/ en Mon, 28 Apr 2025 21:10:58 -0500 Mon, 28 Apr 25 15:04:37 -0500 /resources/2016-04-12-verification-graduate-medical-education <p>Over time, hospitals and their medical staff services offices have developed unique forms to verify resident training for credentialing as required for hospital accreditation. To help streamline and standardize the residency verification process and meet hospital credentialing needs, the AHA, in partnership with other national organizations, has developed templates to provide the necessary information to meet credentialing needs while reducing the need for program directors to complete multiple requests for information.</p> Tue, 12 Apr 2016 00:00:00 -0500 Workforce /guidesreports/2025-04-28-2024-costs-caring <div class="container"><div class="row"><div class="col-md-8"><h2><span>Introduction</span></h2><p><img src="/sites/default/files/inline-images/Figure-1-Labor-constitutes-largest-percentage-of-hospital-expenses.png" data-entity-uuid="d6c1793f-d4c3-44ea-8ba5-d1f15b6518e2" data-entity-type="file" alt="Figure 1. Labor constitutes largest percentage of hospital expenses. Labor: 60% ($839 Billion); Supplies: 13% ($181 Billion); Drugs: 8% ($115 Billion); Other: 19% ($269 Billion). Note: Average expenses estimated by Strata Decision Technology median 2023 values across all hospital spending. Labor is inclusive of purchased services and professional fees." width="718" height="752" id="figure1" class="align-right">Hospitals and health systems have been at the forefront of a major transformation while at a crossroads of increasing demand for higher acuity care and deepening financial instability. Persistent workforce shortages, severe fractures in the supply chain for drugs and supplies, and high levels of inflation have collectively fueled hospitals’ costs as they care for patients 24/7 (see <a href="#figure1">Figure 1</a>). At the same time, hospitals’ costs have been met with inadequate increases in reimbursement by government payers and increasing administrative burden due to inappropriate commercial health insurer practices.</p><p><strong>Taken together, these issues have created an environment of financial uncertainty where many hospitals and health systems are operating with little to no margin. While recent data suggest that some hospital and health system finances have experienced modest stabilization from historic lows in 2022, the hospital field is still far from where it needs to be to meet the demand for care, invest in new and promising technologies and interventions, and stand ready for the next health care crisis.</strong></p><p><img src="/sites/default/files/inline-images/Figure-2-Inflation-growth-was-more-than-double-the-growth-in-IPPS-reimbursement-2021-2023.png" data-entity-uuid="90ce5355-e63a-4187-bfae-5a641d891486" data-entity-type="file" alt="Figure 2. Inflation growth was more than double the growth in IPPS reimbursement, 2021–2023. Inflation: 12.4%; IPPS Increases: 5.2%. Note: Inflation calculated using annual average CPI-U between 2021 and 2023 from BLS. IPPS increase from FY2020–2023 market basket increases net of other adjustments." width="385" height="705" id="figure2" class="align-left">Fresh off a historically challenging year financially in 2022 in which over half of hospitals closed out the year operating at a loss, many hospitals spent much of 2023 simply struggling to break even.<a href="#fn1"><sup>1</sup></a> Economy-wide inflation grew by 12.4% between 2021 and 2023 – more than two times faster than Medicare reimbursement for hospital inpatient care (see <a href="#figure2">Figure 2</a>).</p><p>Since the start of 2022, the number of days cash on hand for hospitals and health systems has declined by 28.3%, according to data from Strata Decision Technology, which provides data and cloud-based financial planning, decision support and performance analytics solutions.<a href="#fn2"><sup>2</sup></a></p><p>Diverting dollars from their reserves to maintain access to care has required tradeoffs that have limited many hospitals and health systems from investing in updated infrastructure, new medical technology and equipment, and other clinical needs — particularly among those hospitals in severe financial distress.<a href="#fn3"><sup>3</sup></a><sup>,</sup><a href="#fn4"><sup>4</sup></a> For example, the average age of capital investments for medical equipment and infrastructure, after years of remaining relatively flat, increased by 7.1% for all hospitals in 2023, according to data from Strata Decision Technology. While the constraints and burdens of increasing plant age present serious challenges to hospitals and health systems in their own right, the inability to make needed capital investments has contributed to bond rating agencies issuing rating downgrades, making it harder for some hospitals and health systems to borrow money.<a href="#fn5"><sup>5</sup></a> Ongoing reimbursement challenges, made worse by crises like the recent Change Healthcare cyberattack, and increased operating costs create an unsustainable financial environment.<a href="#fn6"><sup>6</sup></a> While these challenges alone could cripple any organization, hospitals and health systems continue to face additional threats from ongoing Medicaid redeterminations increasing uncompensated care<a href="#fn7"><sup>7</sup></a>, regulatory changes that add operational burden, cyberattacks that threaten the health care infrastructure and potential legislation that would further cut Medicare payments to hospitals.</p><p>This report provides a snapshot of the current cost realities facing hospitals and health systems and how they impact their ability to care for patients and communities.</p><h2><span>1. Costs of Providing Essential Services</span></h2><p><img src="/sites/default/files/inline-images/Figure-3-Cumulative-Medicaid-and-Medicare-underpayments.png" data-entity-uuid="1846fd31-a865-4fcb-8de7-b4ca6bf1b3f2" data-entity-type="file" alt="Figure 3. Cumulative Medicaid and Medicare underpayments. 2013 to 2017: -$375 Billion; 2018 to 2022: -$522 Billion. Note: AHA Annual Survey 2013 to 2022 all dollars inflation adjusted to 2022 values using CPI-U from the BLS." width="620" height="672" id="figure3" class="align-right">Hospitals often play the critical — and sometimes only — role in providing access to essential health care services, such as emergency care and behavioral health, which are necessary for the health and well-being of the communities they serve. Further, oftentimes these are services that are not offered by other types of health care providers. In 2022, the most recent year for which data are available, hospitals admitted nearly 137 million patients in emergency departments and delivered over 3.5 million babies.<a href="#fn8"><sup>8</sup></a> Many of these essential services are extremely resource intensive and costly to offer. Further compounding this issue are demographic trends such as an aging population and clinical factors such as higher patient acuity. This has driven a steady rise in the share of inpatient utilization among more clinically complex patients covered by Medicare and Medicaid.<a href="#fn9"><sup>9</sup></a> Not only are inpatient services costlier to provide, but public payer payments for these services fall well below costs. In fact, underpayments from Medicare and Medicaid totaled nearly $130 billion in 2022, and Medicare paid just 82 cents for every dollar hospitals spent caring for patients — resulting in a shortfall of almost $100 billion.<a href="#fn10"><sup>10</sup></a> Troublingly, cumulative underpayments in the second half of the last decade totaled more than half a trillion dollars — a nearly 40% increase compared to the first half even after adjusting for inflation (see <a href="#figure3">Figure 3</a>).</p><p>However, the reimbursement challenges do not end with Medicare and Medicaid Reimbursement for some services consistently fall below costs across all payer types. For example, payments for inpatient behavioral health services were 34.3% below costs across all payers on average in 2023, according to data from Strata Decision Technology (see <a href="#figure4">Figure 4</a>). This is especially concerning given the increased utilization of behavioral health services over the last few years.</p><img src="/sites/default/files/inline-images/Figure-4-Hospital-payments-do-not-cover-the-costs-of-providing-vital-patient-services-20240612.png" data-entity-uuid="96ed5e28-677a-4ba0-8659-407033fe0a56" data-entity-type="file" alt="Figure 4. Hospital payments do not cover the costs of providing vital inpatient services. Average margin on services: Behavioral Health -34.3%; Nephrology -34.1%; Burns and Wounds -24.1%; Pulmonology -19.4%; Infectious Disease -15.3%. Note: AHA analysis of 2023 average service line payment and cost across all payers from Strata Decision Technology. Does not include supplemental payments from Medicaid." width="1565" height="623" id="figure4"><p>In the outpatient setting, average payments for costly burn and wound services were 42.9% below costs across all payers (see <a href="#figure5">Figure 5</a>). These shortfalls have been especially acute for government payers like Medicare. For example, average Medicare margins for behavioral health services were -38.9% in 2023.</p><img src="/sites/default/files/inline-images/Figure-5-Hospital-payments-also-fail-to-cover-the-costs-of-providing-essential-outpatient-services.png" data-entity-uuid="a43ea45f-a309-46a9-9acc-fb54b385b5b2" data-entity-type="file" alt="Figure 5. Hospital payments also fail to cover the costs of providing essential outpatient services. Average margin on services: Burns and wounds -42.9%; Nephrology -32.3%; Behavioral Health -31.7%; Pulmonology -17.5%; Infectious Disease -12.1%. Note: AHA analysis of 2023 average service line payment and cost across all payers from Strata Decision Technology. Does not include supplemental payments from Medicaid." width="1558" height="616" id="figure5"><p>Taken together, these data highlight the challenges that hospitals and health systems face in providing essential services that communities need. This is particularly true for hospitals in rural areas, where the financial challenges can be even more severe.</p><h2><span>2. Hospital Administrative Expenses</span></h2><p><span><em><strong><img src="/sites/default/files/inline-images/Figure-6-Premiums-grew-twice-as-fast-as-hospital-prices-in-2023.png" data-entity-uuid="d158d191-431b-4548-aebc-57269df046dc" data-entity-type="file" alt="Figure 6. Premiums grew twice as fast as hospital prices in 2023. Health Insurance Premiums: 6.7%; Hospital Prices: 2.6%. Note: Health insurance premiums represent premiums for a family of four, from KFF Employer Health Benefits Survey, 2023. Hospital Prices: BLS, annual average Producer Price index for hospitals." width="607" height="790" id="figure6" class="align-right">Some commercial health insurer practices increase hospital costs and delay care to patients</strong></em></span></p><p>Hospitals have seen significant growth in administrative costs due to inappropriate practices by certain commercial health insurers, including Medicare Advantage (MA) and Medicaid managed care plans. In addition to increasing premiums, which grew twice as fast as hospital prices in 2023, commercial health insurers have overburdened hospitals with time-consuming and labor-intensive practices like automatic claims denials and onerous prior authorization requirements (see <a href="#figure6">Figure 6</a>).<a href="#fn11"><sup>11</sup></a></p><p>A 2021 study by McKinsey estimated that hospitals spent $10 billion annually on dealing with insurer prior authorizations.<a href="#fn12"><sup>12</sup></a> Additionally, a 2023 study by Premier found that hospitals are spending just under $20 billion annually in appealing denials — more than half which was wasted on claims that should have been paid out at the time of submission.<a href="#fn13"><sup>13</sup></a> Denials issued by commercial MA plans rose sharply by 55.7% in 2023.<a href="#fn14"><sup>14</sup></a> Notably, many of these denials were ultimately overturned, consistent with a study by the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) that found 75% of care denials were subsequently overturned.<a href="#fn15"><sup>15</sup></a> These denials are particularly concerning because they often occur for medically necessary care, which can result in direct patient harm. In fact, a recent HHS OIG report found that nearly one in five MA denials met Medicare coverage rules, which meant that had they been paid via Medicare fee-for-service, they would have been paid without denial.<a href="#fn16"><sup>16</sup></a> Even when denials are ultimately overturned, hospitals are not paid for the costs incurred to navigate that burdensome and resource-intensive process. Making matters worse, MA plans paid hospitals less than 90% of Medicare rates despite costing taxpayers more than traditional Medicare in 2023.<a href="#fn17"><sup>17</sup></a><sup>,</sup><a href="#fn18"><sup>18</sup></a> Although partly a function of lower rates, the worsening administrative overload is simply costing hospitals more and more.</p><p>Though these issues are often felt most acutely with MA and Medicaid managed care plans, it also is true for other commercial payers, where claims denials increased by 20.2% in 2023. Moreover, the time taken by commercial payers to process and pay hospital claims from the date of submission increased by 19.7% in 2023, according to data from the Vitality Index. For hospitals and health systems, these practices result in billions of dollars in lost revenue each year, which require hospitals to divert dollars away from patient care to instead focus on seeking payment from commercial insurers.<a href="#fn19"><sup>19</sup></a> Without further intervention, these trends are expected to continue and worsen. National expenditures on the administrative costs of private health insurance spending alone are projected to account for 7% of total health care spending between 2022 and 2031 and are projected to grow faster than expenditures for hospital care.<a href="#fn20"><sup>20</sup></a></p><h3><span>Other expenses</span></h3><p>Hospitals also are spending more on things that are not direct patient care services but are still critical to delivering care and maintaining operations. For example, the costs associated with implementing, maintaining and upgrading information management systems and overall technology infrastructure, while critical to improving efficiency and quality of care, typically represent significant investments.</p><p>Additionally, given the confidential nature of patient data in these systems, hospitals have increasingly become targets for cyberattacks. As a result, the costs of defending against these attacks and protecting patient data has grown steadily.<a href="#fn21"><sup>21</sup></a> Health care data breaches are by far the costliest of any other sector.<a href="#fn22"><sup>22</sup></a> As cyberattacks and data breaches in health care have grown and regulators are requiring more robust protections, hospitals and health systems are finding themselves increasingly trying to invest in cybersecurity.<a href="#fn23"><sup>23</sup></a> Protecting against cyberattacks and other vulnerabilities is important to patient care, but is increasingly costly. In 2022, hospitals spent nearly $30 billion on property and medical liability insurance, according to data from Lightcast.</p><h2><span>3. Hospital Drug Expenses</span></h2><p>An area of persistent cost pressure for hospitals and health systems has been the rapid and sustained growth in drug expenses. Hospitals spent $115 billion on drug expenses in 2023 alone. One of the factors fueling this growth is drug company decisions to impose large price increases on existing drugs. However, 2023 also saw a continuation of a long-standing trend of drug companies introducing new drugs at record prices. In 2023, the median annual list price for a new drug was $300,000, an increase of 35% from the prior year (see <a href="#figure7">Figure 7</a>).<a href="#fn24"><sup>24</sup></a> A recent report by the HHS Assistant Secretary for Planning and Evaluation (ASPE) found that between 2022 and 2023, prices for nearly 2,000 drugs increased faster than the rate of general inflation, with an average price hike of 15.2%.<a href="#fn25"><sup>25</sup></a></p><img src="/sites/default/files/inline-images/Figure-7-Annual-List-Prices-of-Novel-Drugs-Launched-in-2023.png" data-entity-uuid="b88a70d2-300e-48d9-90f9-e3fbe3b80e83" data-entity-type="file" alt="Figure 7. Annual List Prices of Novel Drugs Launched in 2023*. Elevidys: $3,200,000; Roctavian: $2,900,000; Veopoz: $1,799,980; Altuviiio: $970,000; Pombiliti: $650,000; Talvey: $360,000; Orserdu: $280,526; Adzynma: $245,000; Zynyz: $170,880; Filspari: $129,965; Velsipity: $74,000; Leqembi: $26,000. Median price of new drug: $300,000. Median household: $74,580. Average price of a new car: $48,759. Source: Annual list prices of novel drugs launched in 2023 are from a Reuters survey of new drug costs. Median household income is from 2022 Census Bureau data. Average price of new care is from Kelly Blue Book new-vehicle transaction price in December 2023." width="1563" height="771" id="figure7"><p><img src="/sites/default/files/inline-images/Figure-8-Increase-in-drug-shortages-and-drug-prices-2022-2023.png" data-entity-uuid="e6973989-b4db-4b1f-a2ac-dd8b512598d6" data-entity-type="file" alt="Figure 8. Increase in drug shortages and drug prices, 2022–2023. 2022: Drug Shortages 8.0%; Drug Prices 11.5%. 2023: Drug Shortages: 13.0%; Drug Prices 15.2%. Note: Drug shortage data from Utah Drug Information System; Drug price data from ASPE." width="607" height="691" id="figure8" class="align-right">While high drug prices alone pose significant challenges for hospitals and health systems, it is compounded by the fact that many of these same drugs are in shortage. In fact, 2023 saw the most drug shortages in over a decade; there were an average of 301 drugs in shortage per quarter, an increase of 13.0% from the previous year (see <a href="#figure8">Figure 8</a>). These shortages added as much as 20% to hospital drug budgets, according to data from the American Society of Health System Pharmacists (ASHP). These shortages can occur for many reasons, including fractured global supply chains lack of available raw materials, and decisions by drug companies that lack incentives to produce low-margin generic medications.<a href="#fn26"><sup>26</sup></a> An ASHP survey found that more than 99% of hospital and health system pharmacists experienced drug shortages in 2023, with 85% of respondents describing the severity of drug shortages as critically or moderately impactful.<a href="#fn27"><sup>27</sup></a> While generic drugs comprised the majority of medications in shortage, estimated to make up as much as 83% of shortages, many of these drugs also were used to treat cancer and autoimmune diseases.<a href="#fn28"><sup>28</sup></a></p><p>Hospital pharmacy staff have limited options for navigating drug shortages. They can purchase the drug by going outside their traditional suppliers and group purchasing agreements, access alternate concentrations or package sizes of the drugs than what is needed or purchase a substitute drug with the same clinical indication. However, all three of these options mean hospitals pay higher prices to acquire the drugs. An ASPE report found up to a 16.6% increase in the prices of drugs in shortage; in many cases, the increase in the price of substitute drugs were at least three times higher than the price increase of the drug in shortage.<a href="#fn29"><sup>29</sup></a> The costs incurred as a result of drug shortages are compounded by staff overtime needed to find, procure and administer alternative drugs, to manage the added challenges of multiple medication dispensing automation systems and changing electronic health records (EHRs), and to undergo training to ensure medication safety using alternative therapies.<a href="#fn30"><sup>30</sup></a></p><h2><span>4. Hospital Supply Costs</span></h2><div class="row"><div class="col-md-5"><p>Having adequate and up-to-date medical supplies, devices and equipment are necessary for hospitals to deliver high quality care to patients. These can include artificial joints used to treat patients with conditions such as arthritis, robotic surgery machines used to perform laparoscopic surgical procedures, and complex imaging machinery used for clinical diagnostics. Most of these items are expensive to acquire and maintain and rely on increasingly volatile global supply chains. Comprising approximately 10.5% of the average hospital’s budget, medical supply expenses collectively accounted for $146.9 billion in 2023, an increase of $6.6 billion over 2022, according to data from Strata Decision Technology. As technology and science are constantly evolving, hospitals routinely need to purchase new supplies, devices and equipment that meet clinical care standards and ensure high quality care.</p><p>The upfront costs for critical equipment and device upgrades come at a significant cost (<a href="#table1">Table 1</a>). For example, the advanced technology of cardiac magnetic resonance imaging (cMRI) machines, which have allowed doctors to develop a deeper understanding of cardiac pathologies and has led to improved diagnostics, costs hospitals on average $3.2 million. For some hospitals that have high demand for cardiac services, they may need to purchase multiple cMRI machines. The additional costs for ongoing maintenance, upgrades and staff training also add to the total costs hospitals must incur to deliver their patients with the high quality care.</p></div><div class="col-md-7"> table, th, td { border: 1px solid; } th { background-color: #69b3e733; } } <table id="table1"><tbody><tr><td><h3>Table 1. Medical Device and Equipment Market Prices</h3></td></tr><tr><td><em>Cutting-edge innovation and technologies provide hospitals with the means to enhance patient outcome in their continuous commitment to delivering top-tier patient care. The featured equipment is intricately connected to advancements in diagnostics, heightened success rates in cardiovascular surgery, and more effective joint replacement procedures.</em></td></tr></tbody></table><table><thead><tr><th>Medical Devices and Equipment</th><th>Average List Price</th></tr></thead><tbody><tr><td colspan="2"><strong>Point of Care ultrasound devices</strong></td></tr><tr><td>Pocket-sized handheld or tablet-based</td><td>$8,143</td></tr><tr><td>Compact ultrasound systems*</td><td>$73,797</td></tr><tr><td colspan="2"><strong>Cardiovascular diagnostic and surgical equipment</strong></td></tr><tr><td>Cardiac magnetic resonance imaging (cMRI) machine</td><td>$3,230,728</td></tr><tr><td>Cardiopulmonary bypass system</td><td>$325,442</td></tr><tr><td colspan="2"><strong>Joint implant proprietary software and equipment</strong></td></tr><tr><td>Image based planning software</td><td>$222,132</td></tr><tr><td>Navigation software system (guide surgeons in real-time)</td><td>$135,365</td></tr><tr><td colspan="2"><p>*Larger than handheld devices, but still portable. May have more advanced features.</p><p><span><strong>Note:</strong></span> Market prices of medical devices and equipment are courtesy of ECRI, an independent not-for-profit corporation that provides a wide range of services dealing with health care technology.</p></td></tr></tbody></table></div></div><h2><span>5. Hospital Labor Costs</span></h2><p>Hospitals’ labor costs increased by more than $42.5 billion between 2021 and 2023 to a total of $839 billion, accounting for nearly 60% of the average hospital’s expenses. Hospitals continue to turn to expensive contract labor to fill gaps and maintain access to care, spending approximately $51.1 billion on contracted staff in 2023.</p><p><img src="/sites/default/files/inline-images/Figure-9-Growth-in-Total-Hospital-Employee-Compensation-Far-Outpaces-Inflation.png" data-entity-uuid="5fa4709d-12e9-47f3-af06-07ac3b0937b6" data-entity-type="file" alt="Figure 9. Growth in Total Hospital Employee Compensation Far Outpaces Inflation. 2014 to 2023: Inflation 28.7%; Hospital Employee Compensation 45.0%. Note: BLS Annual average Employee Cost Index, 2014 to 2023 for hospitals and CPI-U, 2014 to 2023." width="522" height="592" id="figure9" class="align-right">Though expenditures on contract labor have moderated since pandemic highs, the spending remains elevated and has added to the financial challenges hospitals and health systems face. This is especially true for smaller, rural hospitals where the local workforce pool is smaller and it can be more difficult to recruit staff. Hospitals’ labor costs also can be very sensitive to sudden fluctuations in the demand and supply of labor. Growth in wages and benefits of hospital employees has vastly surpassed economy-wide inflation over the last decade (see <a href="#figure9">Figure 9</a>).</p><p>Yet, critical labor shortages persist, especially in the face of growing burnout among clinicians. Employee burnout hastened by the pandemic and further exacerbated by commercial insurer administrative burden and increase in violence against hospital employees, led to an unprecedented exodus of health care professionals in recent years.<a href="#fn31"><sup>31</sup></a> Resignations per month among health care workers grew 50% between 2020 and 2023, according to data from McKinsey.<a href="#fn32"><sup>32</sup></a> Additionally, hospitals have been forced to contend with record high turnover rates — fueling additional expenses for hospitals looking to recruit new workers.<a href="#fn33"><sup>33</sup></a></p><p>Consequently, hospitals and health systems have invested more to attract and retain talent. Data from Lightcast indicates that advertised wage rates across all hospital jobs jumped by 10.1% during 2023. With a growing gap between supply and demand for health care workers over the next decade, labor costs will likely continue to be an issue for hospitals.</p><h2><span>A Look Ahead to the Rest of 2024</span></h2><p>Though 2024 is the first full year out of the most recent public health emergency period, hospitals and health systems continue to face many challenges. Credit ratings agencies have painted a bleak picture for the hospital sector in 2024.<a href="#fn34"><sup>34</sup></a> According to the S&P, negative outlooks for not-for-profit hospitals are proportionally at their highest in over a decade, affecting 24% of the sector.<a href="#fn35"><sup>35</sup></a> Similarly, Fitch reported a credit downgrade-to-upgrade ratio of 3:1 — alarmingly close to the ratio seen during the 2008 financial crisis — calling it a “make or break” year and highlighting the sector’s struggles, particularly among smaller hospitals with annual revenues under $500 million.<a href="#fn36"><sup>36</sup></a> While it is expected that hospitals and health systems will continue to face cost increases for labor, drugs, and medical supplies, there are additional headwinds to consider which include:</p><ul><li>Coverage losses due to Medicaid redeterminations: More than 19 million Medicaid enrollees have been disenrolled through 2023.<a href="#fn37"><sup>37</sup></a> Though partially offset by record Marketplace enrollment and possible enrollment in employer-sponsored coverage, this has still resulted in a steady increase in uncompensated care costs throughout 2023 and will likely continue into 2024 – particularly for states that have not expanded Medicaid.<a href="#fn38"><sup>38</sup></a></li><li>Potential legislative actions to cut hospital Medicare payments for patient care: Congress is considering several bills that would impose additional payment reductions to services provided in hospital outpatient departments. These proposals, referred to as “siteneutral” payment cuts, would exacerbate financial challenges for hospitals and threaten patients’ access to quality care.</li><li>Cybersecurity risks impact providers and patient care: The cyberattack on Change Healthcare in February 2024 has underscored the extensive repercussions such incidents can have on patient care and hospital operations. The disruptions stemming from that cyberattack have significantly hindered revenue cycle management, pharmacy services, select health care technologies, clinical authorizations, and more across multiple health systems, serving as an example of how an attack can reverberate across the entire health care sector when a business that provides numerous mission-critical services is compromised.<a href="#fn39"><sup>39</sup></a></li><li>Ongoing and escalating hospital violence: There has been a significant uptick in violence against health care workers in recent years.<a href="#fn40"><sup>40</sup></a> To address this issue, hospitals are making significant investments in violence prevention and preparedness efforts to support their employees.</li></ul><h2><span>Conclusion</span></h2><p>America’s hospitals and health systems are dedicated to providing high-quality 24/7 care to all patients in every community across the country. While the commitment to caring and advancing health never wavers, hospitals continue to face significant challenges making it difficult to ensure the care is always there.</p><p>The AHA continues to urge Congress and the Administration to support policies to make sure hospitals and health systems have the resources they need to continue providing 24/7 care to all patients and communities. These include:</p><ul><li>Rejecting Medicare and Medicaid cuts to hospital care, including harmful site-neutral proposals and forthcoming reductions to Medicaid Disproportionate Share hospitals.</li><li>Supporting and strengthening the health care workforce.</li><li>Protecting the 340B Drug Pricing Program from any harmful changes and reining in the increasing costs of drugs.</li><li>Taking actions to hold commercial insurers accountable for practices that delay, deny and disrupt care.</li><li>Bolstering support to enhance cybersecurity of hospitals and the entire health care system.</li></ul><hr><h2>End Notes</h2><ol><li id="fn1"><a href="www.kaufmanhall.com/news/2022-worst-financial-year-hospitals-and-health-systems-start-pandemic" target="_blank">www.kaufmanhall.com/news/2022-worst-financial-year-hospitals-and-health-systems-start-pandemic</a></li><li id="fn2"><a href="https://www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf" target="_blank">www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf</a></li><li id="fn3"><a href="https://fortune.com/well/2024/01/11/rural-hospitals-are-caught-in-an-aging-infrastructure-conundrum/" target="_blank">fortune.com/well/2024/01/11/rural-hospitals-are-caught-in-an-aging-infrastructure-conundrum/</a></li><li id="fn4"><a href="/guidesreports/2023-04-19-essential-role-financial-reserves-not-profit-healthcare" target="_blank">www.aha.org/guidesreports/2023-04-19-essential-role-financial-reserves-not-profit-healthcare</a></li><li id="fn5"><a href="https://www.modernhealthcare.com/finance/hospital-2023-credit-rating-downgrade-fitch-ratings-sp-global-moodys" target="_blank">www.modernhealthcare.com/finance/hospital-2023-credit-rating-downgrade-fitch-ratings-sp-global-moodys</a></li><li id="fn6"><a href="/cybersecurity/change-healthcare-cyberattack-updates" target="_blank">www.aha.org/cybersecurity/change-healthcare-cyberattack-updates</a></li><li id="fn7"><a href="/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further" target="_blank">www.aha.org/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further</a></li><li id="fn8">AHA analysis of 2022 Annual Survey data.</li><li id="fn9"><a href="https://www.trillianthealth.com/insights/the-compass/the-total-available-market-of-commercially-insured-patients-is-shrinking" target="_blank">www.trillianthealth.com/insights/the-compass/the-total-available-market-of-commercially-insured-patients-is-shrinking</a></li><li id="fn10"><a href="/news/headline/2024-01-10-aha-infographic-medicare-underpayments-hospitals-nearly-100-billion-2022#:~:text=AHA%20infographic%3A%20Medicare%20underpayments%20to%20hospitals%20nearly%20%24100%20billion%20in%202022,-Jan%2010%2C%202024&text=Medicare%20paid%20hospitals%20a%20record,negative%20Medicare%20margins%20that%20year." target="_blank">www.aha.org/news/headline/2024-01-10-aha-infographic-medicare-underpayments-hospitals-nearly-100-billion-2022#:~:text=AHA%20infographic% 3A%20Medicare%20underpayments%20to%20hospitals%20nearly%20%24100%20billion%20in%202022,-Jan%2010%2C%202024&text=Medicare%20 paid%20hospitals%20a%20record,negative%20Medicare%20margins%20that%20year.</a></li><li id="fn11"><a href="https://www.wsj.com/health/healthcare/health-insurance-cost-increase-5b35ead7" target="_blank">www.wsj.com/health/healthcare/health-insurance-cost-increase-5b35ead7</a></li><li id="fn12"><a href="https://www.mckinsey.com/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/administrative%20simplification%20how%20to%20save%20a%20quarter%20trillion%20dollars%20in%20us%20healthcare/administrative-simplification-how-to-save-a-quarter-trillion-dollars-in-us-healthcare.pdf?shouldIndex=false" target="_blank">www.mckinsey.com/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/administrative%20simplification%20 how%20to%20save%20a%20quarter%20trillion%20dollars%20in%20us%20healthcare/administrative-simplification-how-to-save-a-quarter-trillion-dollars- in-us-healthcare.pdf?shouldIndex=false</a></li><li id="fn13"><a href="https://premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-by-refusing-or-delaying-legitimate-medical-claims" target="_blank">premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-by-refusing-or-delaying-legitimate-medical-claims</a></li><li id="fn14"><a href="https://www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf">www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf</a></li><li id="fn15"><a href="https://oig.hhs.gov/oei/reports/OEI-09-19-00350.pdf" target="_blank">oig.hhs.gov/oei/reports/OEI-09-19-00350.pdf</a></li><li id="fn16"><a href="https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf" target="_blank">oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf</a></li><li id="fn17"><a href="https://www.ensemblehp.com/blog/the-real-cost-of-medicare-advantage-plan-success/" target="_blank">www.ensemblehp.com/blog/the-real-cost-of-medicare-advantage-plan-success/</a></li><li id="fn18"><a href="https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/mar21_medpac_report_to_the_congress_sec.pdf#page=401" target="_blank">www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/mar21_medpac_report_to_the_congress_sec.pdf#page=401</a></li><li id="fn19"><a href="https://www.ama-assn.org/practice-management/prior-authorization/health-systems-plagued-payer-takeback-schemes-110000#:~:- text=authorization’s financial impact-,Prior authorization’s financial impact,an increase of 67%.”" target="_blank">www.ama-assn.org/practice-management/prior-authorization/health-systems-plagued-payer-takeback-schemes-110000#:~:- text=authorization’s%20 financial%20impact-,Prior%20authorization’s%20financial%20impact,an%20increase%20of%2067%25.%E2%80%9D</a></li><li id="fn20">AHA analysis of NHE projections of 2022-2031 expenditures.</li><li id="fn21"><a href="https://www.healthcaredive.com/news/healthcare-ransomware-costs-comparitech-77-billion/698044/" target="_blank">www.healthcaredive.com/news/healthcare-ransomware-costs-comparitech-77-billion/698044/</a></li><li id="fn22"><a href="https://intraprisehealth.com/the-cost-of-cyberattacks-in-healthcare/" target="_blank">intraprisehealth.com/the-cost-of-cyberattacks-in-healthcare/</a></li><li id="fn23"><a href="https://www.healthcareitnews.com/news/cisos-face-budgetary-pressures-burnout-during-global-recession" target="_blank">www.healthcareitnews.com/news/cisos-face-budgetary-pressures-burnout-during-global-recession</a></li><li id="fn24"><a href="https://www.reuters.com/business/healthcare-pharmaceuticals/prices-new-us-drugs-rose-35-2023-more-than-previous-year-2024-02- 23/?utm_source=facebook&utm_medium=news_tab" target="_blank">www.reuters.com/business/healthcare-pharmaceuticals/prices-new-us-drugs-rose-35-2023-more-than-previous-year-2024-02- 23/?utm_source=facebook& utm_medium=news_tab</a></li><li id="fn25"><a href="https://aspe.hhs.gov/reports/changes-list-prices-prescription-drugs" target="_blank">aspe.hhs.gov/reports/changes-list-prices-prescription-drugs</a></li><li id="fn26"><a href="https://www.fda.gov/media/131130/download?attachment" target="_blank">www.fda.gov/media/131130/download?attachment</a></li><li id="fn27"><a href="https://news.ashp.org/-/media/assets/drug-shortages/docs/ASHP-2023-Drug-Shortages-Survey-Report.pdf" target="_blank">news.ashp.org/-/media/assets/drug-shortages/docs/ASHP-2023-Drug-Shortages-Survey-Report.pdf</a></li><li id="fn28"><a href="https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/drug-shortages-in-the-us-2023?utm_campaign=2023_ Drug_Shortages_Report_INSTITUTE_IS&utm_medium=email&utm_source=Eloqua" target="_blank">www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/drug-shortages-in-the-us-2023?utm_campaign=2023_ Drug_Shortages_Report_ INSTITUTE_IS&utm_medium=email&utm_source=Eloqua</a></li><li id="fn29"><a href="https://aspe.hhs.gov/reports/drug-shortages-impacts-consumer-costs" target="_blank">aspe.hhs.gov/reports/drug-shortages-impacts-consumer-costs</a></li><li id="fn30"><a href="https://link.springer.com/article/10.1007/s13181-023-00950-6#:~:text=Shortages%20compromise%20or%20delay%20medical,morbidity%20%5B1%2C%202%5D." target="_blank">link.springer.com/article/10.1007/s13181-023-00950-6#:~:text=Shortages%20compromise%20or%20delay%20medical,morbidity%20%5B1%2C%202%5D.</a></li><li id="fn31"><a href="/system/files/media/file/2023/06/fact-sheet-examining-the-real-factors-driving-physician-practice-acquisition.pdf" target="_blank">www.aha.org/system/files/media/file/2023/06/fact-sheet-examining-the-real-factors-driving-physician-practice-acquisition.pdf</a></li><li id="fn32"><a href="https://www.mckinsey.com/industries/healthcare/our-insights/how-health-systems-and-educators-can-work-to-close-the-talent-gap" target="_blank">www.mckinsey.com/industries/healthcare/our-insights/how-health-systems-and-educators-can-work-to-close-the-talent-gap</a></li><li id="fn33"><a href="https://www.healthcarefinancenews.com/news/rn-turnover-healthcare-rise" target="_blank">www.healthcarefinancenews.com/news/rn-turnover-healthcare-rise</a></li><li id="fn34"><a href="https://on24static.akamaized.net/event/44/67/84/2/rt/1/documents/resourceList1709062595167/ushealthcaresectorcreditbeat227241709062595167.pdf" target="_blank">on24static.akamaized.net/event/44/67/84/2/rt/1/documents/resourceList1709062595167/ushealthcaresectorcreditbeat227241709062595167.pdf</a></li><li id="fn35"><a href="https://www.spglobal.com/ratings/en/research/articles/231206-historical-peak-of-negative-outlooks-signals-challenges-remain-for-u-s-not- for-profit-acute-health-care-provi-12927513" target="_blank">www.spglobal.com/ratings/en/research/articles/231206-historical-peak-of-negative-outlooks-signals-challenges-remain-for-u-s-not- for-profit-acutehealth- care-provi-12927513</a></li><li id="fn36"><a href="https://www.fitchratings.com/research/us-public-finance/us-not-for-profit-hospitals-health-systems-outlook-2024-05-12-2023" target="_blank">www.fitchratings.com/research/us-public-finance/us-not-for-profit-hospitals-health-systems-outlook-2024-05-12-2023</a></li><li id="fn37"><a href="https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/" target="_blank">ww.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/</a></li><li id="fn38"><a href="/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further" target="_blank">www.aha.org/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further</a></li><li id="fn39"><a href="/2024-02-24-update-unitedhealth-groups-change-healthcares-continued-cyberattack-impacting-health-care-providers" target="_blank">www.aha.org/2024-02-24-update-unitedhealth-groups-change-healthcares-continued-cyberattack-impacting-health-care-providers</a></li><li id="fn40"><a href="https://apnews.com/article/hospitals-workplace-violence-shootings-aa6918569ff8f76ff8a15b9813e31686" target="_blank">apnews.com/article/hospitals-workplace-violence-shootings-aa6918569ff8f76ff8a15b9813e31686</a></li></ol></div><div class="col-md-4"><p><a href="/system/files/media/file/2024/05/Americas-Hospitals-and-Health-Systems-Continue-to-Face-Escalating-Operational-Costs-and-Economic-Pressures.pdf" target="_blank" title="Click here to download Costs of Caring 2024: America’s Hospitals and Health Systems Continue to Face Escalating Operational Costs and Economic Pressures as They Care for Patients and Communities report PDF."><img src="/sites/default/files/inline-images/Page-1-Americas-Hospitals-and-Health-Systems-Continue-to-Face-Escalating-Operational-Costs-and-Economic-Pressures.png" data-entity-uuid="4315111b-85e5-46dd-9949-8bb4ee5e6246" data-entity-type="file" alt="Costs of Caring 2024: America’s Hospitals and Health Systems Continue to Face Escalating Operational Costs and Economic Pressures as They Care for Patients and Communities page 1." width="695" height="900"></a></p><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2024-09-10-skyrocketing-hospital-administrative-costs-burdensome-commercial-insurer-policies-are-impacting" target="_blank">View the Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Are Impacting Patient Care Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2024-05-01-2023-costs-caring" target="_blank">View the 2023 Costs of Caring Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2023-04-20-2022-costs-caring" target="_blank">View the 2022 Costs of Caring Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2021-10-25-2021-cost-caring" target="_blank">View the 2021 Costs of Caring Report</a></div></div></div></div> Mon, 28 Apr 2025 15:04:37 -0500 Workforce /education-events/2025-aha-leadership-summit <p class="field_lead">The <a href="https://leadershipsummit.aha.org/" target="_blank" title="2025 AHA Leadership Summit"><strong>2025 AHA Leadership Summit</strong></a> senior health care executives, clinicians and experts in the field presenting innovative approaches for delivering better care and greater value, ensuring financial stability, addressing workforce challenges and improving the health care consumer experience through operational excellence, creative partnerships and redefined delivery models.</p><p>Join a diverse community of strategic and visionary leaders who represent excellence in the field as they boldly transform their organizations.</p><p>Our attendees include <strong>CEOs, COOs, CFOs, CMOs, CNOs, CIOs and other C-suite leaders</strong>, as well as <strong>VPs, Physician Leaders, Advanced Practice Professionals, Directors and Managers</strong> overseeing patient care, strategy, innovation, digital transformation, finance, workforce and policy.</p><p>Additionally, the Summit welcomes <strong>emerging and next-generation health care leaders</strong> who are shaping the future of patient-centered care and health system transformation.</p><hr><h2>Leading Hospitals | Leading Health Care</h2><p><strong>Leading Hospitals</strong></p><p>Learn with colleagues in a variety of educational opportunities that facilitate the sharing of insights and leading practices.<br>You’ll hear from innovators investing in the promising ideas, technologies and scientific discoveries that are changing the consumer experience and reimagining care delivery</p><p><strong>Leading Health Care</strong></p><p>Discover inspiration and practical strategies to sustain transformation within your organization, system and community as we prepare for the future.<br>Dive into real-world applications and connect with leaders who share your commitment to driving transformative change in health care.</p><p><a class="btn btn-wide btn-primary" href="https://leadershipsummit.aha.org/" target="_blank" title="2025 AHA Leadership Summit" data-view-context="top-level-view"><strong>LEARN MORE >></strong></a></p><h2>AHA Members – Interested in receiving complimentary registration?<br>Consider our Hosted Buyer Forum to connect with high-quality solutions providers.</h2><p><a href="/hosted-buyer" target="_blank"><strong>Hosted Buyer Forum</strong></a> - Sunday, July 22 | 9:00 AM-12:00 PM and 2:30 PM-5:30 PM<br>The Hosted Buyer Forum offers a private showcase for hospital and health system leaders interested in connecting with solution providers addressing key hospital issues. After the Forum is complete, participants are encouraged to join the Welcome Reception for additional networking.</p><p><a class="btn btn-wide btn-primary" href="https://leadershipsummit.aha.org/hosted-buyer" target="_blank" title="2025 AHA Leadership Summit Sponsorship" data-view-context="top-level-view"><strong>LEARN MORE >></strong></a></p><hr>Call for Speakers</h2> <p>We’re calling on leaders shaping the future of health care to apply to share their real-world strategies and proven solutions with peers across the field. Whether you're tackling workforce challenges, transforming care delivery or driving operational excellence, we want to hear from you. </p> <p>Proposals must be non-commercial in nature. The Call for Speakers deadline is <strong>Monday, November 25</strong>.</p> <a class="btn btn-wide btn-primary" data-view-context="top-level-view" href="https://leadershipsummit.aha.org/program/speaking-opportunities-ls" target="_blank"><strong>LEARN MORE >></strong></a> <a class="btn btn-wide btn-primary" data-view-context="top-level-view" href="https://app.smartsheet.com/b/form/385d7c8476204286b3b500744d75dfe6" target="_blank" title="AHA Leadership Summit Call for Proposals - Apply Today!"><strong>APPLY TODAY >></strong></a> <br /> </p> <div class="RuralButton"><a class="btn btn-primary btn-primary-avc1" href="https://www.cvent.com/c/abstracts/c8eaf006-bb32-489c-8d5e-515f82937464" target="_blank"><strong>APPLY TODAY >></strong> </a></div> --><h2>Sponsorship Opportunities</h2><p>A variety of sponsorship opportunities offer both broad exposure and targeted connections with senior health care executives. Support the entire event, design and deliver a session that features your own executive leadership or gain visibility through numerous other opportunities.</p><p>Participation by the business community in the Leadership Summit is reserved for Summit sponsors and AHA Associates.</p><p>Learn how your organization can align with hospital and health system leaders as they meet to reimagine the future.</p><p><a class="btn btn-wide btn-primary" href="https://leadershipsummit.aha.org/sponsor-exhibit/sponsorship-ls" target="_blank" title="2025 AHA Leadership Summit Sponsorship" data-view-context="top-level-view"><strong>LEARN MORE >></strong></a></p> Tue, 22 Apr 2025 14:15:30 -0500 Workforce /news/headline/2025-04-09-aha-podcast-stronger-workforce-strategies-2025-aha-health-care-workforce-scan <p>Claire Zangerle, DNP, R.N., chief executive officer of the American Organization for Nursing Leadership and senior vice president and chief nurse executive of the ���������� Association, and Joel Moore, DNP, R.N., chief nursing officer of MercyOne Genesis and chair of the AONL Workforce Committee, discuss the strategies identified by the 2025 AHA Health Care Workforce Scan, including how organizations can rethink culture, improve workforce pipelines and leverage partnerships to rebuild a stronger health care workforce. <a href="/advancing-health-podcast/2025-04-09-stronger-workforce-strategies-2025-aha-health-care-workforce-scan" target="_blank"><strong>LISTEN NOW</strong></a></p><div></div> Wed, 09 Apr 2025 15:17:21 -0500 Workforce /advancing-health-podcast/2025-04-09-stronger-workforce-strategies-2025-aha-health-care-workforce-scan <p>The ���������� Association’s 2025 Health Care Workforce Scan offers important insights into the current state of the health care workforce and outlines potential approaches to address both present and future staffing challenges. In this conversation, Claire Zangerle, DNP, R.N., chief executive officer of the American Organization for Nursing Leadership (AONL), and senior vice president and chief nurse executive of the ���������� Association, and Joel Moore, DNP, R.N., chief nursing officer of MercyOne Genesis, and chair of the AONL Workforce Committee, discuss the strategies the Workforce Scan has identified, including how organizations can rethink culture, improve workforce pipelines, and leverage partnerships to rebuild a stronger health care workforce.</p><p>To learn more about The ���������� Association’s 2025 Health Care Workforce Scan, please visit <a href="http://www.aha.org/aha-workforce-scan">www.aha.org/aha-workforce-scan</a>.</p><hr><div></div><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br> </h2> </summary> <p> 00:00:01:05 - 00:00:26:29<br> Tom Haederle<br> Welcome to Advancing Health. There aren't enough people working in health care to meet demand, either current or projected. In today's podcast, we learn more about how the ���������� Association's 2025 Health Care Workforce Scan has identified ways to enhance the overall workforce experience and help employers refresh, retain and recruit health care workers for the future. </p> <p> 00:00:27:01 - 00:00:51:14<br> Elisa Arespacochaga<br> Hello, I'm Elisa Arespacochaga, vice president for clinical affairs and workforce with the ���������� Association. Joining me today are Joel Moore, chief nursing officer with MercyOne Genesis and chair of the AONL Workforce Committee, and Claire Zangerle, chief executive officer of AONL, the American Organization for Nursing Leadership and senior vice president and chief nursing officer with the ���������� Association. </p> <p> 00:00:51:17 - 00:01:10:06<br> Elisa Arespacochaga<br> So today, we're here to talk about workforce, and we're here to talk about the 2025 Health Care Workforce Scan, which focuses on four opportunities hospitals and health systems have to really support their workforce. Because, as I have been known to say many, many times, there are no more people who are going to come work in health care. </p> <p> 00:01:10:06 - 00:01:29:07<br> Elisa Arespacochaga<br> We've got to keep the ones we have, and we really have to do more to encourage them to want to be in health care because there is probably a reason they started in health care. They were called to be there. Those four areas are embracing technologically integrated care models and innovation. Let's use technology as best we can. </p> <p> 00:01:29:10 - 00:01:53:12<br> Elisa Arespacochaga<br> The second is engaging the clinical teams in the design of those innovations. We've got to get them involved in all of those details. Third, boosting access by increasing that workforce through some innovative partnerships, encouraging more people to come into health care, who might not have thought of health care as a career and rethinking how we can engage with our workforce. </p> <p> 00:01:53:12 - 00:02:12:21<br> Elisa Arespacochaga<br> And I know most of the world is rethinking how they engage with their workforce in a more remote era. But we're going to talk a lot about how do we work on all four of those at the same time, while continuing to take care of the patients that come to our doors every day. Joel and Claire and I'll ask Joel - for you to start. </p> <p> 00:02:12:23 - 00:02:34:00<br> Elisa Arespacochaga<br> How are you seeing in your roles the field really connect these ideas together - from everything from how do we use technology? How do we bring the clinicians in to encourage more people to join health care and also really engage those we have? How do you see those threading together as you're trying to address workforce challenges? </p> <p> 00:02:34:02 - 00:03:04:28<br> Joel Moore<br> Yeah, it's a great question. I really appreciate what you said at the beginning about us being called into nursing. And I think that starts with the person at the bedside. And so as I've seen models of care and workforce wrap around and through these four top-of-mind ideas from the Workforce Scan, we have to really focus on the person providing care and engage them at every level of the work. </p> <p> 00:03:05:01 - 00:03:39:03<br> Joel Moore<br> I think some of the work from our history and from our past, how things unfolded, it was very much top down. At this era we need bedside nurses to be a part of technology innovation, redesigning the model of care, helping us establish what a healthy work environment is about. So I think we can tackle all four of these, but I think we have to have it driven by the nurse at the bedside, or from those frontline staff who are providing direct care to our communities. </p> <p> 00:03:39:05 - 00:03:42:17<br> Elisa Arespacochaga<br> Claire, from your perspective at AONL, how do you see this? </p> <p> 00:03:42:19 - 00:04:13:27<br> Claire Zangerle, DNP, R.N.<br> I think all four of these tenants for the Workforce Scan fit together very well to make a bigger picture of what needs to happen with the workforce. Embracing technology is so important because that in and of itself reduces the workload of those who are delivering care, whether they're in acute care setting, an outpatient setting, an ambulatory surgery center, post-acute care - wherever they are. Bringing those clinicians in to help make the decisions around the solution is essential to success. </p> <p> 00:04:14:00 - 00:04:39:22<br> Claire Zangerle, DNP, R.N.<br> There's really no way that anything technologically around the workforce can be successful without that clinician voice. Making sure that we take down some of those barriers that many are seeing as access to getting into health care so that they can become part of the health care ecosystem, I think is important, too, and it's really incumbent upon us as leaders in health care to take those barriers down. </p> <p> 00:04:39:25 - 00:05:01:28<br> Claire Zangerle, DNP, R.N.<br> And again, let's not forget about the people who are already here, who are already doing the hard work so that we can reengage them so that we can, you know, court them again, have them fall back in love with their jobs because we're losing them. And that's the hard part, is all of that knowledge capital and that dedication is leaving. </p> <p> 00:05:02:04 - 00:05:09:10<br> Claire Zangerle, DNP, R.N.<br> And those are let's solve the problems that we can solve because there's a lot of problems we can't. And that's a problem we can solve. </p> <p> 00:05:09:12 - 00:05:28:18<br> Elisa Arespacochaga<br> I completely agree with that. Joel, from your perspective, I know we've gotten to work together on the AHA and AONL care model learning community. What are you seeing organizations embrace in that technology space into their care models? And what do you think is really had the most impact? </p> <p> 00:05:28:21 - 00:05:57:21<br> Joel Moore<br> I am going to be cautious to say what's had the most impact, because I think we're still in development. We're still in the middle of the PDSA cycle. One of the first things that we stood up as a nursing profession in the pandemic and post pandemic was virtual nursing. And that's a model that does work for some. But I am unsure about the sustainability and if it really is having impact on patient outcomes. </p> <p> 00:05:57:24 - 00:06:40:15<br> Joel Moore<br> I think this is our era of really thinking outside the box. I'm getting goosebumps thinking about ambient listening and the forward thinking that's being done with that. Some people are labeling it AI and how that supports the lift of the workforce load. But, you know, I think about the little devices that we have in our homes and that we've had for years that we're bossing around. What can we do to develop technology with these really brilliant people that are at the bedside now to help support and engage and attract future workforce clinicians that won't ever even touch a keyboard? </p> <p> 00:06:40:17 - 00:06:58:00<br> Joel Moore<br> So, you know, there's so much technology  - from help that's moving pharmaceuticals from, you know, one level to another in the hospital to ambient listening to virtual nursing. There's just a long stream of technology that's helping us at this point. </p> <p> 00:06:58:03 - 00:07:20:04<br> Elisa Arespacochaga<br> Absolutely. And I think you are, you hit it on the head. We are very much in a phase of trying all of these different technologies to see which really, truly hit value for our organizations. And, you know, really help at the end of the day, that bedside nurse, that bedside clinician provide the best possible care for their patient. </p> <p> 00:07:20:06 - 00:07:30:15<br> Joel Moore<br> What's driving the outcomes? I don't think we have enough to say what has been the most successful to help drive outcomes, which is what we need to be looking at. </p> <p> 00:07:30:18 - 00:07:51:11<br> Claire Zangerle, DNP, R.N.<br> I think we also have to recognize the maturity of organizations around adopting technology. All organizations are on a different maturity model. Some are just thinking about it and what does it look like? And they're very scared of it. And I get that. And they're also asking themselves, do I have the money to invest in this? Because what if it doesn't work? </p> <p> 00:07:51:13 - 00:08:17:18<br> Claire Zangerle, DNP, R.N.<br> I'm taking a big chance. We're seeing a lot of people do pilots, and this is okay to do a pilot, to say, does this work for me and if not, I'm going to either scale fast or fail fast. And I think it's important that people realize that when they think about technology. But there's also a human side to this technology that's being adopted and that I think will come out loud and clear in the Workforce Scan. </p> <p> 00:08:17:21 - 00:08:51:24<br> Claire Zangerle, DNP, R.N.<br> Because just because you put technology in does not mean that you eliminate the human touch and the human aspect of caregiving. There's a lot of ways to do new models of care, including that human touch. Maybe you're using new disciplines to deliver that care, and they're infusing new technologies into using those new disciplines. We're inviting LPNs back into the acute care space when before we had somewhat dismissed LPNs to other care sites because we didn't have a place for them in acute care. Now we're rethinking that, </p> <p> 00:08:52:01 - 00:09:04:07<br> Claire Zangerle, DNP, R.N.<br> and that's the beauty of our being nimble in health care is to be able to rethink and reapproach for what works today and what is going to work for the future. </p> <p> 00:09:04:09 - 00:09:25:01<br> Joel Moore<br> Claire, I love that. I love that part too, perhaps even the people part of nursing. Perhaps we need to challenge, you know, what's our scope? We haven't revisited that for a while. You know, the scope of the RN, the scope of the LPN. It's, you know, it could be something. I've seen studies over in Europe, and we have opportunity to think about people. </p> <p> 00:09:25:06 - 00:09:31:07<br> Joel Moore<br> And I love the thread of people that is woven through the four core challenges brought forward in the Workforce Scan. </p> <p> 00:09:31:09 - 00:10:01:04<br> Elisa Arespacochaga<br> Joel, let me pick up on that. We all know that, you know, to some extent, the math doesn't work. With the retirement and aging of the baby boomers, the next generation, the staffing shortages, all of those things, they're just not going to go away. What are some of the pathways and partnerships you're seeing locally to really encourage people to not only get into health care, but now get into this, this new version of health care, this one that has the technology that is connecting to its frontline teams. </p> <p> 00:10:01:06 - 00:10:25:12<br> Joel Moore<br> Yeah, it's taking the message out early. You know, we have to engage what we've done here is engage in our community, even at the elementary school age level and talked about the brand image or what is a nurse now? What does that look like? We're still pretty close to the pandemic. So there's this frightening view of what it may appear to be if you were to practice nursing. </p> <p> 00:10:25:15 - 00:10:56:04<br> Joel Moore<br> And so taking the image of nursing and talking about the flexibility and engagement in the community that you can develop when you go into a profession like nursing, or many other professions at the bedside. So it's cultivating relationships early. I have a lot of energy focused on my partnerships with my colleges and universities that are within a 60 mile radius of the buildings. The colleges and universities know </p> <p> 00:10:56:04 - 00:11:21:19<br> Joel Moore<br> I'm going to say yes to every nursing student, once they get into studies to come and do their clinicals in my building. Because that's the future workforce. And there isn't enough of them. So engaging with our colleges and universities and taking the message out in places where we hadn't been before, I think there's still opportunity to perhaps persuade some people in other vocations. </p> <p> 00:11:21:19 - 00:11:32:20<br> Joel Moore<br> I'm a second vocation nurse, so I think we could persuade others to join the health care work environment if they really knew what fulfillment they would get practicing. </p> <p> 00:11:32:22 - 00:11:56:09<br> Elisa Arespacochaga<br> I always say that there are a lot of places I could earn a living with my MBA, but health care is the only place that feeds my soul. Claire, from a national perspective, we know health care works workers are...they're tired. Health care is hard. It's never not been hard. But we've been able to continue to attract a great, amazing group of people to work in health care and be connected to health care. </p> <p> 00:11:56:15 - 00:12:02:25<br> Elisa Arespacochaga<br> What are some of the strategies to now, given the challenges we're seeing, to keep them in health care? </p> <p> 00:12:02:28 - 00:12:24:03<br> Claire Zangerle, DNP, R.N.<br> The first thing we need to recognize is that the workforce is evolving. We have new generations of workers that are here in our midst, and we have to recognize that. We have to recognize the opportunity to embrace those ways of thinking. Back in the day, you would work 24/7 and not think anything about it. That's not healthy. </p> <p> 00:12:24:05 - 00:12:44:24<br> Claire Zangerle, DNP, R.N.<br> We have to recognize that people want to have harmony. They want to have a little bit of balance in their life. And health care is open 24/7, so we have to recognize that. And make sure that we're meeting the needs of a workforce that is before us. If we don't do that, we're not doing ourselves any favors. We're not going to grow our workforce. </p> <p> 00:12:44:24 - 00:13:03:00<br> Claire Zangerle, DNP, R.N.<br> We're not going to retain the people that want to work in this profession. You hear all the time, I love what I do, but I can't maintain the pace. And I think we will attract more people if we become more realistic about what people want in their work life. </p> <p> 00:13:03:02 - 00:13:11:15<br> Elisa Arespacochaga<br> Joel, on the ground at your organization, what some of the ways that you are really building that engagement and connection to your frontline teams? </p> <p> 00:13:11:18 - 00:13:39:15<br> Joel Moore<br> One of the ways is that we are building a culture of trust. You know, my visibility as CNO is really important. So our leaders are with our frontline, our executive level leaders are rounding, being with the frontline as much. So building that culture of trust, picking up on one thing that Claire had said, you know, at my organization, we are really trying to cultivate our workforce to look like our community. </p> <p> 00:13:39:18 - 00:13:57:25<br> Joel Moore<br> So we have a variety of cultures within our community. So we are recruiting from different neighborhoods that we hadn't recruited before. Which, you know, engages us in new ways as we're learning more about the people who may not be exactly like us. </p> <p> 00:13:57:27 - 00:13:59:10<br> Elisa Arespacochaga<br> That's awesome. </p> <p> 00:13:59:12 - 00:14:28:28<br> Elisa Arespacochaga<br> Joel and Claire, thank you so much for joining me today and sharing your views and how you're addressing this work, which are, among just some of the stories that are included in the 2025 AHA Health Care Workforce Scan, which is based on a review of reports and studies and leaders like Joel and Claire providing their input and insights and recommendations of what they are trying to really, support and retain our health care workforce </p> <p> 00:14:28:28 - 00:14:31:09<br> Elisa Arespacochaga<br> staff. So thank you both for joining me. </p> <p> 00:14:31:12 - 00:14:51:08<br> Tom Haederle<br> Thank you for joining us. If you'd like to learn more about the latest health care workforce trends and real world approaches to guide your workforce strategies, be sure to check out the 2025 Health Care Workforce scan at www.aha.org/aha-workforce-scan. </p> </details></div> Wed, 09 Apr 2025 09:54:13 -0500 Workforce /education-events/leading-way-health-care-organizations-commitment-workforce-well-being <div class="TTevent">/* Forces the event Content Type to be 100% */ .container .row .col-md-8{ width: 100% } .event-registration-link a{ margin-left: auto; margin-right: auto; display: block; text-align: center; } .event-registration-link a.btn-block { max-width: 300px; } .TTevent h3{ color:#002855; } .TTeventBonus{ color:#9d2235; font-weight:700; font-style: italic; } .TTeventdate{ font-weight: 700; font-size: 18px; color: #555555bb; line-height: 20px; } .TTeventSponsor img{ max-height:100px; } <p class="TTeventdate">Wednesday, May 14 at 1:00 pm ET (12:00 pm CT, 11:00 am MT, 10:00 am PT)</p><p>In this engaging webinar, explore how health care organizations are approaching workforce well-being through innovative strategies. Our discussion will focus on comprehensive, system-wide approaches that cultivate a culture of well-being within health care environments. We will highlight the significant contributions of professional societies and organizations, such as CHARM and the AHA, in advancing these efforts. Additionally, we will delve into the importance of language and terminology in building consensus and fostering a unified commitment to workforce well-being. Finally, we will discuss how organizations might be held accountable for their commitment to this vital cause, ensuring they uphold their promises to support workforce well-being. If you're passionate about enhancing the well-being of the health care workforce, we encourage your attendance.</p><h3>Learning Objectives:</h3><ul><li><strong>Understand the Importance of Consensus:</strong> Learn how creating agreement on the language and terms used to describe workforce well-being can enhance collaborative efforts</li><li><strong>Explore System-Level Initiatives:</strong> Discover how healthcare organizations can commit to workforce well-being through initiatives like well-being-centered leadership, effective communication strategies, and innovative efficiency tools</li><li><strong>Recognize the Role of Professional Societies:</strong> Identify how entities like CHARM and the AHA contribute to the well-being of the healthcare workforce</li><li><strong>Accountability in Commitment:</strong> Consider strategies for holding healthcare organizations accountable for their efforts in promoting workforce well-being</li></ul><h3>Speaker:</h3><ul><li><strong>Jonathan Ripp, MD, MPH</strong><br><em>Dean for Well-Being and Resilience, Chief Wellness Officer,</em> Icahn School of Medicine at Mount Sinai</li></ul><h3>Continuing Education:</h3><p>Participants will earn <a href="/system/files/media/file/2025/02/2025_Team_%20Training_Webinar_CE_Designation.pdf" target="_blank">1.00 Joint Accreditation credit hour</a> for this webinar by completing all CE requirements. CE credit is provided by Duke University Health System Clinical Education & Professional Development. They are accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE) and the Accreditation Council for Continuing Medical Education (ACCME).</p><p>In order to qualify for credit, you must have an active Duke OneLink Account and watch the webinar live. If you do not have a Duke OneLink account, please follow <a href="/system/files/media/file/2025/02/2025_CE_Instructions_Webinars.pdf" target="_blank">these directions</a> to set up your account and confirm your mobile number (both steps are required). Please note this is a one-time set-up and you may use your account for all future AHA Team Training webinars.</p> <h3>Sponsored By:</h3> <a href="https://cnhs.fiu.edu/" target="_blank"><img alt="Florida International University | Nicole Wertheim College of Nursing & Health Sciences" src="/sites/default/files/2022-04/Florida_International_University_logo_200x70.png" /> </a></div> </div>--> <div data-langcode="en" data-entity-type="webform" data-entity-uuid="0b43a680-6f37-4d3f-9bf9-4cd6c7c7ddc5" data-embed-button="webform_embed" data-entity-embed-display="view_mode:webform.token" data-entity-embed-display-settings="[]" class="embedded-entity"> <div id="edit-processed-text" class="js-form-item form-item js-form-type-processed-text form-item- js-form-item- form-no-label"> <div class="TTwebinarHide"> .webform-submission-form { max-width: 700px; } .TTwebinarHide{ display:none } .event-content.panel .TTwebinarHide { display:block; background-color: #fff; padding: 15px 15px 15px 15px; border: solid 2px #307FE2; text-align: center; } <p><a href="/center/team-training">Team Training</a> offers a variety of webinars - view our <a href="/center/team-training/webinars">current offering(s)</a> or browse the <a href="/center/team-training/webinars/library">library</a>.</p> </div> </div> </div></div> Tue, 08 Apr 2025 13:05:33 -0500 Workforce /advancing-health-podcast/2025-03-31-leadership-dialogue-series-importance-advocacy-and-storytelling-rural-health <p>In this Leadership Dialogue conversation, Tina Freese Decker, president and CEO of Corewell Health and 2025 AHA board chair, talks with Lori Wightman, R.N., CEO of Bothwell Regional Health Center, about the challenges that rural hospitals and health systems face, including razor-thin operating margins and workforce staffing, before pivoting to discuss the importance of advocacy in telling the hospital story.</p><hr><div></div><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br> </h2> </summary> <p> 00:00:01:05 - 00:00:23:09<br> Tom Haederle<br> Welcome to Advancing Health. In the face of today's multiple challenges, every hospital needs support and buy in for its mission of great care. Storytelling - sharing the right kinds of stories with the right audience at the right time - is a great way to build and maintain that support. This is particularly important for rural hospitals and health systems, most of which have razor-thin operating margins. </p> <p> 00:00:23:12 - 00:00:40:10<br> Tom Haederle<br> In this month's Leadership Dialogue, hosted by the ���������� Association's 2025 Board Chair Tina Freese Decker, we hear more about the importance of advocacy and of all team members participating in telling the hospital story. </p> <p> 00:00:40:13 - 00:01:07:25<br> Tina Freese Decker<br> Thank you so much for joining us today. I'm Tina Freese Decker, president CEO for Corewell Health, and I'm also the board chair for the ���������� Association. Last month we talked about trust and how our hospitals and our health systems can strengthen that trust with our communities and the people that we serve. Our rural hospitals are uniquely positioned to do this, as they are often the largest employers in their towns and communities, and frequently the only local source of care. </p> <p> 00:01:07:27 - 00:01:28:07<br> Tina Freese Decker<br> Rural health care is about being a family. We take care of each other in our communities as best as possible, and we're here to provide that care close to home, no matter what headwinds that we all face. I recently had the opportunity to attend the ���������� Association's Rural Conference and you could really feel that sense of family and community in the room. </p> <p> 00:01:28:09 - 00:01:59:15<br> Tina Freese Decker<br> We work in hospitals in red states and blue states all across the country, but we are all focused on the same thing: helping our neighbors in our communities to be healthier. There are some big challenges that are facing real health care, but together with a unified voice, we can get what we need. As I have traveled around our country meeting with the ���������� Association's regional policy boards and visiting the rural hospitals and my health system and others, the number one concern that I have heard from our hospitals, our communities, is access. </p> <p> 00:01:59:18 - 00:02:22:28<br> Tina Freese Decker<br> And that is why it is so integral to the ���������� Association strategy and it is why it is so important that we come together as a field and that we're united as a field, because these challenges that we are facing are real. So today, I am pleased to have a distinguished leader in rural health care with us to talk about how we can all work together to advocate for the needs of our hospitals. </p> <p> 00:02:23:01 - 00:02:45:09<br> Tina Freese Decker<br> I'd like to welcome Lori Wightman. She is the CEO of Bothwell Regional Health Center, a 108 bed acute care hospital in Sedalia, Missouri. Laura has served in this role since 2019, but even prior to Bothwell, she worked in real health care as the president of Mercy Hospital Ada in Ada, Oklahoma. So, Lori, welcome. Glad you were able to join us today. </p> <p> 00:02:45:15 - 00:02:46:17<br> Lori Wightman, R.N.<br> Thank you, Tina. </p> <p> 00:02:46:19 - 00:03:03:20<br> Tina Freese Decker<br> And I wanted to start out with just telling us a little bit about yourself. I know you started your health care career as a nurse and then you made the shift to administration. Can you tell us about yourself and how you see that family aspect in the hospital and the community in our rural areas? </p> <p> 00:03:03:22 - 00:03:30:01<br> Lori Wightman, R.N.<br> Sure. Well, my father was a hospital administrator and my mother was a nurse, so I did both. And so it was a natural progression. And I think the foundation that nursing lays gives you all kinds of transferable skills that have been very helpful as I went into hospital administration. My career and dating advice has always been, you can't go wrong with a nurse. </p> <p> 00:03:30:03 - 00:03:57:14<br> Lori Wightman, R.N.<br> And there's certainly served me well. And you talk about that family atmosphere. That is why I continue to choose rural health care. I've done the CEO position in a suburban hospital, and I sat at our senior leadership team meeting and thinking I was the only one on our senior leadership team that even lived in the area that we served. </p> <p> 00:03:57:17 - 00:04:23:24<br> Lori Wightman, R.N.<br> Everyone else lived in a different suburb, and I just thought that was strange and disconnected. And, so I returned again then to rural health care because it is like a family. And it's ironic because we just finished revisiting our mission, vision and values. And our new mission statement talks about together we work to provide compassionate and safe care to family, friends, and neighbors. </p> <p> 00:04:23:27 - 00:04:37:07<br> Lori Wightman, R.N.<br> Invariably, when I met new employee orientation, a significant number of people were born at the hospital. That's why I love rural. It's like that "Cheers" phenomenon where everyone knows your name. </p> <p> 00:04:37:09 - 00:05:01:02<br> Tina Freese Decker<br> Very true. I used to lead a couple of rural hospitals as well. And like you said, even just walking into a rural hospital it feels like family where everyone there knows your name and of course, protect things from a confidentiality and a privacy perspective, but that feeling that we're all in this together. So I love that your mission statement is about together, that you can make an impact on people's health. </p> <p> 00:05:01:05 - 00:05:13:28<br> Tina Freese Decker<br> I described a little bit about what it's like to walk into a rural hospital. Can you share a little bit about what is like to be a rural hospital, what it means in today's environment and why it's such a great place to work? </p> <p> 00:05:14:01 - 00:05:47:06<br> Lori Wightman, R.N.<br> Well, in many ways, rural hospitals are uniquely the same as our suburban or urban counterparts. Forty six million people depend on a rural hospital for their care. So we struggle with the same labor shortages, the cost of labor supplies and drugs is rising faster than our reimbursement. We have all of those same struggles. Unique is that family atmosphere, I think. </p> <p> 00:05:47:06 - 00:06:13:26<br> Lori Wightman, R.N.<br> And we have multiple generations working at the hospital. Now, you can't say anything bad about anyone because invariably they're somehow related. Or they were best friends in high school, or they used to be married to each other. So I mean, it's unique in that way. We have the same types of struggles that  our counterparts do. </p> <p> 00:06:13:28 - 00:06:18:03<br> Tina Freese Decker<br> What pressures are you feeling the most acutely right now? </p> <p> 00:06:18:06 - 00:06:47:09<br> Lori Wightman, R.N.<br> Well, you take all of those common challenges that I talked about, and you turn up the volume a little bit. Because for us, 78% of our patients and our volume is governmental payers, so 78% of our business, we're getting reimbursed below cost. You can't make that up in volume. So we rely on all of the governmental programs, you know, disproportionate share all of those things. </p> <p> 00:06:47:09 - 00:06:54:22<br> Lori Wightman, R.N.<br> And, 340B is doing exactly for us what it was designed to do, save rural hospitals. </p> <p> 00:06:54:25 - 00:07:11:22<br> Tina Freese Decker<br> Those areas are critical that they remain. And so that we can continue to provide that sustainable, high quality care in our communities and all of our communities. 78% being governmental. It's a huge portion of what we do and what we rely on for access and caring for people. </p> <p> 00:07:11:29 - 00:07:23:15<br> Lori Wightman, R.N.<br> Right. We are the typical rural hospital. We have razor-thin margins and aging plant of 18 years. </p> <p> 00:07:23:18 - 00:07:31:10<br> Tina Freese Decker<br> So those are challenges that you're trying to navigate right now with all of the other things that happen. And how is your staffing levels going? Are those going okay? </p> <p> 00:07:31:13 - 00:07:55:12<br> Lori Wightman, R.N.<br> Have the same labor shortage issues. We still have 22 traveling nurses here, but we have started being very aggressive in a grow your own program. And so as soon as the next month we're going to cut that number in half and then, within six months, we're hoping to have all of contract staff out. </p> <p> 00:07:55:15 - 00:08:02:04<br> Tina Freese Decker<br> Is that something that you're most proud of, or is there something else that you want to share that you're most proud of from a rural hospital perspective? </p> <p> 00:08:02:06 - 00:08:29:24<br> Lori Wightman, R.N.<br> I think what I'm most proud of is you get to personally view the impact of your decisions on people. I'm very proud of our all the talented people that we have here, from clinicians to community health workers. All of our physicians get to use all of the things they learned in medical school and residency, because there isn't a lot of subspecialists, so they are working at the top of their license. </p> <p> 00:08:29:26 - 00:08:50:21<br> Lori Wightman, R.N.<br> Just several months ago, one of our critical care physicians diagnosed a case of botulism. Now as an old infection control nurse I get very excited about that because I never thought in my career I would see botulism. But it was diagnosed and treated here and the person's doing well. </p> <p> 00:08:50:23 - 00:09:25:27<br> Tina Freese Decker<br> Oh, that's wonderful to hear. When you talk about all the different people that are part of health care in rural settings, or also another settings, it's quite amazing to see how many different areas we need to come together to take care of our community. When you think about an even larger scale, from rural hospitals to urban and teaching hospitals and others, how do you think about the whole ecosystem of our field and how we, you know, do we need all of us or and is there a way to form that greater fabric and social connection, or is there something else that we should be doing? </p> <p> 00:09:25:29 - 00:09:50:21<br> Lori Wightman, R.N.<br> We are all very interconnected and I believe we are all needed. And I especially feel that as an independent hospital, not part of a health system, this is my first independent hospital. I rely on my hospital association more than I ever did when I was working for a health system, because it all comes down to relationships. </p> <p> 00:09:50:21 - 00:10:18:13<br> Lori Wightman, R.N.<br> And so how do you develop, how do you get yourself in situations where you are meeting and now working with your partners around the state or the region? Because it comes down to relationships, you really need to know who your neighbors are in terms of other hospitals, who you're referring your patients to and develop that working relationship because it is all interconnected. </p> <p> 00:10:18:13 - 00:10:25:06<br> Lori Wightman, R.N.<br> And we rely on our partners that we refer to, and they rely on us, too. </p> <p> 00:10:25:08 - 00:10:43:23<br> Tina Freese Decker<br> One of the things I heard you say about the Rural Health Conference that the ���������� Association just put on, and the value of the ���������� Association is that we're not alone. And those values of relationships are really critical. So I appreciate that. The ���������� Association also talks a lot about how do we tell the hospital story. </p> <p> 00:10:43:25 - 00:10:55:15<br> Tina Freese Decker<br> So how do you engage in advocacy to make sure we're telling that hospital story so that our legislative leaders and others know the value that we're bringing to the community? </p> <p> 00:10:55:17 - 00:11:22:11<br> Lori Wightman, R.N.<br> Well, we are surrounded by stories. And so the first thing is to always be picking up on what is the story that is surrounding us, and how can we capture that? Because the most effective way is to bring that patient or nurse or physician to the legislator to testify, because they are the most effective way of communicating a message. </p> <p> 00:11:22:18 - 00:11:49:07<br> Lori Wightman, R.N.<br> You know, the suits can go and talk about data, but nothing is more effective than what I call a real person telling their story and how a decision or a potential decision is going to impact them and how it feels. The other thing we do is every October, it's become tradition. We have Advocacy Day with our board, at our board meeting. </p> <p> 00:11:49:09 - 00:12:21:12<br> Lori Wightman, R.N.<br> We invite our state elected officials  - so people representing us at the state capitol - to come to our board meetings. On election years their challengers also come and I invite the hospital association and they all answer two questions: What do you hope to accomplish in the next legislative session, and what do you think might get in the way? That sets the scene for my board to understand that part of their role in governance is advocacy. </p> <p> 00:12:21:14 - 00:12:29:19<br> Lori Wightman, R.N.<br> And so I've had two of my board members...almost every legislative session I go and testify on on some bill. </p> <p> 00:12:29:21 - 00:12:50:01<br> Tina Freese Decker<br> That is really a good idea. Thank you so much for sharing that. Do you have any other final suggestions for us as AHA members, as other hospitals, whether it's rural or urban, that we should think about or do as we think about advocacy and access or also field unity? </p> <p> 00:12:50:03 - 00:13:22:11<br> Lori Wightman, R.N.<br> You know, having been on the board of two different state hospital associations, I get it. You know, sometimes members can be at odds with each other on a given issue. And my advice to AHA would be to play the role of convener, facilitating conversations between members to better understand each other's position. And if a middle ground can't be reached, then that might be an issue that AHA remains neutral on. </p> <p> 00:13:22:14 - 00:13:34:07<br> Lori Wightman, R.N.<br> But there are so many issues where we can agree on and that is very much the role and what all of us depend on AHA to play in advocating. </p> <p> 00:13:34:09 - 00:14:02:15<br> Tina Freese Decker<br> There's a lot that binds us together. Like you said, we're all caring for our neighbors and our communities, and that's the most critical piece of it. And we have to keep that front and center with every decision that we make and every action that we do. Well, Lori, thank you so much for being with us today on this AHA podcast, for sharing your expertise in rural health care and for talking about some new ideas that all of us can take forward to ensure that we're telling the hospital story in the best way possible. </p> <p> 00:14:02:18 - 00:14:21:09<br> Tina Freese Decker<br> So while I know that we have our work ahead of us, I know that I continue to be energized every time I speak with committed and passionate hospital leaders like Lori. Again, appreciate your work that you do every single day for the neighbors and for the people in your community that you serve. We'll be back next month for another Leadership Dialogue conversation. </p> <p> 00:14:21:13 - 00:14:23:01<br> Tina Freese Decker<br> Have a great day. </p> <p> 00:14:23:03 - 00:14:31:13<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts. </p> </details></div> Mon, 31 Mar 2025 01:41:00 -0500 Workforce /news/headline/2025-03-27-aha-others-urge-congress-reauthorize-and-expand-workforce-program-foreign-born-staff <p>The AHA and dozens of other organizations yesterday urged <a href="/lettercomment/2025-03-27-house-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act">House</a> and <a href="/lettercomment/2025-03-27-senate-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act">Senate</a> sponsors of the <a href="https://S. 709 [https://www.congress.gov/bill/119th-congress/senate-bill/709] /H.R.1585 [https://www.congress.gov/bill/119th-congress/house-bill/1585]">Conrad State 30 and Physician Access Reauthorization Act</a> to reauthorize and expand the program which allows foreign-born medical graduates trained in the U.S. to practice medicine in rural and underserved areas. The bipartisan legislation would increase current state allocations from 30 to 35 physicians per year and provide flexibility to expand the number of waivers in states where demand exceeds that limit. <br><br>“One of the strengths of the Conrad 30 program is its flexible design, which allows each state to tailor the program to meet its specific healthcare needs,” the organizations wrote. “This reauthorization will reinforce that flexibility while providing needed clarity and incentives to attract and retain more highly qualified physicians. As workforce shortages worsen, Congress must act with urgency to advance this legislation and strengthen one of the most successful programs for addressing healthcare workforce shortages.” </p> Thu, 27 Mar 2025 15:43:19 -0500 Workforce /lettercomment/2025-03-27-senate-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act <div class="container"><div class="row"><div class="col-md-8"><p>March 26, 2025</p><div class="row"><div class="col-md-6"><p>The Honorable David Valadao<br>US House of Representatives<br>2465 Rayburn House Office Building<br>Washington D.C., 20515</p></div><div class="col-md-6"><p>The Honorable Brad Schneider<br>US House of Representatives<br>300 Cannon House Office Building<br>Washington D.C., 20515</p></div></div><div class="row"><div class="col-md-6"><p>The Honorable Don Bacon<br>US House of Representatives<br>2104 Rayburn House Office Building<br>Washington D.C., 20515</p></div><div class="col-md-6"><p>The Honorable Sylvia Garcia<br>US House of Representatives<br>2419 Rayburn House Office Building<br>Washington D.C., 20515</p></div></div></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/03/senate-letter-from-aha-other-organizations-in-support-of-conrad-state-30-and-physician-access-reauthorization-act-s709-3-26-2025.pdf" target="_blank">Download the Senate Letter PDF</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/lettercomment/2025-03-27-house-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act" target="_blank">Read the House Letter</a></div></div></div><div class="row"><div class="col-md-8"><p>Dear Senators Klobuchar, Collins, Rosen, and Tillis:</p><p>On behalf of the 45 undersigned organizations, we are writing to strongly support the introduction of the Conrad State 30 and Physician Access Reauthorization Act (S. 709).</p><p>The healthcare workforce is under increasing strain. The aging U.S. population is increasing demand for healthcare services while also contributing to physician attrition. At the same time, reimbursement challenges in Medicare, along with insufficient investment in graduate medical education, have made the practice of medicine more difficult and constrained the pipeline of new doctors. These challenges are particularly acute in rural and underserved communities, where workforce shortages have led to severe access issues. Today, more than 80 million Americans lack adequate access to primary care, exacerbating health disparities across the country.</p><p>Confronting this challenge will require a comprehensive approach from Congress. A key part of the solution is leveraging international medical graduates (IMGs). One in five physicians in the U.S. is foreign-born, and these doctors play an essential role in filling workforce shortages in areas and specialties that struggle to recruit and retain physicians. These include geriatric medicine, interventional cardiology, nephrology, neurology, and critical care medicine, where IMGs are disproportionately represented. The Conrad 30 program is an effective tool for incentivizing U.S.-trained international physicians to work in these high-need areas.</p><p>Over the last 30 years, the program has facilitated placement of approximately 20,000 physicians in communities that otherwise might not have had access to health care. The program has also demonstrated success at retaining physicians beyond the three-year commitment. However, misaligned incentives and outdated policies are jeopardizing the future success of the program.</p><p>The Conrad State 30 and Physician Access Reauthorization Act would make necessary updates to strengthen the program. In addition to gradually increasing the number of available waivers per state if certain thresholds are met, it also clarifies and improves the waiver process for both physicians and employers by making clear the transition period between receiving a waiver and beginning work. These commonsense changes will improve program efficiency and help ensure that more IMGs can pursue opportunities in underserved areas.</p><p>One of the strengths of the Conrad 30 program is its flexible design, which allows each state to tailor the program to meet its specific healthcare needs. This reauthorization will reinforce that flexibility while providing needed clarity and incentives to attract and retain more highly qualified physicians. As workforce shortages worsen, Congress must act with urgency to advance this legislation and strengthen one of the most successful programs for addressing healthcare workforce shortages.</p><p>Thank you again for your leadership on this important issue. We look forward to working with you to advance this bill and ensure that the Conrad 30 program continues to serve as a healthcare and economic lifeline for communities in need.</p><p>Sincerely,</p><p>Alliance for Headache Disorders Advocacy<br>Ambulatory Surgery Center Association<br>American Academy of Family Physicians<br>American Academy of Neurology<br>American Academy of Physical Medicine and Rehabilitation<br>American Association of Child and Adolescent Psychiatry<br>American Association of Neuromuscular & Electrodiagnostic Medicine<br>American Brain Coalition<br>American College of Obstetricians and Gynecologists<br>American College of Physicians<br>American College of Radiology<br>American College of Rheumatology<br>American College of Surgeons<br>American Gastroenterological Association<br>American Geriatrics Society<br>���������� Association<br>American Medical Association<br>American Psychiatric Association<br>American Society of Anesthesiologists<br>American Society of Neuroradiology<br>Anxiety and Depression Association of America<br>Association for Advancing Physician and Provider Recruitment (AAPPR)<br>Association of Clinicians for the Underserved (ACU)<br>Association of American Medical Colleges<br>Association of University Professors of Neurology<br>College of American Pathologists<br>Bobby Jones Chiari & Syringomyelia Foundation<br>Dystonia Medical Research Foundation<br>Federation of ����������s (FAH)<br>Hope for HIE<br>Hydrocephalus Association<br>Infectious Diseases Society of America<br>International Bipolar Foundation<br>M-CM Network<br>Miles for Migraine<br>MLD Foundation<br>NANOS (North American Neuro- opthalmology Society)<br>National Ataxia Foundation<br>The Niskanen Center<br>Phelan-McDermid Syndrome Foundation<br>Physicians for American Healthcare Access (PAHA)<br>Premier Inc.<br>Society of Hospital Medicine<br>The Society of Thoracic Surgeons<br>SynGAP Research Fund dba CURE SYNGAP1<br> </p></div></div></div> Thu, 27 Mar 2025 13:13:34 -0500 Workforce /lettercomment/2025-03-27-house-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act <div class="container"><div class="row"><div class="col-md-8"><p>March 26, 2025</p><div class="row"><div class="col-md-6"><p>The Honorable David Valadao<br>US House of Representatives<br>2465 Rayburn House Office Building<br>Washington D.C., 20515</p></div><div class="col-md-6"><p>The Honorable Brad Schneider<br>US House of Representatives<br>300 Cannon House Office Building<br>Washington D.C., 20515</p></div></div><div class="row"><div class="col-md-6"><p>The Honorable Don Bacon<br>US House of Representatives<br>2104 Rayburn House Office Building<br>Washington D.C., 20515</p></div><div class="col-md-6"><p>The Honorable Sylvia Garcia<br>US House of Representatives<br>2419 Rayburn House Office Building<br>Washington D.C., 20515</p></div></div></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2025/03/house-letter-from-aha-other-organizations-in-support-of-conrad-state-30-and-physician-access-reauthorization-act-h-r585-letter-3-26-2025.pdf" target="_blank">Download the House Letter PDF</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/lettercomment/2025-03-27-senate-letter-aha-other-organizations-support-conrad-state-30-and-physician-access-reauthorization-act" target="_blank">Read the Senate Letter</a></div></div></div><div class="row"><div class="col-md-8"><p>Dear Representatives Valadao, Schneider, Bacon, and Garcia:</p><p>On behalf of the 45 undersigned organizations, we are writing to strongly support the introduction of the Conrad State 30 and Physician Access Reauthorization Act (H.R. 1585).</p><p>The healthcare workforce is under increasing strain. The aging U.S. population is increasing demand for healthcare services while also contributing to physician attrition. At the same time, reimbursement challenges in Medicare, along with insufficient investment in graduate medical education, have made the practice of medicine more difficult and constrained the pipeline of new doctors. These challenges are particularly acute in rural and underserved communities, where workforce shortages have led to severe access issues. Today, more than 80 million Americans lack adequate access to primary care, exacerbating health disparities across the country.</p><p>Confronting this challenge will require a comprehensive approach from Congress. A key part of the solution is leveraging international medical graduates (IMGs). One in five physicians in the U.S. is foreign-born, and these doctors play an essential role in filling workforce shortages in areas and specialties that struggle to recruit and retain physicians. These include geriatric medicine, interventional cardiology, nephrology, neurology, and critical care medicine, where IMGs are disproportionately represented. The Conrad 30 program is an effective tool for incentivizing U.S.-trained international physicians to work in these high-need areas.</p><p>Over the last 30 years, the program has facilitated placement of approximately 20,000 physicians in communities that otherwise might not have had access to health care. The program has also demonstrated success at retaining physicians beyond the three-year commitment. However, misaligned incentives and outdated policies are jeopardizing the future success of the program.</p><p>The Conrad State 30 and Physician Access Reauthorization Act would make necessary updates to strengthen the program. In addition to gradually increasing the number of available waivers per state if certain thresholds are met, it also clarifies and improves the waiver process for both physicians and employers by making clear the transition period between receiving a waiver and beginning work. These commonsense changes will improve program efficiency and help ensure that more IMGs can pursue opportunities in underserved areas.</p><p>One of the strengths of the Conrad 30 program is its flexible design, which allows each state to tailor the program to meet its specific healthcare needs. This reauthorization will reinforce that flexibility while providing needed clarity and incentives to attract and retain more highly qualified physicians. As workforce shortages worsen, Congress must act with urgency to advance this legislation and strengthen one of the most successful programs for addressing healthcare workforce shortages.</p><p>Thank you again for your leadership on this important issue. We look forward to working with you to advance this bill and ensure that the Conrad 30 program continues to serve as a healthcare and economic lifeline for communities in need.</p><p>Sincerely,</p><p>Alliance for Headache Disorders Advocacy<br>Ambulatory Surgery Center Association<br>American Academy of Family Physicians<br>American Academy of Neurology<br>American Academy of Physical Medicine and Rehabilitation<br>American Association of Child and Adolescent Psychiatry<br>American Association of Neuromuscular & Electrodiagnostic Medicine<br>American Brain Coalition<br>American College of Obstetricians and Gynecologists<br>American College of Physicians<br>American College of Radiology<br>American College of Rheumatology<br>American College of Surgeons<br>American Gastroenterological Association<br>American Geriatrics Society<br>���������� Association<br>American Medical Association<br>American Psychiatric Association<br>American Society of Anesthesiologists<br>American Society of Neuroradiology<br>Anxiety and Depression Association of America<br>Association for Advancing Physician and Provider Recruitment (AAPPR)<br>Association of Clinicians for the Underserved (ACU)<br>Association of American Medical Colleges<br>Association of University Professors of Neurology<br>College of American Pathologists<br>Bobby Jones Chiari & Syringomyelia Foundation<br>Dystonia Medical Research Foundation<br>Federation of ����������s (FAH)<br>Hope for HIE<br>Hydrocephalus Association<br>Infectious Diseases Society of America<br>International Bipolar Foundation<br>M-CM Network<br>Miles for Migraine<br>MLD Foundation<br>NANOS (North American Neuro- opthalmology Society)<br>National Ataxia Foundation<br>The Niskanen Center<br>Phelan-McDermid Syndrome Foundation<br>Physicians for American Healthcare Access (PAHA)<br>Premier Inc.<br>Society of Hospital Medicine<br>The Society of Thoracic Surgeons<br>SynGAP Research Fund dba CURE SYNGAP1</p></div></div></div> Thu, 27 Mar 2025 12:45:25 -0500 Workforce