Dealmaking in the first quarter was down, "even from 2023's sluggish pace," analysts revealed.

Private equity’s impact on healthcare has been in the headlines of late, but actual investment activity by firms continues to slow down, according to a new report.

Research by market data firm PitchBook found that a tough regulatory climate, price differences between buyers and sellers, and signs that the Federal Reserve will hold rates higher or longer has depressed private equity dealmaking.

In the first quarter of the year, 158 estimated deals were announced or closed by private equity sponsors, which marked a decrease from 2023’s rate and a 20% decline from the 200 deal count over the same period last year.

While private equity investment has been trailing off since the end of 2021, PitchBook notes that it expects activity to ramp back up in 2025 and that more deals will be announced toward the end of this year.

Though more firms are actively looking to invest and financing is easier than it was in 2023, certain factors are driving down numbers at the moment.

Chief among those causes is regulatory concern, which was heightened as a result of the Change Healthcare cybersecurity attack. The breach, which occurred in February, “caused temporary delays in active deal processes as target companies scrambled to reconfigure their billing processes and buyers looked for assurance that revenue would normalize at previous levels,” the report stated. Additionally, the event created heightened awareness for buyers over cybersecurity compliance and HIPAA compliance risk.

PitchBook also highlighted that while antitrust enforcement remains low, the increase in chatter about private equity trends in the news cycle is resulting in a cooler market. For example, the struggles of Steward Health Care have been well documented and brought more attention from lawmakers to private equity’s role in healthcare.

“Even if the public spotlight drifts elsewhere post-election, we fear a lasting effect on perceptions of PE’s interests and approaches among potential sellers and partners in the provider landscape, including physician groups and health systems,” the report said.

From a state perspective, California now has a deal review process that gone into effect, which could lead to extended deal timelines, extra review costs, and the publicizing of information on the parties involved. Other states have followed California’s lead, such as Connecticut, Illinois, Indiana, Massachusetts, Minnesota, Nevada, New York, Oregon, and Washington.

Finally, the report shed light on the ramifications of the Federal Trade Commission’s vote to ban noncompetes in April.

“If implemented, a noncompete ban would theoretically advantage health systems over PE-backed physician groups in physician and clinical staff retention, and could also result in further wage inflation in the industry,” the report said.

Despite private equity investment in healthcare trending downward, a recent report by the Private Equity Stakeholder Project found that more bankruptcies in the industry are coming from private equity-backed companies.

Even more bankruptcies and defaults are expected this year due to many organizations suffering from significant debt and downgraded credit ratings.

CNOs must take a look at how they introduce new nurses into the workforce, says this nurse leader.

On this week’s episode of HL Shorts, we hear from April Prunty, director of nursing professional development at Allina Health, about how CNOs can prepare new nurses for the difficulties they will face on the job. Tune in to hear her insights.

The health system is getting feedback from the front lines to make sure its Virtual Nursing program will meet expectations and become a permanent part of patient care

Virtual nursing programs require careful planning. And no one knows that better than the nurses.

“Including those bedside nurses [in planning] is the most important thing you can ever do,” says Laura Gartner, DNP, MS, RN, RN-BC, NEA-BC, Associate CNIO for Jefferson Health. “Because if you just try to [drop] a program into their unit without taking what they think is important, it’s not going to be successful because it’s not going to fit into their day or what they would value.”

Gartner is one of the point people for the Philadelphia-based health system’s Virtual Nursing program, which is entering its second iteration after a 90-day pilot in 2023 on two floors of one hospital. They’ve sharpened their focus now, she says, with funding for a more durable model and clear goals for sustainability and scalability.

“We’re not calling it a pilot any more because we’re not piloting this,” she says. “We know we’re moving forward with it.”

Jefferson Health is one of a handful of health systems across the country taking part in the HealthLeaders Virtual Nursing Masterminds program, a series of virtual meetings capped off by an in-person event in June. The program is taking a deep dive into virtual nursing strategies with perspectives from some of the top health systems and executives in the country.

Gartner says involving nurses in every phase of the program is crucial, because they know what will work and what won’t. And as Jefferson Health moved beyond the pilot and began to map out a more permanent program, those nurses helped to point out that the bedside nurse and the virtual nurse are two different roles requiring unique skillsets.

“A lesson we learned is that talking to a person through a computer is much different than talking to a person where you can, say, touch their shoulder,” Gartner says. The bedside nurse has always had that in-person connection to patients that influences every task from care delivery to communication. Simply taking a nurse, putting him or her in front of a computer in a separate room and telling him/her to continue being a nurse won’t cut it.

“That’s a little bit of a different conversation and skill set,” she notes, adding that Jefferson Health is working with a local nursing school to plot how to teach “webside” manner.

Gartner says the health system “threw out a broad net” in coming up with goals for the pilot, and has since narrowed its focus.

“With that first phase pilot, use cases came out of the woodwork,” she notes. “But if you focus on everything, do you really make a difference on anything?”

Where they do want to make a difference is on stress, which affects everything from nurse turnover to quality and safety.

That’s why it’s important, Gartner says, to create a partnership between the floor and virtual nurse, so that they’re working together on patient care. And that involves making sure both nurses are comfortable in their roles and their environments.

“I do hope that goes beyond just assigning the tasks to someone, so more of that working in concert with each other, being part of that care team, like you were there on the floor.”

The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives. This Virtual Nursing Mastermind series features ideas, solutions, and insights on exceling your virtual nursing program. Please join the community at our LinkedIn page.

To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.

Fostering a culture that prioritizes employee wellbeing is a vital step towards mitigating burnout.

Editor's note: Kathy Driscoll, MSN, RN, NEA-BC, CCM, is the senior vice president and chief nursing officer at Humana.

As health care professionals, we are no strangers to the perils of burnout. This is a crisis that predates the pandemic and has persisted at an alarming rate in the United States, as 49% of physicians report experiencing burnout and 64% of nurses say they feel “a great deal of stress because of their job.”

During May, we observe both Mental Health Awareness Month and National Nurses Month. This serves not only as an opportunity to acknowledge the more than 5 million nurses who function as the backbone of patient care, but also to consider how we can support the mental health of these nurses who often struggle with work-related stress and burnout.

With more than 30 years of experience in the nursing profession, I recognize the importance of creating a supportive work environment that acknowledges, actively addresses and supports nurses' physical and mental well-being. Strategies such as adjusting staffing models, providing access to mental health resources and fostering a culture that prioritizes employee wellness are vital steps toward mitigating burnout and promoting a healthier, more sustainable nursing workforce.

I’ve been working closely with nurses in the home health field, and I’ve noticed the cause of their stress is different from the cause of stress that nurses experience in a hospital setting. Specifically, the structure of in-home care allows nurses to work in a flexible environment and form close relationships with patients. At the same time, it can place them in situations where they must handle complex medical issues alone, without the immediate backup found in more traditional health care settings. These challenges highlight the importance of a strong, multidisciplinary support network that goes beyond basic needs.

For instance, at CenterWell Home Health — a part of Humana— we ensure that our nurses are supported by a team of diverse clinical professionals, including physical, occupational and speech therapists, and social workers who all work together to ensure that our patients' comprehensive care needs are met. This integrated approach allows for a more holistic care experience for patients and can help build a professional support system that helps prevent our nurses from feeling they’re practicing in a silo. 

In any clinical setting, nurses can and should focus on establishing robust mentorship relationships and fostering camaraderie in the workplace. Structured mentorship can provide essential guidance, knowledge transfer and support from experienced nurses to those at all levels of their career journeys. Mentorship is a great way for nurses to enhance skills, confidence and opportunities.

On a broader scale, advocating for industry-wide changes is critical for sustainable improvements in nursing. Policies to improve work conditions, such as regulating work hours and optimizing nurse-to-patient ratios, are essential to prevent burnout and ensure high-quality care. Integrating new and innovative technology can streamline administrative tasks, allowing nurses more time for patient care. In addition, mental health support programs that include counseling and stress management must be readily available to address the psychological demands faced by nurses.

Nurses operate at a unique crossroads where health, education and community converge. This multifaceted role positions them not only as caregivers, but also as educators and community advocates. As we look toward the future of nursing, initiatives designed to support these professionals must comprehensively address each of these aspects. Such approaches enhance the effectiveness of nursing care and also ensure that nurses are valued, supported and equipped to meet the challenges of their essential roles in our nation's health care system.

Editor's note: Care to share your view? HealthLeaders accepts original thought leadership articles from healthcare industry leaders in active executive roles at payer and provider organizations. These may include case studies, research, and guest editorials. We neither accept payment nor offer compensation for contributed content.

Send questions and submissions to content director Amanda Norris at anorris@healthleadersmedia.com.

Nurses should give their input on new technologies that are meant to help them.

On this week’s episode of HL Shorts, we hear from Lisa Stephenson, chief nursing informatics officer at Houston Methodists, about how CNOs and CNIOs can implement new technology so it doesn't become a burden on staff. Tune in to hear her insights.

Technology is everywhere in healthcare, but budgeting for it lands on the shoulders of the CFO.

Healthcare organizations are at the forefront of technology. From clinical areas to the revenue cycle, every facet of an organization is seeing some sort of new technology or AI. While technology and innovation are needed, CFOs are the ones left to figure out how to pay for it all.

As reducing costs is a top concern for CFOs, especially since bottom lines have been severely stressed and new technology costs are adding up—what are the solutions?

This has been one of the challenges at the forefront of conversations so far at the HealthLeaders CFO Exchange, as dozens of finance leaders from across the country are currently talking shop in San Diego.

Why AI?

Changes in the workforce landscape are forcing CFOs to be more creative, meaning many are looking toward AI and other technology to fill those workforce gaps and optimize processes.  

“AI is great, especially for our workforce issues, but how do we pay for it and redeploy resources?” Jim Wilson, CFO at Mayo Clinic Health Systems, asked the crowd during the morning’s general session.

This is a complex question that explains why it will take more time for healthcare leaders to add in more AI.

And How?

Speaking of budget, budgeting for automation and the impact on future work demands is crucial for preparing for technological advancements, but it’s not as easy as it sounds. And since using AI to automate workflow in clinical and non-clinical departments can lead to improved efficiency and accuracy, CFOs need to prioritize this cost. But how?

Well, many CFOs at this event are starting to figure it out.

A good place to start? Creating a consolidated AI plan. “We have leaders in every pocket of the system asking for AI in their department, but there is no overarching AI strategy in place which makes budgeting disjointed,” said Donna Wallace, VP of financial accounting from Integris Health.

It’s not all bad, though. In fact, one CFO at the event is piloting AI for physicians that creates clinical notes based on the verbal conversations the physician has with patients. The added AI saves so much time for physicians that it allows them to see more patients in a day, helping to pad that bottom line.

This is just a sliver of conversation at this year’s event, so stay tuned as the Exchange continues to unfold over the next two days.

Our Spring 2024 CFO Exchange is taking place until May 10 at the Fairmont Grand Del Mar in San Diego.

Are you a CFO or finance leader interested in attending an upcoming event? To inquire about attending the HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.

The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.

A UCSF study has found that a ChatGPT-4 LLM can prioritize Emergency Department patients for treatment with 89% accuracy

Healthcare organizations looking for help prioritizing patients in the Emergency Department could benefit from an AI tool developed by researchers at the University of California San Francisco (UCSF).

Researchers tested the ChatGPT-4 large language model (LLM) on 10,000 sets of patients seen at the UCSF ED between 2012 and 2023, and found that the tool accurately assessed clinical acuity in 89% of the cases. A subset of 500 cases evaluated by a clinician as well as AI found that AI outperformed the clinician, 88% to 86%.

The study, which appears this week in JAMA, could give health systems a valuable tool for triaging ED patients, particularly during times of heavy traffic or staff shortages. By assessing severity more quickly, the hospital could direct ED staff to those patients in need of emergency care and speed up time to treatment, eventually improving clinical outcomes.

“Imagine two patients who need to be transported to the hospital but there is only one ambulance, or a physician is on call and there are three people paging her at the same time, and she has to determine who to respond to first,” Christopher Williams, MB, BCHir, a UCSF postdoctoral scholar at the Baker Institute and lead author of the study, said in a UCSF press release.

Using data from more than 250,000 ED visits, Williams and his colleagues used an AI model to extract data from clinical notes and determine the severity of the injury. They then compared that analysis to the patient’s score on the Emergency Severity Index (ESI), which rates patients on a scale of 1-5 and is used by ED nurses to prioritize care delivery.

The ESI “uses an algorithm to categorize patients arriving at the ED, estimating the severity of their condition and anticipated future resource use,” Williams and his colleagues said in the study. “The ESI is assigned based on a combination of initial vital sign assessments, the patient’s presenting symptoms, and the clinical judgment of the triage clinician, who is often a trained registered nurse. By capturing clinical acuity at triage, the ESI can be used as a surrogate marker to evaluate, at scale, whether LLMs can correctly assess the severity of a patient’s condition on presentation to the ED. This can be achieved by providing the LLM with patient clinical histories documented in ED physician notes, prompting the model to compare histories to determine which patient has the higher acuity, and evaluating the model output against the ground truth as determined by ESI score.”

While proving the value of the AI tool, Williams pointed out that the technology shouldn’t be introduced to an ED just yet. An incorrect assessment could cause delays in treatment that could harm the patient or even lead to death. In addition, AI tools could reflect biases caused by the data used to train the model, further expanding care gaps for underserved populations.

“It’s great to show that AI can do cool stuff, but it’s most important to consider who is being helped and who is being hindered by this technology,” William said in the press release, while calling for more clinical trials and research. “Is just being able to do something the bar for using AI, or is it being able to do something well, for all types of patients?”

Nurse wellbeing makes the rest of the healthcare team succeed, says this nurse leader.

Nurse wellbeing is essential to the success of a health system, and it is the CNO's job to make sure they are providing programs and support to help keep their staff safe and well.

April Prunty, director of nursing professional development at Allina Health, spoke to HealthLeaders about how CNOs can be visible and provide support, and redesign workflows to give nurses time to prioritize their mental health. Tune in to hear her insights.

Click here to read the accompanying article. 

The South Carolina health system, part of the HealthLeaders Virtual Nursing Mastermind series, is learning to measure ROI in specific, actionable tasks, such as communication

A key component to launching an effective Virtual Nursing program is communication. How will the virtual nurse communicate with the floor nurse, as well as with the patient?

“Clear delineation of roles and communication is going to be really important,” says Emily Warr, administrator for the Center of Telehealth at the Medical University of South Carolina (MUSC), which launched a second iteration of its Virtual Nursing program about six months ago and is now monitoring the program in five hospitals.

Warr says it’s critical to identify specific KPIs in evaluating the success of a Virtual Nursing program, and to focus on small, measurable actions rather than larger concepts. For example, it’s great to say such a program will reduce time spent on admissions and discharge, but there are many factors that go into those processes that Virtual Nursing won’t affect.

“A virtual nurse, as one member of the team, cannot carry all of the factors that impact, say, an HCAHPS score on a unit,” she points out. A more effective way of measuring value would be to focus on single factor, such as how communication between nurses affects admissions or discharge times.

MUSC is one of a handful of health systems across the country that are taking part in the HealthLeaders Virtual Nursing Masterminds program, a series of virtual meetings capped off by an in-person event in June. The program is taking a deep dive into virtual nursing strategies with perspectives from some of the top health systems and executives in the country.

MUSC launched its first version of a Virtual Nursing program about two years ago, with a focus on mentoring new nurses.  Warr said that program didn’t produce the ROI needed to be sustainable, so the health system looked for more “hard outcomes.” That led to a discussion about how to identify meaningful outcomes and understand the KPIs that go into defining a program’s value.

“We needed to focus on something that we felt we could impact and choose to measure,” she says, such as “very specific, task-oriented things.”

In the six months that version 2.0 has been in play, Warr says they’ve learned a few things about those tasks. During the first two months, as everyone was getting used to the new approach, the virtual nurse would often reach out to the floor nurse to take tasks. But as time has passed, the floor nurse is reaching out more often tp the virtual nurse to hand off tasks. In other words, the two nurses are communicating more freely (and equally) about their workflows.

Warr anticipates those conversations will lead to a smoother or more seamless collaboration between floor nurse and virtual nurse, which in turn will lead to better administrative outcomes and, eventually, improved clinical outcomes.

“We’re still learning and evolving (in) what we’re tracking … and where we’re able to make a measurable impact,” she says. But the results so far are truly encouraging.

The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives. This Virtual Nursing Mastermind series features ideas, solutions, and insights on exceling your virtual nursing program. Please join the community at our LinkedIn page.

To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.