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 CEO Report — The State of Healthcare

“Mankind’s greatest achievements have come about by talking, and its greatest failures by not talking. It doesn’t have to be like this. Our greatest hopes could become reality in the future. With the technology at our disposal, the possibilities are unbounded. All we need to do is make sure we keep talking.”
Stephen Hawking

The new year always brings two traditional speeches from lawmakers: Gov. Whitmer just recently delivered her annual State of the State address, while President Biden will share the annual State of the Union address on March 7. While the economy, housing, education, border security, climate change and other important issues are featured in these speeches, the reality is that healthcare remains a top concern for millions of Americans, and therefore will continue to be front and center for elected officials and candidates at the state and federal level throughout this election year.

The bottom line is that the fragility of the healthcare continuum was exposed during the pandemic and four years later, the aftershocks can still be felt. Let’s touch on just a few issues that dictate the state of healthcare in 2024:

Healthcare Workforce

Michigan hospitals employ roughly 219,000 people and are desperately trying to hire thousands more in every corner of the state. A survey we conducted last year showed there were over 27,000 job openings in Michigan hospitals. Hospitals are often the largest employer in their respective communities and serve as critical economic engines. It takes longer to deliver care when hospitals don’t have enough staff, impacting the experience of patients and families.

Much like other industries in Michigan, healthcare has a supply and demand issue, but we feel it in a uniquely acute manner: the aging population not only contributes to an exodus of talent from the field, but it increases demand for healthcare services at the same time. And because we are classic “price-takers” when it comes to a huge share of our business (i.e. Medicare and Medicaid tell us what they are going to pay), our ability to pass rising labor (and supply chain) costs along to consumers is extraordinarily limited. The financial performance of hospitals across the state and country has been negatively impacted as a direct result, and it fuels our advocacy efforts related to our ongoing viability.

Healthcare needs to continue to refill the talent pipeline and we’re making progress on these efforts. From the MI Hospital Careers campaign to the individual partnerships created between health system and secondary-education institutions, the effort is being made to increase the supply of future professionals. I’m encouraged to hear Gov. Whitmer’s proposal for tuition-free community college for all Michiganders who graduate from a Michigan high school. We have been active in advocating for such a policy to improve the number of students pursuing these pathways to address the nursing shortage.

Behavioral Health

Behavioral healthcare in Michigan continues to be in crisis. We need to fund, support and reform our systems to better meet the behavioral healthcare needs of our communities.  Responding to MHA advocacy, the Michigan Legislature provided $50 million in grant funding last year to increase access to pediatric inpatient behavioral health services. We are encouraged by what our member hospitals have planned to improve access, but more needs to be done. This will be a focus area for us in Lansing through the rest of the year, specifically looking at solutions that include continuing to expand care locations, clarifying insurance coverage policies and increasing the number of providers.

Prescription Drug Affordability

Increasing prescription drug costs are a key driver of escalating healthcare costs. These increased costs are not just experienced by patients at their local pharmacies, but hospitals are also large purchasers of prescription drugs and are experiencing the same costs, threatening their viability. Data shows drug costs rose by 36.9% from 2019 to 2021 and currently account for the largest portion of healthcare insurance premiums, costing 22.2 cents for every dollar.

With these dramatic cost increases, the 340B drug pricing program has never been more important. This critical program allows safety net hospitals and other community care organizations to access certain outpatient prescription drugs at discounted prices. It does not require any state taxpayer dollars and has contributed to supporting access to care to Michigan’s most vulnerable patients for more than 30 years. We’re hopeful to see legislation passed to protect these hospitals and the benefits they provide, such as supporting OB services, financial assistance programs for low-income patients or lowering the cost of prescription drugs.

Emerging Technology and AI

Technology continues to provide many opportunities and growth for healthcare. It can serve as a “force-multiplier” that allows our staff to work smarter, extending their impact. If used correctly, technology can improve the patient experience, care delivery, worker satisfaction and more. We’re already seeing it with the dramatic growth in the utilization of telehealth and the emergence of artificial intelligence (AI) applications throughout healthcare. Technology can help expand access to care for many of our rural or disadvantaged residents who are confronted with a variety of social barriers.

We’re seeing great innovation when it comes to technology and I expect even more in the years ahead. The “disruptors,” that is to say, the large, global companies known for their technological innovation (and deep financial resources) are increasingly turning their attention toward the $4 trillion American healthcare market. These entities could be viewed as a potential threat to traditional healthcare providers, payors and others in the health ecosystem – but could also be viewed as potential collaborators and strategic partners. Without a doubt, the future delivery and financing model will be shaped in some way by this development.

At the same time, the rise of sophisticated technology and the inter-connectedness between healthcare entities, their patients and the rest of the world gives rise to the specter of cybercrime. This topic is worthy of its own special focus (stay tuned for more on that in the months ahead), but for now, let me just point to the fact that the MHA was proud to be ahead of the game in this regard, helping to launch our own healthcare-focused cybersecurity operations center right here in Michigan with MHA Endorsed Business Partner CyberForceQ.

These are just a few of the countless, complex issues that will impact Michigan healthcare in the year ahead. Plenty to be concerned about, for sure. But I remain fundamentally optimistic and hopeful about the future. Our healthcare workers are committed and resilient. And our policymakers continue to acknowledge the dependent relationship their communities have with healthcare. While I know better than to predict much of anything in an election year, I feel confident in predicting healthcare will continue to help make Michigan a better place, no matter what the political winds bring our way. All we need to do is continue our most human connection – let’s keep talking with each other and craft a positive future together.

As always, I welcome your thoughts.

Michigan Voters, Healthcare and Business Leaders Agree: One-Size-Fits-All Ratios Will Harm Patients

Michigan coalition opposing mandated nurse staffing ratios.

A diverse coalition of healthcare, business and advocacy organizations published a letter to members of the Michigan Legislature today opposing the proposed House Bills 4550-4552 and Senate Bills 334-336, which threaten to put patient care at risk across Michigan.

“These partners from a broad collection of industries all agree imposing a one-size-fits-all legislative mandate to hospital nurse staffing will harm patients and severely restrict access to care in Michigan communities,” said Brian Peters, CEO of the Michigan Health & Hospital Association. “Our nurses, patients and communities deserve more than political posturing that puts healthcare access at risk.”

The proposed bills would mandate one-size-fits-all nurse staffing ratios for all Michigan hospitals, which would not solve existing staffing shortages, as evidenced in other states that have tried this policy. In California, which has had legislatively mandated staffing ratios for over two decades, the state still faces a shortage of 40,000 RNs. Additionally, Michigan outperforms California in hospital quality, as Michigan has both a higher percentage of 4- and 5-star hospitals than California (49% to 35.3%) and a lower percentage of 1- and 2-star hospitals (18.4% to 38.7%), according to CMS Care Compare Hospital Overall Star Ratings.

The United States is facing a national nurse shortage issue, exacerbated by the aging nursing workforce, as many experienced nurses approach retirement. Currently, 32.3% of licensed RNs in Michigan are 55 years of age or older and nearly 8,500 open nursing positions exist statewide. A survey of 109 Michigan hospitals conducted in July 2023 shows Michigan is at risk of losing up to 5,100 hospital beds across the state if this legislation is implemented. This total represents 23% of Michigan’s overall statewide hospital bed capacity and is equivalent to closing all hospitals north of Grand Rapids and Flint.

The coalition emphasizes that mandatory nurse staffing ratios have a broader impact beyond hospitals alone, affecting all healthcare providers’ ability to hire nurses. With a finite pool of available RNs, nursing homes, rehabilitation facilities, physician practices and other healthcare settings will experience increased difficulty in recruiting and hiring nurses, especially as hospitals compete for the same talent pool.

“The entire healthcare sector is facing historic workforce shortages,” said Melissa Samuel, Health Care Association of Michigan President/CEO. “We all need more nurses. Unfortunately, these bills exacerbate the problem and fail to offer meaningful solutions.”

The potential impact to the business community is significant. Data collected from hospitals indicates the proposed ratios could increase healthcare costs by over $1 billion, impacting economic development and employers.

Recent EPIC-MRA polling of Michigan voters indicates that 82% do not believe the government should mandate one-size-fits-all nurse-to-patient staffing ratios in every hospital, and if the bills were to become law, 83% of Michigan voters would be concerned about their ability to receive care, or the wait times, in a Michigan hospital emergency room.

The coalition supports the following alternative solutions to address the nurse staffing shortages:

  1. Join the Nurse Licensure Compact: Bring Michigan into the national Nurse Licensure Compact to reduce barriers for out-of-state nurses to practice in Michigan immediately, joining 41 other jurisdictions across the country.
  2. Expand Michigan Reconnect Eligibility: Lower the age requirement to 18 and older, encouraging more individuals to pursue nursing careers.
  3. Funding Innovative Approaches to Workplace Violence Prevention in Healthcare Settings: This complements the passage of House Bills 4520 and 4521 that increase penalties for violence committed against healthcare workers and would make the nursing profession more attractive by addressing safety concerns.

To date, Michigan hospitals, health systems and other healthcare providers have focused on addressing staffing shortages by implementing various measures, including increased compensation, partnerships with post-secondary education institutions, emotional well-being support, modernizing scope of practice rules and recruitment awareness campaigns such as MI Hospital Careers.

The coalition includes the following organizations, and joins nursing organizations such as the American Nurses Association – Michigan and Michigan Organization for Nursing Leadership in opposing legislatively mandated nurse staffing ratios:

  • Business Leaders for Michigan
  • Community Mental Health Association of Michigan
  • Detroit Regional Chamber
  • Grand Rapids Chamber
  • Health Care Association of Michigan
  • Michigan Ambulatory Surgery Association
  • Michigan Association of Ambulance Services
  • Michigan Association of Colleges of Nursing
  • Michigan Association of Health Plans
  • Michigan Chamber of Commerce
  • Michigan College of Emergency Physicians
  • Michigan County Medical Care Facilities Council
  • Michigan Health & Hospital Association
  • Michigan HomeCare & Hospice Association
  • Michigan Manufacturers Association
  • Michigan Osteopathic Association
  • Small Business Association of Michigan
  • Traverse Connect

To learn more about the impact of the proposed legislation on care in Michigan, visit www.mha.org/issues-advocacy/key-issues/nurse-staffing-ratios.

MHA Monday Report June 19, 2023

MHA Monday Report

MHA Members Testify in House Judiciary Committee

Several MHA members testified June 13 to the House Judiciary Committee in support of legislation that would increase the fines for assaulting a healthcare professional or volunteer. House Bills 4520 and 4521 were introduced …


MI Hospital Careers Campaign LogoMHA Launches MI Hospital Careers Healthcare Career Campaign

Michigan hospital and education leaders joined forces June 8 to highlight the current state of Michigan’s healthcare workforce shortage and launch a campaign to expand interest in health careers in Michigan. The goal of the …


Webinar Reviews Medicare FFS Quality-based Programs

The MHA and Data Gen hosted June 14 the second webinar focused on the Medicare fee-for-service (FFS) quality-based programs to review the Medicare readmissions reduction program and hospital-acquired conditions reduction programs. The Medicare …


MDHHS Informs Hospitals on Medicare Crossover Files Issue

The Michigan Department of Health and Human Services (MDHHS) recently notified hospitals about an issue with the Medicare crossover files from the Centers for Medicare & Medicaid Services (CMS) that impacts CMS files from May …


New Pediatric Specialty Loan Repayment Program

The Department of Health and Human Services launched a $15 million loan repayment program to recruit and retain clinicians who provide healthcare to children and adolescents. The Pediatric Specialty Loan Repayment Program aims to …


MDHHS Releases REH Medicaid Reimbursement Final Policy

The Michigan Department of Health and Human Services (MDHHS) recently released a final policy to establish Medicaid reimbursement for rural emergency hospitals (REHs) effective Jan. 1, 2023. The MDHHS reimburses REHs based on the existing …


Preceptor Training Available Through HRSA Grant

Michigan nurses have an opportunity to participate in preceptor training as part of a Health Resources and Services Administration (HRSA) Nurse Education, Practice, Quality and Retention Clinical Faculty and Preceptor Academy grant awarded to Southern …


2023 Ludwig Nominee: Trinity Health Coalition Working to Prevent Youth Suicide

Since 1990, the MHA has honored member healthcare organizations working to enrich the overall welfare of their local communities through the Ludwig Community Benefit Award. This year, the MHA is excited to showcase all award nominees, …


The Keckley Report

Paul KeckleySenate Finance Hearing on Hospital Consolidation: Political Theatre or Something More?

“Congress’ concern about consolidation in healthcare is broad-based. Pharmacy benefits managers and health insurers face similar scrutiny. Drug price control referenda have passed in several states and a federal cap was included in the Inflation Reduction Act. The reality is this: the entire U.S. health system is on trial in the court of public opinion for ‘careless disregard for affordability’. And hospitals are seen as part of the problem justifying consolidation as a defense mechanism. …

Sadly, this hearing is the latest evidence that the good will built by hospital heroics in the pandemic is now forgotten. It’s clear hospital consolidation is an issue that faces strong and increased headwinds with evidence mounting—accurate or not– showing more harm than good. …“

Paul Keckley, June 12, 2023


 

News to Know

  • MHA offices will be closed and no formal meetings will be scheduled June 19 in honor of Juneteenth.
  • MHA Endorsed Business Partner Medical Solutions’ Chief Nursing Officer, Patti Artley recently spoke with Becker’s Hospital Review to offer expert insight into the complex challenges facing nurses today and the proven strategies healthcare leaders must adopt to initiate lasting change.
  • Medicare prospective payment system hospitals are reminded that the completed 2022 occupational mix survey is due to the Medicare Administrative Contractor on June 30, 2023.

Sam WatsonMHA in the News

The MHA received media coverage the week of June 12 regarding prescription drug costs, COVID-19 and behavioral health. MHA representatives appearing in published stories include CEO Brian Peters, Senior Vice President Sam Watson and Senior …

MHA Launches MI Hospital Careers Healthcare Career Campaign

MI Hospital Careers Campaign Logo

MI Hospital Careers Campaign LogoMichigan hospital and education leaders joined forces June 8 to highlight the current state of Michigan’s healthcare workforce shortage and launch a campaign to expand interest in health careers in Michigan. The goal of the new Mi Hospital Careers campaign aims to ensure students in high school and college know about those opportunities, as well as working professionals looking for a rewarding career. Without addressing the existing healthcare workforce shortage, Michigan residents risk losing access to quality, accessible healthcare services within their local community.

Member hospitals and health systems, as well as other stakeholders, are encouraged to use the Partner Toolkit on the campaign website to help raise awareness about the benefits of working in healthcare and about the range of career pathways and training/education/financial support mechanisms available.

While many are aware of the shortage of physicians and nurses, high demand exists for non-clinical roles as well, with more than 27,000 total open positions at hospitals across the state. Within the next five years, the U.S. faces a projected shortage of more than 3.2 million lower-wage healthcare workers such as medical assistants, home health aides and nursing assistants, according to a Mercer report.

The campaign launched Monday, June 12. Residents can visit mihospitalcareers.com where they can learn more about the career paths available in healthcare and the different training programs and scholarships available across Michigan.

The MHA received media coverage from outlets including Crain’s Grand Rapids, Michigan Advance, Becker’s Hospital Review, Detroit Free Press, The Detroit News, Lansing City Pulse, WOOD TV, WNEM-TV, WILX News 10, WJR Newsradio 760, Gongwer, MIRS and HealthLeaders Media.

Members with questions may contact Ruthanne Sudderth at the MHA.