THE GROWING WORKFORECE CRISIS IN MA HEALTH CARE by Michael V. Sack

Take a look back at recent posts to this blog and you will see one recurring theme: Health Reform has been a tremendous success so far, but the rise in health care costs continues to worry everyone. The cost associated with the Reform effort has a growing price tag.

Every single blog contributor, who has offered such a thought about rising cost, is right on. Many of the regulars in this space are starting to offer new and innovative proposals to get at the issue. Last week, Blue Cross offered a new, voluntary payment structure that hospitals and other providers should examine.

But proposals like these, while welcome, fail to get at a core cause of what is inflating health care costs – fixed input prices. Significant among those input prices is the rising cost of labor. There is a growing workforce shortage that greatly affects cost. We need to address the shortage of a variety of caregivers – including primary care physicians – in order to maintain the quality of our care delivery. We are also experiencing cost pressures filling jobs in other areas including physical therapists, ultrasound techs, and even in non-clinical areas like medical record coders and billing/collections. To ignore the impact that labor has on health care costs and to focus solely on other cost containment measures would relegate our efforts to the periphery.

Of course, the cost of nursing comes to the forefront when discussing the topic.

The growing workforce shortage in nursing is quickly approaching crisis proportions. In two years, we are projected to have an RN shortage of 10,000. Five years after that, we are on track to be short 16,000 RNs. By the year 2020, the problem is projected to balloon to 25,000.

Think about what that type of shortage could do to the cost of labor in Massachusetts – to speak nothing about the delivery of care. And the situation would be greatly exacerbated with the passage of a law requiring minimum mandatory nurse staffing ratios, based on a canard from one of the state’s prominent nursing unions; it would drive up wages and ultimately the cost of care with no demonstrable measure of improvement in the delivery of care.

Simply put, we must begin to think seriously about new ways to address the RN labor shortage and improve the nursing pipeline, as well as strategies to address the shortage of other essential health care professionals.

How do we accomplish this? Well, by starting. Last month, through an innovative partnership between hospitals in Massachusetts, the Board of Higher Education and Tufts Health Plan, a new effort targeting the most problematic bottleneck in the supply of new RNs – the lack of nurse educators was announced. This plan puts resources into providing incentives to those interested in teaching.

Let’s face it, Massachusetts is expensive - to buy a home, to send kids to school, even to park your car. It is no wonder it is more expensive to hire a skilled clinician to deliver your care. Caregivers deserve fair compensation.

Like with establishing Heath Reform, all stakeholders must come together to solve the workforce shortage, and cost, issues. The problem is bigger than any one sector can handle alone.

It will take more. Reform is a balancing act of access of coverage, and of cost. Focusing on one element only serves to complicate the others. Cost increases must be reined in and must be shared. Changes must occur to access and in coverage simultaneously in order to keep a balance. The State’s caregivers deserve recognition and support while this balance is sought.

Michael V. Sack
President and CEO, Hallmark Health