The decline in healthcare job growth matches employment declines seen in the larger U.S. economy.
Healthcare created 31,000 jobs in August, a sharp drop from the 60,000 new jobs averaged monthly by the sector over the past 12 months, federal data show.
It's the second consecutive month for the healthcare sector to see healthy but cooling job creation. Even with the slowdown, healthcare accounted for more than one-in-five (22%) of the 142,000 jobs created in the U.S. economy in September.
The growth was seen primarily in the ambulatory care sector, (24,000) and hospitals (10,000), the Bureau of Labor Statistics reports.
The 142,000 new jobs created in the overall economy in August marks a precipitous drop (-30%) from the 202,000 jobs created, on average, over the past 12 months.
The unemployment rate in the larger U.S. economy was little changed at 4.2%, BLS says, with 7.1 million people reporting as unemployed in August. These numbers are higher than in August 2023, when the jobless rate was 3.8%, and the number of unemployed people was 6.3 million.
The average hourly earnings for all employees on private nonfarm payrolls in August rose by 14 cents (0.4%) to $35.21. Over the past 12 months, average hourly earnings have increased by 3.8%. In August, the average hourly earnings of private-sector production and nonsupervisory employees rose by 11 cents (0.4%) to $30.27.
The big job maker in August was construction, which reported 34,000 new jobs, up 78% from it's 12-month average of 19,000 jobs.
July and August job numbers are considered preliminary by BLS, and subject to revision. June jobs growth was revised down by 61,000 in June, from 179,000 to 118,000, and 25,000 in August, from 114,000 to 89,000, BLS says.
More than 1.7 million patient injuries and 83,000 deaths have been linked to defective medical equipment over a 10-year span.
The Food and Drug Administration is building a surveillance platform as part of its ongoing and decade-long effort to monitor potential safety issues arising from faulty medical devices.
The project — the status of which was updated this week in a report from the Government Accountability Office — is a response to the more than 1.7 million injuries and 83,000 deaths that have been potentially linked to faulty medical devices over a 10-year span in the U.S., FDA data show.
The surveillance will include everything from implantable pacemakers to surgical masks for medical devices used by tens of millions of Americans.
Tapping data from electronic health records, billing claims, pharmacy and other sources, the FDA surveillance will begin by Decemober 2024 with a few devices and expand over time.
In 2012, Congress ordered the FDA to establish an active post-market surveillance system for medical devices. However, major sticking points have included a lack of funding, and problems tracking patients' unique device identifiers.
To encourage the use of unique device identifiers, the agency may use advertising to explain the benefits to health systems. In addition, the agency has estimated current and future active surveillance costs and is searching for alternative funding sources.
The FDA’s efforts to monitor potentially defective medical devices dates to 2012, and so far have included:
Establishing a coordinating center in 2016 to partner with FDA to organize a network of data sources (health systems and other collaborators);
Completing in 2021 the cloud-based data infrastructure necessary to collect evidence of medical device performance while protecting patient privacy; and
Planning active post-market surveillance of two medical devices by December 2024, with plans to expand over 5 years.
Nurse practitioners, nurse anesthetists, and physician assistants represented nearly one-in-four (23%) of the 2,138 searches conducted from April 1, 2023, to March 31, 2024 by Texas-based recruiters AMN Healthcare.
Family physicians topped AMN's physician searches for the 18th straight year, second only to APPs among all searches. The average starting salary for family physicians was up 6.27% year-over-year, from $255,000 in 2023 to $271,000 this year.
However, while primary care physicians remain very much in demand, that demand is cooling as the demand for APPs heats up. Only 14% of AMN's searches this year were for primary care physicians, down from 17% last year, while 23% of search engagements were for APPs, up from 19% last year.
AMN says the transition away from recruiting primary care doctors and toward APPs reflects the ongoing patient migration from traditional care venues.
"NPs are filling needs created by the physician shortage and are used to staff a growing number of urgent care centers, retail clinics, and telemedicine platforms. In addition, more specialty medical practices are employing them," AMN says in its 2024 Review of Physician and Advanced Practitioner Recruiting Incentives, breaks down salaries, signing bonuses, and relocation allowances.
The high demand for NPs was reflected in starting salaries, which rose 8.6% year-over-year, from $158,000 2024 to $164,000 in 2024. By comparison, the rate of inflation in the U.S. economy as measured by the Consumer Price Index was 4.06% in 2023 and 3.2% in 2024, federal data show.
The review also found that:
• Starting salaries for physicians and APPs were up year-over-year, with increases seen in 13 of the 20 specialties.
• Orthopedic surgeons were paid the highest average starting salary ($686,000). Pediatricians were paid the lowest ($244,000).
• The average signing bonus for physicians was $31,473. The average bonus for APPs was $11,758.
• In addition to salary and signing bonuses, physicians and APPs often got relocation and continuing medical education allowances. The relocation allowance for physicians averaged $11,284, and the allowance for APPs was $7,910. The CME allowance for physicians averaged $3,969 and $3,195 for APPs.
• Most AMN searches this year (63%) were for physician specialists, including OB-GYNs, gastroenterologists, radiologists, cardiologists and other specialists.
• OB/GYNs were 2nd on the list of AMN's most requested physician search engagements this year, up from 4th last year. Demand for OB/GYNs remains strong, but the supply may be inhibited by the U.S. Supreme Court's Dobbs vs. Jackson decision, which discouraged medical school graduates from pursuing OB/ GYN residencies.
• Nearly three-quarters (71%) of searches were in communities of 100,000 people or more, which AMN says shows that demand for physicians and APPs is not limited to small and/or rural communities.
The 55,000 jobs in July marks a slight drop from the healthcare sector's average of 63,000 over the past 12 months.
Healthcare created 55,000 jobs in July and accounted for nearly half (48%) of the 114,000 new jobs in U.S. economy last month, federal data show.
The 55,000 jobs in July marks a slight drop from the healthcare sector's average of 63,000 over the past 12 months, with most of the growth coming from home health care (22,000), hospitals (20,000), and residential and nursing care (9,000), the Bureau of Labor Statistics reports.
Job gains were also reported in construction (25,000), specialty trades (19,000), and transportation and warehousing (14,000).
The 114,000 new jobs created in the overall economy in July marks a precipitous drop (-46%) from the 213,000 jobs created, on average, over the past 12 months.
The unemployment rate in the larger U.S. economy increased 0.2 percentage points to 4.3%, BLS says, with 7.2 million people reporting as unemployed in June. These numbers are higher than in July 2023, when the jobless rate was 3.5%, and the number of unemployed people was 5.9 million.
The average hourly earnings for all employees on private nonfarm payrolls in July rose by 8 cents (0.2%) to $35.07. Over the past 12 months, average hourly earnings have increased by 3.6%. In July, the average hourly earnings of private-sector production and nonsupervisory employees rose by 9 cents (0.3%) to $30.14.
June and July job numbers are considered preliminary by BLS, and subject to revision.
The Orlando-based nonprofit OneBlood says it's still operating but at "a significantly reduced capacity."
Orlando-based OneBlood is recovering from a "ransomware event" discovered on Monday and it's asking the more than 250 hospitals it supplies to "activate critical blood shortage protocols" as cybersecurity teams determine the extent of the attack.
Spokeswoman Susan Forbes says the nonprofit blood center is still operating and collecting and distributing blood but "at a significantly reduced capacity."
"We have implemented manual processes and procedures to remain operational," Forbes says, adding that these stopgap measures "take significantly longer to perform and impact inventory availability."
"In an effort to further manage the blood supply we have asked the more than 250 hospitals we serve to activate their critical blood shortage protocols and to remain in that status for the time being," Forbes says.
OneBlood did not say what the hackers were demanding or if a ransom was paid.
This week's attack on OneBlood is the latest in a string of high-profile cyberattacks targeting healthcare-related entities. The Change Healthcare hack in March paralyzed large swaths of the nation's care delivery system and cost parent UnitedHealth about $2.5 billion, including $22 million in ransom payoffs.
'A National Security Concern'
Mary Mayhew, president and CEO of the Florida Hospital Association, says OneBlood became aware of the hack on Monday, which investigators, including the Federal Bureau of Investigation, have traced back to Russia.
Mayhew says OneBlood handles about 80% of the blood supply for Florida hospitals and also supplies three other southeastern states. The blood center "was completely shut down" in the hours after the attack but has gradually brought services back on-line, Mayhew says.
"What we've heard is that they now have control over all their systems taken back from the cybercriminal," Mayhew says. "They are optimistic day-over-day, that their capacity will continue to increase as they are able to bring their systems back online.
"They are unable to give a date certain, but they believe it's a matter of days, not weeks. But we could continue to operate well below 100% of what a hospital typically receives and depends on for blood supply for at least another three to five days."
To compensate, Mayhew says the National Blood Task Force has been activated.
"They are drawing from the Red Cross and other blood centers and other national resources to try to get some blood into Florida," she says. "The biggest major concern is platelets. Platelets have a very short shelf life by days, and it's important to understand that for transplant surgeries, for open-heart surgeries, for certain cancer treatments, platelets are absolutely critical."
Mayhew says the OneBlood attack "really reinforces a focus on this as a national security concern."
"By that, I mean this is affecting our public health infrastructure when you are threatening the life-saving resource of the supply of blood," she says. "Just as we would have a national security response if there was an attack to our electrical grid or any other infrastructure that we depend on, this is obviously life and death when they jeopardize and undermine the supply of blood in our country."
Ambulatory care and hospitals each accounted for only 22,000 new jobs. Is relief in sight for leaders?
Healthcare grew 49,000 jobs in June, down from the average 64,000 jobs over the past 12 months, but still representing nearly one-in-four (23.7%) of the 206,000 jobs created in the larger economy during the month, federal data show.
Ambulatory healthcare services and hospitals each grew 22,000 jobs, accounting for the bulk of healthcare jobs, the Bureau of Labor Statistics reports.
Job gains were also reported in government (70,000), social assistance (34,000) and construction (27,000)
The unemployment rate in the larger U.S. economy held steady 4.1%, BLS says, with 6.8 million people reporting as unemployed in June.
The average hourly earnings for all employees on private nonfarm payrolls in June rose by 10 cents (0.3%) to $35.00. Over the past 12 months, average hourly earnings have increased by 3.9%. In June, the average hourly earnings of private-sector production and nonsupervisory employees rose by 10 cents (0.3%) to $30.05.
May and June job numbers are considered preliminary by BLS, and subject to revisions.
It's the second-largest criminal financial penalty levied against a drug maker.
The now-reorganized Endo Health Solutions Inc. has agreed to pay $1.086 billion in criminal fines and $450 million in criminal forfeitures after pleading guilty to one misdemeanor charge related to the intentional misbranding of its opioid medication Opana ER with INTAC, the U.S. Department of Justice says.
EHSI pled guilty on April 18 to one count of introducing misbranded drugs into interstate commerce. The drugmaker admitted that from April 2012 through May 2013, its sales reps marketed Opana ER to physicians by baselessly claiming that the opioid was tamper- and crush-resistant and thus purportedly deterred abuse. In some cases the sales reps used hammers to strike non-medicated sample pills.
In addition, EHSI admitted it was responsible for the misbranding of Opana ER by marketing the drug with a label that failed to include adequate directions for its claimed abuse deterrence use, in violation of the federal Food, Drug, and Cosmetic Act.
EHSI stopped selling Opana ER in 2017. The drugmaker was shut down during the bankruptcy process and not allowed to continue its prior form when the company emerged on April 23. The EHSI affiliates that come out of the bankruptcy process can no longer sell or market opioids and must make public millions of documents relating to EHSI's role in the opioid crisis.
EHSI issued a statement calling the agreement "an important step in our settlement with the DOJ."
"The company has made important changes since the historical conduct of certain former sales representatives that took place from 2012 to 2013. We remain committed to operating with integrity and maintaining a culture of compliance and ethics," EHSI says.
EHSI says the settlement with the federal government included $200 million when it emerged from bankruptcy in April, "which fully satisfied the criminal fine, the civil false claims act settlement agreement, and all of the IRS tax claims, with possible additional payments up to a maximum of $100 million to be paid over five years if certain financial metrics are met."
The largest criminal penalty imposed in the sweeping opioid legal actions was levied against Reckitt Benckiser Group plc, which in 2019 agreed to pay $1.4 billion to resolve its potential criminal and civil liability for its role in marketing of the opioid addiction treatment drug Suboxone.
The EHSI settlement is a component of the broader case resolving all monetary claims held by the federal government against EHSI's new corporate entities. The new company has also funded trusts for opioid-related claims that will pay more than $450 million to state, municipal and tribal governments for opioid addiction treatment programs.
DOJ is crediting up to $450 million of these payments against the forfeiture amount.
"The opioid crisis we continue to face today originated, in part, from companies like EHSI building their business on false claims and deceptive business practices," Drug Enforcement Administration Administrator Anne Milgram says. "By intentionally misrepresenting opioid medications, EHSI prioritized profits over the health and well-being of the American people. (This) settlement reflects DEA's commitment to keep Americans safe and holding companies like EHSI accountable."
The Jacksonville, Florida-based health system self-disclosed the improper discounts to encourage patient referrals.
Baptist Health System Inc. will pay $1.5 million to settle self-reported allegations that its subsidiaries offered illegal discounts to patients to induce them to buy or refer Medicare services to the Jacksonville, FL-based provider, the U.S. Department of Justice says.
According to the settlement, Baptist Health subsidiaries gave discounts of 50% or more to Medicare patients from 2016 through mid-2022 "in exchange for the beneficiaries' purchase or referral of services by certain categories of Medicare beneficiaries from Baptist Health subsidiaries. The beneficiaries were chosen by Baptist Health "without regard to any financial need consideration."
DOJ noted that Baptist Health voluntarily self-disclosed the improprieties, cooperated with the investigation and took remedial measures, including discontinuing its discount policy, conducting an internal compliance review and providing federal regulators with a detailed disclosure statement and other supplemental information.
"Self-disclosures like this not only help crucial federal healthcare programs to recoup funds, but are also in the best interests of healthcare providers themselves," Roger B. Handberg, U.S. Attorney for the Middle District of Florida, says in a media release.
Baptist Responds
Baptist issued this statement. "Upon review of its payment practices, Baptist Health made a voluntary self-disclosure of outdated courtesy discount practices. The self-disclosure process encourages transparency and facilitates the resolution of matters that potentially violate federal laws, and it aligns with our commitment to do the right thing. This settlement reaffirms our dedication to compliantly delivering high-quality care."
Finance leaders take heed, your outpatient volumes dropped 5% while physician compensation shot up 2%.
The nation's hospitals booked thinner operating margins in March thanks to lower volumes and revenues combined with rising labor costs, according to Kaufman Hall's latest National Hospital Flash Report.
The consultants say that health system bean counters can expect much of the same going forward as they also contend with growing bad debt and charity care.
The Kaufman Hall Calendar Year to Date Operating Margin Index—a measure of hospital profitability—was 3.9% in March, a 0.2 percentage point drop from 4.1% in February. The index "represents the national median for hospital profitability—or operating revenue less operating expense—inclusive of allocations to hospitals from corporate, physician, and other entities," KH says.
Margins were nicked by the continued rise in labor costs, with KH's latest Physician Flash Report for Q1 2024 showing that staffing accounted for 84% of expenses. There is nothing to indicate that this trend will abate anytime soon, considering the ongoing clinical shortage nationally.
The dramatic rise in clinician labor costs is not exactly breaking news for hospital finance executives. A March survey by the Hospital Financial Management Association for that rising labor costs were by far the biggest concern for hospital CFO.
But acknowledging the problem doesn't make contending with it any easier. In what has become a game of Whack-A-Mole for CFOs, cutting labor expenses oftentimes means cutting into staffing or hours. That can lead to staff unrest and turnover and that hurts retention in a red-hot seller's market for clinician labor. Further, any cost savings seen in staff reductions often are lost in the cost of replacing those workers, or hiring temp labor, and accounting for the expected reduced productivity of replacement workers until they're up to speed.
KH reports that increases in revenues and expenses for health systems also signal increased productivity and compensation for their physicians, whose productivity grew 4% in Q1 24, when compared to Q1 2023 and whose "median investment/subsidy" grew 2% to $227,972 during the same period.
"With the high cost of labor unlikely to change, health systems must think critically about how to optimize downstream margins," Matthew Bates, managing director with Kaufman Hall, says in the report. "Organizations could lean into strategies that enable physicians to be more productive as well as prioritizing outcomes related to lengths of stay or readmissions, which impact revenue."
Outpatient Volumes Down
Outpatient volumes fell 5% in March, which KH attributed to "the competitive challenges of providing outpatient care."
"Declines in outpatient revenue mean hospitals providing outpatient care may face difficulties ahead," says Erik Swanson, a senior vice president with Kaufman Hall. "Organizations may need to reevaluate their assets and consider strategic partnerships to offset current and future challenges with volume."
The National Hospital Flash Report draws on data from more than 1,300 hospitals from Syntellis Performance Solutions, now part of Strata. The Physician Flash Report draws on data based on more than 200,000 providers, also from Syntellis Performance Solutions, now part of Strata.
Healthcare job growth in April was down about 22% from the 72,000 jobs created in March but in line with annual averages.
The healthcare sector grew 56,000 new jobs in April, a 22% drop from March, but in line with monthly averages over the past year, and still among the most robust job-creating sectors in the overall economy, new federal data show.
Ambulatory care and hospitals lead in job creation within the healthcare sector in April, accounting for 33,000 and 14,000 new jobs, respectively, while nursing and residential care created 9,000 new jobs, according to the Bureau of Labor Statistics April jobs report.
Despite the slowdown, the healthcare sector accounted for nearly one-in-three (32%) of the 175,000 jobs created in the larger economy in April, BLS data show.
The healthcare sector has created an average of 63,000 new jobs every month for the past year.
The unemployment rate in the larger U.S. economy held steady at 3.9%, BLS says, with 6.5 million people reporting as unemployed in April.
Big job gains in April were also seen in social services (31,000), and retail (20,000).
The average hourly earnings for all employees on private nonfarm payrolls in April rose by 7 cents (0.2%) to $34.75. Over the past 12 months, average hourly earnings have increased by 3.9%. The average hourly earnings of private-sector production and nonsupervisory employees rose by 6 cents (0.2%) to $29.83.
March and April job numbers are considered preliminary by BLS, and subject to revisions.
