Healthcare News of Note: Sg2 report says lower-acuity care to continue its migration outside of hospital walls

• Additional lower-acuity care will be delivered, and it will be delivered outside of hospital walls, according to a new national report.
• Hospitals and health systems have been reacting to nursing shortages with hefty sign-on bonuses. A shortage also caused the Grande Ronde Hospital and Clinics to close its hospice program.
• In the wake of the COVID-19 pandemic, states are passing laws that could endanger public health, according to a report from the National Association of County and City Health Officials.

Over the last couple of weeks, I’ve found these industry news stories that should be of interest to healthcare finance professionals.  

1. Sg2 report: Lower-acuity care continues its migration outside of hospital walls

As described in a June 4 article in Modern Healthcare (login required), a new national report out from market analytics and insights company Sg2 contributed “to a growing collection of data showing that there will be more lower-acuity care delivered and it will be delivered outside of hospital walls.”

Lisa Gillespie, article author, wrote, “Inpatient discharge volumes overall will decline by 1% by 2029, while outpatient volumes will increase by 19%, and ambulatory surgical centers will see growth of 25% over the same time period.

“In fact, 2017 data from the American Hospital Association showed a shrinking gap between outpatient and inpatient revenue as more patients elected to get care in cheaper outpatient settings, and some believe a flip is inevitable in the coming years. The AHA’s 2019 Hospital Statistics report showed hospitals’ net outpatient revenue in 2017 — the year covered in that edition of the report — was $472 billion and inpatient revenue totaled nearly $498 billion.

“The move away from inpatient care is being driven by a few factors. There are more innovations in medical technology that allows for less invasive procedures and therefore less of a need for all the bells and whistles a hospital provides. There’s also been considerable growth in ambulatory surgery centers, partly due to financial backing from private equity firms.”

The article provides additional insight on the forecasted usage of physician offices and clinics, EDs and skilled nursing facilities.

2. Hospitals and health systems react to nursing shortages with hefty sign-on bonuses

Although the shortage of nurses had begun prior to the pandemic, many healthcare clinicians have exited the field due to burnout, which increased during the pandemic. The toll of this exodus of experienced nurses is now being seen at healthcare organizations across the country.

A June 1 article in Healthcare Dive reported, “Hiring managers across industries may struggle to attract and retain talent as an exhausted workforce pivots to post-pandemic life. Among healthcare workers, nurses in particular have reported widespread burnout, with some planning to leave their jobs for other roles outside of direct patient care, or to retire.

“Now, health systems are offering steep sign-on bonuses. They’re looking to fill permanent roles as delayed care ramps back up, after relying heavily on expensive travel nurses throughout the pandemic.

“Georgia-based Piedmont Healthcare is offering sign-on bonuses of up to $30,000 to attract new nurses to work there, so long as they commit to stay for two years, the nonprofit system with 11 hospitals said in an email statement.

“Piedmont said the offer is working and it will continue it through July.”

The article quoted Piedmont as stating: “So far, our offering of enhanced sign-on bonuses has penetrated the market and encouraged travel nurses to come off the road and has encouraged nurses outside the state to come to Georgia for full-time employment with our organization.”

The article also reported:

• Other health systems are giving nurses sign-on bonuses, including Penn State Health and Baptist Health in Texas.
• Nurses in certain specialties are in higher demand, including those who work in ICUs, med/surg units and operating rooms, while less demand is seen in pediatric care and labor and delivery.

A June 1 article in Becker’s Hospital Review reported a shortage of healthcare workers caused the closure of the Grande Ronde Hospital and Clinics hospice program in La Grande, Oregon.

“Our community is not exempt from the serious national shortage on healthcare workers,” Jeremy Davis, Grande Ronde’s president and CEO said in a news release quoted in the article. “Over the past year, it has become increasingly difficult to find nursing staff to support our hospice program.”

“The 2021 American Nursing Shortage: A Data Study,” released in May by the University of St. Augustine for Health Sciences, provides a review of what factors have caused the nursing shortage, its impact on patient safety, the states with the most critical need for RNs and how rural areas typically have fewer RNs to serve their populations.

The study also describes the following solutions to help address the nursing shortage:

• Greater access to education
• Strategic workplace accommodations and flexibility
• Lobbying and advocacy

3. NACCHO report: Newly passed state laws could endanger public health

An article in MedPage Today on June 3 reports, “In the wake of the COVID-19 pandemic, states are passing laws that could endanger the public health, according to a report from the National Association of County and City Health Officials (NACCHO).

“‘In recent months, at least 15 state legislatures have passed or are considering measures to limit severely the legal authority of public health agencies, and other states may consider such legislation in the future, hindering the ability of health departments to do their jobs and putting wide swaths of the public at risk,’ the organization said in a statement last week when it released the report.”

The article highlights laws that could have an adverse impact, as cited in the report, including those:

• Prohibiting masks in any situation
• Blocking the closure of businesses to prevent the spread of disease
• Banning the use of quarantine
• Giving unilateral power to legislatures to stop public health actions

Joyce Frieden, the article author, also quoted Georges Benjamin, MD, executive director of the American Public Health Association. “We’ve been looking at what one needs to do about this because this is a big issue,” Benjamin said. “Governmental public health is the only entity in the community that has legal authority to protect your health. … The fact that this legal authority is being attacked, which we believe are for reasons that are unacceptable, concerns us.”