Study authors Ralph W. Muller, chief executive officer of the University of Pennsylvania Health System; Dr. Ezekiel J. Emanuel, vice provost for global initiatives at the University of Pennsylvania; Andrew Steinmetz, research assistant to Emanuel; and Dr. Steven M. Altschuler, president and chief executive officer of The Children's Hospital of Philadelphia surveyed 74 senior executives from large hospitals and health systems.
Respondents included 46 CEOs, 17 presidents, four chief financial officers and three chief operating officers. Nearly all worked in large academic medical centers, which on average employed 8,520 workers and had annual revenues of $1.5 billion.
"Pessimism seemingly pervades the national dialogue surrounding healthcare reform," the study authors wrote. The authors suggested a more meaningful source for an appraisal of healthcare reform would be "people who have spent their entire careers on the front lines of the healthcare system deciding how budgets are managed and how care is delivered -- people like the leaders of America's hospitals and health systems."
The survey found the executives were optimistic about the ACA helping to reduce costs:
-- 91 percent of the study's respondents forecasted improvements within their own hospital or health system by 2020.
-- 85 percent expected their organization to have reduced its per-patient operating costs by the end of the decade.
-- Overall, the expected average operating cost reduction was 11.7 percent. Fifty-four percent said the savings could be achieved by reducing the number of hospitalizations, 49 percent said savings could be achieved reducing the number of readmissions, and 39 percent said savings would be achieved by reducing the number of emergency room visits.
"It is easy to be pessimistic about reforming the healthcare system," the authors wrote. "Change causes uncertainty and therefore anxiety -- and anxiety makes people pessimistic. For the leaders of America's flagship hospitals, it would be particularly easy to adopt a pessimistic outlook. Funding for their research missions has been declining. Support for their teaching mission is under threat. Payments for patient care are facing downward pressure, forcing them to transform their business models. Yet hospital leaders appear to be very optimistic about the future of the system."
The survey findings were published on the Health Affairs Blog.