75K Healthcare Workers May Strike, Hospital Operating Margins Grow

Kelsey Waddill:

Hello and welcome to Healthcare Strategies, Headlines edition. In today's episode, we're going to be covering Burnout Problems Surpass Payout Problems, Another Strike on the Horizon?, A Positive Trend for Hospital Finances (Relatively), AI Takes on Kidney Transplants. I'm Kelsey Waddill, senior editor of HealthPayerIntelligence and multimedia manager of Xtelligent Healthcare Media. And I'm here today with my wonderful boss, Kyle Murphy.

Kyle Murphy:

Hey, oh.

Kelsey Waddill:

Vice president of Editorial. Quick question of the week for you, Kyle. We're going to Las Vegas for HLTH next week, and I've never been to Las Vegas. So Kyle, what are your top tips on Las Vegas? Go.

Kyle Murphy:

Don't gamble if you don't like to lose money.

Kelsey Waddill:

That's wise.

Kyle Murphy:

Don't hang out by the tables if you hate the smell of cigarettes.

Kelsey Waddill:

Ooh.

Kyle Murphy:

And don't hang out in the tunnels.

Kelsey Waddill:

Okay. I don't know what the tunnels are, but I'm assuming I will find out when we get there, and I will stay far away from them. All right, so let's get into today's episode.

Burnout Problems Surpass Payout Problems. So people get tired. I'm tired. Right now, this is my-

Kyle Murphy:

I'm always tired.

Kelsey Waddill:

Yep. This is my second coffee of the day, so.

Kyle Murphy:

There's even less, there's nothing in there.

Kelsey Waddill:

There's nothing left, I've actually finished it. I'm on my third soon.

So healthcare workers are people too, and they are exhausted. Droves and droves of them across the nation are tired and worn out. And so much so that they are dropping out of the healthcare workforce. This is not new news, but what is new is that burnout and staffing shortages have become the top challenge that healthcare leaders face according to a symplr survey. That's right, clinician burnout and staffing shortages are in such a crisis state that chief information officers, leaders in health IT and clinicians reported that workforce challenges are even bigger challenges than financial pressures. Given the financial pressures of the healthcare system right now, that says quite a lot.

Kyle Murphy:

A little bit.

Kelsey Waddill:

Yep. So 97 percent of the respondents in this survey said that their organizations struggled with managing staff shortages. 97 percent also said that they struggled with nurse recruitment, and 96 percent struggled with nurse retainment. So Kyle, what are you seeing organizations do to help overcome burnout challenges or what are we supposed to do with this information?

Kyle Murphy:

Well, you did reference that I'm your boss.

Kelsey Waddill:

Yes, boss.

Kyle Murphy:

I would say that one of the things I've learned managing people anywhere, particularly people working on deadlines and really high demand jobs, is to really listen to what is actually happening to these folks and what is it about their jobs they like and do not like. Obviously, there are certain things that you have to get done in a certain industry, in a certain job. But how you get them done is very unique and varies from person to person.

So I think one of the things that I have heard the most of, at least from a clinician burnout perspective, is building support networks where folks can get together, share their problems, and hopefully interact with peers who are in a similar boat. And can learn from these folks what works for you, what doesn't work for you. Maybe they get a hint on, maybe you should start working for X practice or Y organization because they get it.

It's all work-life balance. And when demands are too high and people are pushed to the limit, I think we got the fight or flight response in our brains. And you're going to see safer pastures elsewhere. So it's not surprising.

Kelsey Waddill:

Yep.

Kyle Murphy:

But it's one of those EQ versus IQ questions. There's only so much work a person can do before they need to step back, recharge, and come back at it.

Kelsey Waddill:

Yeah.

Kyle Murphy:

So improve work quality.

Kelsey Waddill:

Yeah. Speaking of which, I need a vacation.

Kyle Murphy:

You need a vacation?

Kelsey Waddill:

Yeah.

Kyle Murphy:

Approved.

Another Strike on the Horizon? Over 75,000 healthcare workers at Kaiser Permanente plan to strike on October 4th, which would mark the largest healthcare strike in US history. The union contract expired over the weekend but didn't lead to a shutdown. See, there are certain things... Yeah, things can expire, but things don't shut down. People still get paid somehow.

But in this particular instance, the coalition of Kaiser Permanente Unions is demanding better staffing, the theme of today's show. And wage increases due to high inflation. See, it's the two things. It's staffing and compensation.

Kelsey Waddill:

Mm-hmm.

Kyle Murphy:

It's not one or the other. The strike will affect facilities in California, Oregon, Washington, Colorado, Virginia--your birth state--

Kelsey Waddill:

Yep.

Kyle Murphy:

and the District of Columbia, which belongs to us all. Workers are declaring short staffing, which has led to longer wait times for patients and increased worker burnout exacerbated by the COVID-19 pandemic. No surprise.

Kelsey Waddill:

Yeah. Not shocked.

Kyle Murphy:

Kaiser serves millions of members and has reported over $3 billion in profits in the first half of 2023. I don't know, it's a big number. Critics have also called into question salaries for nearly 50 executives, which top $1 million annually. There may be some inequity. A spokesperson for Kaiser defended compensation levels and denied a staffing crisis--

Kelsey Waddill:

Of course.

Kyle Murphy:

Deny--noting that the organization has hired over 50,000 frontline employees over the last two years. Okay. Bargaining is ongoing to prevent the striking, contingency plans are in place should one occur.

Kelsey ,strikes appear to be happening all over the place. We see them up in Michigan, we saw them out in California with the actors and writers. What do you think is at the heart of these efforts to get to the negotiation table?

Kelsey Waddill:

Yeah, we were talking about this earlier this week. And I think what came out of the conversation was greater transparency being key, specifically between people at the top and the people on the ground is typically a theme in these kinds of situations. There needs to be more communication and workers need more of a seat at the table and to be heard, like what you were saying in our last headline.

And then also, I think that this episode is pretty geared towards this kind of conversation because as we've seen, it's beyond pay. It's pay and staffing, and behind the staffing shortage is a host of problems that people at the top need to address. And these things are not isolated, they all work together to create the kinds of situations. This is just the outflow of those factors. So yeah, it's a complicated scenario, but if-

Kyle Murphy:

It's one thing to say that you value someone, it's another thing to show them. Actions do speak louder than words.

Kelsey Waddill:

Yeah.

Kyle Murphy:

Moving on.

Kelsey Waddill:

Everywhere. Yeah. So it's not all doom and gloom for hospitals after-

Well, there are some bright patches here. After a turbulent few years, hospitals' finances are finally turning around a little bit.

Median hospital operating margins--which is the stat that identifies a hospital's profitability--they grew by 1.4 percent in August 2023 according to a report from Syntellis. Outpatient revenue was a huge driver behind this growth, increasing 11.6 percent from July to August, and then 10 percent year-over-year.

Kyle Murphy:

Numbers are hard.

Kelsey Waddill:

In contrast, however, inpatient revenue only rose 4 percent year-over-year.

So, this is good news obviously, for hospitals, but it's especially welcome after they experienced a brief dip in operating margins, which spurred concerns about a potential longer term decline. Perhaps the best part of this for hospitals is that the month's results were not isolated. It's part of a six-month-long upward trend.

So seems like good news for everyone, Kyle.

Kyle Murphy:

I would say that thinking about what we're talking about with workforce and compensation, that with the return of profitability, there should be enough money to go around to reinvest in the workforce to reinvest in attracting new members to the workforce. So you can't hide behind, the "well, not in this economy," the macro factors are in the way of doing this. To me, it seemed like folks getting into the green again should mean that there's no excuse. But to invest again in the staff that's currently there, attract new ones, start getting out in front of patients, try to find new ways to really say, "Okay, we're coming out the better." If your organization is functioning and operating efficiently and there's profit, there should be greater room for innovation. So let's see it.

Kelsey Waddill:

Yep. Yeah, let's see it.

Kyle Murphy:

Let's see it. Show me the money.

AI Takes on Kidney Transplants and NIH grants.

So what can't AI do? Can't do this radio show, podcast, whatever you call this place.

Kelsey Waddill:

Unless we are actually AI.

Kyle Murphy:

It's debatable. I've been told that my voice is very...

Kelsey Waddill:

Robotic.

Kyle Murphy:

At times.

The National Institutes of Health is paying the University of Florida researchers $2.8 million to ask this question we're all asking. But in this case, the researchers are specifically focusing on functionality for kidney transplants. With this five-year grant, researchers will explore different AI models and investigate applications in diagnosing, predicting, and managing kidney transplant patient care.

For instance, one of the tools that they're testing, we'll try to use patient data in kidney tissue analysis to forecast transplant outcomes. Ideally, this AI tool would help care teams identify patients likely to succeed in their first transplant, improving outcomes and reducing organ rejections. It will integrate demographic and medical data with biopsy images, enabling more informed decisions compared to existing clinical methods.

The research at University of Florida will provide clinicians with valuable access to comprehensive kidney transplant biopsy imaging data sets, potentially leading to improved patient care.

So Kelsey, in light of the aforementioned workforce challenges, do you see AI adoption healthcare as a positive thing?

Kelsey Waddill:

Yeah, I think, obviously it's a mixed bag, but I think this story is pretty encouraging. I think that this is the exact space where AI could really help streamline a process that is traditionally very fraught and difficult. One of the stats that I saw recently for the National Kidney Foundation said that over 780,000 people needed a kidney transplant and only less than 25,000 people got one in 2021. And that's just not the kind of stat we want to see, obviously. And there [are] hundreds of thousands of people who could benefit potentially from this research. So hopefully, people who are naysayers of AI can see this kind of research as a possible positive to it.

Kyle Murphy:

I mean, as we've already mentioned, and this is your first day back in the office after you took a nice little break, so.

Kelsey Waddill:

Yes, I did.

Kyle Murphy:

Hope you enjoyed yourself 'cause you won't have another break for quite some time.

Kelsey Waddill:

It's a Monday for me.

Kyle Murphy:

Yeah. It's a Monday for you. But you would think that if the workforce is overworked, if folks are stressed, tired, there's no way in heck that you could look at a massive data set and do this type of analysis.

Kelsey Waddill:

Right.

Kyle Murphy:

Save your energy for human-to-human interaction, things that involve empathy, kindness, affection, those types of things, and real problem-solving. And let the machines do the work in the background. So I can only see this as a positive and it's good to see that the money is flowing in the right direction. And that researchers will have the resources to look at this because there's a lot we don't know about AI and that has obviously contributed to a lot of doubt and confusion about it. But there [are] some really basic things that machines can do very well and we should support that effort.

Kelsey Waddill:

Let them do that. Yeah.

Kyle Murphy:

And let me have this job. Keep my job.

Kelsey Waddill:

Yes. All you AI bots listening out there, stay away from our podcast.

Kyle Murphy:

All you bots, I support you and your autonomy. You can have plenty of time off if you need it. I'll pay you handsomely.

Kelsey Waddill:

All right. Well, that's it for this episode. Thank you so much for listening. As I mentioned, we will be at the HLTH conference next week, so we are not going to have a Headlines episode next week, but we will be back the following one with more headlines for you, more news. So please stay tuned, subscribe, review, all that. And we will see you in a couple of weeks.

Kyle Murphy:

Bye, everybody.

Kelsey Waddill:

Bye.

• Tagged
• Artificial Intelligence
• Staffing
• Workforce Management