Student loan repayment and tuition reimbursement are the most common options.
Education benefits have risen in popularity among healthcare organizations in recent years, with organizations such as Blue Cross Blue Shield and Aetna offering options like student loan repayment and tuition reimbursement for employees.
Benefits such as tuition reimbursement is common in markets like healthcare where employees need a certain degree to do a role, said Gwen Cymerman, a benefits manager with Orlando Health. While Orlando Health offers student loan repayment and tuition reimbursement, in December 2020 it launched its preferred education program.
"The idea behind preferred education was to offer high-quality education at local schools at low cost to the organization, and what we've done is made it very easy for our team members to participate in it," Cymerman said. "We remove any financial barrier that the team member may have had in order to participate in these programs."
Orlando Health has partnered with four schools local to the system—Valencia College, Seminole State College, St. Petersburg College, and Lake-Sumter State College—where it covers 100% of the books and tuition for its employees.
The preferred education program helps Orlando Health differentiate itself from other healthcare systems, Cymerman said.
"It's easy to sell Orlando Health and the growth and the path you can create here with these programs," she said. "So, our talent acquisition team, whenever we're rolling out new benefits or expanding it, I definitely made sure we got in front of them to explain things."
While employees can continue their education via the preferred education program, the health system is able to grow its own pipeline of potential talent.
"They really do show that if you come here to work, we believe in you, we believe in you obtaining an education," she said. "Wherever you might want to go with that we can map it out for you."
The program allows nonclinical team members to take on everyday tasks so their frontline colleagues can focus on patient care.
On any given day at one of Sentara Healthcare's hospitals, you might find Jillian Ouyang, a corporate strategic planner, stocking equipment shelves or Tasha Ringo, an Optima Health claims processor, cleaning rooms.
The unique teamwork is part of Sentara's efforts to quell pandemic-caused stress and strain for healthcare workers via the new Nonclinical Resource Pool program in which nonclinical employees can volunteer their time to help clinical colleagues.
The program was created to support healthcare workers on the frontline amid the current omicron variant surge.
Volunteers handle such tasks as fetching materials, distributing meal trays, and any other jobs that allow the clinical staff to focus on patient care.
The health system has had a COVID task force in place for about two years, along with a clinical resource pool with staff that rotate to different areas of need across the system, says Terrie Edwards, Sentara's corporate vice president.
"We have about 20,000 [full-time employees] across our system, and there are about 6,000 that are in corporate services or health plans or finance and other areas, and they want to help," she says. "They're highly engaged, motivated employees. What would be the best ways to engage them and what roles could they play in the hospital?"
John Michael Eargle, division vice president for system service lines, designed and developed the program for nonclinical employees.
"From a design perspective, the way that it really worked was we created a standard survey and it was distributed out to those 6,000 employees, and it asked them to sign up for shifts," Eargle says.
"We created seven positions of need that were identified within our acute care hospital settings and those nonclinical employees had the opportunity to volunteer at their home hospital or their regional based hospital in those positions," he says.
The hospitals within the system sent a list of things that needed to be done at their facility. Using the answers from the initial survey, Eargle and his team matched those individuals up with the positions they favored in a way that supply and demand would be balanced.
In two weeks, program volunteers completed more than 3,000 hours—an average of 228 hours per day—with nearly 500 nonclinical team members having expressed interest.
"The volunteers were incredibly grateful as well to be able to help out their hospital and clinical-based teams in the acute care setting," Eargle says.
Initially, the program was to be used throughout the system until February 12, after which the need for volunteers will be evaluated on a weekly basis. However, because of such positive reception to the program, Edwards says the health system is looking into ways to make it permanent.
Bridget Frazier's job is usually to process claims, but volunteering through the program has been an eye-opening experience, she says.
"For us that work from home, I think it's a great opportunity to break us from the routine and to come out and help," she says.
"It feels good to give back to my workplace," Ouyang says. "I feel like everyone who has been working in the hospitals are superheroes. We can't thank them enough for their hard work and truly they are the backbone to keep us going."
Dr. Margaret Larkins-Pettigrew of Allegheny shares her expertise as a Chief Clinical Diversity, Equity, and Inclusion Officer.
While the pandemic has aggravated many issues in the healthcare industry, disparities driven by lack of diversity, equity, and inclusivity have been the most persistent.
In a report on the importance of diversity in the healthcare workforce published in 2021, Fatima Cody Stanford, MD, MPH, FAAP, FACP, FTOS, expressed the experiences of racial and ethnic minorities when pursuing their medical degrees compared to those from majority groups. In a survey of about 3,500 healthcare professionals, the findings showed that minorities and women were less likely to rank their organization as "culturally competent."
Margaret Larkins-Pettigrew, MD, Med, MPPM, is the senior vice president and Chief Clinical Diversity, Equity, and Inclusion Officer for Allegheny Health Network, a nonprofit health system headquartered in Pittsburgh, Pennsylvania.
In a recent interview with HealthLeaders, Larkins-Pettigrew said that as the leaders of their respective organizations, C-suite executives must be the "diversity champions" of their institution.
"They have to really want to acknowledge and embrace the historical events that have brought us to this place where we are recognizing that we have such disparate care and medical disparities," Larkins-Pettigrew said.
She explained that healthcare is not only what patients receive at the hospital, but the way healthcare professionals take care of people—how they ensure they are providing services patients may need, and how they make the best decisions for each patient.
"[Healthcare is] how we treat people who come to our system and who rely on us as experts, and what services we offer them to give the comprehensive care that allows us to decrease the disparity in the health gap that we see across the world," Larkins-Pettigrew said.
The first step for many organizations seeking to improve their DEI is to hire someone at the executive level who can recognize, acknowledge, and engage the necessary methods or initiatives to begin improving.
"C-suite leaders understand that we, ourselves, are biased. We need to make sure that we understand what it will take to make sure that we are checking our biases," Larkins-Pettigrew said. "That the trickle-down effect in our decision-making are those not based on biases, but based on scientific literature, is evidence-based, and that we're giving everybody the same [quality of care]."
Additionally, organizations must be mindful of the trust patients give their hospitals, healthcare facilities, and healthcare workers, and strive to keep it.
"Patients and healthcare workers should be able to show up as their authentic selves, with workers being mindful to meet the patient where they are in the moment regarding their care to continue that trust," Larkins-Pettigrew said.
In hiring, she added, the importance isn't as much in recruiting diverse individuals as it is retaining them.
"Retaining them means that they have to feel that they belong, that they're included, and that they are part of that big picture." Larkins-Pettigrew explained. "That their expertise matters."
From a socioeconomic perspective, the need for DEI increases when it comes to healthcare organizations and systems serving patients in rural communities. The current rural healthcare crisis is a result of several factors including the closing of numerous rural hospitals and healthcare facilities, staffing shortages, and the lack of expert or specialist care.
"[Healthcare systems] have to be connected to all of the folks we need to take care of. That means we need to understand what the needs are of people who live in rural communities," Larkins-Pettigrew said. "We need to pay attention to educate more primary care physicians who will be dedicated to these rural areas."
American Association of Nurse Practitioners president offers actionable suggestions.
As the COVID-19 pandemic enters its third year, protecting the well-being and mental health of nurses and other healthcare workers is more important than ever, says April Kapu, president of the American Association of Nurse Practitioners (AANP). Kapu, based in Nashville, remembers when COVID first began to affect the community in March 2020.
From setting up testing centers to developing COVID ICUs and ensuring they were staffed 24/7, there were a number of steps taken early on to attempt to wrestle control of the virus.
"I think at the beginning it was all-hands-on-deck, thinking that things will maybe wind down in mid-2021 if people got vaccinated," she said.
Kapu admitted that the surge of the Delta variant in the late summer of 2021 was a "huge hit." By that time, the staffing shortage had been aggravated further by the pandemic, including healthcare workers getting sick with COVID themselves.
According to Kapu, Nashville has reached its peak with Omicron variant cases, with children's and adult hospitals treating a high number of cases. She notes that while those being treated are "largely unvaccinated," they have begun to see more breakthrough cases with less severe symptoms.
"Having a staffing shortage, working day in and day out … that is physically exhausting," Kapu said, explaining how the stress and strain leads to burnout.
The long hours and constantly being on the move are physically exhausting for healthcare workers, she explained. Another factor of burnout is the emotional and mental toll the pandemic has taken on healthcare workers.
A number of studies have been conducted on the burnout healthcare workers are experiencing. Leading a group in her own study last year, Kapu found that 26% of nurse practitioners were exhibiting signs and symptoms of burnout. When asking participants what enabled their resilience to continue to push through their burnout, the "overwhelming recurrent" answer was wanting to make a change.
"Nationally, we just need to increase the supply of nurses and to support the education and training of nurses. Allow them to practice to the full extent of their education and training [and] increase autonomy," Kapu said, noting that the lack of the latter is directly related to burnout.
Having mental health services readily available to healthcare workers, in addition to emphasizing and implementing a healthy work environment, are also key to supporting workers. Workers also must not be afraid to seek out those resources if they feel like they need them, or to take days off.
"We cannot continue to run on the empty tank of gas. We need to take the time off now so that we can bring our very best self to our patients," Kapu said. "And when we do take that time off, we need to unplug and really spend that time getting out with nature, spending time with others, thinking about things other than work. That’s how we'll be able to come back and do what we really love."
Editor's note: This story was updated on February 9, 2022.
The tentative name for the new system is BHSH System and is set to launch on February 1.
Beaumont Health and Spectrum Health announced Monday that they will be merging to launch a new, combined health system "For Michigan, By MichiganTM."
The new system, which will temporarily be referred to as BHSH System, is set to launch on February 1. BHSH System will be led by an equal number of board members from both organizations, with the current Beaumont Health board chair, Julie Fream, serving as chair of the new board.
"Now, more than ever, our communities rely on physicians, nurses, and other caregivers for essential and life saving care. As we know, healthcare is personal and local. The ability to make decisions at the local level is crucial," Fream said in a virtual news conference. "We look forward to partnering with our patients, team members, and health plan members as we build a new organization designed to improve the health of the communities we serve."
Tina Freese Decker, president and CEO of Spectrum Health, will lead as president and CEO of BHSH System.
"This latest experience with delta's steady climb, and adding omicron on top of an already exhausted system has been overwhelming and at times heartbreaking," Decker said. "Our team member's never ending passion, grit, courage, and integrity everyday – even in the midst of so much trauma and burnout – demonstrates our determined commitment to providing outstanding care and coverage to all the communities we serve."
Other members of the BHSH leadership team include Jason Joseph as Chief Digital and Information Officer, Matthew Cox as Chief Financial Officer, Pamela Ries as Chief Integration Officer, and David Leonard as Chief Legal Officer.
The organization will be conducting internal and national searches to fill additional C-suite roles including Chief People Officer and Chief Strategy Officer. The organization will also be recruiting a new president of BHSH Beaumont Health, as Beaumont's Health's current president, John Fox, announced his plans to leave the organization last year. His last day will be February 4.
"I am very proud of our Beaumont team members for their many accomplishments, and I'm especially proud of the compassionate, extraordinary care they have provided for our patients throughout this long pandemic," Fox said in a statement. "I'm confident BHSH System will become one of the best health care systems in the nation.
Current Spectrum and Beaumont Health patients and health plan members will continue to have access to their same sites of care, providers, and plans. They are also encouraged to access care just as they would normally as both organizations focus on the creation of BHSH System.
Women-owned and -led virtual providers could increase awareness and provide more comprehensive care for women's health.
Awareness of the gender health gap has grown in recent years, with calls for more gender-sensitive care throughout the industry. While progress has been made, the telehealth industry has the potential to lead the way toward more comprehensive care for women.
Rachel Blank is the founder and CEO of Allara, a telehealth provider specifically for women's healthcare. The idea for Allara came from Blank's own frustrations from when she was diagnosed with polycystic ovary syndrome (PCOS) and struggled to find the comprehensive care that she needed. PCOS affects one in seven women.
While Allara was able to secure venture capital funding, Blank stated that only about 2% of venture funding goes to female led startups.
"If we think about increasing treatment and awareness for women's health conditions, I think it can be hard for men because they don't have the lived experience to know what it's like," she said. She added that if there aren't women leading companies for women's health, in venture funds investing into women's healthcare, or even working at the insurance level, it can be hard to understand why women's health is so important.
Blank began to take her care into her own hands, doing research, learning how to manage her condition, and she found that many other women were struggling with the same issue.
"When we think about living with chronic conditions, you really need more touch points than just that annual [gynecologist] visit," Blank explained. "Women should still be seeing their primary care [gynecologist], their primary care providers; but, if you are a woman with high complexity care needs like PCOS, that's just not sufficient for your care."
She described Allara as an "add-on service" that offers specialty care for more complex, ongoing healthcare needs. Currently, Allara is focused on care for PCOS and endometriosis, but she hopes to grow Allara to treat more complex health conditions.
As a telehealth provider, Blank sees Allara's potential to connect women to expert specialists who they currently may not have access to. Noting the fact that there are only 1,300 reproductive endocrinologists in the U.S., for women who don't live in major cities or reside in rural areas, it's difficult to access the expert care they may need, she said.
After launching last year, Allara is currently servicing women in 15 states, working toward nationwide availability by the end of 2022, with over 15,000 women on its waitlist. Community building through educational social and digital content has been a large part of Allara's growth strategy.
"The interesting thing about the conditions that we're serving, PCOS and endometriosis, is [that] the pain point is so high that we have a captive audience of women who are desperately seeking answers, who are desperately seeking better resources, and have not been able to find them," Blank said.
A new study digs into the reasons why women are not having regular cervical cancer screenings.
January is cervical cancer awareness month, and new data shows there is a declining rate of cervical cancer screenings among women.
While it's recommended that women get screened for cervical cancer every 3–5 years according to age, risk, and type of testing done, a study by the JAMA Network Open surveyed 20,557 women (aged 21–65) across sociodemographic groups who were eligible for cervical cancer screening, and found that the proportion of women overdue for a screening had gone up from 14.4% in 2005 to 23% in 2019.
Findings also showed "substantial variation in cervical cancer screening rates" by ethnicity, LGBQ+ identifying women, women living in rural areas, and uninsured women.
The study authors surveyed the women about reasons why they were not getting screened and found that the biggest barrier across sociodemographic groups cited was "lack of knowledge" about screening being needed.
The authors recommended that "campaigns addressing patient knowledge and practitioner communication may help to improve cervical screening rates, and cultural adaption of interventions is needed to reduce existing disparities."
Dr. Maurie Markman, a medical oncologist and president of medicine and science at Cancer Treatment Centers of America, called the results of the study a "catastrophe," emphasizing the importance of getting screened regularly, as well as the importance of both men and women getting vaccinated for human papillomavirus (HPV), which can cause cancer in the cervix as well as in the head and throat.
"We have the potential of coming as close to eliminating a cancer as one can come to," Markman said, referring to cervical cancer. He explained that cervical cancer, among others, is caused by persistent HPV infection, which is sexually transmitted.
It's recommended that individuals get vaccinated for HPV when they're children; however, because it's a sexually transmitted disease, Markman said people weren't as open to having a conversation about how it affects women and men when the vaccine was first introduced to the market.
"The mistake was saying that [getting the vaccine was meant] to prevent a sexually transmitted disease," Markman explained. "What should have been done is saying that this is simply a cancer-preventing vaccine."
While the vaccine was initially advertised with emphasis on young girls and preventing cervical cancer, Markman adds that vaccinating young boys can also protect them if they're ever exposed to HPV and lower the risk of transferring it to someone else in the future.
Healthcare providers that received Provider Relief Fund (PRF) monies will be assessed on how they billed for out-of-network patients who received treatment for COVID-19.
Healthcare providers and hospitals that received funding from the Provider Relief Fund (PRF) will be audited for their compliance of the balanced billing requirement (or "surprise billing"), a requirement they must follow to receive the funds. The PRF reimburses eligible healthcare providers for related expenses or lost revenue due to COVID-19. The PRF funded $178 billion to providers and hospitals through the CARES Act, Paycheck Protection and Health Care Enhancement Act, and Consolidated Appropriations Act, 2021.
The U.S. Department of Health and Human Services (HHS), Office of Inspector General, plans to conduct a nationwide audit to determine whether hospitals that received PRF funding complied with the billing requirements for COVID patients. This requirement stipulates that those hospitals must not pursue out-of-pocket payments from COVID patients whose bill exceeded "what the patients otherwise would have been required to pay" for in-network care.
"We will assess how bills were calculated for out-of-network patients admitted for COVID-19 treatment, review supporting documentation for compliance, and assess procedural controls and monitoring to ensure compliance with the balance billing requirement," an HHS statement said.
In related news about surprise billing, the Texas Medical Association (TMA) filed a brief yesterday asserting its opposition to a federal ruling that TMA thinks unfairly favors health insurers in situations to resolve payment disputes between payers and physicians via the No Surprises Act. The brief stated that the rule fails to implement the No Surprises Act the way Congress wrote it.
"The last thing federal regulators should do is make health care more expensive and less accessible for people when they need it, especially during a pandemic," E. Linda Villarreal, MD, TMA president said in a statement. "The courts must reject the federal agencies' flawed approach, because it goes against the public interest and our democratic process."
With the omicron surge and possible future variants, it's a matter of stabilizing the number of cases, says one medical director.
As we enter year three of the pandemic, amid the spread of the most infectious variant of the virus, signs could be pointing toward COVID-19 becoming endemic, says one medical director.
According to Dr. Sachin Nagrani, medical director for primary care provider Heal, during a pandemic the number of COVID cases rise and fall across the world at an unstable rate. However, for a virus to become endemic, there needs to be a prevalence of it at an expected level.
"A good example to bring it home for people is that endemic doesn't mean that its constant all the time. You can have [seasonal] variants," Nagrani said.
He noted that while 12,000 to 50,000 individuals die of the flu each year, it's an infectious disease we've come to live with as a society. COVID-19 becoming endemic will depend on the number of cases stabilizing, as well as the progression—or further mutation—of the virus.
The omicron variant has proven to be the most contagious variant of COVID by far, yet with less severe symptoms. As for new variants, Nagrani stated there will be more in the future.
"Viruses are routinely undergoing mutation as they spread around and so there are different strains of it," he said. "Strains are just changes in the DNA or mutation [of the virus]. The way we've been using the word variant is to define a strain that has spread significantly around the population."
While 'deltacron' has been mentioned in recent news as cause for concern, Nagrani explained that it's not a new variant, but rather a popularized term used to describe the infectivity of the current omicron variant and the severity of the delta variant.
COVID-19 becoming endemic is dependent on infections arriving at a stabilized state, which can happen naturally or steadily with the use of preventive measures.
"Preventive measures affect not only COVID, but also other [infectious agents]," Nagrani said, noting that there was a drop in the number of flu cases for the 2019–2020 flu season—right when individuals began taking precautions for COVID. "The trifecta of impacting the virus is preventative measures, testing, and treatments—and preventive measures are generally the most important."
As hospitals everywhere struggle to accommodate the surge of omicron variant COVID cases, healthcare workers are being stretched to their limits while also having an increased risk of getting sick. While the staffing strain is a result of COVID, looking at things from a policy perspective, Nagrani explained how the pandemic seems to have disrupted the systems previously in place.
'We have hospitals that have been traditionally designed, such that you don't have excess capacity. Having extra staff, extra beds—is not a good operating model for a hospital," he said. 'When you see surges like this from public health emergencies, we're not well equipped to handle it. So going forward, what type of public health policies are taken not just from a prevention measure but from a responsiveness measure, will be something that will be interesting to see."
He added while certain measures may not have a fixed cost, like building a bigger hospital, they may be more along the lines of setting up field hospitals and emergency centers that can be easily deployed to areas that need additional assistance.
Editor's note: This story was updated on January 26, 2022.
OSHA withdrew a majority of provisions in its Healthcare Emergency Temporary Standard in December 2021.
OSHA's withdrawal of non-recordkeeping portions in its Healthcare Emergency Temporary Standard (Healthcare ETS) on December 21, 2021, which protected healthcare workers from COVID-19 in healthcare settings, is causing employee safety and worker morale concerns, says Liz Borkowski, senior research scientist at George Washington University’s Department of Health Policy and Management.
Borkowski explains that whenever OSHA adopts a temporary standard, like the Healthcare ETS for healthcare workers last June 2021, six months is then allotted in the OSH Act for the agency to create a permanent standard.
However, OSHA was unable to finalize a final Healthcare ETS rule within the timeframe, stating delays due to the recent surge of COVID-19 variants. OSHA withdrew a majority of provisions in its Healthcare Emergency Temporary Standard in December 2021.
Among the requirements in the Healthcare ETS were the designation of a safety coordinator to monitor compliance with the COVID plan specific to the workplace; limiting and monitoring points of entry to areas where patients are treated; screening patients, visitors, and non-employees for symptoms; and providing and enforcing the use of masks, as well as social distancing.
In its statement announcing its withdrawal of non-recordingkeeping provisions in the Healthcare ETS, OSHA stated it would "vigorously" enforce the general duty clause and its general standards to protect healthcare employees.
"OSHA does not have a standard for every single thing that might appear in a workplace, but the general duty clause basically means that they expect employers to be keeping up on what the hazards in their industry, in their workplace [are], and to have protections for those," Borkowski says.
The enforcement of the general duty clause is, of course, dependent on employers being proactive and evaluating potential hazards (in this case, the possibility of getting COVID), having protective measures in place, and OSHA holding employers accountable through inspections. Yet, with OSHA not having enough inspectors to visit every workplace, Borkowski says there's a possibility some employers could see this as an opportunity to cut corners.
Amid a surge of omicron variant COVID-cases and worsening healthcare staffing crisis, organizations like National Nurses United have pleaded with OSHA to implement a permanent standard and to reimplement the temporary Healthcare ETS, holding a National Day of Action on January 13 to demand the Biden administration take action to protect the nurse workforce.
"Our employers claim there is a 'nursing shortage,' and that's why they must flout optimal isolation times, but we know there are plenty of registered nurses in this country," Zenei Triunfo-Cortez, NNU president, said in a statement. "There is only a shortage of nurses willing to work in the unsafe conditions created by hospital employers and this government's refusal to impose lifesaving standards. So this is a vicious cycle where weakening protections just drives more nurses away from their jobs."
That same day, the U.S. Supreme Court voted in favor of the Biden administration's authority to mandate that all healthcare workers be vaccinated. However, the court also ruled against requiring employees for large businesses to be vaccinated.
"It's always up to the employers to protect [their] employees. They've always had this duty to protect their employees, to have safe and healthy workplaces," Borkowski says. "The difference now is that OSHA—if they're going to be using the general duty clause rather than a specific standard—employers might feel that they have more wiggle room and that they don't have to do quite as much."
Borkowski adds that her hope is that employers, including those outside of the healthcare sector, recognize that keeping their workers healthy is the best way to keep their workers at their organizations.
In a survey by the NNU, 83% of nurses said half their shifts are "unsafely staffed." Sixty-eight percent said they've considered leaving their current position.
With healthcare workers handling the brunt of the stress and strain of the pandemic, Borkowski isn't surprised at the low morale many of them feel.
"People—potential and current healthcare workers—might think twice about entering or staying in a job where they don't feel like they are protected or they don't feel like employers are looking after their health," she says. "If we don’t protect healthcare workers now, not only are many of them going to get sick, but we will have fewer healthcare workers doing these essential jobs into the future."