522 US mid-market executives were surveyed in October/November 2015 about their economic expectations and plans. 56% reported their workforces grew over the past year and 61% expect continued growth in 2016. However, confidence in the economy improving over the next two years dropped from 19.6% in Fall 2014 to 9.8% in Fall 2015. The top obstacles to growth cited were an uncertain economic outlook (40.8%), rising health care costs (34.0%), and increased regulatory compliance (31.9%).