/ en Wed, 30 Apr 2025 11:06:18 -0500 Tue, 11 Mar 25 12:52:15 -0500 /testimony/2025-03-11-aha-statement-house-ways-and-means-subcommittee-health-hearing-march-11-2025 <div class="container"><div class="row"><div class="col-md-8"><h2>Statement<br>of the<br>şÚÁĎŐýÄÜÁż Association<br>for the<br>Committee on Ways and Means<br>Subcommittee on Health<br>of the<br>U.S. House of Representatives<br>“After the Hospital: Ensuring Access to Quality Post-Acute Care”<br>March 11, 2025</h2><p>On behalf of our nearly 5,000 member hospitals and health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and our 2,425 post-acute care members, the şÚÁĎŐýÄÜÁż Association (AHA) appreciates the opportunity to submit this statement for the record to the Ways and Means Subcommittee on Health on the value of post-acute care and how Congress can better support patients’ access to these critical services.</p><h2>General Policy & Regulatory Challenges</h2><p>Post-acute care is provided to patients who have been discharged from an acute-care hospital but still require services such as close medical supervision, nursing care, therapies and other support. Long-term care hospitals (LTCHs) act as a pressure relief valve for high-acuity patients needing extended hospital stays, thereby easing the burden on intensive care units (ICUs). Inpatient rehabilitation facilities (IRFs) assist patients recovering from life-changing illnesses like brain injuries, spinal cord injuries and amputations. Skilled nursing facilities (SNFs) offer rehabilitation therapy services aimed at strengthening patients and making them more independent before they return home. Home health agencies (HHs) enable seniors to remain independent by providing medical or non-medical care in their homes. Each of these facilities plays a crucial role across the continuum of care.</p><p>While each specific post-acute sector faces unique challenges, there are several policy and regulatory issues that are universal.</p><h3>Medicare Advantage</h3><p>Medicare Advantage (MA) plans are an increasingly popular choice for older Americans, and measures must be taken to ensure that patients who require post-acute care services are able to access them in a timely manner. Perhaps the biggest challenge facing post-acute care providers and their patients is the ongoing restrictions that MA plans place on access to care. The issue has been well documented by providers as well as by Department of Health and Human Services Office of Inspector General and congressional investigations.<a href="#fn1"><sup>1</sup></a><sup>,</sup><a href="#fn2"><sup>2</sup></a> The prior authorization process used by MA plans places significant administrative burden on both acute-care hospitals and post-acute care providers. Perhaps more importantly, it is directly harmful to Medicare beneficiaries — at best delaying their care and at worst outright denying medically necessary treatment.</p><p>MA plans’ practices have directly contributed to the growing discharge delay problems plaguing acute-care hospitals. While all beneficiaries have faced these delays, the increase in length of stay for MA beneficiaries seeking post-acute care has increased twice as much compared to Traditional Medicare beneficiaries. Specifically, the average length of stay (ALOS) prior to discharge to post-acute care settings has grown by 11.3% for MA patients between 2019 and 2024. However, for patients in Traditional Medicare, the ALOS has grown by only 5.2%, according to industry benchmark data from Strata Decision Technology, LLC.</p><p>Despite steps taken by the Centers for Medicare & Medicaid Services (CMS) in recent years, providers have seen little to no meaningful change in MA plan behavior and no increased access for beneficiaries. Additionally, post-acute care providers still face challenges with MA plans listing them within their networks. CMS should conduct regular audits to ensure that MA plans include robust post-acute care options with sufficient bed spaces and resources to provide the in-network care that patients need. As MA enrollment continues to grow, it is imperative that Congress continue to rein in these harmful practices to ensure that beneficiaries are not denied the care to which they are entitled.</p><h3>Ongoing Workforce Challenges</h3><p>The U.S. health care system is facing unprecedented workforce shortages, with the Bureau of Labor Statics estimating there will be 193,100 openings for nurses in each of the next 10 years.<a href="#fn3"><sup>3</sup></a> For physicians, there could be a shortage of between 37,800 and 124,000 physicians by 2034 for both primary and specialty care.<a href="#fn4"><sup>4</sup></a> Since mid-2020, post-acute care providers have seen a significant number of patient care technicians, registered nurses, and respiratory therapists, among other vital professionals, shifting employment to other organizations. Some post-acute care providers in rural areas have experienced significant challenges in filling open positions, sometimes going months without receiving an application for open registered nurses, licensed practical nurses, certified nursing assistants or key leadership roles. Staffing challenges jeopardize the ability of seniors to access the care they need and deserve.</p><p>To ensure residents and families have access to high-quality care close to home, meaningful, long-term solutions and investments in workforce development must replace stop-gap measures, reimbursement cuts and punitive regulations. The AHA encourages Congress to pass the Conrad State 30 and Physician Access Reauthorization Act (S.709/H.R.1585) and the Healthcare Workforce Resilience Act, as well as support visa recapture initiatives and continue support for the Health Resources and Services Administration’s (HRSA) health professions and nursing workforce development programs.</p><h2>Sector Specific Comments</h2><h3>Long-Term Care Hospitals</h3><p>LTCHs play a unique role for Medicare and other beneficiaries by caring for the most severely ill patients who require extended hospitalization. LTCHs offer an intensive, hospital-level of care that may not be available in other post-acute care settings. LTCH patients are typically very medically complex, with multiple organ failures, and stay in LTCHs on average for at least 25 days. Many LTCH patients depend on ventilators due to respiratory failure or similar ailments, which require highly specialized care and extended stays. In addition, LTCHs are critical partners for acute-care hospitals, alleviating capacity for overburdened ICUs and other parts of the care continuum that would otherwise be further strained without access to LTCHs for these patients.</p><p>In 2016, Congress put in place a dual-rate payment system under the LTCH prospective payment system (PPS) for Traditional Medicare beneficiaries.<a href="#fn5"><sup>5</sup></a> This fundamental change in the payment system and other coinciding market factors dramatically reshaped the landscape of both LTCHs and the beneficiaries they serve. Since implementation of the dual-rate payment system, the volume of standard LTCH cases has fallen by approximately 70% from its peak under the legacy payment system and the number of LTCH providers also has decreased by 20%. At the same time, the average acuity of LTCH patients has risen by 20% or more in that same period, and these patients are increasingly consolidated into a limited number of Diagnosis-Related Groups (DRGs).<a href="#fn6"><sup>6</sup></a> In addition, approximately one-third of all Medicare LTCH discharges nationally are paid the inpatient PPS-equivalent rate. However, these reimbursements fall well short of the cost of care. AHA’s analysis shows that as of fiscal year 2020 reimbursement for these cases totaled only 46% of the cost of care.<a href="#fn7"><sup>7</sup></a> Finally, the growth of MA has further shrunk the patient population for LTCHs as MA plans routinely inappropriately deny access to LTCHs.</p><p>The smaller, sicker patient population and dwindling reimbursement has created many challenges for LTCHs, as evidenced by the closure of so many of these facilities. The remaining patient pool is notably more acute and costly to treat, resulting in cases increasingly qualifying for high-cost outlier (HCO) payments to compensate for lack of precision in the DRGs as so many cases are consolidated into a limited number of DRGs. In 2016, the fixed-loss amount (FLA) for HCO cases, which is the amount of financial loss an LTCH must incur before qualifying for an HCO payment, was $16,423. Since that time, the FLA has risen by more than 300% to $77,048. This unsustainable figure puts LTCHs in the untenable position of having to lose tens of thousands of dollars in order to care for some of the sickest patients. Unfortunately, CMS has been unable to deviate from its current methodology to provide relief from this policy due to a congressional mandate to cap total outlier payments at 8% of total payments.<a href="#fn8"><sup>8</sup></a></p><p>The AHA appreciates this Subcommittee’s awareness of the need to provide relief to the LTCH sector and supports efforts to provide additional flexibility and funding for HCO cases, and additional flexibility to provide care for different types of patients through the standard payment system.</p><h3>Inpatient Rehabilitation Facilities</h3><p>IRF patients are typically admitted directly from an acute-care hospital following a serious accident or illness such as stroke, brain injury, amputation or others that have resulted in serious functional deficits and medical complications. IRFs provide hospital-level care, which means they are closely supervised by a physician who also oversees patients’ overall rehabilitation. The intensive course of rehabilitation provided in IRFs must include a minimum of 15 hours per week of intensive therapy services involving multiple therapy disciplines, as well as around-the-clock specialized nursing care. This level of care is critical for debilitated patients who are stable enough to be discharged from the acute-care hospital to begin intensive rehabilitation but are at risk for medical complications without continued close medical management.</p><p>The AHA continues to hear from IRFs regarding their concerns with CMS’ IRF Review Choice Demonstration (RCD). CMS initially created the IRF RCD to “assist in developing improved procedures for the identification, investigation, and prosecution of potential Medicare fraud.” However, the agency never provided credible evidence to support its belief that there may be high rates of fraud in the IRF field — it only cited its improper payment rate for IRFs, which, as it knows, is not the same as fraud. Since being operationalized by the Biden administration in 2023, CMS has not subsequently provided any evidence that the IRF RCD has revealed or assisted in uncovering any fraud. Specifically, the demonstration currently subjects 100% of IRF claims to review in both Alabama and Pennsylvania. Yet, according to CMS’ <a href="https://www.cms.gov/files/document/irf-rcd-stats-fy-2024.pdf" target="_blank" title="CMS: Review Choice Demonstration for Inpatient Rehabilitation Facility Services (IRF RCD) Quarterly Updates. Fiscal Year 2024 (Oct 2023 – Sept 2024).">most recent data</a> collected during fiscal year 2024, approximately 90% of all claims reviewed have been approved. Of those, more than 95% were approved on the initial submission. Despite this high affirmation rate and lack of evidence of any fraud, CMS says it still plans to continue its expansion of the demonstration to more than half of all states and territories, subjecting hundreds of thousands of IRF claims annually to the burdensome manual medical review process. It has become clear that this demonstration is burdensome, diverts valuable clinical resources, and is not achieving its stated objective of uncovering or preventing fraud in the Medicare program.</p><p>Therefore, the continued need for the IRF RCD remains highly dubious, and the AHA continues to encourage CMS and Congress to end this program.</p><h3>Skilled Nursing Facilities</h3><p>SNFs play another critical role for many hospitalized patients who need continued care after discharge. However, hospitals have faced increasing difficulty discharging patients to post-acute care settings, including SNFs. This challenge has largely been due to staffing shortages and the associated reduced capacity of SNFs and other providers. These shortfalls then place additional burden back on hospitals, including the need for hospitals to board patients until a discharge location can be found. Therefore, it is vital for the entire continuum of care, including for acute-care hospitals, that SNFs are properly resourced.</p><p>The AHA and its members are committed to safe staffing to ensure high-quality, patient-centered care in all health care settings, including long-term care (LTC) facilities. Yet, the process of safely staffing any health care facility is about much more than achieving an arbitrary number set by regulation. It requires clinical judgment and flexibility to account for patient needs, facility characteristics, and the expertise and experience of the care team. The Biden administration’s one-size-fits-all minimum staffing rule for LTC facilities creates more problems than it solves and could jeopardize access to all types of care across the continuum, especially in rural and underserved communities that may not have the workforce levels to support these requirements.</p><p>The AHA supports the Protecting America’s Seniors Access to Care Act (H.R. 1683) to prohibit the Department of Health and Human Services from implementing the provisions of the minimum staffing rule. We have recommended to CMS specific alternative strategies that take more patient- and workforce-centered approaches to ensuring LTC facilities have a strong foundation of policies and processes to continually assess, reassess and adjust their staffing levels. These strategies constitute starting points for further standards development, which we would encourage CMS to engage in with the assistance of patients and the entire health care continuum. Not only would these proposed alternatives support more timely and effective action by LTC facilities to address staffing challenges, but they also would be more consistent with modern clinical practice. Thus, repealing the Biden-era mandate would both protect patient access to care and allow for the development of more effective and clinically appropriate strategies to improve LTC patient outcomes.</p><h3>Home Health Agencies</h3><p>Approximately one in five hospitalized Medicare beneficiaries are discharged to HH.<a href="#fn9"><sup>9</sup></a> These services alleviate pressure on hospitals, other post-acute care sites and caregivers, who would otherwise be responsible for these patients. HH agencies also can prevent rehospitalization by safely providing needed interventions at home thus avoiding potential complications and accidents.</p><p>Over the last few years, the AHA has seen a strain on HH operations — along with other post-acute care providers — due to financial challenges, creating ripple effects throughout the continuum of care. Hospitals have seen the length of stay for patients being discharged to HH increase as they face increasing difficulty finding placements for these patients.<a href="#fn10"><sup>10</sup></a> This has been due in large part to the reductions in reimbursement to HH providers put in place by CMS since its implementation of the new Medicare fee-for-service payment system in 2020. CMS determined it must permanently cut HH payments from between 4% to 8% annually in order to meet statutory budget neutrality requirements. In addition, CMS has indicated that it intends to recoup billions more in temporary reductions in the coming years. These payment reductions, paired with staffing shortages, and other administrative burdens and costs will continue to have serious implications for access to services for Medicare beneficiaries. The AHA is thankful for the Committee’s ongoing support of home health agencies.</p><h2>Conclusion</h2><p>Thank you for your leadership on these important issues and for the opportunity to provide comments. We look forward to continuing to work with you to address these important topics on behalf of our patients and communities.</p><hr><ol><li id="fn1">HHS, Office of Inspector General (OIG); Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care (April 2022) (<a href="https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf" target="_blank">https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf</a>).</li><li id="fn2"><a href="https://www.hsgac.senate.gov/wp-content/uploads/2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf" target="_blank">https://www.hsgac.senate.gov/wp-content/uploads/2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf</a>.</li><li id="fn3">3<a href="https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-6" target="_blank">https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-6</a>.</li><li id="fn4">4<a href="https://www.aamc.org/news/press-releases/aamc-report-reinforces-mounting-physician-shortage" target="_blank">https://www.aamc.org/news/press-releases/aamc-report-reinforces-mounting-physician-shortage</a>.</li><li id="fn5">Bipartisan Budget Act Of 2013 (P.L. 113–67).</li><li id="fn6"><a href="/white-papers/2023-12-29-white-paper-medicares-ltch-outlier-policy-needs-reforms-protect-extremely-ill-beneficiaries" target="_blank">/white-papers/2023-12-29-white-paper-medicares-ltch-outlier-policy-needs-reforms-protect-extremely-ill-beneficiaries</a>.</li><li id="fn7"><a href="/system/files/media/file/2019/06/aha-cms-long-term-care-proposed-rule-fy2020-6-21-2019_0.pdf" target="_blank">/system/files/media/file/2019/06/aha-cms-long-term-care-proposed-rule-fy2020-6-21-2019_0.pdf</a>.</li><li id="fn8">Section 15009(b) of the 21ST Century Cures Act added section 1886(m)(7) to the Act.</li><li id="fn9">MedPAC; July 2024 Data Book; Section 8, Pg. 107 (<a href="https://www.medpac.gov/wp-content/uploads/2024/07/July2024_MedPAC_DataBook_Sec8_SEC.pdf" target="_blank">https://www.medpac.gov/wp-content/uploads/2024/07/July2024_MedPAC_DataBook_Sec8_SEC.pdf</a>).</li><li id="fn10"><a href="/lettercomment/2024-08-26-aha-comments-calendar-year-2025-home-health-prospective-payment-system-proposed-rule" target="_blank">/lettercomment/2024-08-26-aha-comments-calendar-year-2025-home-health-prospective-payment-system-proposed-rule</a>.</li></ol></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/03/AHA-Statement-to-House-Ways-and-Means-Subcommittee-on-Health-for-Hearing-March-11-2025.pdf" target="_blank" title="Click here to download the AHA Statement to House Ways and Means Subcommittee on Health for Hearing March 11, 2025 PDF.">Download the Testimony PDF</a></div><a href="/system/files/media/file/2025/03/AHA-Statement-to-House-Ways-and-Means-Subcommittee-on-Health-for-Hearing-March-11-2025.pdf"><img src="/sites/default/files/inline-images/Page-1-AHA-Statement-to-House-Ways-and-Means-Subcommittee-on-Health-for-Hearing-March-11-2025.png" data-entity-uuid="ef5df51a-efdf-417b-bd24-197ee16b5607" data-entity-type="file" alt="AHA Statement to House Ways and Means Subcommittee on Health for Hearing March 11, 2025 page 1." width="695" height="900"></a></div></div></div> Tue, 11 Mar 2025 12:52:15 -0500 Workforce Shortages /aha-center-health-innovation-market-scan/2025-03-04-emory-healthcare-network-partnership-builds-new-paths-access <div class="container"><div class="row"><div class="col-md-8"><img src="/sites/default/files/inline-images/Emory-%20Healthcare-Network-Partnership-Builds-New-Paths-to-Access.png" data-entity-uuid="427b2645-479d-4131-9fff-19a46a157001" data-entity-type="file" alt="Emory Healthcare Network Partnership Builds New Paths to Access. A clinician in scrubs holding a clipboard stands in front of a CVS Health MinuteClinic kiosk." width="1200" height="751"><p>At a time when many retail pharmacies are rethinking their strategies and cutting back on primary care service offerings, Emory Healthcare Network and CVS Health are bucking that trend in Georgia.</p><p>Emory is expanding its relationship with CVS’ MinuteClinics in 35 locations. The <a href="https://news.emory.edu/stories/2025/02/hs_cvs_minuteclinic_ehn_primary_care_collaboration_20-02-2025/story.html" target="_blank" title="Emory University Emory News Center: MinuteClinic and Emory Healthcare Network expand primary care access to Georgians">partnership</a> that began in 2011 is evolving to provide more options for primary and preventive care throughout the Atlanta metro area that Emory Healthcare serves. It’s all part of Emory’s continuing push to look for meaningful ways to broaden access to primary care in the state and to address a shortage of critical providers, Emory Healthcare leaders note.</p><p>MinuteClinic primary care patients will have access to Emory Healthcare Network’s extensive resources, including hospitals, specialists, diagnostic and radiology facilities and specialty labs, making it easy for patients to receive additional care when needed.</p><p>Since the outset of their relationship, Emory and MinuteClinic have worked together to offer walk-in adult wellness exams or physicals and sick visits at various MinuteClinic locations. MinuteClinic nurse practitioners and other advanced practice providers staff the clinics and Emory physicians serve as collaborating physicians for the locations, which offer same-day visits and offer evening and weekend hours or virtual services that make care more convenient.</p><p>MinuteClinics largely serve younger, healthier patients, and their expectations around interacting with the health care system are unique, so having MinuteClinic as a network option expands the reach of primary care, Creagh Milford, D.O., president of retail health, recently told Fierce Healthcare.</p><p>And because both Emory and MinuteClinics use Epic electronic health records, it’s easier to keep the full care team abreast of patient encounters. CVS also has introduced training and new workflows for MinuteClinic staff to focus on such preventive care services as health maintenance visits, screenings and management of chronic conditions.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2 { color: #9d2235; } Tue, 04 Mar 2025 06:00:00 -0600 Workforce Shortages /advancing-health-podcast/2025-02-10-case-change-addressing-new-yorks-health-care-challenges <p>Key findings from a report titled "The Case for Change" have identified four drivers of some of the most pressing challenges facing health care in New York state. In this conversation, Bea Grause, R.N., J.D., president of the Healthcare Association of New York State, discusses the tough findings and partnerships needed to solve these problems, insights into the correlation between health care and legislative advocacy, and how the report’s learnings are translatable to states around the country.</p><hr><div></div><hr><div class="raw-html-embed"> <details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br>   </h2> </summary> <p> 00:00:01:07 - 00:00:21:05<br> Tom Haederle<br> Welcome to Advancing Health. Coming up in today's episode, a conversation with Bea Grause, president of the Health Care Association of New York State, about the drivers that have health care in the Empire State perched on the edge of - quote - an existential cliff. We'll talk about what can be done and what the rest of the country can learn from how New York is handling its health care challenges. </p> <p> 00:00:21:08 - 00:00:29:27<br> Tom Haederle<br> Your host today is yours truly. I'm Tom Haederle, senior communication specialist with the AHA. </p> <p> 00:00:30:00 - 00:00:45:26<br> Tom Haederle<br> Bea, thank you so much for joining me this morning. Really appreciate your time. And, appreciate your effort in helping our listeners get into what Billy Joel might call a New York State of Mind about what health care challenges and the most effective ways to address them. So welcome. And thank you for being here. </p> <p> 00:00:45:29 - 00:00:46:27<br> Bea Grause, R.N., J.D.<br> Thank you, Tom. </p> <p> 00:00:47:00 - 00:01:05:26<br> Tom Haederle<br> You really are so well qualified to assess the challenges of today's health care from so many angles. And I'd like to just briefly share with our Advancing Health friends a little bit about your background so they know you know where you're coming from. You began your career as a nurse, an RN. You have done time on Capitol Hill as a legislative aide. </p> <p> 00:01:05:29 - 00:01:26:11<br> Tom Haederle<br> I know you're a veteran of senior positions with two other state health associations, Vermont and Massachusetts. You're a former member of AHA's board of trustees - thank you for your service. You also found time along the way to earn a law degree. So you've been a very accomplished person. And now, of course, you're president of one of the largest and most influential health care associations in the country. </p> <p> 00:01:26:13 - 00:01:44:01<br> Tom Haederle<br> And really, the purpose of our discussion today is, to discuss the concern that you and many other people have about what you see happening in New York State that's led to the production of "The Case for Change," this this new report that's kind of - frankly, a punch in the gut when it comes to - in terms of shaking things up and speaking </p> <p> 00:01:44:02 - 00:01:55:09<br> Tom Haederle<br> very candidly about some of the problems that the state is facing, what needs to be done. So let's start there. What is happening in New York state that prompted the release of The Case for Change? </p> <p> 00:01:55:12 - 00:02:23:02<br> Bea Grause, R.N., J.D.<br> Sure. I think what is happening, really was the post-pandemic reality. We realized that state and federal lawmakers wanted to move on from the pandemic. And our members - and this was true for members, for hospitals and health systems across the country - they hadn't moved on. They were not able to move on from the pandemic. The workforce shortage that was beginning to emerge, exacerbated during the pandemic. </p> <p> 00:02:23:03 - 00:02:55:10<br> Bea Grause, R.N., J.D.<br> It's now a chronic national workforce shortage. As a nurse, I recognized that demographically, New York had an aging population, which, again, I know is happening in many other states, not all, but many other states across the country. And we wanted to understand that environment better, what was actually happening at the core? Because at the core of health care, I understood, is you have patients and you have people taking care of patients. </p> <p> 00:02:55:13 - 00:03:33:00<br> Bea Grause, R.N., J.D.<br> And we knew that we were facing a crisis in both the demographics and who was able to take care of the increasing and changing demand that we saw happening and our members saw happening every day. That's why we did the report, was really to better understand that environment. And it has really helped us in creating a narrative that cuts through all the clutter and gets to a common set of facts where, rather than talking about, you know, this is, you know, a sophisticated podcast. </p> <p> 00:03:33:00 - 00:04:08:13<br> Bea Grause, R.N., J.D.<br> So rather than continuing to talk about all the symptoms of what's wrong with our system: 343B crisis, site neutral, all of the many, many, many issues that are very confusing to lawmakers, very confusing to us. You know, we're the experts in that space. And to patients and to consumers and to businesses completely impenetrable. We began this report with looking at demographic data on patients who were currently using hospitals and post-acute care </p> <p> 00:04:08:15 - 00:04:38:13<br> Bea Grause, R.N., J.D.<br> now and ten years out into the future. That was our starting place and then obviously looked at workforce data as well. And that really helped us to create the narrative that patient demand was increasing and changing. We didn't have the right number or the right type of health care worker to meet that demand. We had consistent and long standing disparities in care, urban rural poverty, haves and have nots, both on the provider space as well as the patient space. </p> <p> 00:04:38:15 - 00:05:13:27<br> Bea Grause, R.N., J.D.<br> And all of that was leading to unaffordability at every level. At the government level, at the business level and the consumer level. And without resolution in those four areas, that is the tipping point or the existential cliff that will cause our system to fail. Everything else is a symptom. We're trying to make it more understandable as well as more compelling, not just to all of us who understand all the nouns and verbs in health care, but to lawmakers and consumers and others. </p> <p> 00:05:14:00 - 00:05:35:14<br> Tom Haederle<br> Of the four drivers that you just outlined: health care demand is growing. Health disparities persist. Affordability, and lack of enough workers to provide the care that really is ever-growing. Of those four, is there one that is - they're all important - but is there one that's primary concern, that really needs the most urgent attention? </p> <p> 00:05:35:16 - 00:06:16:12<br> Bea Grause, R.N., J.D.<br> I'm going to stick with demand. Because as a clinician, to me, demand drives everything. And you'll see in that report, as I often say, there's not a HANYS ten point plan on how to fix our health care system. It's not designed for that. It is designed to, again, put out a common set of facts to bring people together, particularly, you know, for here in New York, lawmakers and others, other stakeholders to talk about what are some of the strategic things that we need to begin to work on in order to solve some of these much more difficult problems that are not being talked about or not being understood and then therefore not being resolved. </p> <p> 00:06:16:15 - 00:06:54:10<br> Bea Grause, R.N., J.D.<br> So to me, the most important one is demand. And I'll just use New York for a second. In five years we are going to have 700,000 new, net new, senior citizens in New York State. And you know, I think, as you well know, the per capita spending for senior citizens increases as people age. And so when you think about our blue H, and the brand of that blue H, I always think about that from a patient perspective as the only open door. </p> <p> 00:06:54:12 - 00:07:21:18<br> Bea Grause, R.N., J.D.<br> So if you have other open doors to get health care in a community, you will use them. But if there are none, you will go into that blue H. And if you have a medical need at any point you will go through that hospital door and then your care journey will begin from there. So that demand and you can you see it in the headlines with crowded emergency rooms, overload, nursing home closures, back up in the emergency room, the inability to get an appointment. </p> <p> 00:07:21:19 - 00:07:47:06<br> Bea Grause, R.N., J.D.<br> You're starting to see the overload in health care systems happening today. It is largely being driven by elderly patients coming in, not being able to get upstairs to get to a bed because there are no health care workers there, or there are 80 or 90 patients who would be better served in a nursing home and cannot be discharged because there's no nursing home bed. </p> <p> 00:07:47:09 - 00:08:12:06<br> Tom Haederle<br> And what is the role of community collaboration and partnership in addressing that particular problem? And frankly, all four drivers. I know one of the key takeaways of the report is that it's a joint effort that involves many different partners. And if you could talk a little bit about finding the right organizations to work with and who needs to lead that discussion, and what comes out of having these collaborative partnerships underway? </p> <p> 00:08:12:09 - 00:08:51:18<br> Bea Grause, R.N., J.D.<br> There are no right or wrong organizations that we're looking at. We're talking to other provider groups, businesses, unions. Using The Case for Change report to try to get a common understanding on the core facts and the core reasons for why our health care system is beginning to fail. And that collaboration is essential when you think about politics, state politics in this case, because you need to have, at least in New York, it is much better to get initiatives over the legislative finish line if you have a coalition, formal or informal. </p> <p> 00:08:51:24 - 00:09:02:01<br> Bea Grause, R.N., J.D.<br> But if you have broad based support, in other words, for an initiative for that year is a priority to try to get enacted. </p> <p> 00:09:02:03 - 00:09:07:25<br> Tom Haederle<br> Is there consensus around what we need to do in New York right now, or you feel or do you feel like you're getting there? </p> <p> 00:09:07:27 - 00:09:34:24<br> Bea Grause, R.N., J.D.<br> I feel like we're getting there. I have two examples. One is in the workforce space and the other is in the governor's budget, which our budget cycle has just begun. And we've been talking all year with Governor Hochul on using the case for change. And talking about the challenges that the state of New York faces with an aging population and a workforce shortage, primarily. </p> <p> 00:09:34:24 - 00:09:58:09<br> Bea Grause, R.N., J.D.<br> And, as you may know, I mean, the state of New York is already beginning to try to address disparities in care with the recent 1115 waiver. But certainly affordability is a huge problem for the state of New York. And helping them to understand that demand is going to increase for the next 25 years. The aging population will increase. </p> <p> 00:09:58:12 - 00:10:46:28<br> Bea Grause, R.N., J.D.<br> And it's not a question of if patients are going to need care, it's when and how much and where are they going to get that care. And if there's a mismatch between the capacity or the workforce gap gets worse, the cost to the state gets higher. And those kind of related messages, case for change related messages, were all part of our narrative with the governor all during last year. And in her budget and her state of the state, she did take a more strategic view, adopting many of those concepts in her budget and in her message to fund hospitals and nursing homes, but also for other across the continuum, continue to invest in workforce, </p> <p> 00:10:47:01 - 00:11:12:25<br> Bea Grause, R.N., J.D.<br> but also invest in capital so that more sites of care can be provided upstream or, you know, pre-hospital, so that patients are actually getting care outside of the hospital where they need to get care, and decreasing that expensive demand on hospital and post-acute services. So we were very pleased to see more strategic framing with the governor. So that's example number one. </p> <p> 00:11:12:25 - 00:11:48:06<br> Bea Grause, R.N., J.D.<br> Example number two is in workforce. As an advocacy organization where we are particularly and more externally or visibly focused on reaching out to other stakeholders to work on a whole host of workforce initiatives that are designed to recruit new workers, retain workers, eliminate the bottleneck in terms of not enough, faculty for, as one example, helping various health professions expand, work up to their full license. </p> <p> 00:11:48:09 - 00:12:01:29<br> Bea Grause, R.N., J.D.<br> And all of that is designed to close that gap in health care workers, particularly in the post-acute space, which hopefully will improve capacity. But it will help to bend that expense growth curve. </p> <p> 00:12:02:02 - 00:12:21:12<br> Tom Haederle<br> As we wrap up, we're almost at the end of our time, let me ask this. The concepts that are presented in The Case for Change, how translatable are they, would you say, to other systems because the four drivers that you've mentioned facing New York's system really can be found to a greater or lesser degree in every health system in the country. </p> <p> 00:12:21:12 - 00:13:11:18<br> Bea Grause, R.N., J.D.<br> 100% translatable. I mean, just imagine, Tom, if there were a case for change narratives, rather than having lawmakers and others confused around 50 different issues where you have different groups, one side opposes, the other supports, lawmakers cannot break through that noise. And I've talked to many lawmakers who find health care impossibly confusing. So I think having this common set of facts that are based in what we all care about, that we have access to care that someone's going to be there to take care of us, that we're helping communities and individuals who don't have access to care, and that we're trying to make health care more affordable over time. </p> <p> 00:13:11:21 - 00:13:38:23<br> Bea Grause, R.N., J.D.<br> That is a narrative that I think we can all relate to. And I think when people understand and look at the details in the report and again, anybody who wants to take that report and make it, you know, it's open source, take it and build on that narrative. But if we were all and when I say we, but if providers across the continuum, providers in other states or associations in other states were using that, I call it a patient forward-narrative, </p> <p> 00:13:38:23 - 00:14:15:20<br> Bea Grause, R.N., J.D.<br> and framing it that way, lawmakers would then begin to think that way. Because if they if that's all they're hearing and they're hearing that consistent message: We're concerned about access. We're concerned about ED overloading. We're concerned about a workforce shortage. We want to make sure, we think it makes good economic sense to provide health care to underserved communities. If they're hearing those messages consistently and have written documents and written reports and other information to help them to understand that, and it will start to make sense to them. </p> <p> 00:14:15:22 - 00:14:34:20<br> Tom Haederle<br> That is a great summation. Thank you so much. You have been listening to us discuss a new report called The Case for Change. This has, come from the Health Care Association of New York State. Thanks again, Bea. Really appreciate your time. And good luck with making progress on the changes facing New York State right now. </p> <p> 00:14:34:23 - 00:14:39:04<br> Bea Grause, R.N., J.D.<br> Thank you, Tom, so much. This has been such a great conversation. </p> <p> 00:14:39:07 - 00:14:47:13<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details> </div> Mon, 10 Feb 2025 08:36:45 -0600 Workforce Shortages <div class="raw-html-embed"> </div><div class="row"><div class="col-md-8"><p>The <a href="/aha-workforce-scan" title="2025 AHA Health Care Workforce Scan">2025 Health Care Workforce Scan</a> will help you better understand the latest forces and trends affecting health care human resources. Based on a review of reports, studies and other data sources from leading organizations and researchers, it provides workforce insights you can use to guide your organization forward during this time of uncertainty and continued transformation.</p></div><div class="col-md-4"><div class="panel panel-default"><div class="panel-heading"><h3><strong>Latest Health Care Workforce Scan</strong></h3></div><div class="panel-body"><p><a class="btn btn-wide btn-primary" href="/aha-workforce-scan" rel="noopener noreferrer nofollow" data-view-context="top-level-view">See the Latest Edition</a></p></div></div></div></div><div class="row sp_Resource1"> .sp_Resource1 { padding: 25px 0 0px 0; } /* .sp_Resource1 h3{ margin:10px 0 0 0; color:#555; font-size:.7em; text-transform:uppercase; font-weight:400; letter-spacing:3px; } .sp_Resource1 h4{ color:#002855; line-height: 1.2em; font-size:30px; margin: 10px 0 15px 0 } */ .sp_Resource1 p, .sp_Resource1 ul li { font-size: 16px; } .sp_Resource1_holder { background-color: ; padding: 0; overflow: auto } .sp_Resource1 .sp_Resource1_holder img { padding-bottom: 15px; margin: auto; display: block } @media (max-width:768px) and (min-width:340px) { .sp_Resource1 .sp_Resource1_holder .col-xs-3 { width: 40%; } .sp_Resource1 .sp_Resource1_holder .col-xs-9 { width: 60%; } } @media (max-width:500px) and (min-width:361px) { .sp_Resource1 .sp_Resource1_holder.col-xs-3 { width: 100%; } .sp_Resource1 .sp_Resource1_holder .col-xs-9 { width: 100%; } } @media (max-width:360px) { .sp_Resource1 .sp_Resource1_holder .col-xs-3 { width: 100%; max-width: 150px; /* margin-left: calc(50% - 75px);*/ margin-right: } .sp_Resource1 .sp_Resource1_holder .col-xs-9 { width: 100%; padding: 0 25px } } @media (max-width:500px) { .sp_Resource1 .sp_Resource1_holder center .btn { width: 250px; right: calc(25% - 115px); } } /* .sp_Resource1 .btn { margin-top: 20px; }*/ <div class="col-md-12 sp_Resource1_holder"><div class="col-md-8"><div class="row"><div class="col-md-4"><a href="/system/files/media/file/2024/11/2025-Health-Care-Workforce-Scan-Presentation.pptx" target="_blank" title="2025 AHA Health Care Workforce Scan - Presentation"><img src="/sites/default/files/2024-11/2025-workforcescan-PPT-Cover-196x113.jpg" alt="AHA Health Care Workforce Scan" width="196" height="113"></a></div><div class="col-md-8"><h3 class="margin-top-0">2025 Health Care Workforce Scan Presentation</h3><p>This downloadable PowerPoint presentation highlights key talent management trends to consider in your workforce planning.</p><div class="spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2024/11/2025-Health-Care-Workforce-Scan-Presentation.pptx" target="_blank" title="2025 AHA Health Care Workforce Scan - Presentation">Download Presentation</a></div></div></div></div><div class="col-md-4"><img alt="Cover image of workforce scan" src="/sites/default/files/2023-11/2024-workforcescan-cover-thumbnail-247x320.jpg"></a> <a class="btn btn-primary" data-view-context="top-level-view" href="/system/files/media/file/2023/11/2024_AHA_Health_Care_Workforce_Scan.pdf" title="2024 Health Care Workforce Scan" target="_blank">Download the 2024 Scan</a> <a href="/system/files/media/file/2023/11/2024_AHA_Health_Care_Workforce_Scan.pptx" target="_blank" title="2024 AHA Health Care Workforce Scan - Presentation"><img src="/sites/default/files/2023-11/2024-workforcescan-196x113.jpg" alt="AHA Health Care Workforce Scan" width="196" height="113"></a> <p>PowerPoint presentation highlights key talent management trends to consider in your workforce planning.</p> <div class="spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2023/11/2024_AHA_Health_Care_Workforce_Scan.pptx" target="_blank" title="2024 AHA Health Care Workforce Scan - Presentation">Download 2024 Presentation</a></div> --> </div></div></div> Wed, 13 Nov 2024 07:00:00 -0600 Workforce Shortages <div class="raw-html-embed"> </div> .bannerHero { background-image: /*linear-gradient(rgba(0, 0, 0, 0.5), rgba(0, 0, 0, 0.5)),*/ url("/sites/default/files/2024-11/2025-workforcescan-Banner-1170x500.jpg"); background-position: center; background-repeat: no-repeat; background-size: cover; position: relative; height: 1000px; max-height:500px; max-width: 100%; margin: 0 auto; overflow:hidden; } .bannerHero .contentBottom { position: absolute; bottom: 0; background-image: linear-gradient(-180deg, rgba(46,46,46,0), rgba(46,46,46,1)); width: 100%; /* left + right + border */ padding: 15px 100px 50px 100px; /*! 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Based on a review of reports, studies and other data sources from leading organizations and researchers, it provides workforce insights you can use to guide your organization forward during this time of uncertainty and continued transformation.</p></div><div class="col-md-5"><div class="panel panel-default"><div class="panel-heading"><h3>Latest Health Care Workforce Scan</h3></div><div class="panel-body"><p><a class="btn btn-wide btn-primary" href="/aha-workforce-scan" rel="noopener noreferrer nofollow" data-view-context="top-level-view">Latest Edition</a></p></div></div></div></div></div><div class="row"><div class="col-md-8 col-md-offset-2"><div class="col-md-12"><h2 class="text-align-center"><u>View the Latest Presentation</u></h2></div><div class="col-md-4"><a href="/presentation-resource/2024-11-13-2025-aha-health-care-workforce-scan-presentation" title="2024 AHA Health Care Workforce Scan - Presentation"><img src="/sites/default/files/2024-11/2025-workforcescan-PPT-Cover-196x113.jpg" alt="AHA Health Care Workforce Scan" width="196" height="113"></a></div><div class="col-md-8"><h3>2025 Health Care Workforce Scan Presentation</h3><p>This downloadable PowerPoint presentation highlights key talent management trends to consider in your workforce planning.</p><div class="spacer"><a class="btn btn-wide btn-primary" href="/presentation-resource/2024-11-13-2025-aha-health-care-workforce-scan-presentation" title="2024 AHA Health Care Workforce Scan - Presentation">Get the 2025 Presentation</a></div></div></div></div> Wed, 13 Nov 2024 07:00:00 -0600 Workforce Shortages /aha-workforce-scan <div class="raw-html-embed"> </div> .bannerHero { background-image: /*linear-gradient(rgba(0, 0, 0, 0.5), rgba(0, 0, 0, 0.5)),*/ url("/sites/default/files/2024-11/2025-workforcescan-Banner-1170x500.jpg"); background-position: center; background-repeat: no-repeat; background-size: cover; position: relative; height: 1000px; max-height:500px; max-width: 100%; margin: 0 auto; overflow:hidden; } .bannerHero .contentBottom { position: absolute; bottom: 0; background-image: linear-gradient(-180deg, rgba(46,46,46,0), rgba(46,46,46,1)); width: 100%; /* left + right + border */ padding: 15px 100px 50px 100px; /*! 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Solving near-term and long-term workforce challenges calls for us to develop fresh ways to nurture and support our current staff while attracting the workers we need to meet the demands of today and tomorrow.</p><p>For innovative steps to enhance the overall workforce experience to help you refresh, retain and recruit health care workers, look to the 2025 AHA Health Care Workforce Scan. Based on a review of the latest reports, studies and other data sources, it offers valuable insights into the workforce landscape and practical guidance from experts and your peers to help your organization navigate the future of the health care workforce. 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MktoForms2.whenReady(function(form){ if(form.getId() == 4088 ) { form.onSuccess(function(values, followUpUrl) { form.getFormElem().hide(); document.getElementById("successAndErrorMessages").innerHTML="<div><p>Thank you.<\/p><br /><p><a class='btn btn-wide btn-primary' data-view-context='top-level-view' href='https:\/\/www.aha.org\/system\/files\/media\/file\/2024\/11\/2025-Health-Care-Workforce-Scan.pdf' target='_blank' rel='noopener noreferrer nofollow'>Download 2025 Health Care Workforce Scan <\/a><\/center><\/div>"; return false; }); }; }); <div id="successAndErrorMessages"> </div></div></div></div></div></div></div><div class="row"> .CenterProgram { background-color: #f6f6f6; /*margin-bottom:25px;*/ } .CenterProgram .CpHeader{ padding-top:15px; } .CenterProgram .CpHeader h2 { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 30px 0; text-align:center; } .CenterProgram .CpHeader h4 { margin: 25px 0 0 0; color: #555; font-size: .7em; text-transform: uppercase; font-weight: 400; 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margin: 0; color: #55555599 } .CenterFilterWrapper input[type=checkbox]:checked + label{ color: #555555; } .CenterProgramSection img{ margin-bottom:15px; } .CenterProgramSection ul { list-style: none; width:100%; /*padding-left:15px;*/ text-indent: -20px; /* key property */ /*margin-left: 20px;*/ /* key property */ } .CenterProgramSection ul li::before { content: " "; font-size: 1em; margin-right: 5px; display: inline-block; height: 12px; background-color: #002855; width: 12px; position: relative; top: 0px; } .CenterProgramSection ul li h4{ margin-top:0px; display: initial;; font-weight:300; } .CenterProgramSection ul li { margin-bottom:10px; } @media (min-width:768px){ .CenterProgramSection.CenterProgramSectionLast{ margin:15px 25% } } <div class="CenterProgram col-md-12"><div class="CpHeader"><h2>Key Drivers Transforming the Health Care Workforce</h2><p class="text-align-center">The 2025 Health Care Workforce Scan reveals six fundamental factors propelling core changes in the workforce.</p></div></div><div class="CenterProgram rowEqual_768 col-md-12"><div class="CenterProgramSection"><div class="FilterInner"><img src="/sites/default/files/2024-11/Section-01-banner-1170x250.jpg" alt="Stock image: Medical staff in a meeting" width="1170" height="250"><h3>Skyrocketing Costs Are Shrinking Budgets</h3><p>High interest rates, inflation, drug/supply costs and labor expenses have forced hospitals and staff to do more with less.</p> <li><h4><a href="xxxx">xxxxx</a></h4></li> </ul>--></div></div><div class="CenterProgramSection"><div class="FilterInner"><img src="/sites/default/files/2024-11/Section-02-banner-1170x250.jpg" alt="Stock image: Medical staff helping a person in a wheelchair" width="1170" height="250"><h3>An Aging Population Requires New Care Solutions</h3><p>America’s aging population will require new care models and incentives for both formal and informal caregivers.</p> <li><h4><a href="xxxx">xxxxx</a></h4></li> </ul>--></div></div><div class="CenterProgramSection"><div class="FilterInner"><img src="/sites/default/files/2024-11/Section-03-banner-1170x250.jpg" alt="Stock image: Medical staff greeting a person at their house" width="1170" height="250"><h3>Care Continues to Migrate Outside Hospital Walls</h3><p>Home-based care and outpatient services are projected to grow.</p> <li><h4><a href="xxxx">xxxxx</a></h4></li> </ul>--></div></div><div class="CenterProgramSection"><div class="FilterInner"><img src="/sites/default/files/2024-11/Section-04-banner-1170x250.jpg" alt="Stock image: Medical staff talking in a small group" width="1170" height="250"><h3>Payer Market Dominance Raises Questions</h3><p>Some commercial health insurance companies have dramatically expanded their market share and scope, and are increasingly involved in Medicare Advantage plans.</p> <li><h4><a href="xxxx">xxxxx</a></h4></li> </ul>--></div></div><div class="CenterProgramSection"><div class="FilterInner"><img src="/sites/default/files/2024-11/Section-05-banner-1170x250.jpg" alt="Stock image: Medical staff looking over medical data and scans" width="1170" height="250"><h3>Large Technology Solutions Providers Advance AI Adoption</h3><p>Tech giants are playing a more direct role in care delivery and creating solutions that can drive widespread AI adoption.</p> <li><h4><a href="xxxx">xxxxx</a></h4></li> </ul>--></div></div><div class="CenterProgramSection "><div class="FilterInner"><img src="/sites/default/files/2024-11/Section-06-banner-1170x250.jpg" alt="Stock image: Medical staff in a lab" width="1170" height="250"><h3>Health Care’s AI Sprint Gets an Ethics Safety Net</h3><p>Industry groups have been created to establish ethical standards for AI’s implementation to help address bias, accuracy and data privacy.</p> <li><h4><a href="xxxx">xxxxx</a></h4></li> </ul>--></div></div></div></div> Wed, 13 Nov 2024 07:00:00 -0600 Workforce Shortages /aha-center-health-innovation-market-scan/2024-09-10-5-health-care-workforce-shortage-takeaways-2028 <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/5-Health-Care-Workforce-Shortage-Takeaways-for-2028.png" data-entity-uuid="5e51fed2-4d2e-4b79-9448-b5d54ec1fd6f" data-entity-type="file" alt="5 Health Care Workforce Shortage Takeaways for 2028. An empty operating room with a caution icon displayed above the table due to a shortage of health care workers." width="100%" height="100%"></p><p>Projections on potential health care workforce shortages came fast and furious during the pandemic and after the public emergency expired. So, what should the field make of all this data?</p><p>A <a href="https://www.mercer.com/en-us/insights/talent-and-transformation/attracting-and-retaining-talent/future-of-the-us-healthcare-industry/" target="_blank" title="Mercer: Future of the U.S. Healthcare Industry">new study</a> based on research conducted by the Mercer consultancy and its partner Lightcast projects changes to the U.S. health care labor market by 2028 by state and metro and micro statistical areas.</p><p>The study’s projections and analysis provide context to some of the more nuanced shortages among the clinical workforce and which states may be impacted most and least by shifting market conditions, demographics and other influences.</p><h2><span>5 Key Findings on Coming Workforce Changes</span></h2><h3><span>1</span> <span>|</span> Expect a shortage of about 100,000 critical health care workers by 2028.</h3><p>The impact of the shortages will be uneven and an added burden to a system strained by geographic and demographic disparities in access to care, the report states. Populous states like California, Texas and Pennsylvania are expected to weather the storm with the estimated labor supply exceeding demand. Acute shortages are projected, however, in states like New York and New Jersey.</p><h3><span>2</span> <span>|</span> Shortage of nurse assistants (NAs) may be severe.</h3><p>Only 13 states are expected to meet or exceed future demand and Mercer forecasts a shortage of about 73,000 NAs by 2028. Because NAs make up a large share of the overall health care workforce, these projected shortages warrant close attention.</p><h3><span>3</span> <span>|</span> Gaps may differ widely by state on registered nurse availability.</h3><p>Mercer projects a slight surplus of RNs by 2028. This is counter to many other projections by experts who forecast a shortage of nurses. Mercer does project nursing shortages for New York and other East Coast states.</p><h3><span>4</span> <span>|</span> Modest surplus of physicians expected nationally.</h3><p>While research and popular discussions have predicted physician shortages in the U.S. under different scenarios, the report’s authors expect a surplus of about 28,000 doctors. The authors based their findings on the Bureau of Labor Statistics standard occupation codes for all physician jobs. While some states may find a modest surplus of physicians by 2028, states like California (-2,580), Texas (-2,830) and New York (-2,706) could see sizable shortages and the combined impact of shortages for both NPs and physicians may result in significant disruptions to the continued delivery of preventive care.</p><h3><span>5</span> <span>|</span> Compensation variation could lead some workers to move.</h3><p>Understanding compensation variation by occupation and geography is crucial to prepare for potential shortages. If NAs can earn more for doing the same job by moving to a neighboring state, or even a metropolitan area, they may choose to relocate, the authors note.</p><p><img src="/sites/default/files/inline-images/States-with-the-Largest-Gaps-for-3-Key-Occupations-That-Deliver-Primary-Care.png" data-entity-uuid="649f6a9f-ea85-4a0d-9801-d757145b8323" data-entity-type="file" alt="States with the Largest Gaps for 3 Key Occupations That Deliver Primary Care (Market projections by 2028). OB-GYNs: 1. California (-406); 2. Texas (-287); 3. Virginia (-104); 4. South Carolina (-91); 5. Missouri (-90). Pediatricians: 1. California (-732); 2. Massachusetts (-512); 3. Texas (-395); 4. Georgia (-223); 5. Ohio (-148). Family Medicine: 1. North Carolina (-1,394); 2. California (-852); 3. Illinois (-614); 4. Georgia (-223); Michigan (-575). Source: Mercer, 2024." width="100%" height="100%"></p><h2><span>3 Talent Areas to Focus on Now</span></h2><p>Given that workforce challenges are not going away any time soon, the authors suggest focusing on these key areas to address ongoing talent needs. And remember, provider organizations aren’t only competing with other health care employers but often with other fields — particularly when filling lower-wage support positions that are vital to the overall delivery of quality patient care.</p><h3>One: <span>Assess your specific supply/demand risk by occupation and department.</span></h3><p>Project internal demand for critical occupations due to attrition, expansion of services and evaluate demand against projected supply. Determine where the greatest risks lie for not filling vacant positions promptly.</p><p>Some occupations are more critical than others and will require special attention and investment. Develop an understanding of the local labor market for these critical roles. If there is not a sufficient local labor market to fill critical shortages, discuss needed steps to address the situation.</p><h3>Two: <span>Rethink sourcing strategies and processes.</span></h3><p>To ensure a consistent pipeline of talent in your local market, consider collaborating on investment in occupational development, increasing educational capacity and reviewing compensation. These include expanding your current talent acquisition efforts, internal training and graduate pipeline. You may need to pivot recruitment beyond current boundaries to meet talent where it is. Explore ways to build talent internally through training, development and certification programs. This takes time and requires proactive decision-making and a planned investment.</p><h3>Three: <span>Ensure the well-being of existing employees.</span></h3><p>This can help improve retention and reduce burnout among staff — a common source of attrition in health care. Monitor the marketplace and fine-tune the employee value proposition with respect to pay and benefits, schedule flexibility, career growth opportunities and job satisfaction. The AHA’s webpage, <a href="/building-systemic-well-being-program-5-step-blueprint">Building a Systemic Well-Being Program: 5-Step Blueprint</a>, provides a step-by-step resource for health care leaders.</p><hr><h2><span>Learn More</span></h2><p>The AHA’s American Organization for Nursing Leadership <a href="https://www.aonl.org/resources/Nurse-Leadership-Workforce-Compendium" target="_blank" title="AONL: Nursing Leadership Workforce Compendium">Workforce Compendium</a> provides a wealth of best practices and innovations to help leaders strategize and manage the complexities of the nursing workforce. Separate chapters are devoted to talent attraction and acquisition and recruitment and retention. The AHA’s <a href="/workforce-home">Workforce webpage</a> also provides a multitude of resources to help hospitals and health systems address staffing issues.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 10 Sep 2024 06:00:00 -0500 Workforce Shortages /news/headline/2024-06-25-aha-responds-senate-finance-committee-working-groups-gme-proposal <p>The AHA June 24 submitted <a href="/lettercomment/2024-06-24-aha-comments-senate-finance-committee-bipartisan-working-group-gme">comments</a> to the Senate Finance Committee’s Bipartisan Medicare Graduate Medical Education Working Group, which is developing legislation to address physician shortages. The AHA urged the working group to substantially increase the number of Medicare-funded residency slots, which have been essentially frozen since 1997. AHA expressed support for several legislative proposals that would increase the number of physicians working in rural and underserved communities and enhance opportunities for rural hospitals to train physicians. Additionally, AHA urged the working group to ensure that Medicare Advantage plans provide appropriate direct GME payments to hospitals. </p> Tue, 25 Jun 2024 16:03:32 -0500 Workforce Shortages /member-knowledge-exchange/2024-06-05/enabling-growth-nonoperating-room-anesthesia-procedures-amid-workforce-shortages <div class="raw-html-embed">   </div> header.jumbotron {display:none} <div> /* center_body */ .center_body { /*margin-top:50px;*/ /* margin-bottom: 50px;*/ } .center_body h3 {} .center_body p { font-size: 16px } p.center_Intro { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 25px 0; font-weight: 700; font-size: 2em; } @media (max-width:768px) { p.center_Intro { line-height: 1.2em; font-size: 23px; font-size: 1.45em; } } .center_body .center_Lead { color: #63666A; font-weight: 300; line-height: 1.4; font-size: 21px; } /* center_body // */ /* Banner_Title_Overlay_Bar */ .Banner_Title_Overlay_Bar { position: relative; display: block; overflow: hidden; max-width: 1170px; margin: 0px auto 25px auto; } .Banner_Title_Overlay_Bar h1 { position: absolute; bottom: 40px; color: #003087; background-color: rgba(255, 255, 255, .8); width: 100%; padding: 20px 40px; font-size: 3em; box-shadow: 0 3px 8px -5px rgba(0, 0, 0, .6); } @media (max-width:991px) { .Banner_Title_Overlay_Bar h1 { bottom: 0px; margin: 0px; font-size: 2.5em; } } @media (max-width:767px) { .Banner_Title_Overlay_Bar h1 { font-size: 2em; text-align: center; text-indent: 0px; padding: 10px 20px; } } @media (max-width:530px) { .Banner_Title_Overlay_Bar h1 { position: relative; background-color: #63666A22; } } /* Banner_Title_Overlay_Bar // */ <header class="Banner_Title_Overlay_Bar"><img src="/sites/default/files/2024-06/ASA_GrowthNonoperatingRoom_banner_1170x250.png" alt="Banner Image" width="1170" height="250"><div><h1>Enabling Growth in Nonoperating Room Anesthesia Procedures Amid Workforce Shortages</h1></div></header> /* CntMenuSub */ .CntMenuSub{ margin:20px 0px; padding-bottom: 5px; color: #afb1b1; letter-spacing: 1.5px; font-weight: 400; font-size: .7em; } .CntMenuSub .CntMenuBar{ border-bottom: 1px solid lightblue; } .CntMenuSub .CntMenuBar a:after{ content: "|"; padding: 0 3px 0 6px; color: #555; } .CntMenuSub .CntMenuBar a:last-child:after{ content: ""; } .CntMenuSub .CntMenuSubHome, .CntMenuSub .CntMenuSubParent{ text-transform: uppercase; color: #555; opacity: .9; } .CntMenuSub .CntMenuSubParent{ } .CntMenuSub .CntMenuSubChild{ } .CntMenuSub .CntMenuSubCurrent{ opacity: .7; } .CntMenuSub .CntMenuSubHome:hover, .CntMenuSub .CntMenuSubParent:hover{ text-transform: uppercase; color: #d50032; } /* CntMenuSub // */ <div class="container CntMenuSub"><div class="col-md-1"> </div><div class="col-md-10 row CntMenuBar"><a class="CntMenuSubHome" href="/education-events/aha-virtual-executive-dialogues">AHA Knowledge Exchange</a> <span class="CntMenuSubChild" id="CntMenuSubChild">Enabling Growth in Nonoperating Room Anesthesia Procedures Amid Workforce Shortages</span></div><div class="col-md-1"> </div></div><div class="row spacer"><div class="col-sm-3"><div><a href="#DownloadFile" title="Get your AHA Knowledge Exchange | Enabling Growth in Nonoperating Room Anesthesia Procedures Amid Workforce Shortages"><img src="/sites/default/files/2024-06/ASA_GrowthNonoperatingRoom_cover_910x1220.jpg" alt="AHA Knowledge Exchange | Enabling Growth in Nonoperating Room Anesthesia Procedures Amid Workforce Shortages" width="100%" height="100%"></a></div></div><div class="col-sm-9 center_body"> .sponsortype { color: #9d2235; font-size: 1.5em; margin: 0px; font-weight: 700; } <p class="sponsortype">AHA Knowledge Exchange</p><h2>Optimizing procedural selection and operations to enhance patient safety and quality outcomes</h2><p>Driving the rapid rise in anesthesia cases performed outside the traditional operating room suite are advances in surgical technology, innovations in complex invasive procedures, payer incentives to shift cases to ambulatory surgery centers (ASCs), and an aging population with increasing comorbidity burden. Nonoperating room anesthesia (NORA) cases are expected to account for more than 50% of all anesthesia cases in the next decade. Anesthesiologists are taking a lead role in working with surgeons, proceduralists and hospital executives to create a care redesign process for the increase in NORA services across sites and maintain high-quality outcomes based on the hospital’s strategic priorities and resources. This Knowledge Exchange explores strategies to address considerations in patient selection and the perioperative process to improve efficiency and safety.</p><div class="row"> @media (min-width:768px){ .EDsponsorFloat{ float:right; } } @media (max-width:767px){ .EDLinkFloat{ position:relative; left:27%; } .EDsponsorFloat { text-align:center } } <div class="col-sm-6"><a class="btn btn-wide btn-primary EDLinkFloat" href="#DownloadFile" title="Get your AHA Knowledge Exchange | Enabling Growth in Nonoperating Room Anesthesia Procedures Amid Workforce Shortages">Download the Report</a></div><div class="col-sm-6"><div class="EDsponsorFloat"><strong>Sponsored by:</strong> <a href="https://www.asahq.org/" target="_blank" rel="noopener nofollow"><img src="/sites/default/files/2024-06/ASA_GrowthNonoperatingRoom_logo_834x313.png" alt="ASA Logo" width="100%" height="100%"></a></div></div></div></div></div> .sp_CTA5_holder { margin-top:0px; border-bottom: solid 1px #555; padding-bottom: 50px; } .sp_CTA5_holder_last { border-bottom: solid 0px #555; } .sp_CTA5_holder >div{ overflow: auto; } .sp_CTA5_holder ul { list-style: none; /* Remove default bullets */ padding-left: 0px; /*width: calc(100% - 15%);*/ /*margin: 50px auto 0;*/ margin:auto 50px; } .sp_CTA5_holder ul li{ margin-bottom:7px; line-height: 1.5em; font-size:16px; } .sp_CTA5_holder ul li::before { content: " "; font-size: 1em; margin-right: 10px; display: inline-block; height: 12px; background-color: #9d2235; width: 12px; position: relative; top: 0px; -webkit-transform: rotate(45deg); -moz-transform: rotate(45deg); -o-transform: rotate(45deg); } .sp_CTA5_holder ul li{ padding-left:23px; text-indent:-23px; } .body ol>li, .body ul>li{ font-size:16px: } .sp_CTA5_holder h2 { color: #002855; /*! line-height: 2em; */ font-size: 2.15em; margin: 0 0 15px 0; /*! font-size: 30px; */ } .sp_CTA5_holder h3 { /*color: #002855;*/ line-height: 1em; /*font-size: 1.5em;*/ margin-bottom: 25px; margin-top:5px; font-size: 28px; } .sp_CTA5_section{ margin-top: 25px } .sp_CTA5_ImgShadow { /*background-color:green;*/ /* just a visual */ text-align: center } .sp_CTA5_ImgShadow { padding-bottom:75px; /* must match the padding on the img*/ margin: 0px; } .sp_CTA5_ImgShadow img{ width: calc(100% - 35px - 15px); -webkit-box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); -moz-box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); position: relative; top: 75px; max-width: 490px; } @media (max-width:990px){ .sp_CTA5_ImgShadow img{ max-width: 350px;} } @media (max-width:990px){ .sp_CTA5_ImgShadow { padding-bottom:75px; /* must match the padding on the img*/ margin: 0px; margin-right: 40px } } <div class="row spacer sp_CTA5_holder sp_CTA5_holder_last"><div class="col-md-12"><h3>10 steps health leaders are taking to meet patients’ surgical and procedural demands with high-quality outcomes</h3><div class="sp_CTA5_section"><ul><li><strong>Screen and select patients for appropriate sedation and setting</strong>. Conduct an anesthesia preoperative assessment and address modifiable risk factors.</li><li>Use anesthesia preoperative evaluations to <strong>reduce same-day NORA cancellations</strong>.</li><li><strong>Streamline communication</strong> among surgeons, proceduralists and anesthesia services with electronic health records (EHRs) and health information exchanges.</li><li><strong>Provide anesthesia guidelines</strong> to practitioners, surgeons and other providers who may be responsible for hypertension management programs.</li><li>Develop <strong>specialized training for procedural physicians and RNs for moderate sedation</strong> in endoscopy, interventional radiology and pain procedures.</li><li>Evaluate the <strong>appropriate anesthesia staffing model</strong> based on patient risk, procedure complexity, and available staff resources and training.</li><li><strong>Create NORA rules</strong> and culture similar to that of the regular operating rooms (ORs), e.g., measuring first-case, on-time starts.</li><li><strong>Centralize scheduling for both OR and NORA cases</strong> for anesthesia staffing and support personnel who may be deployed to these areas.</li><li><strong>Employ dashboards and perioperative tracking</strong> for procedures with metrics for on-time starts, case lengths, any case delays, and utilization of anesthesia minutes.</li><li><strong>Position NORA locations</strong> as close as possible to OR locations in new facilities or renovations.</li></ul></div></div></div><h2>Participants</h2> /* people */ .people { margin-top: 50px; } .people img:nth-child(1) { border-radius: 200px; -moz-border-radius: 200px; -webkit-border-radius: 200px; margin-bottom: 10px; max-width:200px; /* for Transformation Talks */ display:block; /* for Transformation Talks */ margin:auto; /* for Transformation Talks */ } .people img:nth-child(1):hover { opacity: .7 } @media (max-width:991px) { .people { margin: auto; } .people p { text-align: center } } .ci_profile { 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5PX auto 10px; } <div class="people"><div class="row rowEqual_768"><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2024-05/Ajja_Olivia_300x300.png" alt="Olivia Ajja" width="300" height="300"><p class="ci_profile_name">Olivia Ajja, MBA, CRNA</p><p class="ci_profile_title">Senior Vice President and Chief Operating Officer</p><p class="ci_profile_company">University of Minnesota Medical Center</p>profile_combined</p> <p class="ci_profile_award"> profile_award </p> <div class="ci_profile_social">profile_social</div> --></div><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2024-05/Bertany_Kathryn_300x300.png" alt="Kathryn Bertany" width="300" height="300"><p class="ci_profile_name">Kathryn Bertany, M.D., MBA</p><p class="ci_profile_title">CEO</p><p class="ci_profile_company">Bozeman Health</p></div><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2024-05/Davis_Brenda_300x300.png" alt="Brenda Davis" width="300" 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views-field-field-page-title-background"> <div class="field-content sed-thumb"> <a href="/2024-09-26/transforming-behavioral-health-journey" hreflang="en"><img loading="lazy" src="/sites/default/files/styles/small_200x200/public/2024-09/Iris-Telehealth-banner-620x381.jpg?itok=QQ9C-7Mp" width="200" height="123" alt="Iris-Telehealth-banner-620x381" /> </a> </div> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-09-25T14:49:38-05:00">Sep 25, 2024</time> </span> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/2024-09-26/transforming-behavioral-health-journey" hreflang="en">Transforming the Behavioral Health Journey</a></span> </div><div class="views-field views-field-body"> <div class="field-content">Transforming the behavioral health journey with strategic initiatives to build a sustainable and coordinated behavioral health services continuum.</div> </div></div> </div> </div> <div class="more-link"><a href="/aha-knowledge-exchange-archive">View All: AHA Knowledge Exchange</a></div> </section> </div> </div></div> Tue, 04 Jun 2024 16:49:06 -0500 Workforce Shortages /aha-center-health-innovation-market-scan/2024-03-26-workforce-shortages-and-violence-are-rising-concerns-state-nursing-poll <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/Workforce-Shortages-and-Violence-Are-Rising-Concerns-in-State-of-Nursing-Poll.png" data-entity-uuid="9fb86f2d-81c6-481c-a43f-339975907424" data-entity-type="file" alt="Workforce Shortages and Violence Are Rising Concerns in State of Nursing Poll. A clinician walks in front of a wall with unused scrubs handing from hooks." width="1200" height="800"></p><p>The nursing field remains in a state of flux as caregivers wrestle with staffing shortages, concerns about their safety and more. Nevertheless, nearly four out of five say they plan to remain in the field until retirement, according to the recently released <a href="https://www.incrediblehealth.com/wp-content/uploads/2024/03/2024-Incredible-Health-State-of-US-Nursing-Report.pdf" target="_blank" title="Incredible Health: State of U.S. Nursing Report 2024">State of U.S. Nursing Report 2024</a> from the health care career marketplace company Incredible Health.</p><p>The fifth annual report, based on the firm’s review of its proprietary data of 1 million nurses and a survey of 3,300 RNs, also found that mental health among nurses is improving. The slow but steady improvement in this area is attributed to efforts by health systems to reduce burnout and foster a greater sense of community.</p><p>The findings about nurses who plan to remain in the field until retirement is similar to results from last year’s survey (79% vs. 81% in 2023) and should come as welcome news to health care executives. This is a sharp contrast to the 2022 survey, when only 55% of respondents said they planned to remain in the field until retirement — an apparent reaction to being overwhelmed during the pandemic.</p><h2><span>Concerns about Staffing Shortages, Violence Persist</span></h2><p>Despite a small decline in staffing level dissatisfaction, dropping from 55% in 2023 to 48% this year, 88% of respondents said they are concerned about the detrimental effects of staffing shortages on patient care. That’s up from 73% who voiced similar concerns last year.</p><p>Nearly two out of three nurses (63%) reported being assigned to too many patients and 23% said they have been asked to perform tasks outside their job descriptions.</p><p>And in what was a growing concern in this year’s survey data, on-the-job safety may cause many to reconsider their career options. Half of nurses reported having been verbally and/or physically assaulted by a patient or a member of a patient’s family within the past two years. More than one in four (26%) said they are likely to leave their current role due to these incidents.</p><p>Survey data also found that 21% of nurses had moved to another state through Incredible Health’s marketplace. Meanwhile, the largest spikes in demand on the company’s platform were for nurses in cardiac care, medical-surgical and the operating room.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 26 Mar 2024 06:00:00 -0500 Workforce Shortages