Signed Legislation Supports Hospital Workforce

Gov. Whitmer signed House Bill 4016 today, appropriating $75 million for the recruitment, retention and training of hospitals workers. This funding will directly benefit hospital workers and play an important role in helping to support hospitals experiencing a generational workforce shortage.

According to a recent survey of hospitals conducted by the MHA, there are more than 27,000 job openings in hospitals throughout Michigan, including nearly 8,500 nursing job opportunities. Other areas with a high need include technicians with more than 4,500 job openings, clinical assistants with 3,000 openings and 1,700 openings for operational support in areas such as environmental services and food service.

Hospital staffing levels determine patient capacity within facilities. Michigan has lost a high of about 1,700 staffed hospital beds since 2020 because of workforce shortages. Filling these job openings would increase statewide inpatient hospital capacity, expand service availability and assist in the transition of care outside of a hospital.

“Maintaining the sustainability of our healthcare workforce is a universal priority for all Michigan hospitals and health systems,” said MHA CEO Brian Peters. “We appreciate the work from the Michigan Legislature and Gov. Whitmer in passing this funding that will support hospital workers and help solve staffing shortages that persist throughout healthcare.”

House Bill 4016 was introduced by Rep. Angela Witwer (D-Delta Township) and passed the Michigan Senate Feb. 28 and the Michigan House of Representatives March 1 with bipartisan support.

Those interested in a healthcare career should visit the careers webpage of their local hospital or health system.

MHA and Rural Members Advocate on Capitol Hill

Rural hospital leaders at NRHA Rural Health Insitute event in Washington D.C.

The MHA and rural hospital leaders visited Capitol Hill in Washington D.C. Feb. 7-9 to advocate for specific rural healthcare policies as part of the National Rural Health Association’s (NRHA) Rural Health Policy Institute event.

During the trip, the MHA and members met with Michigan’s congressional delegation and staff to discuss rural health issues facing Michigan hospitals. Topics included protection of the 340B drug pricing program, the new Rural Emergency Hospital (REH) designation, rural workforce shortages and reimbursement issues. Also participating in the visit were representatives from the Michigan Center for Rural Health.

Members with questions should contact Lauren LaPine at the MHA.

MHA Monday Report Dec. 19, 2022

MHA Monday Report

Michigan legislation modernized the scope of practice for certified registered nurse anesthetists (CRNAs) in 2022, eliminating the state requirement that a CRNA must work under direct physician supervision. CRNAs enhance the ability to deliver care in a multitude of scenarios, particularly in rural areas where anesthesia services may be limited. …

Webinar Series Reviews Critical Access Hospitals CMS CoPs Requirements

Critical access hospitals (CAHs) that accept Medicare and Medicaid payments must follow the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs). The CMS Critical Access Hospital Manual has seen multiple changes to regulations and interpretive guidelines. …

Latest AHA Trustee Insights Outlines Multitiered Governance Structures

The latest edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), is now available. The Dec. issue includes an article noting the uptick in hospital and health system mergers and affiliations and defining expectations for board members in a multitiered governance system. …

The Keckley Report

Paul KeckleyMedPAC Needs to Revisit its Analysis

“At its December 8-9 meeting, MedPAC considered future funding for hospitals and physicians along with other sectors in healthcare. The 17-member commission will vote on its recommendations at its meeting January 12-13 after staff makes some changes based on commissioner feedback and then submit its official recommendations to Congress in March for FY2024…

The lag indicators used by MedPAC to evaluate Medicare utilization and payments for physician and hospital services are accurate. However, they’re of decreasing relevance to the future of Medicare’s formula for paying providers.”

Paul Keckley, Dec. 12, 2022

News to Know

Due to the holidays, Monday Report will not be published Dec. 26 and Jan. 3. Monday Report will resume its normal schedule Jan. 9. Member alerts and MHA newsroom articles will continue to be published during that time to provide relevant updates to the MHA membership, as necessary.

MHA EVP Laura Appel speaks with WOOD TV8.MHA in the News

WOOD TV8 published a story Dec. 12 on the passage of Senate Bill (SB) 183, which includes language allowing rural emergency hospital (REH) licensure in Michigan. The bill passed Dec. 6 with overwhelming support in both the State House and Senate following collaboration between the MHA, the Michigan Department of Health and Human Services, the Michigan Department of Licensing and Regulatory Affairs and the Whitmer administration on making the necessary changes in state statute to allow for the new federal designation. …

MHA Monday Report Dec. 12, 2022

MHA Monday Report

capitol building2022 Legislative Session Adjourns

The Legislature took their final votes for the 2021-2022 legislative session during the week of Dec. 5. Given the results of the election, very few bills passed during the legislative lame-duck session compared to a typical year. …

Media Join Hospital Viability Press Conference

The MHA conducted a virtual press conference Dec. 6 to discuss the economic and staffing challenges impacting hospitals across the state to generate awareness with lawmakers of these issues and the potential impact on access to timely, high-quality healthcare for Michiganders. …

MHA and Michigan hospital representatives pictured with Rep. John Moolenaar (R-Midland).

MHA Visits Capitol Hill with Member Hospitals for AHA Advocacy Day

The MHA visited Capitol Hill in Washington DC last week to emphasize year-end priorities to Michigan’s congressional delegation. The MHA and several hospital representatives met with House members and with U.S. Senator Debbie Stabenow to deliver the message that pending Medicare cuts are unsustainable and unacceptable. …

Rural Emergency Hospital Legislation Passed in Michigan

On Dec. 6th, the legislation needed for hospitals to begin converting to Rural Emergency Hospitals (REH) in Michigan was sent to the Governor’s desk for final approval. Due to the limited session days left, the language to allow for REH licensure in Michigan were officially included in Senate Bill (SB) 183. …

CMS Issues Proposal to Modify the Prior Authorization Process

The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule to modify the prior authorization process for certain payers. The proposal would require payers to: Include a specific reason when denying a request. Publicly report certain prior authorization metrics. …

MHA Workforce Webinar to Discuss Diverse Workforce Solutions

Understanding the workforce’s values, preferences, triggers and character traits is essential to developing relationships that create a healthy organization. This may sound basic, but many organizations continue to miss the mark. …

Keckley Report 

Paul KeckleyThe Transitioning of US Healthcare from A Virtuous to Vicious Cycle

“U.S. healthcare has moved into a vicious cycle marked by intensified competition and noticeable acrimony between major players. Growing tension between major health insurers and health systems is illustrative.

Virtuosity to insurers is predicated on the core belief that keeping providers honest and care affordable and their domain; its vicious pursuit is to attribute unsustainable health costs to hospital inefficiency and price gauging.

The virtuous cycle for hospitals is premised on community health and provision of services to those unable to pay; the vicious cycle is the unwelcome intrusion of insurers and private investors who put profit above all else by paying them less so they can keep more. …”

Paul Keckley, Dec. 5, 2022

News to Know

Medtel was approved for associate membership in Nov. 2022. Medtel was founded in 2016 with a mission to improve surgical care experiences and outcomes for patients and providers by developing and delivering technology solutions. …

Brian PetersMHA in the News

The MHA received media coverage the week of Dec. 5 following a virtual press conference Dec. 6 on the financial and staffing challenges impacting hospital viability, as well as topics including hospital capital improvements, mergers and acquisitions and respiratory illness hospital admissions driven by RSV and COVID-19. …

Media Join Hospital Viability Press Conference

Dec. 6 Teleconference Speakers
Dec. 6 virtual press conference speakers.

The MHA conducted a virtual press conference Dec. 6 to discuss the economic and staffing challenges impacting hospitals across the state to generate awareness with lawmakers of these issues and the potential impact on access to timely, high-quality healthcare for Michiganders.

The event occurred while children’s hospitals continue to operate near capacity levels as they continue to care for a surge of children suffering from respiratory illnesses amid staffing shortages. Speakers also referenced how the loss of 1,700 staffed adult inpatient hospital beds across the state has led to longer wait times in the emergency department, reduced services and more difficulty transferring patients. Lastly, the point was made that no other industry is prevented from responding to inflationary pressures and growing expenses to the degree that healthcare is.

Speakers included:

  • T. Anthony Denton, senior vice president and chief operating officer, University of Michigan Health System.
  • JJ Hodshire, president and chief executive officer, Hillsdale Hospital.
  • Dan Hurley, chief executive officer, Michigan Association of State Universities.
  • Brian Peters, chief executive officer, Michigan Health & Hospital Association.
  • Susan Smith, executive director, Economic Development Partnership of Hillsdale County.
  • Rudolph P. Valentini, chief medical officer at Children’s Hospital of Michigan, group chief medical officer at Detroit Medical Center.

Over a dozen media outlets from across the state joined the call, with stories published from Bridge Michigan, The Detroit News, Gongwer, MIRS, Michigan Business Network, MLive, SBGTV and WXYZ.

Following the press conference, a press release was also distributed to statewide media.

Members with questions related to media should be directed to John Karasinski at the MHA.

Michiganders Need Continued Access to High-quality, Timely Healthcare

Michigan’s hospitals are facing a funding crisis, putting communities and families across the state at risk of losing access to high-quality, timely healthcare. Health systems, business and university leaders are urging policymakers to address the crisis to avoid further reduction of available beds and access to care and healthcare services.

Michigan has lost a high of 1,700 staffed hospital beds since 2020 due to lack of staffing. This creates a cascade of problems, from longer wait times in the emergency department, reduced services, particularly in rural areas, and more difficulty transferring patients to the appropriate care setting. Respiratory illnesses are also surging, making problems worse.

T. Anthony Denton

“Recently, we have seen a surge in cases of respiratory syncytial virus (RSV), flu and COVID. This puts an additional pressure on emergency departments and our already-strained inpatient bed capacity across Michigan, impacting care statewide. Without funding to address staffing shortages, we run the risk of compromising our ability to provide the same level of exceptional care that we’re accustomed to across the state,” said T. Anthony Denton, senior vice president and chief operating officer, University of Michigan Health System and Michigan Health & Hospital Association board chair.

A 2021 Washington Post-Kaiser Family Foundation survey found that nearly 30% of healthcare workers are considering leaving their profession altogether. The U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses nationwide by 2030, the Association of American Medical Colleges estimates two out of every five active physicians nationwide will be 65 or older within the next 10 years, and the nation 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 overall health and prosperity of Michigan is inextricably tied to the state’s investment in its healthcare and higher education enterprises,” said Daniel Hurley, CEO of the Michigan Association of State Universities. “Michigan’s public universities, together with our hospital and other healthcare partners, look forward to working with state leaders to ensure a future healthcare workforce that is capable of providing the highest levels of quality care for all Michiganders.”

The healthcare workforce shortage — combined with an aging population, a rise in chronic diseases and behavioral health conditions and advancements in medical care delivery — all contribute to an immediate need for resources that will allow hospitals to continue to provide the care residents need and deserve.

Despite staffing losses attributed to the COVID-19 pandemic, healthcare directly employed nearly 572,000 Michigan residents in 2020, continuing to make it the largest private-sector employer in the state. The 2022 Economic Impact of Healthcare in Michigan report found that direct healthcare workers in Michigan earned $44.2 billion in wages, salaries and benefits, with indirect, healthcare-supported workers earning about $28 billion wages, salaries and benefits.

“With healthcare being the largest private-sector employer, a healthy Michigan economy is directly linked to a properly funded healthcare system,” said Susan Smith, executive director, Economic Development Partnership of Hillsdale County. “Without access to healthcare services to support our communities, ranging from obstetrical units to trauma centers, we cannot remain economically competitive, attract or retain talent, or support placemaking for young families and care for everyone at all stages of life.”

Michigan officials have made recent short-term investments to address the hospital staffing crisis, but additional funding remains unappropriated that if used as intended, can improve hospital capacity and service lines. Michigan also needs a long-term funding solution to address stagnant reimbursement that has yet to respond to inflationary pressures to improve the retention of existing healthcare workers and recruit future workers to ensure that residents continue to have access to healthcare services.

Learn how you can help your local hospital or health system by visiting

Additional quotes:

JJ Hodshire

“Hospitals have an immediate need for resources to continue to provide the services residents need and deserve – like ambulances available for lifesaving care,” said JJ Hodshire, president and chief executive officer, Hillsdale Hospital. “As a rural hospital, we excel at being innovative to make the best use of our resources, particularly staff. However, we can only stretch resources for so long. Everyone can agree that access to lifesaving emergency medical care is a basic need for Michiganders and residents should be able to receive specialized care no matter where they live.”

“My colleagues in pediatric units across the state have spent the past month responding to one of the worst respiratory illness surges I can remember as a physician and the biggest challenge to our ability to care for more children was our lack of available staff,” said Dr. Rudolph P. Valentini, chief medical officer, Children’s Hospital of Michigan and group chief medical offer at Detroit Medical Center. “We can’t afford to have another surge of sick, hospitalized children before something is done to improve the health of our hospitals and health systems.”

Brian Peters

“Michigan residents deserve quality, accessible healthcare services and without hospital resources to adequately provide that care, Michigan hospitals have and will continue to face difficult decisions about what services they can offer,” said Brian Peters, chief executive officer, Michigan Health & Hospital Association.

Webinar Dispels Misinformation About Unionization and Outline Legal Guidelines

Healthcare workforce shortages, particularly nursing shortages, are severely hindering the ability to provide patient-centered care. Unionizing to negotiate for policies like staffing ratios is popular but does not consider the complexity of significant workforce shortages. As healthcare leaders face an environment where clinicians are experiencing burnout, leaders must understand collaboration strategies that improve organizational stability and patient outcomes.

The Dispelling Misinformation About Unionization and Legal Guidelines webinar will outline several topics related to the healthcare workforce and unionization. Topics will include how recent dynamics such as the COVID-19 crisis and worker shortages have increased the healthcare industry’s vulnerability to union organizing, current trends and tactics unions use to recruit healthcare employees, evolving rules from the National Relations Labor Board, including those applicable to social media, and other tips and guidelines for leaders responding to a union or other protected concerted activity.

The webinar is scheduled for 8:30 a.m. ET Nov. 11. Sponsored by the MHA Service Corporation Unemployment Compensation Program and Miller Johnson, it is offered free of charge. Human resource executives and professionals and chief nurse executives are encouraged to register.

Members with questions should contact Erin Steward at the MHA.


Peters Speaks to Lansing Rotary on Past, Present and Future of Healthcare

Peters speaks to Lansing Rotarians at weekly meeting.

MHA CEO Brian Peters presented as the keynote speaker at the Rotary Club of Lansing’s weekly meeting May 13, discussing the MHA’s work supporting hospitals and healthcare systems across the full care continuum.

During his presentation, Peters kept his focus on the current workforce shortages Michigan’s hospitals have been facing. “The healthcare workforce staffing shortages existed before COVID-19 but have worsened and are expected to continue beyond this pandemic. Our hospitals must remain ready for and responsive to patients affected by COVID-19 as well as other patients who need urgent and life-saving care outside of COVID-19,” said Peters.

Peters also discussed the election forecast for the year ahead and what implications the midterm election will have on the healthcare community. To learn more about these issues facing healthcare, visit the MHA’s Workforce Sustainability and Elections pages.

Trustee Insights Edition Highlights Workforce Trends

The latest edition of Trustee Insights, the monthly digital package from the American Hospital Association (AHA), is now available. This month’s issue includes a report on the latest forces and trends affecting healthcare human resources, including education, training and the evolving practice landscape, growing the workforce to keep pace with demand, and the effects of the pandemic on the workforce.

In addition, the newsletter features tips for new CEOs on how to establish and nurture an effective strategic partnership with the board.

The expanded website and enhanced monthly e-newsletter of Trustee Insights are available through the AHA Trustee Services webpage. They are free, do not require AHA membership and include articles, tools and webinars. Those interested in subscribing to AHA Trustee Insights may do so online.

For information about MHA trustee resources, contact Erin Steward at the MHA.

Headline Roundup: Week of Sept. 20 for COVID-19 in Michigan

Mackinac Policy Conference Peters and Mitchell

MHA CEO Brian Peters and MHA EVP Chris Mitchell speak with Crain's Detroit Business at the Mackinac Policy Conference.The MHA has been actively fielding and responding to media requests related to the growth in COVID-19 cases and hospitalizations, as well as statewide healthcare workforce shortage. Also included is coverage of Blue Cross Blue Shield of Michigan (BCBSM)’s $5 million commitment through 2024 to expand the MHA Keystone Center’s quality and safety improvement programs.

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

Sunday, Sept. 26

Friday, Sept. 24

Wednesday, Sept. 22

Tuesday, Sept. 21

Members with questions on COVID-19 efforts and resources should contact Ruthanne Sudderth, and any questions regarding media requests should be directed to John Karasinski at the MHA.