But even if they buy into the notion that improving quality pays dividends that don't easily show up on an income statement, not many top leaders are currently willing to take that kind of risk when it's uncertain that higher quality will pay off in the long run. Some of those concerns are justified, as many feel they can't count on staying viable long enough to make such investments pay off over a long time frame.
"The bottom line CEOs and CFOs are asking is how can we do this in an efficient way and meet all of these initiatives that we have to meet and remain financially sound?" says Sloan. "I was at an event recently with a couple of hospital CFOs. Their biggest concern was the immediate uncertainty of inpatient volume and whether health exchanges will increase the number of insured while they simultaneously see a rise in their charity cases and bad debt. That's hard to predict for CFOs. When you get uncertainty like that, you can only take so much risk."