Hospital leaders concerned about labor shortages and behavioral health demands

Hospital leaders were most concerned about staffing issues in 2022, but they were increasingly concerned about meeting the growing demand for mental health services.

Labor shortages remained at the top of the list of hospital leaders’ biggest problems last year, according to the American College of Health Leaders’ annual survey. According to respondents, the lack of registered nurses and technicians is the biggest problem. As in last year’s review, financial constraints driven by rising labor and consumable costs came in second.

Behavioral health issues were third among the top concerns for hospital leaders, rising from fourth in the 2021 survey. Respondents noted lack of adequate facilities, insufficient earmarked funding and insufficient reimbursement rates as hospital operators were forced to treat patients in their emergency departments for extended periods as their traditional outpatient and inpatient referral partners were overwhelmed.

“There are not many local mental health facilities and programs,” said ACHE CEO Deborah Bowen. “Those that are working are struggling with increased demand.”

The survey of short-term, emergency, non-federal hospitals was conducted in September. Here are some conclusions.

• Staffing problems for registered nurses and technicians were also the biggest problem for hospital leaders in 2021, but these problems were not as common in 2022. 90% and 83% of respondents, respectively, said they had problems staffing registered nurses and technicians. This is up from 94% and 85% in the 2021 survey. Data from Kaufman Hall shows that labor pressures have eased somewhat in recent months.
• 65% of hospital managers said they had problems with their primary care physician workforce in 2022, up from 45% in 2021. In recent years, the number of residents practicing primary care has increased, but there are still not enough clinicians to meet the needs of the current demand. Medical graduates entering specialized care can earn twice as much as primary care physicians, depending on the specialty.
• 70% of hospital managers reported under-reimbursement for mental health and addiction services. Even though the Mental Health Equity and Equity for Drug Addicts Act was passed in 2008, there is still a large gap between mental and physical care payment due in part to a lack of enforcement. President Joe Biden said last week in a speech to the US Congress that his administration would propose new rules to fill this gap in reimbursement.
• 66% of respondents were looking to cut operating costs in 2022, compared to 53% in 2021. Over the past year, more hospitals, especially in rural areas, have had to cut services.
• 51% of respondents stated that demand for opioid dependence and related treatment has increased. Thirty percent of hospital leaders said legal and regulatory issues limit treatment options, and 29% said behavioral health stigma hinders care.