As the 118th Congress begins its work for 2023, hospitals and health systems continue to face significant challenges that are jeopardizing access to care for patients and communities. At the top of the list are workforce pressures and financial challenges.
The health care workforce is exhausted — physically and mentally — as we persevere through a third pandemic winter. More than 100,000 nurses left the profession in 2021, and nearly 70% say they experience verbal abuse on the job. Physicians also are struggling, with nearly 63% reporting feeling burned out.
While hospitals and health systems have made many efforts to “care for the caregivers” and reward, retain and recruit staff, the bottom line is we don’t have enough clinicians to care for patients today and not enough are in the pipeline to care for an aging population, more complex diseases and increased behavioral health conditions.
At the same time, inflation and cost increases for essential medical supplies, drugs and labor have been at historic highs. More than half of all hospitals were projected to operate at a financial loss in 2022. And experts expect the financial outlook to be extremely difficult for many hospitals in 2023 as well.
Our mission to advance health for all patients and communities has never been more critical.
We cannot accomplish this alone. We need to involve all stakeholders, including consumers, higher education institutions, front-line caregivers and health care administrators, commercial insurance companies, drug manufacturers and technology companies, just to name a few.
Similarly, all stakeholders at every level of government have a role. Preserving the ability of hospitals and health systems to continue to advance health for individuals and communities is not a partisan issue.
At the end of 2022, Congress passed and President Biden signed legislation that provided some support, including preventing Medicare cuts, extending vital rural health programs, mitigating physician payment reductions, and extending critical regulatory flexibilities for telehealth and the Acute Hospital Care at Home program, among other provisions.
But more must be done. The AHA this year will work with leaders on both ends of Pennsylvania Avenue and both sides of the political aisle to enact legislation and policies in four areas:
- Ensure Access to Care and Provide Financial Relief
- Strengthen the Health Care Workforce
- Advance Quality, Equity and Transformation
- Enact Regulatory and Administrative Relief
Ensure Access to Care and Provide Financial Relief: We must protect funding for Medicare, Medicaid and other federal programs that support hospitals’ ability to provide a wide range of essential services to patients. In addition, we must continue to support the 340B drug pricing program and acknowledge the special role that “metropolitan anchor hospitals” and rural hospitals play in their communities. And we must hold commercial insurance companies accountable for their harmful practices that deny or delay patient care.
Strengthen the Health Care Workforce: The lifeblood of our health care system are its caregivers and workers. We must do more to support and protect them, as well as build a stronger and deeper talent pipeline. Among other actions, we should enact federal protections for health care workers against violence and intimidation; increase the number of residency slots for eligible Medicare funding to address physician and behavioral health shortages; and work to address nursing shortages.
Advance Quality, Equity and Transformation: High quality care should never be determined by insurance status, age, race, gender, sexual orientation, or geography. We need to enact policies that advance hospitals’ efforts to deliver higher quality and safe care to all patients, including improving maternal and child health outcomes with a particular focus on eliminating longstanding racial and ethnic disparities. We also must protect health care organizations and patients from the growing threat of cyberattacks.
Enact Regulatory and Administrative Relief: Every day, hospitals and health systems confront the daunting task of complying with a growing number of regulations and commercial insurer requirements. This burden contributes to clinician burnout and drives up the cost of delivering care, or in some cases, delays necessary care. We can’t improve care without addressing regulatory burden. We also must streamline commercial insurer prior authorization practices because clinicians — not insurance companies — should determine what care patients receive.
For many people, health care careers are a calling. The more than 6 million people who work at our nation’s hospitals and health systems were there for our families, friends, and neighbors during the darkest days of the pandemic. They are still there, 24/7. We must support them.
Rick Pollack is the president and CEO of the American Hospital Association.