"It is pointing out some real concerns to grapple with," she says. "We've seen concerns around financial challenges. A lot of that has to do with Medicare funding and we all know the predicament that a lot of states were in with respect to funding Medicaid. In some respects that is not necessarily a new problem, but the magnitude is getting larger and larger as we seek to cover patients in growing numbers as Obamacare takes hold."
"We know that bad debt and everything else is going to get worse with high-deductible plans. In some respects it is more of the same, but the magnitude and the order of it might be changing somewhat," she says. "I also think there is promising news in the sense that patient safety and quality care are moving forward in a very challenging time."
Bowen says she doesn't expect the concerns of healthcare executives to shift much in next year's survey either.
"We won't see anything wildly different, but we will see some of the same themes, perhaps in a different order," she says. "Financial challenges have been on the top of the list for a long time because you have to have a certain amount of money to keep organizations afloat. It is interesting that patient safety and quality and redesigning care and engaging physicians are tops on the list. The order may shift a little bit but I don't think this is momentary transition. It's going to take a little while for accountable care to take hold and be the new paradigm for healthcare."