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.

Michigan Hospitals Fill 61,000 Jobs in 2023

Healthcare Remains the Largest
Private-Sector Employer in Michigan

The Michigan Health & Hospital Association (MHA) published results from their second annual Michigan hospital workforce survey that shows hospital recruitment, retention and training efforts in 2023 helped fill 61,000 total positions in 2023, reducing job vacancies by 29% to a total of 19,000 statewide. More than 13,000 nurses were hired during that time, decreasing the number of nursing vacancies by 44%. The survey includes responses from more than 95% of all Michigan acute-care inpatient hospitals.

Nearly all job categories in the survey experienced double-digit percentage decreases in vacancies year-over-year. Hospitals successfully reduced vacancies in the following job categories:

  • Nursing – 44% decrease
  • Operations – 43% decrease
  • Behavioral health – 42% decrease
  • Administration – 34% decrease
  • Clinical assistants – 28% decrease
  • Pharmacists – 26% decrease
  • Technicians – 25% decrease

Bar graph of decline in hospital job vacancy by category.

Amidst a national nursing shortage, the results show Michigan hospitals are outperforming national nurse retention rates. The registered nurse (RN) turnover rate for Michigan hospitals is 3.7 percentage points lower than the national average of 18.4%. Examples of how Michigan hospitals are retaining and recruiting nurses include offering better and faster pay, improved benefits and employee support, and expanding educational opportunities for students to consider a nursing career. State funding obtained through Public Act 9 of 2022 and Public Act 5 of 2023 contributed to these efforts and have directly benefitted at least 69,000 healthcare workers.

To complement the efforts of individual hospitals, the MHA launched the statewide MI Hospital Careers public awareness campaign in 2023 targeting students and professionals considering a career change to express the value of healthcare careers. The MHA also engaged in efforts that ultimately led to four-year Bachelor of Science in Nursing programs at community colleges, expansion of the Michigan Reconnect program to allow funds to support Michiganders accessing healthcare credentials for technician and nursing careers, and new state law that increases the penalties for individuals who commit acts of violence against healthcare workers.

Michigan hospitals remain focused on solutions that build the healthcare workforce that patients need now, and in the future, to fill the remaining 19,000 open hospital positions, including 4,700 in nursing.

These efforts will strengthen healthcare in Michigan, which remains the state’s largest employer of direct, private-sector jobs according to 2024 Economic Impact of Healthcare in Michigan data. More than one million jobs in Michigan were directly or indirectly related to or induced by healthcare in fiscal year 2022, the most recent data available. Hospitals collectively employ 217,000 full- and part-time employees, remaining one of the largest employers in many Michigan communities. In addition, direct healthcare workers in Michigan earned nearly $47 billion in wages, salaries and benefits.

“Retaining and growing the workforce is a top priority shared by hospitals throughout the state,” said Michigan Health & Hospital Association CEO Brian Peters. “We’re extremely encouraged by the data demonstrating the success of hospitals over the past year in increasing the talent pipeline to care for patients and strengthening the healthcare workforce. Hospitals provide Michigan communities with good jobs that help drive our state’s economy and keep residents healthy.”

The 19th edition of The Economic Impact of Healthcare in Michigan was compiled using IMPLAN® cloud software to quantify healthcare’s significant economic impact in the state. The data represents direct, indirect[1] and induced[2] 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. It is available at www.economicimpact.org.

[1] Indirect jobs are those created to support a larger employer or industry (for example, a laundry that cleans linens for a hospital).

[2] Induced jobs are those created by the spending of people who work in the indirect jobs (for example, a restaurant waiter who serves the laundry workers).