58,200: The number of healthcare jobs added in January, with ambulatory healthcare services seeing the biggest increase. Despite this, health systems and independent providers are still struggling with staff shortages. Henry Ford said they’ve hired back only about 25% of their nurses who left during the pandemic and a recent article in NPR highlighted the increased use of mid-level providers in ERs.
But It’s A Match: The number of internal medicine doctor residency training positions has fluctuated over the last three decades but offered 9,380 in 2022, the highest on record with 95% of them filled, including about 1 in 4 who are citizens of countries other than the U.S. and who graduated from medical schools outside the U.S. There were 47,675 applicants overall across all types of doctors, the 2nd highest in history. 3,108 pediatric related positions were offered for 310 programs but 33 of those programs – presumably in more rural areas – were unfilled. By comparison, just 3 of the 288 obstetrics-gynecology programs went unfilled for 1,503 spots and dermatology had just 4 unfilled programs out of 169 available for 544 spots.
Home Acuity: Archie Bunker used to complain about healthcare all the time – like “why do you nurses always have to put the needle where the pain ain’t,” he’d wince. The pain got so bad his doctor once visited him at home and said he’d have to go to the hospital for tests. “But why can’t you just do the tests here,” Edith asked. As we know, the 1970s TV couple was ahead of its time, and now 51% of home health providers say they have plans to pursue higher-acuity care in the home in 2023, a new survey found. Many will pursue a hospital-at-home or SNF-at-home model, both have grown in popularity since 2020. Large health systems like Kaiser Permanente have rolled out hospital-at-home models, and other hospitals have created partnerships with Contessa and other home care companies to provide acute care in the home.
Healthcare’s Runway: Just as New York fashion week wraps up, United rolls out of a new kind of fashion trend that could earn members up to $1,000 a year. Eligible members can use wearable devices, including an Apple Watch, FitBit or Garmin to complete health goals and activities. Logging 5,000 steps a day, tracking sleep for 14 nights, getting a biometric screening or even choosing paperless billing are all examples of activities that earn members rewards. As members complete activities and reach goals, these rewards are put into their HSA or a prepaid debit card.
Neat Feet: Neatsy, an orthopedic and podiatry tech-based company, is partnering with Massachusetts General Hospital to launch a telemedicine platform for orthopedists. Neatsy’s platform uses the patient’s smartphone camera to create a 3D model of the patient’s foot through AI. The model can be used to identify ailments and collect dimensions to accurately size any specific footwear needed. Doctors can then access the 3D model and any risk assessments the scan picked up to confirm a diagnosis remotely.
Caregiver Rollout: Caregiver health is declining in the U.S. – with reports of increased weight, blood pressure and alcoholism, trends driving health plan adoption of services to support families. Superior HealthPlan, a Texas subsidiary of Centene, is expanding its partnership with eFamilyCare, the New York-based telehealth company that helps caregivers find services and collaborate with providers. Originally rolled out in 2022 for certain Superior members, the services are now available to their broader STAR Health Medicaid program.
Top 20 Rankings: Payer priorities for 2023 are ranked in our annual report. You can view it here and register for a call to get the scoop on the rankings by clicking here.
College Psych Screen: Indiana University will soon begin offering around the clock remote mental health services through TimelyMD, a 24/7 virtual mental health care service platform that can diagnose and treat students remotely. The platform allows students to make one-on-one appointments in minutes, compared to a wait time of up to two days for counseling services offered on campus.
Extra Point: 5-year-old Dylan used to hide under a gray wicker chair on our porch until Jack was done with supper, then the pair of kindergarteners would play wiffle ball until dark. Dylan is now a sophomore at Michigan State and Jack at Indiana University—they came of age in a neighborhood without struggle, not real struggle anyway, and now they live on their own in places where they are learning to see and grapple with their own challenges and humanity, and that of their new neighbors. The trauma of last week’s shooting hit home for us. Dylan heard the shots within Berkey Hall, hid under a chair and luckily is safe, but now in the days since he and many others are dealing with the traumatic effects. Colleges – much like secondary schools – are at a crossroads these days as they are having to take on more responsibility for the health of their students, addressing both trauma and suicide. It’s no secret my own son is like many his age trying to manage mental health ups and downs. He reached out to student services many times during his first couple years at IU, missing classes and insulating as many tend to do, but he did not hear from student services, nor did my wife and I. These departments are in all likelihood understaffed and overwhelmed with an increasingly challenging mission. They are doing their best amidst impossible circumstances. IU’s response to add a 24/7 virtual mental health system is a good step many colleges have taken. But these solutions tend to still rely on the student to reach out. Colleges could use help creating a database that collects input from professors about students who have missed classes. If a student is missing multiple classes and across multiple courses this could create a flag in the system and prompt student services to reach out. My wife who has taught at the college level tried on her own to help a student but eventually went to administration for guidance, “but I am not sure how they intervened from there,” she said, still worried about the youngster. “I like the database idea because you create a more holistic set of information,” says Haley Gregory, an MSW from New Jersey. “Leaving it up to one professor at these big schools, even small ones, is asking a lot – the students will invariably find their person – maybe it’s a coach, a roommate, a waiter at the diner – but often times they will isolate after trauma or due to depression, so having some data that student services can monitor makes sense.” As I’ve said from experience raising teens, the best idea for any student transitioning into college may just be to have a relationship with “their person” already established – a therapist, a pastor, someone – so when crisis comes – and it will come – they have a lifeline. For Jack, his lifeline has been a mental health therapist who in some ways my wife and I see as an extension of ourselves. We’ve even talked with her, and our son encouraged it. For students at MSU, I wonder who their person is. For Dylan, the kid I can still picture playing wiffle ball in our backyard, his lifeline was Jack.