Category Archives: Health Care Workers

Growth in Health Hiring and Hospital Spending Decline

Source: Altarum Institute Center for Sustainable Health Spending, Press Release, September 8, 2017

Hiring in the health sector moderated in August after rising over the last few months, while July spending growth slowed, according to analysis of health economic indicators released today by Altarum’s Center for Sustainable Health Spending. Driving low overall spending growth is historically low hospital spending, which, at a revised .8% June growth rate, is the lowest year-over-year monthly growth rate recorded in more than 25 years. After 2 months of unexpectedly robust growth (41,000 in July and 36,000 in June), the health sector only added 20,000 jobs in August, consistent with the slower level of growth seen in the first 5 months of the year. … Hospital hiring is continuing to grow at about two-thirds the 2015 and 2016 pace (6,000 versus 10,000-11,000 new jobs per month). With indications of declining hospital utilization and reports of potential job losses at individual hospitals, further declines in hospital job growth are expected in coming months. …

Health Sector Trend Report
Source: Altarum Institute Center for Sustainable Health Spending

A Prescription For Good Jobs In The Industrial Midwest: Labor Standards And Unions In The Booming Hospital Industry

Source: National Employment Law Project (NELP), Data Brief, August 29, 2017

…..In many major cities in the Industrial Midwest, hospitals (or health care systems) are among the largest private-sector employers. See Appendix A. Hospitals are often the economic anchors of their communities, generating millions of jobs, directly or indirectly. As a result, hospitals and the wages they pay have an outsized role on the impact of the economic health of communities.

But today, the vast majority of hospital service jobs are not objectively “good jobs.” For every high-paid doctor in the hospital industry in the Industrial Midwest and indeed nationwide, there are more than six workers providing vital supportive services that a strong health care system needs: workers who sterilize surgical instruments, clean hospital rooms, maintain patient files, prepare and deliver food, keep patients clean and comfortable, and transport patients within the hospital. Today, too many of these jobs fail to pay a living wage, to the detriment of the more than 300,000 workers who hold these jobs in the Industrial Midwest alone, many of whom are women and people of color.

We have the opportunity as a nation to improve these jobs by applying key principles from manufacturing jobs—specifically, by improving labor standards and ensuring that workers have voice in the workplace. Raising the minimum wage to $15 per hour and respecting hospital workers’ right to join a union would significantly improve the jobs in the growing hospital industry and the health care sector more broadly…..

Dirty Laundry: An Investigation

Source: Annie Hylton, Dissent, Summer 2017

…..While most New Yorkers recognize the thousands of storefront laundromats scattered across the city that offer drop-off washing or dry-cleaning services as well as coin-operated machines, few may be familiar with larger corporate-owned commercial laundromats, to whom these services are increasingly being contracted. Many of us have likely used a sheet or table cloth cleaned in a commercial laundry, which typically provides services for hotels, hospitals, restaurants, and neighborhood laundromats that outsource their laundry. The commercial laundry industry is growing: in the New York metropolitan area alone, the number of laundry and dry cleaning workers grew from about 9,480 in 2011 to 12,680 in 2016, according to the Department of Labor.

Commercial laundries can range from massive industrial operations employing hundreds or even thousands of workers to more modest “sweatshop” laundries, with anything from a dozen employees to fifty or more, like Suffolk, where Marlyn Gonzalez worked. It is in such commercial laundries, most of which are housed in large factory-like buildings in Queens, Long Island, and the Bronx, that thousands of laundry workers—largely African-American or immigrant women—labor in hot, crowded, and often dangerous or toxic conditions to clean the linens used by millions of New Yorkers. And it is these workers who endure the consequences of an industry plagued by poor working conditions, exploitation, and abuse…..

Prevention Is Key (Er…Required): Will Your State Soon Mandate Workplace Violence Prevention Programs?

Source: Sean Kingston, JDSupra, August 4, 2017

It is no secret to hospital and other healthcare employees that their workplace is no longer a guaranteed safe zone. In fact, recent statistics released by the Occupational Safety and Health Administration (OSHA) indicate that workplace violence is four times more prevalent in the healthcare and social services industries than in other private industries. Violence may come from many sources, including patients or those accompanying them, employees and those who have relationships with employees, and third parties with no business at the facility.

Responding to an outcry from nurses’ unions and patients’ rights groups, and following the lead of seven other states, the California Occupational Safety and Health Administration (CalOSHA) recently enacted a new law (effective April 1, 2017) creating a standard for workplace violence prevention in the healthcare industry. While the breadth of coverage and depth of action required of employers in California now exceeds what can be found in any other state, it could be a sign of things to come for other states.

Because the national tide is turning to legislation that mandates workplace violence prevention programs, particularly in the healthcare context, all healthcare employers would be wise to emulate the practices required by CalOSHA. The federal OSHA and numerous state counterparts are working to assemble similar legislation. …

State Health Agency and Local Health Department Workforce: Identifying Top Development Needs

Source: Angela J. Beck, Jonathon P. Leider, Fatima Coronado, and Elizabeth Harper, American Journal of Public Health (AJPH), Vol. 107 no. 9, September 2017
(subscription required)

From the abstract:
To identify occupations with high-priority workforce development needs at public health departments in the United States.

We surveyed 46 state health agencies (SHAs) and 112 local health departments (LHDs). We asked respondents to prioritize workforce needs for 29 occupations and identify whether more positions, more qualified candidates, more competitive salaries for recruitment or retention, or new or different staff skills were needed.

Forty-one SHAs (89%) and 36 LHDs (32%) participated. The SHAs reported having high-priority workforce needs for epidemiologists and laboratory workers; LHDs for disease intervention specialists, nurses, and administrative support, management, and leadership positions. Overall, the most frequently reported SHA workforce needs were more qualified candidates and more competitive salaries. The LHDs most frequently reported a need for more positions across occupations and more competitive salaries. Workforce priorities for respondents included strengthening epidemiology workforce capacity, adding administrative positions, and improving compensation to recruit and retain qualified employees.

Strategies for addressing workforce development concerns of health agencies include providing additional training and workforce development resources, and identifying best practices for recruitment and retention of qualified candidates.

Industry Payments to Physicians for Opioid Products, 2013–2015

Source: Scott E Hadland, Maxwell S. Krieger, and Brandon D. L. Marshall, American Journal of Public Health (AJPH), Vol. 107 no. 9, September 2017
(subscription required)

From the abstract:
To identify payments that involved opioid products from the pharmaceutical industry to physicians.

We used the Open Payments program database from the Centers for Medicare and Medicaid Services to identify payments involving an opioid to physicians between August 2013 and December 2015. We used medians, interquartile ranges, and ranges as a result of heavily skewed distributions to examine payments according to opioid product, abuse-deterrent formulation, nature of payment, state, and physician specialty.

During the study, 375 266 nonresearch opioid-related payments were made to 68 177 physicians, totaling $46 158 388. The top 1% of physicians received 82.5% of total payments in dollars. Abuse-deterrent formulations constituted 20.3% of total payments, and buprenorphine marketed for addiction treatment constituted 9.9%. Most payments were for speaking fees or honoraria (63.2% of all dollars), whereas food and beverage payments were the most frequent (93.9% of all payments). Physicians specializing in anesthesiology received the most in total annual payments (median = $50; interquartile range = $16–$151).

Approximately 1 in 12 US physicians received a payment involving an opioid during the 29-month study. These findings should prompt an examination of industry influences on opioid prescribing.

The Better Care Reconciliation Act: Economic and Employment Consequences for States

Source: Leighton Ku, Erika Steinmetz, Erin Brantley, Nikhil Holla, Brian Bruen, Center for Health Policy Research, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, July 2017

From the abstract:
Issue: A draft Better Care Reconciliation Act (BCRA) has been introduced in the U.S. Senate as an alternative to the American Health Care Act (AHCA), which was passed by the House of Representatives on May 4, 2017. The Congressional Budget Office estimates the BCRA would raise the number of uninsured by 22 million by 2026.

Goal: To determine the consequences of the draft BCRA on employment and economic activity in every state. This report updates an earlier analysis of the effects of the AHCA.

Methods: We compute changes in federal spending and revenue from 2018 to 2026 for each state and use the PI+ model to project the effects on states’ employment and economies.

Findings and Conclusions: While the draft BCRA and the AHCA would have similar effects on the number of uninsured Americans, the BCRA would lead to significantly larger job losses and deeper reductions in states’ economies by 2026. A brief spurt in employment would add 753,000 more jobs in 2018, but employment would then deteriorate sharply. By 2026, 1.45 million fewer jobs would exist, compared to levels under the current law. Every state except Hawaii would have fewer jobs and a weaker economy. Employment in health care would be especially hard hit with 919,000 fewer health jobs, but other employment sectors lose jobs too. Gross state products would be $162 billion lower in 2026. States that expanded Medicaid would be especially hard hit.

Interactive map
Press release

The Health Care Job Engine: Where Do They Come From and What Do They Say About Our Future?

Source: Bianca K. Frogner, Medical Care Research and Review, OnlineFirst, First Published January 19, 2017
(subscription required)

From the abstract:
Health care has been cited as a job engine for the U.S. economy. This study used the Current Population Survey to examine the sector and occupation shifts that underlie this growth trend. Health care has had a cyclical relationship with retail trade, leisure and hospitality, education, and professional services. The entering workforce has been increasingly taking on low-skilled occupations. The exiting workforce has not been necessarily retiring or going back to school, but appeared to be leaving without a job, with potentially more child care duties, and with high rates of disability and poverty levels. This study also found that the number of workers staying in health care has been slowly declining over time. As the United States moves toward team-based care, more attention should be paid to the needs of the lower skilled workers to reduce turnover and ensure delivery of quality care.

‘Giving Help and Not Asking for It’: Inside the Mental Health of First Responders

Source: Katherine Barrett & Richard Greene, Governing, July 7, 2017

Teaching cops, firefighters and prison workers to recognize and know how to handle people with mental illness is a big part of the efforts to reduce suffering and death at the hands of law enforcement. Less talked about is the mental health of the cops, firefighters and prison workers themselves. ….

Physician Workforce: Locations and Types of Graduate Training Were Largely Unchanged, and Federal Efforts May Not Be Sufficient to Meet Needs

Source: U.S. Government Accountability Office (GAO), GAO-17-411: Published: May 25, 2017

From the summary:
The federal government has reported physician shortages in rural areas; it also projects a deficit of over 20,000 primary care physicians by 2025. Residents in graduate medical education (GME) affect the supply of physicians. Federal GME spending is over $15 billion/year.

We found that, from 2005-15, residents were concentrated in the Northeast and in urban areas. And, while many trained in primary care, primary care residents often subspecialize in other fields. Federal efforts to increase GME in rural areas and primary care were limited. In 2015, we recommended HHS develop a plan for its health care workforce programs—it has yet to do so.