The healthcare industry is facing a wide variety of challenges—and solutions aren’t always straightforward. Each month, Modern Healthcare asks leaders in the field to weigh in on their approaches to the sector’s thorny issues.
Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, and Israel Rocha, CEO of Cook County Health, discuss the challenges and priorities of the country's safety-net providers.
Related: Two associations share policy wish lists as an election year looms
Some parts of the country, including big cities far from the Southern border, are seeing a rising number of migrants. What can you share regarding this population’s healthcare needs?
Feldpush: The general sense I’m hearing among our members is that the demand varies by city or region. I’ve read headlines about the number of migrants coming to Chicago. Some areas are seeing a lot of migrants coming in, and they obviously need a lot of healthcare in those situations. So there’s an influx here and there, but I’m not hearing anything about hospitals being overwhelmed.
Rocha: Over 12 months ago, we got a call from the City of Chicago, asking us to help coordinate the healthcare response to newly arriving migrants. Within 24 hours, we started a intake clinic that we were able to put together to offer comprehensive physical screenings, vaccinations, testing and a variety of other services. To date, we have provided more than 14,500 comprehensive intake screenings, physicals and testing.
Which operational issues, such as staff shortages and burnout, are continuing to challenge providers after the end of the COVID-19 public health emergency?
Feldpush: We still see lingering challenges. Labor costs have come down a bit in that hospitals have been able to reduce their reliance on contract labor to some extent, but most places are not back to where they were with their workforce prior to the pandemic. And it’s not just nursing positions, it’s across the board with allied health professionals as well.
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Rocha: We have seen improvement. We’ve made gains in the number of people who are taking our open positions. In fact, this has been a record year of hiring, with over a thousand individuals joining the team. That’s almost a 100% increase over previous years. And our turnover rate is also about half the national average. … These results took hard work; it didn’t happen accidentally.
What are some of your organization’s top policy concerns for the coming year?
Feldpush: Financial concerns are still there. Inflation is an issue with the supply chain as well as with labor. … And as states continue to go through the Medicaid eligibility redetermination process, we’re likely to see more individuals—millions so far—losing coverage, and we don’t yet know if those people will be eligible for other coverage. This raises questions about higher uncompensated care costs.
Rocha: I think it’s still very clear that we need to have a national discussion about how we can dramatically increase the healthcare workforce—providers across the spectrum, not just nurses and physicians. These national shortages are not new; the pandemic only accelerated the problem. We could talk about funding and other priorities, but until we have a sufficient hold on this, it’s going to impact everything else.