JOHNSON CITY, Tenn. – Ballad Health Chairman and Chief Executive Officer Alan Levine served as an expert witness and testified before the U.S. House of Representatives’ Committee on Energy and Commerce Subcommittee on Health on Tuesday, expressing his concern about the challenges we face as a rural healthcare system.
Levine spoke via live video feed from his office at Ballad Health’s corporate headquarters.
His remarks centered around concerns for the ability of Ballad Health – and many other health systems across the nation – to continue providing high-quality care despite a nursing shortage that is made worse by the novel coronavirus (COVID-19) pandemic. He called it “an emerging national crisis.”
The Subcommittee was conducting a legislative hearing titled “Caring for America: Legislation to support Patients, Caregivers, and Providers,” and several pieces of legislation that could ease the burden on hospitals were under consideration.
Levine was one of seven expert witnesses who provided testimony during the session, and his comments focused on:
- The resiliency of the healthcare workforce
- The critical nature of the national nursing shortage
- The impact of the workforce issues on rural and non-urban communities
- Ballad Health’s success with value-based care, which has reduced the cost of healthcare by $200 million annually while helping reduce the burden on the workforce
Contract labor expenses
Levine told the committees the cost of using contract labor in the form of traveling nurses is extremely high – sometimes four times the cost of employed nurses – and is creating a problem for health systems across the country. There was bipartisan agreement on that point. Ballad Health has 700 nurse openings, Levine said, which is partly being offset by about 400 traveling nurses.
Ballad Health has invested about $100 million to increase nursing and allied health salaries since last year, but too many nurses are leaving the profession altogether, prompted in part by the intense stress of the pandemic, and not enough nurses are being trained for the supply to meet the demand.
Levine also informed the committee about Ballad Health’s $10 million commitment to creating the Appalachian Highlands Center for Nursing Advancement at East Tennessee State University, working with other regional colleges and universities.
COVID-19 vaccination mandates
Levine and the committee discussed the pros and cons of mandating COVID-19 vaccinations, which could decrease the risk of COVID-19 in hospitals but also cause clinical workers to quit their jobs, creating a dangerous staffing shortfall. Levine said about 63% of Ballad Health team members are vaccinated, and about 90% of our physicians.
Medicare payment structure
Levine also expressed concern over the Medicare payment structure for rural hospitals, which is why Ballad Health has been working with Congress to gain passage of the Save Rural Hospitals Act to establish a permanent national minimum Area Wage Index.
“This would permanently prevent all hospitals from falling into the Medicare payment death spiral created by a flaw within the Medicare Area Wage System, where annually declining Medicare payments negatively impact the wages a hospital is able to pay its employees, which in turn results in further declines in future Medicare payments for the hospital and more downward pressure on wages,” Levine testified.
Looking ahead
Levine summarized the session as a productive discussion and emphasized the problems at hand can’t be solved unless everyone works together – especially with the level of uncertainty about the pandemic and the constant threat of new pandemics arising in the future.
To see more on the congressional testimony:
- Click here to read Levine’s written testimony can be found.
- Click here to see a video of the full session, housed on YouTube. Levine begins speaking at about 56:20 into the video, and speaks numerous times after that.
- Click here to see a WJHL article about the session, focusing on Levine’s remarks.
