MHA CEO Report — Cybersecurity Takes Center Stage

“There are only two types of companies: those that have been hacked, and those that will be.”  Robert Mueller

“Dear Health Care Leaders,

As you know, last month Change Healthcare was the target of a cyberattack that has had significant impacts on much of the nation’s health care system. The effects of this attack are far-reaching; Change Healthcare, owned by UnitedHealth Group (UHG), processes 15 billion health care transactions annually and is involved in one in every three patient records. The attack has impacted payments to hospitals, physicians, pharmacists, and other health care providers across the country. Many of these providers are concerned about their ability to offer care in the absence of timely payments, but providers persist despite the need for numerous onerous workarounds and cash flow uncertainty.”

So began a letter dated March 10 from Xavier Becerra, the Secretary of the U.S. Department of Health and Human Services (HHS), referencing what is emerging as one of the most extensive and impactful cyberattacks in U.S. history. The scrutiny directed at Change’s parent company UnitedHeath Group – from Congress, HHS, the media and others – is only just beginning, and there is no telling what sort of new regulations, penalties and associated policy change will be the end result. In the meantime, the MHA has stepped up to support our members by sharing as much information and intelligence as possible, and by advocating for flexibility and relief from both private payers and the state Medicaid program.

America’s hospitals are no strangers to external events creating seismic upheaval in our daily operations. Sometimes those events emanate from the world of public policy and politics, sometimes they come in the form of a localized natural disaster or tragic mass casualty event, and no one needs to be reminded of the impact of the global COVID-19 pandemic. But in the wake of the Change Healthcare crisis, there is no doubt cybersecurity now deserves to be on the top of the list of concerns for hospital leaders across the country, and right here in Michigan.

For some time now, the FBI has stated that healthcare organizations are the top target of cybercriminals across the globe, and these attacks have increased significantly in the last two years. Data sharing requirements in healthcare and the connectivity of health information – while well-intended – creates many potential risks for cybercriminals to exploit. Hospitals take these attacks extremely seriously. They are threat-to-life crimes because of the impact they can have on patient safety and access to care, and are formally treated as such by the FBI.

Again, this is not a new issue. A year and a half ago, cybersecurity was the topic for my CEO Report, where we expressed the potential for cybercrimes to cripple an organization. At that time, we saw how multi-national organizations with U.S.-based operations were impacted when Ukrainian government and critical infrastructure organizations were victims of cyberattacks during the Russian invasion of Ukraine. Yet again, we saw how the breach of one organization can cause rippling consequences for an entire industry; one that accounts for 17.3% of our nation’s Gross Domestic Product.

This is why the MHA has been engaged on this topic for many years and goes to great lengths to assist our members. The MHA was closely involved in the creation of the Michigan Healthcare Security Operations Center (HSOC) to help monitor and react to cyber risks with participating member organizations. We also partner with MHA Service Corporation Endorsed Business Partner CyberForceQ, a leader in the field, to assist members who need cybersecurity assistance. For the first time, we also have our very own MHA Vice President and Chief Information Security Officer, Mike Nowak, who works closely with the HSOC, our member CISOs and our external partners in this space. And Jim Lee, our senior vice president, data policy & analytics, continues to lead our MHA Health Information Technology Strategy Council, which is providing meaningful insight on the impact of this latest attack.

It can take months for a third-party review to determine what information was breached and ultimately taken. But from the hospital perspective, it is clear the Change Healthcare cyberattack is yet another example of a breach that initiates with an outside vendor, and those vendors are not always completely transparent and forthcoming with those organizations directly impacted by the breach. One thing we know for sure: our hospitals are victims in these situations and should be treated as such. We want to work with state and federal policymakers and regulatory agencies to prevent cyberattacks, and to root out and punish the criminals who perpetrate these crimes. We will be very concerned about any proposals that unfairly punish hospitals or create new barriers to our ability to provide timely access to quality care.

Our members are going to great lengths to mitigate potential risk. However, more can be done at a federal level to thwart bad actors. Hospitals and health systems are part of critical infrastructure, so our law enforcement agencies need the funding and staff to defend against cybercriminals. The American Hospital Association urged the government to use all diplomatic, financial, law enforcement, intelligence and military cyber capabilities to disrupt these criminal organizations, much like what was done in the global fight against terrorism in the wake of 9/11.

Thankfully, it appears our hospitals and health systems in Michigan have been able to manage this crisis better than counterparts in other states. The work of the MHA and our partners has helped make Michigan a leader in this space and to be prepared to respond to these situations. Our cybersecurity efforts are constantly at work, 24/7 year-round, mirroring the same cadence of our hospitals and their patient care. Yet the human component of healthcare is the most vulnerable. It only takes one individual to not notice a phishing or social engineering attempt for yet another failure that can impact hundreds of organizations, thousands of healthcare workers and tens of thousands of patients. This is why we must remain constantly vigilant as the cyber threat landscape continues to grow.

As always, I welcome your thoughts.

MHA CEO Report — Prioritizing our Workforce

“When people are financially invested, they want a return. When people are emotionally invested, they want to contribute.” – Simon Sinek 

Workforce Support and Innovation is the top priority for the MHA this program year, as identified by our board of trustees and echoed by every member hospital and health system throughout the state. This should come as no surprise, as few sectors of our Michigan economy have been more challenged in this regard. I am proud to say the MHA has tackled this challenge head-on, using every tool in our increasingly diverse association toolbox.

For our members, we know delivering exceptional care begins with hiring, developing and retaining quality talent. We also know that the demographic realities of an aging population and the associated retirements, rising stress and burnout, and increased rates of violence against healthcare workers are all contributing to retention challenges and staffing shortages. Finally, as with any daunting issue, we know the best way for us to be helpful to our members is to first tap their expertise, letting them share the details of their day-to-day experience so we can identify the most impactful solutions both inside and outside of the public policy domain. In short, we listen.

Through our MHA Human Resources & Workforce Council, we convene our HR professionals to discuss issues such as workforce development, the education and training pipeline, diversity, equity and inclusion efforts, workplace safety, and emerging technologies that can aid in the completion of clinical and non-clinical tasks. The council generates robust information sharing on best practices, as well as discussion on HR-related legislative and regulatory proposals at the state and federal level.

Our work with this council does not occur in a vacuum but is instead complemented by our continual engagement with MHA committees, councils and task forces that include chief medical officers, chief nursing officers, hospital and health system attorneys and government affairs leaders. So, what have we accomplished to date? The list is long and impressive. Just a few examples:

  • Over the past two state budget cycles, we secured $300 million in new funding for our member hospitals for the specific purpose of workforce recruitment and retention.
  • We launched the new MI Hospital Careers campaign, which has helped to shine a light on hospitals and healthcare as a viable career path for Michiganders. We also continue to partner with state universities and community colleges to ramp up health-related training programs.
  • We successfully advocated for Public Acts 271 and 272 of 2023, recently signed by Gov. Whitmer, which increase the penalties for violence committed towards healthcare workers or volunteers.
  • Our MHA Keystone Center launched the Well-B workforce well-being initiative, which has now reached thousands of hospital workers and is contributing to enhanced resiliency of our front-line caregivers.
  • Our MHA Graphic Services division designed and produced workplace safety posters, which are now prominently displayed in hospitals throughout Michigan.
  • The MHA is hosting our annual Human Resources Conference this month, which brings together chief human resource officers and leaders to collaborate, strategize and network. The conference is headlined by Kerry Ebersole Singh, the chief talent solutions & engagement officer at the Michigan Economic Development Corporation. Her presence confirms the MEDC’s recognition of the significant role healthcare plays in our state’s labor force and economic success – a fact we annually lift up in our Economic Impact of Healthcare report.
  • The MHA Service Corporation (MHASC) plays a vital role in this realm. Our HR Conference is sponsored by MHA Endorsed Business Partners AMN Healthcare and Salary.com (as well as MHA members Executive Core and HPS, and event sponsor Vault Verify), who are all involved in the workforce solutions space. The MHASC is working with partners who assist hospitals with de-escalation training and staff safety, virtual nursing programs and other emerging technologies, and more.
  • The MHASC is crucial to our work here in yet another way. The MHA Unemployment Compensation Program has a decades-long track record of success, saving millions of dollars every year for their more than 700 clients.

Everything listed is an example of proactive, positive activity. In other words, “playing offense.” Of course, one of our most significant activities in the workforce realm is an example of “playing defense” by ensuring government mandated nurse staffing ratio legislation that would significantly jeopardize patient access to care is not advanced by the state legislature. As discussed at length in a recent CEO Report, the MHA has worked very effectively to explain the complexity associated with hospital staffing and the tangible solutions that will actually address workforce shortages.

There is no silver bullet to solving healthcare’s workforce challenges. Michigan’s population is not growing and there are many market forces at play unique to healthcare. However, I’m extremely pleased by the work our own MHA staff has put forth to best position our members to achieve our workforce goals. And it couldn’t be done without the engagement from our colleagues in hospitals throughout the state who are doing all they can to ensure access to high quality care 24/7/365. Collectively, these are people who are clearly emotionally invested and making significant contributions to this worthy cause.

As always, I welcome your thoughts.

MHA Monday Report Feb. 26, 2024

MHA Monday Report

Workplace Safety Posters Available

The MHA has new, updated signage available for MHA members to order at no cost to help hospitals comply with the requirement from Public Acts 271 and 272 of 2023 that hospitals display signage informing …

 


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The Keckley Report

Paul KeckleyThe Four Conflicts that Hospitals Must Resolve in 2024

If you’re a U.S. health industry watcher, it would appear the $4.5 trillion system is under fire at every corner. Pressures to lower costs, increase accessibility and affordability to all populations, disclose prices and demonstrate value are hitting every sector. Complicating matters, state and federal legislators are challenging ‘business as usual’ seeking ways to spend tax dollars more wisely with surprisingly strong bipartisan support on many issues. No sector faces these challenges more intensely than hospitals. …

Nonetheless, conflict resolution on these issues must be pursued if hospitals are to be effective, affordable and accessible contributors and/or hubs for community health systems in the future. The risks of inaction for society, the communities served and the 5.48 million (NAICS Bureau of Labor 622) employed in the sector cannot be overstated. The likelihood they can be resolved without the addition of new voices and fresh solutions is unlikely.”

Paul Keckley, Feb. 19, 2024


News to Know

  • Registration is open for the 2024 MHA Human Resources Conference, scheduled for March 5, 2024 at the ACH Hotel Marriott University Area, Lansing.
  • MHA Endorsed Business Partner CommerceHealthcare® recently published an annual report on 2024 Healthcare Finance Trends presenting a set of themes that capture the positive momentum, significant challenges and major strategies for provider organizations in 2024 and beyond.
  • The Joint Commission is hosting a webinar March 26 from 1 to 2:15 p.m. EST to review recent updates to Michigan regulations for Cardiac Systems of Care (STEMI Referring and STEMI Receiving).

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News to Know – Feb. 26, 2024

  • Registration is open for the 2024 MHA Human Resources Conference, scheduled for March 5, 2024 at the ACH Hotel Marriott University Area, Lansing. Attending the conference provides human resource professionals with an opportunity to network with other industry experts for idea sharing. HR Certification Institute® (HCRI®) has pre-approved this activity. This program, ID No. 658271 has been approved for 4.0 HR (General) recertification credit hours toward aPHR™, aPHRi™, PHR®, PHRca®, SPHR®, GPHR®, PHRi™ and SPHRi™ recertification through the HR Certification Institute. Members should contact Brenda Carrat the MHA for assistance with registration. Questions regarding the conference should be directed to Erica Leyko at the MHA.
  • MHA Endorsed Business Partner CommerceHealthcare® recently published an annual report on 2024 Healthcare Finance Trends presenting a set of themes that capture the positive momentum, significant challenges and major strategies for provider organizations in 2024 and beyond. The themes explore four areas: Finance, Patient Financial Experience, Automation and Advanced Technology and Collaboration/Trust as Strategic Context. The trends identified reflect the analysis of a broad spectrum of industry data and perspectives. CommerceHealthcare® solutions are provided by Commerce Bank. Members with questions may contact Dan VandenBosch, vice president, Michigan healthcare banking. To learn more about the EBP program, contact Rob Wood at the MHA.
  • The Joint Commission is hosting a webinar March 26 from 1 to 2:15 p.m. EST to review recent updates to Michigan regulations for Cardiac Systems of Care (STEMI Referring and STEMI Receiving). Cardiovascular service line directors, quality and regulatory professionals and EMS coordinators are encouraged to register.

Workplace Safety Posters Available

The MHA has new, updated signage available for MHA members to order at no cost to help hospitals comply with the requirement from Public Acts 271 and 272 of 2023 that hospitals display signage informing individuals they may be subject to higher financial penalties if they assault a healthcare worker or volunteer. With the help of MHA Endorsed Business Partner AMN Healthcare Language Services, translated versions in Spanish and Arabic are also now available. The deadline to have signage posted is March 5, 2024.

Members are asked to coordinate orders within a hospital and/or health system to increase the efficiency of the ordering process and printing. Larger, bulk orders are preferred compared to multiple orders from separate departments within the same organization.

As a reminder, the MHA supported the legislation signed into law by Gov. Whitmer last December as a positive step towards ensuring violence against healthcare workers is not tolerated. The MHA continues to work on more opportunities to protect healthcare workers from violence in the workplace and improving the recruitment, retention and training of healthcare workers.

Members with questions about ordering workplace posters may contact John Karasinski at the MHA. Members with questions about the new laws and legislative activity should contact Adam Carlson or Elizabeth Kutter at the MHA. Members interested in learning more about AMN Language Services should contact Eric Glaser, regional sales director.

New Physician Recruiting Incentives Report

AMN Healthcare’s Physician Solutions division (formerly known as Merritt Hawkins) has released its Review of Physician and Advanced Practitioner Recruiting Incentives annually for the last 30 years.

Cited every year by Modern Healthcare and many other publications, the Review offers benchmark data and analysis used by hospitals, medical groups and other organizations to determine which physician and advanced practitioner (AP) recruiting incentives are customary and competitive.

The recently released 2023 Review continues to be the most comprehensive source of data regarding physician and AP starting salaries, signing bonuses, production bonuses and related recruiting incentives in the industry. It also offers an in-depth analysis of the latest trends driving physician supply and demand, recruitment and retention.

Some key findings from the 2023 Review are:

  • 64% of AMN Healthcare’s search engagements this year were for physician specialists.
  • Average starting salary offers made to specialists were generally up year-over-year.
  • Nurse practitioners topped the list of AMN Healthcare’s most requested search engagements for the third consecutive year.

MHA Members interested in obtaining a copy of the complete report may reach out to Ben Jones at AMN Healthcare.