BOSTON (State House News Service) — Staffing shortages in health care may be here to stay, and the industry must reinvent how it delivers care, Gov. Charlie Baker said Thursday morning.
“There is this giant staffing problem throughout the system, but this staffing problem is causing significant damage to the normal process by which the system works,” Baker told a Massachusetts Association of Health Plans at the Seaport Hotel. “People really need to think differently about how everything in the system is organized.”
The governor partly blamed the staffing shortages on a swathe of baby boomers who retired earlier than they otherwise would have had it not been for COVID-19, taking “a huge chunk of the great talent out of your role models.” endowment”.
Staffing issues are also affecting health care payments, he said. Understaffed rehabilitation and long-term care facilities are unable to accommodate new patients from hospitals, resulting in patients staying longer in hospital beds waiting for a place in their next processing facility opens.
“If you look at the average length of stay in a hospital right now, not just in Massachusetts, or in many places across the country, it’s about a day and a half longer than before,” Baker said. “So now you have a situation where hospitals are providing a lot of care that they’re not getting paid for.”
In October, the Massachusetts Health & Hospital Administration estimated that hospitals in Massachusetts had about 19,000 full-time vacancies.
Baker said he didn’t have an exact answer on how to fix the problem, but the future of the industry may never return to what it looked like before the pandemic.
Tim Foley, executive vice president of 1199SEIU, which represents more than 70,000 healthcare workers, said staffing shortages are a “whole-system problem,” in hospitals, nursing homes, nursing homes, home and other care facilities, requiring a “complete system solution.”
“Some of these jobs won’t be replaced, we need to come together and think about new models of care delivery,” Foley said.
The health union promotes apprenticeship programs to retain and attract new talent, and says apprenticeships allow low-wage workers already in the field to move up the career ladder without having to take unpaid leave to follow lessons.
Of the students enrolled in the 1199SEIU Vocational Education and Training Program fund, 82% are women, 45% have dependents, their average age is 48, 42% speak a second language, and 41% are born outside the United States.
“That’s what our healthcare system is made of,” Foley said. “We need to make sure they have a seat at the table to figure out what these new models of care delivery are.”
At the MAHP conference, Health and Human Services Secretary Marylou Sudders announced a loan forgiveness program for people working in behavioral health, “to really say we recognize you and we want you to stay in this area,” she said.
Social workers, doctors, nurses, psychiatrists, addiction recovery coaches and others who work in community health centers will be able to apply next month for the state to reimburse between $12,500 and $300,000 of loans under the $130 million program.
“I think going forward my goal would be to invest in educating people,” Sudders said. “For people to work in these areas, we need to tell them, ‘We appreciate you and we want to work with you.'”
As part of rethinking what health care looks like in Massachusetts, Baker said it’s possible to reinvent public health care plans.
The governor said Medicare’s current federal reimbursement model is not designed for the increased chronic care needs that come with the addiction and mental health crises that have risen across the country.
A recently approved waiver agreement that pledges $67 billion to tailor public health insurance programs to specific state preferences “sets the stage for a very significant shift in how, over time, MassHealth and Medicaid pay for things,” Baker said.
The Centers for Medicare and Medicaid Services approved the Section 1115 demonstration waiver in September, allowing the state to invest tens of millions of dollars in primary health care workforce development and conditions and to provide continued Medicaid eligibility for certain vulnerable populations. It went into effect Oct. 1 and extends through December 2027, well beyond Baker’s tenure.
This will allow the state “to expand both service delivery and capacity,” Baker said in September, highlighting mental health care as an area particularly strengthened by the agreement that represents federal support to move forward. beyond the basic outlines of Medicaid requirements.
“The most important thing people need to do in general is to recognize and understand that some of the after effects of COVID are probably not temporary, and you need to think about that as part of how you manage and organize…at the ‘future,’ Baker said.
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