Media Recap: Pediatric RSV Surge

Laura Appel

Laura AppelThe MHA received media coverage during the weeks of Nov. 21 and 28 on the capacity status of hospital pediatric units amid the surge of hospitalized pediatric patients with respiratory illnesses driven by respiratory syncytial virus (RSV).

The Detroit Free Press published an article Nov. 23 on the status of hospitals throughout the state caring for a large number of children and requests made by hospitals to add additional licensed beds. Laura Appel, executive vice president of government relations and public policy, MHA, is quoted in the story on how staffing challenges continue to hamper hospitals, even for those with declining pediatric patient census.

“It’s worth noting that even where hospitalizations have receded, many of our members continue to face severe space and staffing challenges,” said Appel

Additional stories were published by The Detroit News, The Center Square and Chief Healthcare Executive.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Media Recap: Hospital Financial Viability

Laura Appel

Laura AppelThe MHA received media coverage during the week of Nov. 14 on financial and staffing challenges impacting hospitals in Michigan and the potential for further state funding support.

The Detroit Free Press published an article Nov. 14 that reviewed the factors influencing declining financial performance, including lower patient volume, increased supply costs, higher workforce expenses and stagnant reimbursement. Laura Appel, executive vice president of government relations and public policy, MHA, is quoted throughout the story. Appel expressed appreciation for the one-time $225 million state grant for the recruitment, retention and training of healthcare workers and discussed the increased rates for staffing agencies.

“We are immensely grateful for that,” said Appel. “But the $225 million (is) a one-time payment that really only offsets a small amount of what we’re paying in 2022 … and none of it is designed to help us in 2023.”

Additional stories were published by Crain’s Detroit Business and The Detroit News.

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Parents Urged to Take Preventive Measures As Pediatric Beds Fill Up

As Respiratory Viruses Circulate, Michigan Hospitals Urge Vigilance, Prevention

Michigan children’s hospitals and pediatric healthcare leaders are raising awareness about a pediatric hospital bed shortage and urging the public to help prevent respiratory illnesses, which are rapidly spreading in the form of respiratory syncytial virus (RSV) and influenza.

Michigan pediatric intensive care unit hospital beds are currently 89% occupied, according to data from the Michigan Health & Hospital Association (MHA) and Michigan Department of Health & Human Services (MDHHS). Hospitals are also reporting large surges in young patients visiting emergency departments, for both emergent and non-emergent care. Hospitals are urging those with mild cold-like symptoms to stay at home. If symptoms worsen, an urgent care or primary care physician’s office would be the most appropriate setting to seek care, while emergency department visits should be reserved for those with moderate to severe symptoms including shortness of breath. Wait times and patient volumes in emergency rooms are increasing, and emergency department capacity in some areas is being depleted by visits for non-emergency medical conditions. Pervasive hospital staff shortages further complicate surges in hospital visits.

These pediatric bed shortages are impacting care statewide, making transfers of the sickest young patients to higher acuity care settings difficult.

“Hospitals are here for Michiganders, particularly in emergencies,” said Gary Roth, DO, chief medical officer, MHA. “But our capacity to provide pediatric hospital care is extremely strained. Right now, the staffing challenges we have been sounding the alarms about all year combined with rapid spread of respiratory illnesses are impacting our hospitals’ ability to care for our sickest children in a timely manner.”

The MHA and the MDHHS are monitoring the pediatric bed capacity among Michigan hospitals. Nationally, the U.S. Department of Health and Human Services data shows that 76% of pediatric beds across the country are full, with anecdotal reports largely pinning the shortage on widespread RSV infections.

“Many of us in the pediatric medical community across Michigan are working to care for the surge of children battling RSV,” Matthew Denenberg, MD, chief of pediatrics, Corewell Health East, the new name for Beaumont Health, and chair of the MHA’s Council on Children’s Health. “Our teams are here to help when the illness becomes severe. Parents and guardians can also help stop the spread of illness in our communities by getting children vaccinated against both flu and COVID-19. We all need to work together to keep our children safe.”

“In recent weeks we have seen a significant surge in cases of RSV which is most greatly impacting our infants and young children,” said Rudolph Valentini, MD, chief medical officer, Children’s Hospital of Michigan. “Since Oct. 1, more than 450 patients have tested positive for RSV at our hospital. This is putting a strain on our hospital’s emergency department and inpatient bed capacity; further, this could intensify if influenza cases begin to rise in the near future. It is also important to note that RSV and its associated bronchiolitis cause symptomatic disease in 20% of infants and children less than one year of age. Although RSV may only cause a mild cold in older children and adults, it is important for parents to keep their infants and young children away from others who are ill, because RSV causes inflammation to the smallest airways making infants especially vulnerable sometimes resulting in hospitalization or ICU care. Other patients who need to avoid RSV are children with a history of prematurity, chronic lung disease, congenital heart disease, immunodeficiency or solid organ transplant.”

“As we see this concerning trend in high volumes of pediatric emergent care and hospitalizations, we need to all work together to protect our children and conserve resources.  Pediatric beds are a shared resource across the state,” stated Christine Nefcy, MD, chief medical officer, Munson Healthcare. “Many smaller community or rural hospitals in Michigan have minimal pediatric bed capacity and rely on other facilities for higher level or specialty care for these patients. At this time of year, we naturally want to gather more often with family and friends; so as you make plans, we urge parents to follow these guidelines to ensure we manage this surge using all the tools at hand.”

“We are urging Michiganders to have a plan for their families this respiratory season to help prevent hospital overcrowding and prevent outbreaks of respiratory illnesses using the tools available,” said Dr. Natasha Bagdasarian, the state’s chief medical executive. “This includes getting available vaccines, staying home if unwell, having a supply of masks at home, covering coughs, washing your hands often and finding out if you are eligible for treatment options if you do become unwell.”

The MHA and its pediatric clinical leaders and partners offer the following tips for the public:

  • DON’T: Seek hospital emergency care for non-emergency medical conditions, such as mild symptoms and routine testing.
  • DO: Seek hospital emergency care if symptoms are worrisome and emergency care is needed. Emergency medical conditions can include difficulty breathing, dehydration and worsening symptoms.
  • DO: Immediately get vaccinated against respiratory illnesses. Visit www.vaccines.gov to search for vaccine availability or call your provider or the local health department.
  • DO: Be patient if seeking care through a hospital emergency department. Consider that wait times may be elevated as respiratory illnesses reach seasonal peak levels.
  • DO: Consider having your children wear a mask in public places including school when you know local case rates of respiratory illnesses are high.
  • DO: Practice frequent and proper hand washing and stay home if you’re not feeling well.

Additional information: 

Influenza is a viral respiratory illness with symptoms that include fever, cough, stuffy or runny nose, sore throat, headache, chills and fatigue. A flu test is not always needed to diagnose the flu, however in some cases it may be recommended by a healthcare provider. People at risk of complications should consult their healthcare provider.

RSV infection is a viral respiratory illness that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. Symptoms include runny nose, decreased appetite, coughing, sneezing, fever and wheezing.

Reporters may contact the following representatives from the Pediatric Leadership Collaborative to schedule interviews:

Natasha Bagdasarian, MD, MPH, FIDSA, Chief Medical Executive, State of Michigan
Media Contact: Lynn Sutfin, SutfinL1@michigan.gov

Francis Darr, MD, Pediatrician, UP Health System – Marquette
Media Contact: Janell Larson, Janell.Larson@mghs.org

Marcus DeGraw, MD, Chairman, Department of Pediatrics, Ascension St. John Hospital St. John Children’s Center
Media Contact: Airielle Taylor, airielle.taylor@ascension.org

Matthew Denenberg, MD, Chief of Pediatrics, Corewell Health East
Media Contact: Mark Geary, mark.geary@beaumont.org

Michael Fiore, MD, Medical Director, Pediatric Intensive Care Unit, Covenant Healthcare
Media Contact: Kristin Knoll, kknoll@chs-mi.com

Steven Martin, MD, E.W. Sparrow Hospital, Interim Chief Medical Officer & Co-Director of University of Michigan Health at Sparrow Children’s Center, Sparrow Health System
Media Contact: John Foren, John.Foren@Sparrow.org

Kimberly Monroe, MD, MS, Interim Chief Clinical Officer, C.S. Mott Children’s Hospital & Von Voigtlander Women’s Hospital
Media Contact: Beata Mostafavi, bmostafa@med.umich.edu

Christine Nefcy, MD, Chief Medical Officer, Munson Healthcare
Jacques Burgess, MD, MPH, System Pediatric Medical Director, Munson Healthcare
Media Contact: Dale Killingbeck, dkillingbeck@mhc.net

Brian M Nolan, MD, Hurley Children’s Hospital
Media Contact: Peggy Agar, pagar1@hurleymc.com

Dominic Sanfilippo, MD, Associate Department Chief / Pediatrician-in-Chief, Corewell Health Helen DeVos Children’s Hospital
Media Contact: Andrea Finnigan, Andrea.Finnigan@spectrumhealth.org

Uzma Shah MD, FAAP, FAASLD, Chair, Department of Pediatrics, Henry Ford Health
Media Contact: Dana Jay, djay2@hfhs.org

Gregory Tiongson, MD, Medical Director, Bronson Children’s Hospital
Media Contact: Erin Smith, smither@bronsonhg.org

Rudolph Valentini, MD, Chief Medical Officer, Children’s Hospital of Michigan
Media Contact: Brian Taylor, BTaylor8@dmc.org

Media Recap: Stop Nurse Shortages Act & MiCare Champion Cast Coverage

Brian Peters

The MHA received media coverage on through a couple stories during the week of Oct. 17, including on the introduction of the Stop Nurse Shortages Act at the federal level and the latest MiCare Champion Cast episode.

U.S. Rep. Haley Stevens (D-Birmingham) introduced Oct. 18 the Stop Nurse Shortages Act with Rep. David Joyce (R-Ohio), which would authorize a $10 million/year grant program to help nursing schools create, expand or support an accelerated nursing degree program. MHA CEO Brian Peters was quoted in the news release supporting the legislation.

“The shortage of nurses is disrupting our entire health care system,” said Peters. “Michigan hospitals welcome every effort to increase the availability of education opportunities for those who wish to join the high-skilled career of nursing. The MHA applauds this comprehensive effort to fund capacity, faculty, and student financial assistance for accelerated training programs.”

State of Reform also published a story Oct. 19 recapping the latest MiCare Champion Cast podcast episode that included a conversation with Peters and T. Anthony Denton, J.D., MHSA, senior vice president and CEO of University of Michigan Health – Michigan Medicine, and 2022-2023 Chair of the MHA Board of Trustees discussing the top priorities for the MHA’s 2022-23 program year.

Crain’s Op-Ed: Hospital financial strain is unsustainable, threatens access to care

Brian Peters

Brian PetersCrain’s Detroit Business published an op-ed from MHA CEO Brian Peters Sept. 22 on the unsustainable financial strain currently being experienced by Michigan hospitals and health systems. The op-ed was in response to a Sept. 2 Modern Healthcare article detailing the struggles of hospitals nationwide.

Peters describes the untenable situation where hospitals are experiencing skyrocketing costs combined with stagnant and inadequate reimbursement and staffing challenges. Statewide, Michigan has lost approximately 1,700 staffed hospital beds since 2020 due to lack of available staff. Peters also mentioned the many actions the MHA and member hospitals are taking to address these challenges.

“Multiple factors have contributed to the drain on hospital resources: fewer workers, increasingly sicker patients, and higher costs that cannot keep up with inflation,” said Peters. “According to a new American Hospital Association report, the average length of a hospital stay rose almost 10 percent from 2019 to 2021. Compensation for direct jobs in nursing and residential care rose by about $200 million from 2019 to 2020, but the number of jobs fell by about 11,000. Hospital labor expenses per patient also increased 19 percent. Health care reimbursement is unable to quickly respond to inflation since rates are negotiated in advance, presenting additional financial challenges.

Michigan Hospitals Invested $4.2 Billion in Community Programming Mid-pandemic to Improve Health, Well-being of Residents

New report outlines hospital community health efforts in FY 2020

The Michigan Health & Hospital Association (MHA) released today the Healthy Futures, Healthy Communities report that demonstrates a nearly $4.2 billion investment in community-based partnerships and programming in fiscal year (FY) 2020. Overall, hospitals invested more than $869 million in community and voluntary-based activities, from education and prevention services to community outreach, research and workforce development.

Data in the report shows investments made throughout the first year of the COVID-19 pandemic, demonstrating Michigan’s hospitals and health systems continued offering a wide range of services and resources to their communities inside and outside of the traditional healthcare setting that improved the overall health, wellness and quality of life of residents.

“Even through some of the most challenging times in healthcare, hospitals and health systems haven’t wavered in their commitment to helping improve the overall health and wellness of the communities they serve,” said MHA CEO Brian Peters. “This report gives a clear and simple message: The impact of our healthcare workforce reaches far beyond the walls of patient rooms.”

In addition to community benefit services and programs, the report also highlights the contributions of hospitals when it comes to uncompensated care. In FY 2020, the unpaid costs of patient care at Michigan hospitals totaled more than $3.4 billion, which includes both financial assistance and bad debt at cost, as well as Medicaid and Medicare payment shortfalls, other means-tested government programs and subsidized health services.

“The programs​ and services that ​hospitals and health systems provide ​have ​a long-term and positive impact on community health,” said T. Anthony Denton, J.D., MHSA, senior vice president and chief operating officer of University of Michigan Hospitals, Health Centers and Medical Group and 2022-2023 Chair of the MHA Board of Trustees. “Patients and communities bec​ame more intertwined ​than ever as ​healthcare teams worked to provide care, compassion, financial and in-kind resources and knowledge throughout the COVID-19 pandemic and continue to do so. Our role as anchor institutions ​is and has always been vital, providing an important uplift to those in need by way of various contributions which demonstrate our value as a major community asset. Through our many efforts, we are privileged to build bridges and connect communities to inform, elevate and empower individuals and families to mitigate social determinants and advance health, inspire hope and foster meaningful presence.”

Included in the report are examples of programs implemented by hospitals throughout Michigan that expand access to care and improve the health of vulnerable populations within their communities.

“McLaren, as a large health system, serves large urban settings and smaller rural communities, and the critical charge of being a community-integrated provider is having a sound, community-based system of care in place,” said Dr. Justin Klamerus, McLaren Health Care chief medical officer. “Increasingly, health care is moving toward care that existed outside of the hospital, both in treatment and preventive practices. It’s part of our responsibility to attune ourselves to the needs of our communities, especially in critical access areas, and doubly so during a time when many may still be hesitant to seek care in a hospital setting. Our facilities in Bay, Caro and the Thumb Region are true in the commitment to their communities and are really working to meet their needs.”

The full report and stories from hospitals across the state that exhibiting community benefit can be accessed online here.

Healthcare Remains Michigan’s Largest Private-sector Employer Despite Pandemic Losses

Economic Impact in Michigan infographic

Provides Nearly 572,000 Direct Jobs, 224,000 in Hospitals Alone

Economic Impact in Michigan infographicThe Partnership for Michigan’s Health reports healthcare directly employed nearly 572,000 Michigan residents in 2020, demonstrating that healthcare continues to be the largest private-sector employer in the state despite staffing losses attributed to the COVID-19 pandemic. The 2022 release of The Economic Impact of Healthcare in Michigan shows direct healthcare workers in Michigan earned $44.2 billion that year in wages, salaries and benefits. Hospitals alone employed 224,000 individuals in the state in 2020.

Direct healthcare employment helps create additional jobs that are indirectly related to or induced by healthcare. These indirect, healthcare-supported jobs are held by more than 502,000 people who earned about $28 billion in 2020 in wages, salaries and benefits. Together with their employers, the nearly 1.1 million workers in the healthcare sector contributed almost $15.2 billion that year in local, state and federal taxes. These taxes include Social Security, income, motor vehicle, sales, property, corporate and more.

Data from 2020 shows the early impact the pandemic had on the economic strength of the healthcare sector in Michigan. In particular, the data illustrates the rise in labor costs as many nurses transitioned to contract labor with staffing agencies. Compensation for direct jobs in Nursing and Residential Care rose by about $200 million from 2019 to 2020, although the number of jobs fell by about 11,000. Specific to hospitals, the number of jobs fell by about 7,000 jobs from 2019 to 2020, but total compensation remained about the same.

The loss in jobs represents the initial exit of many healthcare workers due to burnout and stress associated with the pandemic. Both nationally and in Michigan, healthcare experienced a shortage of healthcare employees for several years and the pandemic caused a sudden loss of existing workers. With Medicare beneficiaries in Michigan increasing by more than 8% over the past five years to a total of 2.1 million people, Michigan needs more healthcare workers, now more than ever, to serve the changing needs of the state’s aging population.

The trend of nurses transitioning to contract labor is supported by recent research from the American Hospital Association, which found labor expenses per patient for hospitals increased 19% through 2021 compared to 2019. Increased labor expenses have a more profound impact on hospitals and health systems, as labor expenses account for more than 50% of total expenses for most hospitals. In addition, healthcare reimbursement is unable to quickly respond to inflationary pressures since rates are negotiated months in advance, presenting additional financial challenges when responding to sudden labor market demand.

The report was compiled by the Partnership for Michigan’s Health, which consists of the Michigan Health & Hospital Association, the Michigan State Medical Society and the Michigan Osteopathic Association, all based in the greater Lansing area. It uses 2019 and 2020 data, which is the most recent available.

“This report demonstrates the unquestionable and significant role healthcare, and specifically hospitals, play in Michigan communities,” said Michigan Health & Hospital Association CEO Brian Peters. “Not only have they played a vital role in the care and treatment of patients, but they remain far and away the leading employers and large drivers of economic activity.”

“Healthcare careers are not only extremely rewarding, but crucial to our society,” said Kris Nicholoff, executive director of the Michigan Osteopathic Association. “While healthcare careers remain in high demand, the data shows there are over a million individuals we owe our gratitude toward for providing care during one of the most trying and tumultuous years in modern history.”

“Physicians are and will continue to remain a key driver of healthcare employment and economic growth,” said Julie L. Novak, CEO of the Michigan State Medical Society. “Investing in physician-led team-based care and healthcare careers is key to the economic vitality and health of our state, local communities and residents. Physician practices, hospitals and other care settings offer good paying and stable jobs in careers that truly improve and save lives.”

Hospitals and healthcare providers remain focused on ensuring these jobs meet the needs of their employees, from offering competitive compensation and benefits to ensuring a safe and supportive work environment. The Partnership for Michigan’s Health joined several other organizations in the Healthcare Workforce Sustainability Alliance to advocate for state funding to support the recruitment, retention and training of healthcare workers. These efforts were successful in Public Act 9 of 2022 which allocates $300 million in state funding to support Michigan’s healthcare workforce.

The 16th and 17th editions of The Economic Impact of Healthcare in Michigan were compiled using IMPLAN® cloud software to quantify healthcare’s significant economic impact in the state. The data represents direct, indirect  and induced  healthcare jobs; taxes paid by those workers and their employers; and salaries, wages and benefits earned. The report is an online, interactive tool that allows users to examine these economic impacts from a statewide perspective and by region, county or congressional district. The data from both 2019 and 2020 is provided in two separate data tables. It is available at www.economicimpact.org.

Court of Appeals Rules for Providers in ANF Case

The Michigan Court of Appeals ruled 2-1 in favor of providers to declare that statutorily set reimbursement rates for auto accident no-fault claims could not be applied retroactively. The new reimbursements went into effect in July, 2021.

The 2-1 ruling, in Ellen M. Andary, Philip Krueger, & Eisenhower Center, v. USAA Casualty Insurance Company and Citizens Insurance Company of America, called upon the fact that legislative intent did not make it clear that the new rates were intended to be retroactive for cases that had arisen previous to the rates that went into effect, and even if it had, the legislature would be unable to make such a law due to impairments of constitutional contract provisions.

While the case is a victory for providers, especially those caring for auto accident victims from prior to 2019, it is highly likely that the case will be appealed for a final decision at some point before the Michigan Supreme Court. There is not an automatic right to appeal for the defendants, but the Michigan Supreme Court could grant leave to appeal. Under the Court of Appeals ruling, payments to providers for patients with injuries incurred before the effective date of the law return to charges 21 days after this ruling unless there is further court action. The MHA will provide an analysis to members of the policy impact of this decision and will keep members apprised of the legal status of challenges to the amended auto no fault law.

Those with questions may contact Laura Appel at the MHA.

Headline Roundup: Healthcare Workforce Sustainability

MHA CEO Brian Peters Appears on Michigan Business Beat

The MHA responded to several media requests the weeks of Aug. 15 and Aug. 22 which focused on different aspects of healthcare workforce sustainability, ranging from emergency department wait times to efforts to address the talent pipeline.

MHA CEO Brian Peters Appears on Michigan Business Beat
MHA CEO Brian Peters appears on Michigan Business Beat.

Below is a collection of headlines from around the state that include interviews or statements from MHA representatives.

Tuesday, August 23

Monday, August 22

Thursday, August 18

Members with any questions regarding media requests should contact John Karasinski at the MHA.

Behavioral Health Legislation Introduced in State House

capitol building

capitol buildingNew legislation to make changes to the screening process for potential admission to inpatient psychiatric care for behavioral and mental health patients was introduced Aug. 17 in the Michigan House of Representatives.

Rep. Graham Filler (R-St. Johns) introduced House Bill (HB) 6355 to amend the Mental Health Code and make the preadmission screening process more efficient. Under the bill, preadmission screening units, whether operated by the Michigan Department of Health and Human Services or Community Mental Health services programs, must provide a mental health assessment within three hours of being notified by a hospital of the patient’s need. If a preadmission screening unit is unable to perform the assessment in a timely manner, HB 6355 would also allow for a clinically qualified individual at the acute care hospital to perform the required assessment. The bill provides for reimbursement to the hospital if hospital staff provide the preadmission screening.

The MHA supports HB 6355 because it addresses the ongoing issue of long wait times for emergency department behavioral and mental health patients. This legislation should help shorten the difficult wait times between the evaluation and beginning services.

HB 6355 was referred to the House Health Policy Committee. Members with questions regarding HB 6355 should contact Adam Carlson at the MHA.