Half Blame Government for Industry Mess

"We kind of know what we're facing in 2012; that's not where the significant changes will occur. It's what's happening in 2013 and beyond that we aren't as confident about. In 2012 it's all about sharpening our focus for better operational returns."

To achieve that end and to continue to strengthen the financials overall, one area finance leaders will likely concentrate on in 2012 is growth, according to the survey. Fifty-five percent of finance leaders surveyed say their organization will be part of an accountable care organization within the next three to five years, with half expecting to be part of the Medicare Shared Savings program and only 16% planning to participate in a commercial ACO.

Adding or expanding service lines may also be on the agenda for hospital and health system finance leaders, with the survey showing the most likely areas for growth to be: geriatrics (66%), cancer centers (66%), orthopedics (64%), primary care (63%), and emergency medicine (62%). This year may also see finance leaders investing more in capital projects, such as service line expansion and technology; nearly 20% expect to significantly increase the organization's capital spending and another 36% say a slight increase over last year is planned.

Pumpian believes the majority of capital dollars will go toward technology, as hospitals and health systems strive to meet the ICD-10 and meaningful use deadlines. However, some funds could go toward long-delayed equipment and facility upgrades or physician practice acquisitions.