Hospitals and health systems are seeing some signs of stabilization and margin improvement, but challenges around workforce, expenses and patient access persist according to Kaufman Hall’s 2023 State of Healthcare Performance Improvement report.

Patient access to care is a growing concern as hospital and health system leaders work to figure out what sustainable operations look like following a complete transformation in how patients interact with the healthcare system and providers. The report found that 66% of respondents’ institutions have run at less than full capacity at some point during the past year due to shortages, and 32% of respondents say that patient concerns or complaints about access to physicians are increasing.

“Having enough healthcare workforce to meet patient demand continues to be one of the most pressing concerns for hospitals and health systems,” said Kaufman Hall Managing Director Lance Robinson, leader of the firm’s performance improvement practice. “It’s clear that for many, this is a long-term issue. The older generation of providers is moving into retirement without a robust talent pipeline in place to fill the gaps retirees leave behind.”


However, one area that is showing improvement is the utilization of contract labor, which appears to be declining. Only 4% of organizations are experiencing increased utilization of contract labor, compared to 27% last year. Almost all surveyed (98%) are pursuing one or more recruitment and retention strategies, including raising starting salaries or the minimum wage (90%).

Kaufman Hall experts expect that it will be a slow climb for hospitals to return to the 3-4% operating margins that help ensure long-term sustainability. While staffing and capacity issues have clear implications for revenue, an increased rate of claims denials—reported by 73% of respondents—has had the most significant impact on hospitals’ revenue during the past year.

“Healthcare leaders must assess the realities of this new environment and begin making the strategic decisions and investments necessary to improve operations, or risk not being able to meet the care needs and preferences of their patients,” said Robinson.

Other report highlights include:
Patients are increasingly seeking care in outpatient settings, as almost half of respondents say that volumes for outpatient surgery and provider clinics are above pre-pandemic levels.
Despite the ongoing labor crisis, no respondents believe that their organization has fully optimized the automation technologies it has invested in.

U.S. Healthcare Homepage