COVID-19 and the Health Workforce 7/6-7/19

7/6-7/19 Updates

Health Workforce Shortages

The US Department of Health and Human Services (HHS) awarded $155 million for primary care and dental resident training programs to address health inequities compounded by the pandemic in rural and underserved communities.

A new Omicron subvariant is exacerbating nursing shortages.

Despite female health workers’ crucial roles during the pandemic, the gender pay gap remains.

Health Workforce Shortages

(7/18/22) As US Covid Hospitalizations Climb, a Chronic Nursing Shortage Is Worsening
According to an article published in The New York Times, there is a chronic shortage of nurses amidst steadily increasing hospitalizations owing to coronavirus in the past few weeks. The daily average number of people in hospitals who are infected with the coronavirus now exceeds 39,000, the highest it has been since March. This rise is largely driven by the rapidly spreading Omicron subvariant BA.5, which is best at evading some antibodies. The chronic shortage of nurses has been at an “all-time high” according to some. The critical shortage levels are even more challenging in rural areas. There is a turnover rate of 25 to 30%, the highest we have seen in decades. Demand for nurses is projected to keep growing significantly in the United States, while the demand for travel nurses, which climbed to record high in 2021, after receding earlier this year, is rising steadily again.

(7/13/22) The Gender Pay Gap in the Health and Care Sector a Global Analysis in the Time of COVID-19
According to a joint report by the International Labor Organization (ILO) and World Health Organization (WHO), women in the health care sector face a larger gender pay gap, earning on average 24% less than men. The high degree of feminization in the health and care sector is a key factor behind the lower earnings for both women and men within the sector and contributes to overall prevailing pay gap in the economy. Much of the gender pay gap in health and care that is unexplained by labor market attributes, cannot be objectively explained by differences in the abilities of men and women to contribute productively to paid work. However, it could be attributed to conscious or unconscious discrimination in pay against women for the same work or work of equal value. Two important factors that contribute to the unexplained pay gap are “motherhood gap” and lower wages paid on average in highly feminized sectors. In addition, evidence indicates that the employment impact of COVID-19 in the sector disproportionately affected workers at the low end of the pay scale, most of whom are women.

(7/12/22) HHS Awards Over $155 Million to Expand Training for Primary Care Residents in Underserved and Rural Communities
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA) recently announced $135 million in awards in American Rescue Plan funds, $1.9 Trillion COVID-19 relief package into law by the President early in the administration, to support existing and new teaching health centers to support additional resident positions and $20 million in Fiscal Year 2022 funds to support existing Teaching Health Center Graduate Medical Education residency programs to continue resident training in the upcoming academic year. HRSA’s Teaching Health Center Graduate Medical Education program focuses on supporting residents in primary care residency training programs to meet the medical and mental health care needs of rural and underserved communities. The recipients of the award are 72 teaching health centers that operate primary care medical residency programs which include psychiatry and dental residency programs. Increasing the number of primary care residents training in community health centers and other outpatient community clinics is a key part of the current administration’s plan to address long standing health inequities in the most vulnerable communities. During the pandemic, the community health centers and hospitals across the country, cared for COVID-19 patients, supported the mental health of their communities, administered COVID-19 tests and lifesaving treatments.

Health Workforce Resilience

A newly proposed Center for Medicaid and Medicare Services (CMS) rule is being criticized by patient-safety advocacy groups for waiving penalties for roughly 750 hospitals with the worst patient-safety track records.

The White House announces its plan of over $16 billion in health care workforce investments to strengthen the health care sector post pandemic.

Biden’s strategy to manage Omicron subvariant BA.5 includes several measures to protect the healthcare workforce.

A new Medscape article examines 3 key strategies to deal with nurse turnover.

A recent Health Affairs article identifies organizational actions and policy strategies that can help support ongoing, post-pandemic innovations in health care.

A new special issue of Health Policy analyzes countries’ responses to the pandemic and explores lessons learned to better help policy makers prepare for future challenges.

A new article examines how to best protect and support nurses with long COVID-19.

Health Workforce Resilience

(07/18/22) Long Covid 3: Supporting Nurses With Long COVID in the Workplace
This Nursing Times article examines how to support nurses with long term COVID-19. This UK article looks at case studies of nurses and how best to protect the wellbeing of nurses experiencing high occupational risk. Due to the large vacancy rates, the industry cannot afford to lose more staff for extended periods of time due to long COVID. The article argues for a flexible approach and redeployment opportunities to decrease the loss of nurses and having a lead nurse in every organization for long COVID to help ensure effective support.

(07/18/22) COVID-19 Impact Assessment Survey–The First Year
The American Nurses Foundation has released the results of its “Pulse on the Nation’s Nurses COVID-19 Survey Series: COVID-19 Impact Assessment Survey – The First Year, February 2021.” The survey included over 22,000 responses from US nurses in an effort to understand the personal and professional impacts of the pandemic. In the survey, issued between January 19 and February 16, nurses rated their optimism for the future as 6.2 out of 10. Additionally, 18% indicated they intended to leave their position within 6 months. The top reasons for leaving included their health/well-being and insufficient staffing.

(07/17/22) Three Key Strategies for Combatting Nurse Turnover—Nursing Industry Policies, Benefits, and Tech Are Ripe for Modernization
This Medscape article examines 3 key strategies for dealing with nurse turnover. According to research 900,000 registered nurses will leave the profession in the next 5 years which will lead to nursing shortages and will impact all stakeholders in health care. The 3 key strategies discussed in this article are new models of nursing care delivery, balance and mental health benefits, and technology-based care.

(07/14/22) Health Policy Journal: COVID-19 Special Issue Now Available
A special Health Policy journal issue analyzes 50 countries, mainly in the WHO European region, response to the pandemic and lessons learned to better help policy makers prepare for future challenges and pandemics/outbreaks. The papers examine health care responses across 5 main areas: preventing transmission, sufficient infrastructure and workforce capacity, adapting service delivery, financing systems, and governance.

(7/15/22) Fact Sheet: Biden Administration Outlines Strategy to Manage BA.5
The White House COVID-19 Team is announcing its strategy to manage BA.5, which is a subvariant of the Omicron variant. The administration will continue to work with healthcare workers and other stakeholders to ensure that Americans have easy and convenient access to and use vaccines, tests and treatments. The Administration will continue to make masks, which were earlier made available through Defense Production Act, for health care and other essential workers, through states, building on the over 75 million masks and respirators we already distributed to states, Tribes, and territories across the country. The Administration is also working to drive additional uptakes of booster shots including long-term care facility staff and residents. The Administration has purchased 20 million treatment courses of Paxlovid to make these treatments widely available and to educate health care providers and patients about their availability and efficacy.

(7/13/2022) White House: Over $40B in Coronavirus Relief Funds Going Towards Workforce Development
Out of the $40 Billion in American Rescue Plan funds committed to strengthening and expanding the US workforce, the White House has earmarked $16 billion for strengthening the healthcare workforce at the Workforce Development Summit. An additional $3 billion will be invested at a later time to strengthen the future public health workforce including offering community health workers and others hired for COVID-19 response support in continuing their careers as public health professionals beyond the pandemic. Another $2 Billion in CDC grants have been allocated to fund the public health workforce, while $7 Billion in health workforce investments by HHS programs have been allocated to support the staffing needs to respond to COVID-19 pandemic and over $9 Billion of Home and Community Services Funds have been proposed for health workforce.

(07/11/2022) Feds Want a Policy That Advocates Say Would Let Hospitals Off the Hook for Covid-Era Lapses
Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS) have proposed a set of rules. Some of these rules propose suppression of the several measures in the Hospitals Acquired Condition (HAC) Reduction Program. Under the proposed rules, the hospitals will not receive penalties for HAC and the publication of PSI90, or “Patient Safety and Adverse Events Composite,” which allows the public to compare the safety records of hospitals, would be suppressed. Patient advocacy groups such as nonprofit US Public Interest Research Group accused CMS of letting hospitals off the hook by waiving approximately $350 million in financial penalties for around 750 hospitals with the worst patient-safety track records and of hiding the safety record data from the public. CMS chief medical officer said that safety metrics were not designed to properly account for how a pandemic might affect hospital systems, that the data is skewed and inaccurate and CMS will make data available when it is credible. However, an OIG report which used data from 2018 and which was released in May 2022, found that even before the pandemic, 1 in 4 Medicare patients suffered HAC, with nearly half of such events being preventable.

(07/1/22) COVID-19 Inspired Creativity in Health Care: Lessons for Management and Policy
An article published in Health Affairs throws light upon the recent use of creative innovations and implementation strategies by the workforce in hospitals to address the negative externalities of the pandemic. The articles quotes various examples where creativity was demonstrated such as repurposing of equipment for COVID-19 care, turning closed Sears stores into vaccine centers or examples of creative solutions using industry partnership such as HP’s 3-D printers to create personal protective equipment. The policy and management lessons include but are not limited to recognizing Health Care Workforce as a ready source of creativity, understanding the complementarity between creativity and standardization, recognizing the advantages of cross-industry collaborations and supporting, incentivizing and rewarding creativity.