Healthcare Triage: Cars are the enemy on Halloween, not tainted candy
Monthly Archives: October 2017
Cartoon – CFO Looking at Something Incredibly Small
Cartoon – Please Accept Our Apology
Cartoon – Human Capital Defined
Cartoon – I was looking for Funding, not a Hug
Cartoon – Depends on what you mean by “Anything”
The financial impact of the nationwide nursing shortage: Hospitals pay billions to recruit and retain nurses
A new Reuters analysis finds that collectively, hospitals have been paying billions to recruit and retain nurses—offering higher salaries, signing bonuses and even repaying student loans—to address the nationwide nurse shortage.
The problem is only going to get worse. With many Baby Boomer nurses set to retire, and an aging population that will need healthcare services, the Bureau of Labor Statistics projects that there will be more than a million openings for registered nurses by 2024.
Although the industry has faced shortages before, the current shortfall is more difficult to address, according to the Reuters report.
“I’ve been a nurse 40 years, and the shortage is the worst I’ve ever seen it,” Ron Moore, who recently retired as vice president and chief nursing officer for West Virginia’s Charleston Area Medical Center, told the news service. To help attract nurses—and get them to stay—the organization will reimburse their tuition if they agree to work at the hospital for two years.
While some hospitals try to meet staffing needs by employing foreign nurses, the current political climate has caused delays in issuing visas. Healthcare advocates are pushing Congress to pass proposed legislation to open the door for 8,000 international nurses to get the necessary visas to help alleviate the nursing shortage.
In the meantime, Reuters notes that some hospitals have turned to travel nurses to fill the gaps. Staffing Industry Analysts told Reuters that so far healthcare organizations have paid $4.8 billion for travel nurses in 2017.
But the costs are hitting rural hospitals hard. Reuters reports that J.W. Ruby Memorial Hospital in Morganstown, West Virginia, has paid more than $10 million this year to hire and retain nurses. That money is used in part to give $10,000 signing bonuses and free housing for nurses who live more than 60 miles away from the hospital.
And that’s just the beginning. To entice longtime nurses to continue to stay in West Virginia and work at the hospital, next year J.W. Ruby Memorial may begin to pay college tuition for their family members.
Healthcare experts say other hospitals may want to follow J.W. Ruby Memorial Hospital’s lead and prepare in advance for potential shortages. Among their suggestions: develop a succession plan now, and see if experienced nurses will consider delaying retirement if they can take on new roles in patient navigation or education or decrease their hours.
Robotic surgery comes with a hefty price tag, but studies show it’s often no more effective
Over the past decade, hospitals have invested significant dollars in robotic surgical equipment, often to keep pace with their regional competitors.
But the costs associated with robotic systems don’t always pay off, according to two new studies published in JAMA last week that show robot-assisted surgeries cost more but are just as effective as certain laparoscopic surgeries. The results led one surgeon to question how hospitals should track the value of robotics, particularly as the industry transitions to value-based reimbursement models.
In one study, researchers at Stanford University Medical Center, Brigham and Women’s Hospital and the University of California San Diego reviewed 13 years’ worth of data linked to nearly 24,000 patients that had a kidney surgically removed. Although just over 5,000 of those patients underwent robot-assisted nephrectomies, the use of robot increased dramatically from 1.5% in 2003 to 27% in 2015, surpassing the percentage of laparoscopic surgeries.
But researchers found that robotic surgeries were often longer and more expensive than laparoscopic surgeries. Over the 13-year period, robotic surgeries cost approximately $2,700 more per patient without any notable difference in post-operative complications.
A second study by researchers in the United Kingdom, Germany, Italy and New Zealand found surgeons performing resection for rectal cancer were just as likely to convert to open surgery whether they were using a laparoscopic or robot-assisted technique.
In an accompanying editorial, Jason Wright, M.D. chief of gynecologic oncology at Columbia University Medical Center said the new research highlights the need for hospitals to balance the costs associated with new devices and their potential impact. While hospitals currently absorb most of those costs, that dynamic could change with new reimbursement models.
“The implementation of alternative payment models, particularly those with two-sided risk, may heighten the awareness of surgeons of these costs if reimbursement is more directly affected,” he wrote.
Wright also pointed specifically to the promise of the Food and Drug Administration’s new National Evaluation System for Health Technology (NEST), established by the new Medical Device User Fee agreements authorized in August. The system looks to use real-world data buried in EHRs and health registries to conduct post-market surveillance, which could offer a more comprehensive look at device functionality after its approved by the agency.
Tenet Healthcare to slash 1,300 positions to cut $150M in expenses
Tenet Healthcare, which recently went through a management shakeup amid financial losses, plans to eliminate 1,300 positions in order to cut expenses by $150 million.
The Dallas-based healthcare system announced Friday it had begun an “enterprise-wide cost-reduction imitative that would primarily involve job cuts and renegotiation of contracts with suppliers and vendors.”
The majority of the savings will be through actions within the company’s hospital operations, including eliminating regional managers and streamlining overhead and centralized support functions. Job cuts will also take place within the company’s ambulatory care and Conifer business segments.
In total, the company intends to eliminate 1,300 positions or about 1% of its workforce, including contractors, by the end of 2018.
The announcement comes in the wake of the sudden departure of longtime CEO Trevor Fetter, who last week stepped down from the top post and left earlier than planned with a severance package worth nearly $23 million. Reuters also reports that the organization has scrapped its sale plans and is continuing to explore ways to reduce its $15 billion debt.
The news about the layoffs also included the company’s preliminary financial results for the third quarter of 2017. Tenet expects a net loss of $366 million in the third quarter.
Ronald A. Rittenmeyer, who was recently appointed CEO while the organization searches for Fetter’s permanent replacement, said in the announcement that the organization is moving quickly to improve the financials and return for shareholders. The cost-reduction plans include structural changes in the way the organization operates to improve agility and speed decision-making, he said.
“We believe these changes will help us drive organic growth, expand margins, and better support our hospitals and other facilities in delivering higher levels of quality and patient satisfaction,” he said.
CFO’s FATAL FLAW
SURVEY FINDS
9 OF 10 HOSPITAL
EXECUTIVES DON’T KNOW THEIR COST
CONCLUSION
In the past, cost accounting has been undervalued and underutilized as accuracy and accessibility of information on cost wasn’t seen as a necessity in traditional volume-driven payment models. This is not the case in risk- or value-based medicine. Without
credible and detailed cost data, it will be extraordinarily difficult for healthcare organizations to strategically manage their operations and minimize the impact of declining reimbursement.
With close to 90 percent of healthcare leaders operating in the dark on cost, leveraging data from advanced cost accounting that is comprehensive, accurate and accessible is mission critical. Providers are then able to collaborate and make more informed decisions in order and ultimately deliver more value to the patients and the community that they serve.
HENRY KOTULA 