The lagging economy is beginning to influence a typically untouchable employment sector -- healthcare.
According to the Associated Press, rising costs and tight revenue has forced many Tennessee hospitals to cut staff and place a freeze on new hires. More than half of the 82 facilities that responded to a recent Tennessee Hospital Association survey have implemented such expense-saving measures.
Locally, Mountain States Health Alliance and Wellmont Health Systems report they were able to avoid layoffs in 2008. And each says there is no hiring freeze on clinical positions, such as physicians, nurses, pharmacists and technicians.
According to MSHA Vice President Ed Herbert, expenses are being cut in other areas: mileage, travel, advertising.
Attrition has also aided hospitals in saving on expenses. Herbert said vacated positions in non-clinical areas are not being filled, as staff in those departments are adjusting their duties to pick up the slack.
"It's been working so far, but if (the economy) does not improve, yes, Mountain States will have to look at further expense reductions," Herbert said. "And these (layoffs) will not be bedside; they'll be administrative, non-clinical, away from the bedside."
"The focus is on the patient. We are not trying to cut corners. We're giving the patient that quality care, that patient-centered care that we promise."
Well before Tuesday's AP report on hospital cuts, rumors had been circulating locally that area organizations were laying off employees and not hiring new personnel. Wellmont and MSHA denied both counts, and a search of their websites show hundreds of positions are available to qualified applicants.
"Somebody out here is telling people we've got a hiring freeze," Herbert said. "If you're a nurse, if you're a pharmacist, if you're a clinician, we probably have a job for you. We're going to keep putting the best people bedside that we can, put the best people in our pharmacies, put the best people in our physical therapy areas."
According to the Tennessee Hospital Association's survey, conducted earlier this month, 43 of the 82 responding hospitals said they’ve cut jobs. The survey didn’t ask about the types of jobs.
"In terms of membership surveys we do, this is as good a cross-section as we find," said Phil Martin, Tennessee Hospital Association spokesman.
Seventy Tennessee hospitals said they’ve put a freeze on hiring or are considering it.
"Everybody is looking right now for places where they can save money and keep their core business going," said Craig Becker, Tennessee Hospital Association CEO.
Becker told the AP that more than three-quarters of hospitals in the state have experienced a drop in elective surgeries, which tend to be moneymakers for hospitals.
At the same time, 95 percent have seen costs grow for charity care, the medically indigent and bad debt. With unemployment on the rise, things are expected to get worse.
The survey shows that emergency department visits increased at two-thirds of the hospitals, while the number of patients seeking care for behavioral health needs — a symptom of a slumping economy, according to the hospital association — is up at 38 percent of them.
The association also says the value of invested hospital reserves is down across the board, adding to the hardship.
Besides cutting jobs and services, the association says hospitals are delaying vendor payments, trimming administrative costs, delaying pay raises for employees and postponing construction and information technology projects.
"I have not seen a recession hit health care as this one has in the 30 years I’ve been in this business," Becker said.
With a new state Legislature preparing to convene next month, he hopes lawmakers will be "gentle" with the state’s TennCare program.
"We recognize that the state has big problems, but if they’re going to cut as much as they’re talking about out of TennCare, it’s only going to make things worse," Becker said.
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