About 800,000 nurses plan to leave the workforce by 2027, and more than half of newly graduated nurses are leaving the profession within two years. The reasons why this is happening have nothing to do with a lack of passion for the profession or care for patients. Rather, it has everything to do with poor working conditions that stem from an outdated reimbursement model for nursing services.
State leaders began implementing a new law requiring people with certain diagnoses to be moved out of the Montana State Hospital. House Bill 29 says, by June 30, 2025, the Montana Department of Public Health and Human Services must begin transferring patients out of MSH and into community-based services if they have a primary diagnosis of Alzheimer’s disease, dementia or traumatic brain injury. There’s still a lot to be determined before that deadline arrives.
Two agencies that keep 600 people out of nursing homes by providing in-home care have learned the state will give them a direly needed 42 percent Medicaid rate increase. Waypoint and Ascentria Care Alliance warned the state this year that without significantly higher Medicaid payments, they’d have to end the care that allows people to manage their health needs in their homes. Doing so would leave their clients at a fork in the road: join nursing homes’ long waiting lists or try to persuade a family member to step in.
Mounting pressures on the state’s health care system are putting patient access at risk. Our member facilities face growing financial challenges that have been exacerbated by the pandemic. Statewide, Indiana hospitals operated on a -2% operating margin last year due to inflation and rising costs of drugs, labor, supplies and equipment. In 2023 and beyond, many are facing difficult decisions about which services they can continue to provide to remain viable.
The Arkansas Legislative Council approved more than $16 million to be dispersed to four hospitals in the state on Friday. The Fulton County Hospital in Salem is receiving $5 million. The ARPA money is funds the federal government sent to states so they can allocate it to organizations that were affected by COVID.
The Republican-led states that have refused to expand Medicaid are trying a variety of strategies to save struggling hospitals and cover more people. A decade after the U.S. Supreme Court ruled that states’ participation in Medicaid expansion was voluntary, the 10 holdouts (plus North Carolina, which recently approved expansion but hasn’t implemented it yet) account for most of the rural hospital closures over the past decade, according to the American Hospital Association.