Monthly Archives: March 2014

Healthcare employment flat for third consecutive month


Feb 2014 BLS (Bureau of Labor Statistics) Healthcare Employment Statistics:

  • For the third consecutive month overall healthcare employment had little change, increasing by 10,000 in February.
  • Hospital employment declined by 1,000 in February, and has shed 10,000 jobs over the past 3 months.
  • Ambulatory healthcare services employment continued its upward trend in February, with the largest gains occurring in offices of physicians (+8,000), after adding 9,000 jobs in January.

Over the past year, 167,000 of the 191,000 jobs added in health care have been in ambulatory healthcare services. Offices of physicians, outpatient care centers, and home health care services have expanded employment over the 12-month period. However, growth has decelerated over the last 3 months in outpatient centers and in home health care.

2013 BLS Healthcare Employment Trends:

  • 2013: Overall healthcare employment added an average of 17,000 jobs per month
  • 2013: Ambulatory healthcare services added an average of 15,000 jobs per month (as it did in 2012)
  • 2013: Hospital employment showed little net change (after adding an average of 4,000 jobs per month in 2012)
  • 2013: Nursing and residential care facilities added an average of 2,000 jobs per month (after adding an average of 4,000 per month in 2012)

To read the February BLS reports:

Washington state legislature passed two Cost & Quality Transparency bills

Washington state is creating a statewide database listing hundreds of medical procedures, their cost, and information about the quality of medical providers, clinics and hospitals. The cost information is a compromise. It will display the lower “allowed” rate for plans covering the state employees and Medicaid, vs. the providers’ higher “billed” rates. But the Premera Blue Cross, Regence Blue Shield and private employers’ (ie. Microsoft & Boeing) negotiated rates will not be included.

The second bill requires health exchange plans to include a tool so consumers can compare the cost and quality of specific procedures across their network. A committee will be formed to determine the quality metrics (insert your favorite jab here).

Maine developed the first statewide All Payer Claims Database (APCD) system in 2003. Kansas, Maryland, Massachusetts and New Hampshire also had APCDs by 2008. Minnesota, Tennessee, Utah and Vermont had them by 2010. Today more than 30 states have, are implementing, or have strong interest in APCDs.

The Affordable Care Act is a handy scapegoat, but APCDs clearly predate the ACA. And bravo to Maine for launching the first. We’re a consumer society. We know some meals, cars, hotels and clothes cost more than others, and we’re ok with that. It’s about time we had the opportunity to decide for ourselves. And it will only get better over time.

Read more:

Proposed CMS guidelines to reign in Narrow networks in 2015

Narrow Networks, where the insurance companies severely limit the hospitals and providers that patients are allowed to use, are likely to be curtailed for 2015 on the Federal ACA Exchange. This will benefit non-profit hospitals as well as the patient population.

For example, in Seattle, WA 75% of the health plans exclude the nationally acclaimed Seattle Children’s Hospital, Harborview Medical Center (the northwest’s regional trauma center), and the University of Washington Medical Center (one of the nation’s leading academic medical centers). Their collective research and trauma expertise make them destination hospitals when critical medical capability is required. Taking the sickest children and most severe trauma patients make them too expensive for these insurance plans to include them in their network, harming these organizations as well as the patients. And this occurring across the U.S.

The Centers for Medicare & Medicaid Services (CMS) has issued new guidelines to reign in this trend for health insurers looking to sell health plans through the federally facilitated ACA marketplace in 2015. Hopefully the state run exchanges will follow suit.

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