Stronger economy drives more nursing turnover, higher wages

A stronger economy is increasing employee turnover rates at hospitals, particularly among nurses, and putting additional pressure on wages that are already straining hospital balance sheets.

Hospital operators around the country have been reporting increases in staffing costs, including contract labor, in the third quarter. Nursing positions have been most in demand, and the need is compounded by the increased patient volume that many health systems are seeing under the Affordable Care Act.

HCA, the largest hospital operator by revenue, last month attributed a year-over-year drop in third-quarter net income in part to increased labor costs.

“We do have an improving economy across most of HCA’s markets and we think that is having some effect on our overall labor equation,” Samuel Hazen, president of operations for the Nashville-based chain, said on an earnings call.

The company said its nursing turnover has increased to 19%, up from 17.5% in 2014. Contract labor has been used to fill the gaps.

Providence Health & Services, a Renton, Wash.-based system, similarly reported last week that it spent $85 million more than it expected on labor costs and purchased services. Contract labor was used to fill open positions at its hospitals.

Labor costs in the third quarter pressured not only acute-care hospital groups but also post-acute care operators like Kindred Healthcare, which blamed “a tightening labor market in certain regions” for driving up its third-quarter expenses.

The rising costs have come amid a hiring boom in the healthcare industry, which has added 407,000 jobs during the first 10 months of 2015. Healthcare companies shed jobs during the uncertainty in the lead-up to the ACA, but as patient volume has returned, they’re now rushing to meet the demand.

Health improving for urban residents, but racial disparities persist

Residents in 27 of the nation’s big cities are experiencing lower rates of cancer, diabetes and motor vehicle-accident deaths in 2012 compared with 2007, though African-Americans have not shared in many of these gains, according to a reportfrom the Big Cities Health Coalition.

Also, 23 cities have reduced diabetes death rates, 12 have reduced cancer death rates and 17 have met targets for lowering obesity.

The coalition is a program of the National Association of County and City Health Officials that receives financial support from the Robert Woods Johnson and de Beaumont foundations. The Centers for Disease Control and Prevention provided funding for the report, the Big Cities Health Inventory.

Despite the progress, though, the report also found that urban blacks experienced higher cancer death rates than blacks in other areas. Also, racial disparities persist for HIV-related deaths in all cities tracked except for Denver.

The report noted “extraordinary strides” made in improving urban Hispanic health. The main exception would be diabetes. For Hispanics, diabetes led to 79.9 deaths per 100,000 in 2012 while the national rate was 69.1.

The coalition also unveiled a searchable database that tracks 30 health indicators from 26 cities, and encouraged journalists and policymakers to use it. These indicators include HIV/AIDS, infectious diseases, infant mortality, tobacco use, homicide, suicide, food safety and behavioral health. Other socio-economic measures spotlight poverty, unemployment and income levels.

Public health officials lauded the data, saying it will improve outcomes and help target services to specific communities.

“Public health officials who work every day to improve the lives of urban Americans will benefit greatly from the insights in this report,” said Dr. LaMar Hasbrouck, executive director of the National Association of County and City Health Officials.

Walgreens puts hold on more Theranos centers

Walgreens Boots Alliance has placed a temporary hold on expanding Theranos blood-testing centers after an all-day meeting at the startup company’s headquarters in Palo Alto, Calif., the Wall Street Journal reported late Friday.

In a series of recent articles, the Journal alleged that Theranos, whose founder and CEO Elizabeth Holmes developed a proprietary blood-testing technology that requires minimal blood draws, used standard blood draws and another company’s equipment for most of its blood tests.

The newspaper reported that Walgreens officials who attended Thursday’s meeting were unaware that the Food and Drug Administration had conducted surprise inspections of Theranos facilities in August and September until the paper reported it. Holmes told a conference last week that Theranos, whose proprietary technology doesn’t require FDA approval under the Clinical Laboratory Improvements Act because it does its testing in-house, is now seeking agency approval for its test.

“We have to move, as a company, from the lab framework and quality systems to the FDA framework and quality systems,” Holmes told a Wall Street Journal-sponsored conference in Laguna Beach, Calif., last week.