The 3 top healthcare industry staffing challenges--and how to solve them

By Marla Durben Hirsch

Editor's note: The following is an excerpt from FierceHealthcare's newest free eBook, Human Management in Healthcare: Hiring Right to Meet the Demands of Healthcare Reform

The recruitment and retention of employees--always a challenge in the healthcare industry--will be especially difficult in the age of healthcare reform, with its focus on new payment models, such as accountable and value-based care.

Hospitals, health systems and other providers, already feeling the pinch in hiring and retaining employees, will have to cope with 32 million more newly insured Americans seeking healthcare services once the health insurance mandates of the Affordable Care Act go into effect in 2014.

"Healthcare reform is forcing hospitals to reconsider how to deliver value-based care," says David L. Longworth, M.D., chair of the Medicine Institute at Cleveland Clinic, an arm of the nonprofit multispecialty academic medical center that studies approaches to improve patient-centered care. "It also causes hospitals to consider new roles like care coordinators and clinical pharmacists who can focus on management of medically complex patients."

And organizations must prepare for an influx of formerly uninsured patients who will seek out care now that they have better access to services, says Michael Lynch, president of Tiva Healthcare, a physician outsourcing and recruitment company in Sunrise, Fla. "In the next five years staffing needs will grow exponentially," he says.

To help you plan for these growing staffing needs, below is a list of the top three challenges organizations will face and expert advice on how to solve them.

1. The need for primary care and emergency department physicians
As the industry shifts to outpatient services, patient-centered medical homes and preventive care in response to healthcare reform, hospitals will need to add primary care practitioners to their medical staffs.

But the primary care physician shortage, already acute, will worsen, says Bill Fera, M.D., chief medical officer for Ernst & Young's Health Advisory Group, in Pittsburgh, Pa.

In addition, Lynch says there will be a corresponding shortage in physicians specializing in emergency medicine, as the influx of newly insured patients will be more likely to present to emergency departments than before, even for routine care, because they don't have a regular physician. "Health reform is really making the shortage [of these physicians] come to light," Lynch says.

Solution: Employ more physicians; use more mid-level staff. Some hospitals are filling the gaps by moving to an employment model for the specialties they need, buying physician practices and employing physicians on a full-time basis.

Hospitals should also consider hiring more mid-level professionals. Allied clinicians, such as nurse practitioners and certified registered nurse anesthetists, are a lower-cost alternative to physicians for staffing healthcare services, such as urgent care centers and telehealth programs. "Care extenders can deal with a lot of short fall and fill in gaps. They'll be picking up the slack when there aren't enough physicians," says Fera.

2. The lack of physician leadership.

As hospitals diversify into new care models, such as accountable care organizations, they need more physicians in leadership roles. However, the market for physician leaders is "very competitive," says Dan Zuhlke, vice president of human resources for the 22-hospital Intermountain Healthcare in Salt Lake City, Utah, which employs, 800 physicians.

Solution: Develop leaders internally. Healthcare organizations are turning to their own talent pipeline to identity and groom physician leaders. Hospitals, already familiar with their affiliated physicians, can develop leaders from their own medical staff quickly. "If you rely on the outside [market] for physician leaders, it won't work," says Zuhlke.  

3. The shortage of ancillary providers and health information technology personnel.
As hospitals diversify into urgent care centers and home health to make up for lower admissions due to healthcare reform they'll need more nurses, home health staff and personal care aides. However, those are the three health occupations with the greatest shortages, so that shortfall will exacerbate, especially when patients begin to take advantage of the health insurance exchanges, Fera says.

Solution: Be creative in reducing staffing needs and boosting morale. Technology, such as self-service registration kiosks, voice recognition equipment and remote monitoring can take the place of some employees and enable organizations to use staff elsewhere. Predictive modeling programs can help determine staff scheduling needs and identify patient-flow logistic bottlenecks so that hospitals can reassign employees accordingly. Combined EHR/practice management systems can streamline billing and reduce the number of billing personnel needed.

To read the entire article, which includes more challenges and solutions, download the free FierceHealthcare eBook, Human Management in Healthcare: Hiring Right to Meet the Demands of Healthcare Reform.