Challenges, the HealthCare C-Suite Has its Share

An aspect I especially enjoyed during my time in the hospital C-Suite was that every day was different. The same is true when covering and writing about hospital C-suite matters. Here are some odds and ends that caught my eye in the past few weeks.

 Medicare Advantage is a Disadvantage – Especially for Rural Hospital

 Medicare Advantage Plans now cover more than half of patients eligible for Medicare. However, providers complain that the plans are often slow to pay or don't reimburse at all for care, according to reporting by the Kaiser Family Foundation and NPR. Such a reality is especially true at rural hospitals where Medicare advantage has increased fourfold since 2010. Is it a coincidence that 150 rural hospitals have also closed since 2010?

 My experience at rural hospitals as CEO is that there is a higher mix of Medicare and Medicaid patients, reflecting the poorer and older populations in rural areas. One rural hospital C-suite leader noted that they were owed $800,000 from Medicare Advantage Plans, a big chunk of the current $`1.3 million loss it was running. As we noted in a post earlier this year, the closure of rural a hospital, which are often the largest employer/payroll, can be especially devastating in a small town.

 As an aside, I participate in a Medicare Advantage Plan that adds $75 a month back into my Social Security payment. It also provides a quarterly over-the-counter benefit of $75 for a direct financial benefit of $1,200 a year. So, I think it unlikely that rural hospitals are going to talk Medicare beneficiaries out of these plans.

 Employer-sponsored health Insurance is on the Rise

 According to HealthAffairs, employer-sponsored family health insurance is up 7% in 2023 to an eye-popping $23,968. Employees contributed 29% of family coverage ($6,575) and 17% for single coverage ($1,401). According to an industry report, 45% of lower-paid workers are not signing up for employer-provided insurance because they can't afford the premiums. Those patients will end up as charity or bad debt for hospitals to sort out.

 Hospitals Still Haven’t Scratched the Surface in Deploying Data

 I was surprised to read that, according to Microsoft, hospitals are using a paltry 3% of available data for decision support. The company came to this conclusion after analysis of its AI decision support Fabric platform. It’s not like hospitals don’t have a boatload of data available, creating some 50 petabytes, equivalent to 10 billion music files. Data analysis is, of course, critical to reducing costs and improving patient outcomes.

 When I shared this info with site co-founder Steve Lindsey, he reported that the lack of data analysis is one of the top frustrations he hears from hospitals, with the exception being HCA Healthcare hospitals (Steve was longtime HCA hospital CEO, where I also served as his brand manager). When I looked it up, I learned that HCA signed an agreement with Google Cloud in 2021 to "streamline both clinical and non-clinical operations…to give doctors and nurses workflow tools, analysis and alerts on their mobile devices for real-time updates on patients' conditions, while also improving workflows such as supply chain, human resources, and physical plant operations.”

 Cyber Attacks Can Delay Care, a Link to Higher Mortality

 In 2021, I reported on a cyber-attack at an Alabama hospital that directly caused brain damage and the eventual death of a newborn. A 2021 report found that cyberattacks "caused…strain through outages of network-based services" that "could be correlated with loss of life." The authors said: “Although there are no deaths directly attributed to hospital cyberattacks, statistical analysis of an affected hospital's relative performance indicates reduced capacity and worsened health outcomes, which  in the time of the COVID-19 pandemic in excess deaths.”

 Deaths aside, TechTarget reported that cyberattacks increase costs and poor outcomes due to longer lengths of stays, transfers, and procedure delays and yield more complications.

 One Person’s Nursing Shortage is Another Person’s Market Opportunity

 I was dismayed to see C-Suite leaders still blaming nurses for the current workforce shortage. As one official stated (I won't identify him, but you can go to the link): “The “nursing shortage is real…blaming it on nurses leaving staff positions for lucrative travel jobs, nurses contracting linkCovid-19, and not enough support for nursing education.” As we wrote a year ago, the healthcare C-suite needs to stop vilifying nurses for leveraging their earnings. I mean, really, the C-suite, with their mega compensation, is in no position to make such a complaint. Another perspective from National Nurses United is: “There isn't a nurse shortage at all. There are plenty enough nurses for the country, they say — merely a shortage of nurses who want to work under current conditions.” All signs point towards creating a great workplace culture rather than one based on an adversarial relationship. We've written much (as in this post by Lucien Roberts) about good workplace culture; check out our other past posts on the topic.

 Early in my career, when we both worked for HCA, my site co-founder, Steve Lindsey, told me that a good way for hospitals to lose money was to employ doctors. HCA has recently realized that lesson, too. The for-profit company missed earnings and attributed the shortfall to higher labor costs in its joint venture with Valesco, a physician staffing company. The point of all this continued post-pandemic turmoil is that labor costs will continue to rise. Complaining about it won't solve the challenge. We think the answer lies in a collaborative approach, good communication, and servant leadership.

John blogs at https://healthcarecsuite.com/