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Employer Quotes

The quotes below are from employers in this industry: Health Care

They are talking about this topic: Industry Trends

 

The quotes below are about this issue:
Financial cuts are a prominent challenge in the health care industry. Many speak of having "to do more with less." Reimbursements for long-term care are being cut while demands for care are growing. Workloads are increasing with a push toward greater efficiency. The need to hire is not always matched with the financial capacity to hire.

Employer Quote Region
"Plus the cost of it, the cost of the agency when our reimbursements are dropping constantly every year. What we get reimbursed is dropping in long-term care facilities and home care. So, to provide that kind of training is costly." Central
"We are going to need to expand the care we offer without any additional dollars. We are going to have to figure out more cost-effective ways of providing that care. And I think the level of providers is going to be one of the answers—it's one of the things that we're going to have to continue to expand." Central
"Employer 1: It's an amazing amount of money. It's all reimbursement driven. But it's no wonder we lose people.

Employer 2: We are in kind of a squeeze in terms of reimbursement in long-term care."
Central
"The big rock-your-socks-off change is in medical coding and billing. That's going to happen when we go to ICD-10. And that's never thought of in the health care sector, but we have people at the clinic sites and other areas who have to understand this, so that it gets billed and coded correctly. It's going to be a big deal." Metro
"With the Affordable Care Act, our reimbursement's going to be cut, so preventative health, making people healthier, is going to be so important. So, patient education is huge. We're not going to be reimbursed for re-admits. So, that's up to the nursing staff to do the education to keep the patients from coming back. It's a collaborative effort between the whole health care team, but teaching patients how to stay healthy is going to be key to the growth of our organizations. Otherwise, we're going to end up losing money because we won't be reimbursed for what we do." Northeast
"Question: Any more about the Affordable Care Act that causes concern? Clearly, you have to avoid re-admittances and clearly more emphasis on getting results for chronically ill folks, but any other things?

Employer: Well, reimbursement will be based on quality of care and [?]. There is a service piece along with it.

Question: So, not just based on results?

Employer: The whole experience, not just results."
Northeast
"With the economy, we're going to have to do more with less." Northeast
"We have the old labor contracts and other things that might have something in there about ratios of patients to nurses. So, we can't go below that really, but they could be either the same or down to less. Probably not more." Northeast
"Educational incentives are being slashed. They're not paying for tuition hardly at all anymore. There's no step process. So, if you go from a CNA to a LPN, it used to be many, many, many years ago that you get a little stipend for going on with your education and staying working there for a year or two. There's none of that now. It's all been cut. I see the retention issue as being the biggest fiend in all of this." Northwest
"If you look five years out, the average person who comes to a nursing home is going to need more complicated care and attention. So, it will be a tighter budget, but yet we need the skills of those RNs that are coming out." Northwest
"The other issue is whether you're considered urban or rural because those areas are paid differently by the state. Here in Winona, we are reimbursed less from the state than we would be in Rochester because Rochester is considered urban. So, those are challenges that we have behind the scenes in terms of attracting people." Southeast
"Employer 1: Reimbursement is our biggest challenge. It's going to really affect us in the next one to three years. And how that implicates the workforce is that the less we get reimbursed the less we can pay our employees. Or they just have to be worked a lot harder to see more patients—and then quality of care decreases.

Question: When we use the word 'reimbursements,' my mind initially goes to things like Medicare and Medicaid and other types of state or federal programs. But I'm wondering if, with all the changes in health care in the private sector, when the word 'reimbursements' is used, is it across-the-board whether it's private insurance—well, of course, in Minnesota all insurance is non-profit—but is it Blue Cross/Blue Shield as well?

Employer 1: Everything.

Question: It's everything. So, when you say 'reimbursements,' it's across-the-board. It's not one sector or another.

Employer 1: Right. Every year we're getting paid less from insurance.

Employer 2: But the costs aren't going down."
Southeast
"We want them to keep insurance for their staff, but if it becomes cost-preventive, they'll drop it. We've seen employers drop insurance here and that's not a good thing. So, from my perspective, we're constantly looking at how to take waste out of the system and how to manage our costs. And it almost looks like it's in a fixed way regardless of who your payer type is. So, that's this whole shifting that's happening right now. But I don't foresee why you might get a little adjustment here and there from time to time. I think it's going to be flatter. It's going to be less reimbursement going forward and that's the challenge that we have to work with.

Question: Do you agree that that's one of the major challenges when you look at hiring in the next one to three years?

Employer: Oh, yeah."
Southeast
"There's a difference between a need to do something and the ability to afford to do something—there might be limits on how many people facilities can hire. So, in the future, I think facilities are going to have a lot of workers that are pushing their limits on efficiency, and are also getting pushed—you know, get as many hours as you can out of those people. And you're going to end up with a workforce that's very tired and run down because you're going to be pushing them. And you won't have the ability to hire more staff. So, the need and the ability of the facilities are two different things." Southeast
"Employer 1: So, what the need might be versus what the financial capacity of being able to bring that workforce on are two different things. Without the financial capacity to pay those positions, you're going to be asking the current workforce to do more with less, which we've been doing since the recession. And it sounds like we're not, at least in the health care industry, seeing that trend change anytime soon.

Employer 2: Well, there's doing more with less, and then there are needs not meet."
Southeast
"That's happening everywhere. You can go anywhere around Minnesota—or across the U.S.—and you hear it if you're talking to people, 'I can't get in to see so-and-so for two months,' or 'I'm trying to get to this specialist in six months, but I can't get in.' It's just basic primary care, but people can't get in for three weeks or things like that. That's not how it used to be. And it's about any type of service for the most part. And it happens because we're not going to ask people to work 80-hour work weeks and things like that. There's a limit to what people can do. But could we grow it? Yeah, but we're not—I mean there is an issue of what you get paid and what you don't get paid for. So, how can you sustain all of your services? In health care, about 55 percent of our expenses are salaries and benefits. If you were to compare that to manufacturing that would seem very high. Most industries would probably only be 20 to 30 percent being actual salary cost. In long-term care with senior services, it's quite a bit higher because that's just a dominant expense—it's salaries and benefits. And then you look at fixed costs. We don't have a lot of other variable costs here, so we try to manage what we do get paid. And the government programs don't even pay cost, and that's where you have the insurance. That's the dynamic of working through this." Southeast
"Employer 1: I will say that in hospital settings over 50 percent, nearly in any hospital, over 50 percent of their volume is Medicare.

Employer 2: Is that true with acute care and older adult care?

Employer 1: Absolutely."
Southeast