The Healthcare Financial Management Association has released its most recent survey of hospitals regarding business trends. (HFMA survey) Most hospitals are anticipating a decline in inpatient volume, but outpatient volume growth. Overall hospitals are expecting a small net patient revenue increase. The outpatient growth is expected in radiology, laboratory, surgery and home health services. The primary area of inpatient and surgery growth is cardiac procedures. Underinsured and uninsured patients continue to have negative effects on hospital revenue, as do the Medicare and Medicaid programs. The anticipated changes in volume are primarily being responded to with staffing changes, but many hospitals are continuing to focus on physician relationships, including employment of doctors, as a method to ensure a steady stream of business. The survey gives a good high-level overview of hospital business trends.