MHA CEO Report — A Program Year in Review

MHA Rounds graphic of Brian Peters

“Winning is not a sometime thing, it is an all the time thing. You don’t do things right once in a while…you do them right all the time.”  — Vince Lombardi

MHA Rounds image of Brian PetersI am pleased to share we just completed a successful MHA Annual Meeting, continuing a long-standing June tradition whereby we celebrate the conclusion of one MHA program year, and prepare for the next. Each program year is unique with the different challenges it presents. At this point five years ago, no one could have predicted how the emergence of COVID-19 would flip healthcare on its head and drastically alter the tactical objectives of our association. However, there is a constant: the MHA continues to rise to any challenge presented to us and we deliver results for our membership to improve the health and wellness of individuals and communities.

The 2023-2024 program year focused intensely on workforce, viability and behavioral health, while addressing the various “wildcard” issues that always come up. We were led with great wisdom and compassion by Shannon Striebich, president and CEO, Trinity Health Michigan, as our board chair. Due to Shannon’s commitment and leadership, the MHA accomplished numerous highly successful and impactful outcomes on behalf of our members.

One of the most significant challenges in this past year was the threat posed by government-mandated nurse staffing ratio legislation. This proposed policy had the potential to dramatically reduce access to care for individuals throughout the state. Our advocacy on the issue lasted throughout the entire year but was highlighted by an Advocacy Day we hosted in September that featured more than 150 hospital representatives, primarily consisting of nurse leaders, who came to the Capitol and conducted 118 meetings with lawmakers that day. Later in the year, the MHA successfully advocated our position at a committee hearing, where more than 60 supporters attended on very short notice to push back on false narratives and to support alternative nurse staffing solutions. As a result of our efforts, no committee votes have been scheduled, and momentum on this harmful legislation has been effectively stalled.

While we had to play defense against this harmful proposed legislation, the MHA spent the program year actively engaged in workforce development and efforts to grow the healthcare talent pipeline. The MHA worked with stakeholders to implement new funding designed to expand access to Bachelor of Science in Nursing degrees through partnerships between community colleges and four-year universities, while also engaged in partnerships with other organizations to promote healthcare careers, increase clinical faculty and nurse preceptors, address high turnover rates in rural areas and promote healthcare career options. We continued our award-winning healthcare career marketing campaign designed to attract future workers and also redeployed our annual hospital workforce survey that shows the efforts of Michigan hospitals to recruit, retain and train healthcare workers is making a real difference. Finally, we hired our first-ever chief nursing officer at the MHA, which is already strengthening our ties to the nursing community throughout the state.

The viability of hospitals was another key focus and was largely supported through our legislative advocacy work. MHA funding priorities continued to be protected in the state budget, which includes $163 million for graduate medical education, $45 million for traditional disproportionate share hospitals, $15 million through the rural access pool and an additional $8 million for the obstetrical stabilization fund. The fiscal year 2024 budget also included $60 million annually to support hospitals with Level I and II trauma centers and $34 million annually to support hospitals that provide inpatient psychiatric care. Besides state funding, the MHA protected Medicaid funding, medical liability, the 340B drug pricing program and certificate of need.

The MHA is also intricately involved in in addressing the behavioral health crisis plaguing our state and country. Expanding access to care is a key focus, which included the MHA administrating a $50 million grant program to expand access to pediatric inpatient behavioral health services. The Michigan Department of Health and Human Services (MDHHS) is a close partner in this work and the MHA participated in the MDHHS Advisory Committee on the creation of a psychiatric bed registry. The MHA launched a new member ED boarding survey to quantify the number of patients struggling with behavioral health access in the emergency department and the MHA is using this data when engaging with lawmakers, stakeholders and the public to explain the scope of the program. These learnings informed the creation of a four-bill package of legislation to address board-identified issues in the behavioral and mental health system, such as coverage parity and community mental health shortcomings.

Much of the work in the past year has focused on maternal and infant health and improving maternal health and birth outcomes. And I am pleased to share that our MHA Board of Trustees just approved the full slate of recommendations emanating from the MHA Community Access to Health Task Force, giving us the support to continue this important journey together.

And as usual, we effectively dealt with a long list of “wildcard” issues that emerged during the program year, including drug shortages, guardianship, infection control, patient transport, population growth and safety and quality. We also continued to strengthen our efforts related to the growing cybersecurity threat. Indeed, the Change Healthcare cyberattack was one of the largest and most impactful attacks ever seen and served as a clear reminder of the importance of our work in this space.

At our Annual Meeting, I spoke to our attendees about “the power of zero.” In the 2023-2024 program year, the following were true:

  • The number of Michigan acute care community hospitals and health systems that are not members of our association is zero. We have everyone at the table, which allows us to speak with one powerful, united voice.
  • We passed 39 MHA-supported bills through the state legislature that were enacted into law, with five more on their way to the governor for her signature. The number of MHA-opposed bills that made their way to the finish line was zero.
  • The MHA now has a full-time chief medical officer and a full-time chief nursing officer (as noted above). How many other state hospital associations can say this? Zero.
  • And most importantly, how many other associations – in any sector – are as relevant, as impactful, as mission-driven and successful as the MHA? I believe that number is zero.

I would like to recognize and thank our outstanding MHA Board of Trustees, our members, sponsors and business partners, but most of all, our incredible MHA staff for coming together to achieve such tremendous results for the patients and communities we collectively serve. I hope you will take the opportunity to celebrate these results with us.

As always, I welcome your thoughts.

MHA CEO Report — Moving the Workforce Needle

MHA Rounds image of Brian Peters

“Luck is not chance, it’s toil; fortune’s expensive smile is earned.” — Emily Dickinson

The healthcare workforce has been one of the MHA’s strategic action priorities for the past several years. As we near completion of our 2023-2024 program year, I’m extremely pleased to see the results of the MHA’s second annual hospital workforce survey, which shows Michigan hospitals are making real progress in reducing staffing shortages. Michigan hospitals hired more than 61,000 employees in 2023, including 13,000 nurses. Overall job vacancies were reduced by 29%, while nursing vacancies dropped by 44%. These gains are seen across nearly all job categories and they’re significant, with double-digit decreases for many of them. I can tell you with certainty: our “luck” in this regard has been earned through extremely hard work.

Michigan hospitals still have 19,000 job openings, including 4,700 for nurses, so more work and investment needs to be done. However, the accomplishments of Michigan hospitals in this area shows the recruitment, retention and training tactics implemented throughout the state are working.

It starts with retaining the existing workforce, which leads to improved morale and reduced recruiting expenses. Michigan hospitals are outperforming hospitals across the country when it comes to registered nurse retention. Michigan’s turnover rate is 3.7 percentage points lower than the national average. Offering better pay, improved benefits, flexible scheduling and integration of technology to improve patient monitoring and reduce the administrative burden on nurses are examples of tactics implemented by Michigan hospitals that are making a difference.

Michigan remains an aging state, and as more people become eligible for Medicare, the demand for healthcare services will continue to grow. In response, our hospitals are very serious about expanding the talent pipeline and increasing awareness of hospital careers to students. Hospitals are expanding educational opportunities and partnerships with higher education institutions to attract more students to healthcare, including clinical positions like nursing. The MHA is assisting by leading the MI Hospital Careers public awareness campaign that targets students and professionals considering a career change to consider healthcare as a great option.

The MHA also recently published the latest results from the Economic Impact of Healthcare in Michigan report, which shows the important role hospitals have in Michigan’s workforce and economy. Healthcare remains Michigan’s largest employer of direct, private-sector jobs. Hospitals provide the largest percentage of healthcare jobs in the state, employing 217,000 full-and part-time employees. Not only are these good-paying, stable jobs, but many offer career pathways that allow employees to further develop their skills and move up the job ladder with additional certifications and/or degrees. Many of Michigan’s communities also depend on their local hospital as one of, if not their very largest, employer.

These results led our conversations last week while a team of MHA staff attended the Detroit Regional Chamber’s annual Mackinac Policy Conference, connecting with business, higher education and political leaders throughout Michigan. In addition to this public announcement, we also produced a palm card and video for event attendees to highlight our work. Our goal is to increase the awareness of the large role hospitals play in the economy and the success they’re having in welcoming new talent to their organizations.

Reducing job vacancies and staffing shortages is a marathon and not a sprint. The Michigan Legislature has played a large part in assisting hospitals, whether it be through direct worker funding or new policies, such as increased penalties for violence committed against healthcare workers or allowing community colleges to offer Bachelor of Science in Nursing degree programs in collaboration with a four-year institution. The MHA is proud to help lead many of these discussions with policymakers to find more ways to reduce barriers to healthcare careers.

Public policy, advocacy and communications are key – but we are using every tool in our toolbox to address our workforce challenges. The MHA Endorsed Business Partner (EBP) program promotes industry-leading firms, carefully vetted by the MHA, that can meet the most pressing needs of our member hospitals and health systems, and we just announced a new endorsement of AMN Healthcare as a national leader in workforce solutions. The MHA has endorsed several of AMN’s legacy brands, including Merritt Hawkins, a physician search division, for many years. As AMN brings its solutions under one brand, we proudly continue this partnership with AMN Healthcare. They are the largest workforce solutions company in the market, which allows them to serve clients more effectively across all levels of healthcare.

Economic development and workforce are not just a one-year strategy. This will continue to remain a priority for hospitals and health systems, and we’re encouraged that at this time next year, we will have a similar story to tell in the reduced number of healthcare vacancies in the state. Until then, please join us and encourage as many people as you can to consider a job in healthcare. Make no mistake: whether clinical or non-clinical, healthcare is hard work; but it truly is one of the most rewarding, mission-driven careers you can pursue.

As always, I welcome your thoughts.