Workforce Key Constraint on Healthcare Organization Growth Strategies, Survey Finds

The vast majority of healthcare executives surveyed said workforce will have a significantly negative or negative impact on growth strategies this year.

Workforce issues loom large for healthcare C-Suite executives, according to a new survey report from Guidehouse and the Healthcare Financial Management Association (HFMA).

Workforce shortages are widespread in the healthcare sector. In an annual survey published last month by the American College of Healthcare Executives, workforce challenges were the Number One concern of 2022.

The new survey report from Guidehouse and HFMA features data collected from 182 healthcare executives, 80% of whom were C-Suite leaders such as CEOs, CFOs, and COOs. The survey asked the executives five questions.

1. What impact is your workforce having on your 2023 growth strategy?

• 62% of survey respondents said the state of their workforce is expected to have a significantly negative impact on 2023 growth strategy
• 34% of survey respondents said the state of their workforce is expected to have a negative impact on 2023 growth strategy
• Only 1% of survey respondents said the state of their workforce is expected to have a significantly positive impact on 2023 growth strategy

The workforce is a pivotal concern at healthcare organizations, the survey report says. "Labor is the root cause of delays in care delivery innovation. Clinician burnout, staff resignations, executive retirements, and equity issues now define many health system work environments. Fundamental changes in culture, work redesign, and workforce development are essential for providers to thrive in the new healthcare economy."

2. By how much do you project staffing to increase or decrease in the following areas?

Advanced practitioners:

• 55% of survey respondents expect staffing of advanced practitioners to increase by as much as 10%
• 34% of survey respondents expect staffing of advanced practitioners to increase by 10% or more

Behavioral and mental health providers:

• 45% of survey respondents expect staffing of behavioral and mental health providers to increase by as much as 10%
• 36% of survey respondents expect staffing of behavioral and mental health providers to increase by 10% or more

Physicians:

• 60% of survey respondents expect staffing of physicians to increase by as much as 10%
• 23% of survey respondents expect staffing of physicians to increase by 10% or more

Nurses:

• 47% of survey respondents expect staffing of nurses to increase by as much as 10%
• 31% of survey respondents expect staffing of nurses to increase by 10% or more

Contractors and travelers:

• 41% of survey respondents expect staffing of contractors and travelers to decrease by 10% or more
• 24% of survey respondents expect staffing of contractors and travelers to decrease by as much as 9%
• 19% of survey respondents expect staffing of contractors and travelers to increase by as much as 10%
• 15% of survey respondents expect staffing of contractors and travelers to increase by 10% or more

Healthcare organizations should not limit their primary recruitment strategies to physicians, the survey report says. "As organizations determine the best way to establish themselves as preferred providers, they may find they need fewer physicians to achieve these goals. Adding more behavioral health providers, social workers, and case managers to the team could help take pressure off overloaded medical professionals while giving patients the right support in the right setting, including in the home."

Health systems cannot continue to rely on contractors and travelers, Thomas Zenty III, a national adviser at Guidehouse, said in a prepared statement. "Health systems are struggling to afford the vast increase in the need for contractors and traveling clinicians. As their short-term contracts come to an end, leading organizations are finding attractive ways to keep these caregivers on full-time and integrate them into the business."

3. By how much do you project patient volumes to increase or decrease over the next 12 months?

Outpatient:

• 54% of survey respondents expect outpatient volume to increase by as much as 10%
• 41% of survey respondents expect outpatient volume to increase by 10% or more

Inpatient:

• 17% of survey respondents expect inpatient volume to decrease by 10% or more
• 24% of survey respondents expect inpatient volume to decrease by as much as 9%
• 35% of survey respondents expect inpatient volume to increase by as much as 10%
• 21% of survey respondents expect inpatient volume to increase by 10% or more

Patient volumes are an area of volatility for health systems as the country emerges from the coronavirus pandemic, Richard Bajner, Guidehouse partner and payer-provider leader, said in a prepared statement. "Most health systems are still experiencing volumes below pre-COVID levels, resulting in sizable market challenges. These shifts should inform strategic growth efforts that are focused on person-centered care, such as excellence in ambulatory services, to create sustainable business models that attract and retain patients while driving financial resiliency in an era of volatility."

4. What are your expectations for emergency department (ED) and elective procedure volumes?

ED volume:

• 55% of survey respondents expect ED volume to increase by as much as 10%
• 32% of survey respondents expect ED volume to increase by 10% or more

Elective procedure volume:

• 56% of survey respondents expect elective procedure volume to increase by as much as 10%
• 26% of survey respondents expect elective procedure volume to increase by 10% or more

The expectations for ED and elective procedure volumes are optimistic given market conditions, the survey report says. "Fundamental changes are contributing to unpredictability in the demand for emergency room visits, inpatient volume, ambulatory surgery procedures, outpatient visits, length of stay, case mix index, virtual care, and more. In turn, almost universally, hospitals and health systems are facing financial and operational instability like never before."

5. Please select the area your organization is projecting the greatest percentage budget increase in the next 12 months.

• 20% of survey respondents said digital engagement and virtual care
• 18% of survey respondents said revenue cycle automation
• 17% of survey respondents said investing in physician organizations
• 16% of survey respondents said managed services and outsourcing partners
• 13% of survey respondents said merging or acquiring strategic assets
• 10% of survey respondents said cybersecurity
• 5% of survey respondents said home care or hospital at home

Digital engagement, virtual care, and automation are top priorities for healthcare organizations, Zenty said. "With growth in labor and supply costs, many leaders are turning to purposeful artificial intelligence, automation, and digital care strategies to improve engagement and efficiency. Successful organizations are reevaluating their digital connectivity capabilities to ensure patients and caregivers know how to access and use patient portals, EHRs, and other technologies, as well as to streamline corporate and non-clinical services."

Related: Top Clinical Leaders Share Solutions for Workforce Shortages