEOs’ top concerns from 2013. The Top 10 concerns, in order, are below.

1. Financial challenges
2. Healthcare reform implementation
3. Governmental mandates
4. Patient safety and quality
5. Care for the uninsured
6. Patient satisfaction
7. Physician-hospital relations
8. Population health management
9. Technology
10. Personnel shortages
11. Creating an accountable care organization

CEOs also ranked specific aspects of the top three categories they found most pressing. CEOs could select as many as desired. Here are the top five for “financial challenges”.

Within “financial challenges”
1. Government funding cuts — 85 percent
2. Medicaid reimbursement (including adequacy and timeliness) — 81 percent
3. Medicare reimbursement (including adequacy and timeliness) — 71 percent
4. Bad debt — 67 percent
5. Decreasing inpatient volume — 64 percent

As I read the article I was surprised by one thing:  Why isn’t patient safety and quality at the top of the list?