As the Affordable Care Act reached its first major milestone with open enrollment ending on March 31, those in the healthcare services industry continue to monitor current operations closely. Since there is always room for improvement – not to mention an influx of 7.1 million insured Americans – healthcare staffing organizations want to make sure they are well positioned to handle this transformative change.
One essential area of opportunity is found in a survey called Hospital Care Quality Information from the Consumer Perspective. In general, this survey offers insight by measuring hospital care based on patients’ perspective. Healthcare staffing providers can benefit from the results of this survey to recruit and place healthcare professionals trained to meet patient needs.
Hospital Consumer Assessment of Healthcare Providers and Systems is responsible for collecting data on a national perspective from the patients’ perspective. Using a random sample of adult patients, the 32-question survey measures nine key topics:
Typically, adult patients receive the survey between 48 hours and six weeks after being discharged from the hospital. The survey is interested in whether their hospital stay was good enough to recommend the facility to others. Answers to the survey could carry a tremendous amount of weight in the hospital’s approach to caring for patients. An increase in consumer awareness and social transparency encourages this level of probing.
Furthermore, the ACA ties performance of hospitals from survey responses to how some payments to hospitals are calculated. Healthcare staffing providers can use the quality scores as they partner with hospitals to provide staffing services. By partnering with medical facilities that are part of the survey results, healthcare staffing companies share in the commitment to ensuring employees provide the highest quality of patient care.
The federal government surpassed its target of enrolling seven million people in new health insurance plans. In addition, over three million Americans enrolled in the Medicaid expansion. By 2023, estimates are that at least 25 million people will benefit from having health insurance in the United States. Beyond the excitement generated by increased numbers, healthcare staffing providers must succeed in a quality of patient care environment.
Healthcare staffing providers have a pivotal role in driving quality patient care in hospitals. This is realized through a commitment to providing tools, training and education as necessary to associates before placing them on assignments. Doing so will help to ensure that clients receive high HCAHPS scores. Not only is this a reflection on the quality of service patients receive, but also on what staffing providers deliver. Therefore, hospitals and staffing providers have a shared commitment to high quality care.
The war for top talent will continue as acute shortage of healthcare professionals forces staffing providers to provide innovative staffing solutions. They will need to create a culture of value among associates that will be critical to retention. Additionally, the need to feel appreciated and engaged will not change among workers. Nevertheless, this fundamental shift in how the business of healthcare is conducted can directly impact how patients feel while receiving treatment.
There are other changes underway that will impact healthcare staffing for 2014 and beyond. Consumer access to healthcare will change, as well as new payment models for healthcare providers.
The volume-driven payment model is being replaced with a value-driven agenda that reinforces caring for patients’ needs. What this means for the healthcare staffing industry is a rapidly changing regulatory landscape that could complicate the decision-making process for some patients.
The last several years have seen a consolidation wave in the healthcare industry. Larger hospital systems continue to expand by acquiring independent physician practices. Most common disciplines going through these changes have been primary care, oncology and cardiology.
This trend is largely contributed to the way the Medicare payment system has evolved. Essentially, services performed in a hospital outpatient setting can be reimbursed 30 percent more when conducted in a physician’s office. Additionally, larger hospital systems can rationalize making technology investments to improve patient care when their scale is leverage through greater purchasing power.
At the same time, bigger is not necessarily better if everything is done at a cheaper cost. Some procedures are more economically feasible when performed in an ambulatory setting. In response, some local hospital systems are turning to a hub-and-spoke model. This model has a main hospital that centralizes management and performs certain types of patient care while other procedures are conducted at satellites.
The consequence of this consolidation trend for healthcare staffing providers is the creation of larger clients to target. When a consistent hospital client grows by acquiring a physician’s office, it is close to obtaining new business – without spending resources to solicit the business. However, the change in structure could also increase staffing competition and price sensitivity. This is particularly true if the acquired facility controls staffing decisions.
Some staffing providers might need to rethink recruitment efforts. Education and training standards may change and become more stringent than former requirements. What is more is that hospitals historically had a higher temporary penetration rate compared to other healthcare facilities such as community health centers and ambulatory care. Selling to hospitals and their satellite locations might require a learning curve for staffing providers to meet expectations.
The broad expansion of health insurance coverage under the ACA should have a huge factor in how Americans choose to access healthcare. However, the nature of the impact might not be as spontaneous as expected. For example, healthcare experts predict a relative decline in emergency care admissions since the newly insured can access treatment from more appropriate channels.
Although it is worth noting that Massachusetts, which implemented a similar law in 2006, reports seeing a spike in ER utilization. This was mostly due to a backlog of patients seeking care in the ER because an appointment with their primary physician would take months. For the most part, however, the demographics of the newly insured under federal healthcare reform are younger and healthier. Outpatient, primary care and preventive services are expected to experience the increase.
Beyond the changing settings of patient care, new payment structures are predicted to have a greater impact on healthcare staffing providers. Government and private insurance companies are shifting to models that reward positive health outcomes. The current paradigm is a fee-for-service model.
For instance, an Accountable Care Organization will limit revenue being linked to the number of bed days. Instead, the focus will be on lower readmission rates and hospital acquired conditions. Bundled payments, which reimburse healthcare providers on an expected cost basis for an episode of care is expected to become more common. These payments apply to the collection of care providers must use to treat a condition over a given period of time.
On its face, some healthcare staffing providers might view this as a negative since procedure volume was the main driver of demand. Multiple studies seem to show favorable results for staffing providers. This is because staffing levels correlate with value-based results such as a reduction in unfavorable outcomes and low readmission rates.
What is critical for healthcare staffing providers to focus on is closer engagement with clients to determine underlying needs and objectives. The response for healthcare providers should be to articulate how their services meet those needs.
As the U.S. healthcare system transforms under ACA provisions, change might be the only constant for staffing providers – at least for the near future. All stakeholders will need to adjust and the successful staffing providers will position their firms as solutions experts, not simply suppliers of temporary workers. Because of more focus on quality patient outcomes, healthcare staffing can witness a revolution for an industry that has been more reticent than others in using staffing services.
