Congress returns from its July 4 break today and its focus will be on the President: will he resign or tough it out through the election in 120 days. But not everyone is paying attention to this DC drama. In fact, most are disgusted with the performance of the political system and looking for something better. Per Gallup, trust and confidence in the U.S. Congress is at an all-time low.
The same is true of the healthcare system: 69% think it’s fundamentally flawed and in need of systemic change vs. 7% who think otherwise (Keckley Poll). And 60% think it puts its profits above all else, laying the blame at all its major players—hospitals, insurers, physician, drug companies and their army of advisors and suppliers.
These feelings are strongly shared by its workforce, especially the caregivers and support personnel who service patient in hospital, clinic and long-term care facilities. Their ranks are growing, but their morale is sinking. Career satisfaction among clinical professionals (nurses, physicians, dentists, counselors) is at all time low and burnout is at an all-time high.
Last Friday, the Bureau of Labor issued its June 2024 Jobs report. To no one’s surprise, job growth was steady (+206,000 for the month) –slightly ahead of its 3-month average (177,000) despite a stubborn inflation rate that’s hovered around 3.3% for 15 months. Healthcare providers accounted for 49,000 of those jobs–the biggest non-government industry employer. But buried in the detail (Table 2) is a troubling finding: for hospital employment (NAICS 6221.3): productivity was up 5.9%, unit labor costs for the month were down 1.1% and hourly wages grew 4.8%–higher than other healthcare sectors. For the 4.7 million rank and file directly employed in U.S. hospitals, these productivity gains are interpreted as harder work for less pay. Their wages have not kept pace with their performance improvements while executive pay seems unbridled. (See “workforce” section below).
Next weekend, the American Hospital Association will host its annual Leadership Summit in San Diego: 8 themes are its focus: Building a More Flexible and Sustainable Workforce is among them. That’s appropriate and it’s urgent.
An optimistic view is that emergent technologies and AI will de-lever hospitals from their unmanageable labor cost spiral. Chief Human Resource Officers doubt it. Energizing and incentivizing technology-enabled self-care, expanding scope of practice opportunities for mid-level professionals and moving services out of hospitals are acknowledged keys, but guilds that protect licensing and professional training push back.
By contrast, the application of artificial intelligence to routine administrative tasks is more promising: reducing indirect costs (overhead) that accounts for a third of total spending is the biggest near-term opportunity and a welcome focus to payers and consumers.
Thus, most organizations advance workforce changes cautiously. That’s the first problem.
The second problem is this: lack of a national healthcare workforce modernization strategy to secure, prepare and equip the health system to effectively perform. Section V of the Affordable Care Act (March 2010) authorized a national workforce commission to modernize the caregiver workforce. Due to funding, it was never implemented. It’s needed today more than ever. The roles of incentives, technologies, AI, data and clinical performance measurement were not considered in the workforce’ ACA charter: Today, they’re vital.
Transformational changes in how the healthcare workforce is composed, evaluated and funded needs fresh thinking and boldness. It must include input from new players and disavow sacred cows. It includes each organization’s stewardship and a national spotlight on modernization.
It’s easier to talk about healthcare’s workforce issues but It’s harder to fix them. That’s why incrementalism is the rule and transformational change just noise.
Paul
PS: In doing research for this report, I found wide variance in definitions and counts for the workforce. It may be as high as 24 million, and that does not include millions of unpaid caregivers. All the more reason to urgently address its modernization.
Resources
- National Health Expenditure Projections 2023-2032 (cms.gov)
- Gen Z and millennial workers are struggling with their mental health and managers can help | Fortune
- S.-Chamber-Amicus-Brief-U.S.-ex-rel.-DAnna-v.-Lee-Memorial-Health-System-M.D.-Fla.PDF (uschamber.com)
- New NC rules for ‘unregulated’ Mission/HCA health care monopoly? Lawmaker: explore options (msn.com)
Sections in this report
- Quotables
- Hospitals
- Insurers
- Investors
- Physicians
- Polling
- Prescription Drugs
- Workforce
Quotables
Re: retail primary care: “Just a few years ago, it looked as though national retail chains were going to be your doctor, too. Now they are medical-school dropouts.”
Why the Walmart Model Doesn’t Work in Healthcare – WSJ
Re: health system transformation: “Healthcare revolutionaries confront the largest industrial complex ever created by human beings. Healthcare Inc. works tireless to line its own coffers at the expense of American society. It has done so for decades, but it now confronts an unavoidable reckoning. Irresistible macro and market forces are attacking Healthcare Inc.’s dysfunction and profligacy. Innovative health companies are reconfiguring the industry’s competitive landscape in ways that create value and serve consumers. Like the British in 1776, Healthcare Inc. has loyalists who defend its prerogatives and sustain its illicit practices. Their safe havens are disappearing. Their days are numbered. The coming healthcare revolution will be exponential, not incremental in scope and impact. It will reward better health outcomes, lower costs and superior customer service. It will eviscerate waste and influence-peddling. When the dust settles, the American people will enjoy greater access to care services, better health and more affluence. Collectively, we will be healthier, more productive, more connected and happier. With rampaging chronic disease, particularly in low-income urban and rural communities, the U.S. is well on its way to becoming the land of the sick and home of the frail. Countering that trend, it’s time for all Americans to get healthier together! Toward that end, on this July 4th, let’s pledge to use our talents, energies and passions to create a more effective, efficient and equitable healthcare system of, by and for the American people.”
Johnson_Revolutionary_Times.MCC.7_2_24.03.pdf (mcusercontent.com)
Re: SCOTUS Chevron ruling: “The June 28 decision overturns a 1984 precedent that said courts should give deference to federal agencies in legal challenges over their regulatory or scientific decisions. Instead of giving priority to agencies, courts will now exercise their own independent judgment about what Congress intended when drafting a particular law.
The ruling will likely have seismic ramifications for health policy. A flood of litigation — with plaintiffs like small businesses, drugmakers, and hospitals challenging regulations they say aren’t specified in the law — could leave the country with a patchwork of disparate health regulations varying by location.
Agencies such as the FDA are likely to be far more cautious in drafting regulations, Congress is expected to take more time fleshing out legislation to avoid legal challenges, and judges will be more apt to overrule current and future regulations.”
Note: This June 28 SCOTUS ruling overturning the Chevron doctrine came in response to two separate lawsuits: Relentless, Inc. v. Department of Commerce and Loper Bright Enterprises v. Raimondo. In each case, fishermen challenged a requirement that they pay a fee to have government-mandated observers monitor their fish intake.
Re: Amazon: About a week ago, Amazon joined an exclusive club. Its market value ticked over $2trn, putting it in the company of only four other firms: Alphabet, Apple, Microsoft and Nvidia. In its 30 years Amazon, which began life as an online bookseller in Seattle on July 5th 1994, has been astonishingly successful. Its network of warehouses and vans delivers more packages each year than FedEx or ups, equivalent to $850bn-worth of goods worldwide. Its pioneering cloud-computing business is used by millions of customers and generates annual revenues of $100bn. Beyond its core operations, it is investing in delivery drones, satellite networks and self-driving cars.
This success is the result of the company’s tireless focus on customers and its enthusiasm for experimenting… Last year no firm spent more on research and development or capital expenditure than Amazon. Plenty of companies say they are customer-obsessed. But for Amazon, that claim actually rings true.
What lies in store for the company as it enters its fourth decade? In recent years Apple and Microsoft have joined a more rarefied club still; both have a market capitalization above $3trn. Whether Amazon manages to catch up with them will depend on how well it navigates three tricky areas: slowing e-commerce; increasing competition in artificial intelligence (ai); and an onslaught from antitrust regulators…
All told, the company’s fourth decade will be harder going than its third. It will have to factor antitrust scrutiny into its decisions, which could impede growth. There may come a time when it will need to pull the plug on groceries as ruthlessly as it did with the Fire phone. In ai, cut-throat competition from startups will test the giant firm’s ability to keep pace.
Yet Amazon’s focus on its customers and innovation should stand it in good stead throughout. People often counted Amazon out over the years; in the build-up to the dotcom bust commentators nicknamed it “Amazon. Bomb”, and many jeered when the firm launched its cloud-computing service. To dismiss Amazon again today would be a mistake
As Amazon turns 30, three factors will define its next decade (economist.com)
Re: Steward Health, private equity role in healthcare: “The Steward Health Care saga plays into much broader conversations about hospital business models, the appropriateness of profit-seeking in medical care and the methods by which hospitals ultimately try to make money.
The specific outcome that everyone is trying to avoid is the closure of eight Massachusetts hospitals, and potentially more around the country, which would curtail access to care for thousands, if not millions, of patients. That’s the same outcome that communities around the country are trying to avoid as hospitals’ business model becomes less sustainable. But some experts argue that private equity is making the problem worse, not better
Re: IVF therapy moral dilemma: “Moral inconsistency is a pretty normal part of the human condition. Attitudes to in-vitro fertilization (ivf) are a case in point. While the vast majority of Americans support access to the technology, which now accounts for over 90,000 births per year, many struggle with a key component of it: the destruction of embryos in the process. Indeed, whereas 82% of Americans believe ivf is morally acceptable, only 49% say the same about destroying excess embryos, according to recent polling by Gallup. This presents moral purists with a conundrum…
Americans are far from alone in having complex feelings about embryos. In Germany, embryos have a particular status which falls short of “personhood” but is more than just gametes, a legacy of the Nuremberg trials. Several countries prohibit genetic testing or donation of embryos. Most European countries prohibit selecting embryos based on sex, though America allows it. Yet whereas most other countries allow for moral flexibility, whereby politicians can be anti-abortion but pro-ivf, or pro-ivf but uncomfortable with embryo destruction, in America cultural wars around reproductive rights leave less room for such elasticity.
Will IVF really be the next frontier in America’s culture wars? (economist.com)
Re: disconnect between price and quality in healthcare: “How is it that there is no correlation between quality and rate in the U.S. health economy? Because CMS doesn’t even uniformly enforce quality reporting, much less incentivize quality, and the ACA inaugurated an era of cost-plus insurance, leaving “consumers” trapped in a system they don’t understand and cannot afford.
As Rand analysts are fond of noting biennially, employer-sponsored insurance pays ~2.5X as much as Medicare.6 Of course, the deleterious impact of employer-sponsored health insurance on costs is well-known, as the Congressional Budget Office detailed in March 1994. For Congress to refuse continually to address something that is the catalyst for healthcare’s continuously increasing cost is tyrannical.
Today, the health economy is too opaque for the American public to articulate all the grievances they should lodge as their forefathers did in 1776. However, even if modern-day Americans don’t understand healthcare quality to quantify value for money, they are beginning to figure out that healthcare is often unaffordable… the U.S. health economy is, ironically, much closer to Britain’s National Health Service than stakeholders realize. Americans will really hate the parts that we don’t yet have, and a bunch of individuals who were fed up with government overreach is how we got to July 4, 1776. Health economy stakeholders who fail to realize that delivering value for money is table stakes should not be surprised when they lose healthcare’s negative-sum game. “
How Congressional Tyranny Constrains Value for Money in the Health Economy (trillianthealth.com)
Re: methodological bias in systematic reviews: “In April, Hilary Cass, a British pediatrician, published her review of gender-identity services for children and young people, commissioned by NHS England. It cast doubt on the evidence base for youth gender medicine. This prompted the World Professional Association for Transgender Health (WPATH) the leading professional organization for the doctors and practitioners who provide services to trans people, to release a blistering rejoinder. wpath said that its own guidelines were sturdier, in part because they were “based on far more systematic reviews”.
Systematic reviews should evaluate the evidence for a given medical question in a careful, rigorous manner. Such efforts are particularly important at the moment, given the feverish state of the American debate on youth gender medicine, which is soon to culminate in a Supreme Court case challenging a ban in Tennessee. The case turns, in part, on questions of evidence and expert authority.”
Research into trans medicine has been manipulated (economist.com)
Re: Biden age: “Biden had to overcome worries about his age to win the Democratic primary in 2020…In the summer of 2022, a poll by The Times and Siena College found that 61% of self-identified Democrats wanted someone other than Biden to be the presidential nominee. The top reason Democratic voters provided for why they wanted someone else? His age. (Job performance wasn’t far behind.)
Last summer, a poll by The Associated Press-NORC Center for Public Opinion Research found that 77 % of voters — including 69% of Democrats — thought Biden was too old to be effective for another four years, a slightly different question than The Times asked .
In February, according to a Times/Siena poll, more than half of Democrats — 56% — said they thought Biden was too old to be an effective president. By June, before the debate, that figure had dipped to 51% — a sign that his strong performance at the State of the Union may have slightly improved Democrats’ perceptions of his age.
But it seems likely that the debate will have erased those gains.”
On Politics: The problem in plain sight (nytimes.com)
Re: US Chamber of Commerce on healthcare system: “America has the most advanced health care in the world, in large part due to private sector-led innovation and employer-sponsored healthcare coverage. While Americans benefit tremendously from ongoing advancements in bioscience, technology, and care, we continue to wrestle with the challenge of making quality health care more affordable, more accessible, and more reliable for all Americans. At the U.S. Chamber, we’re pushing for value-based healthcare solutions that reduce costs and reward quality outcomes.
The Department of Health and Human Services (HHS) have started the process of imposing government price controls on critical medical treatments. This will have devastating consequences for patients who are counting on new life-saving drugs. Unless we act, this is going to happen to us…The U.S. Chamber is promoting effective private sector solutions to our health care challenges. These solutions will help control costs, expand access, and improve the quality of care. We support policy that strengthens the employer-based model of coverage, through which 180 million Americans receive—and overwhelmingly like—their health care.”
Health Care | U.S. Chamber of Commerce (uschamber.com)
Hospitals
Study: hospital consolidation and prices: “We analyze the economic consequences of rising health care prices in the US. Using exposure to price increases caused by horizontal hospital mergers as an instrument, we show that rising prices raise the cost of labor by increasing employer-sponsored health insurance premiums. A 1% increase in health care prices lowers both payroll and employment at firms outside the health sector by approximately 0.4%. At the county level, a 1% increase in health care prices reduces per capita labor income by 0.27%, increases flows into unemployment by approximately 0.1 percentage points (1%), lowers federal income tax receipts by 0.4%, and increases unemployment insurance payments by 2.5%. The increases in unemployment we observe are concentrated among workers earning between $20,000 and $100,000 annually. Finally, we estimate that a 1% increase in health care prices leads to a 1 per 100,000 population (2.7%) increase in deaths from suicides and overdoses. This implies that approximately 1 in 140 of the individuals who become fully separated from the labor market after health care prices increase die from a suicide or drug overdose
NBER Report on Mergers.pdf
Study: ED use during covid: “Although emergency department (ED) and hospital overcrowding were reported during the later parts of the COVID-19pandemic, the true extent and potential causes of this overcrowding remain unclear. Using data on the traditional fee-for-service Medicare population, we examined patterns in ED and hospital use during the period 2019–22. We evaluated trends in ED visits, rates of admission from the ED, and 30-day mortality, as well as measures suggestive of hospital capacity, including hospital Medicare census, length-of-stay, and discharge destination. We found that ED visits remained below baseline throughout the study period, with the standardized number of visits at the end of the study period being approximately 25% lower than baseline. Longer length-of-stay persisted through 2022, whereas hospital census was considerably above baseline until stabilizing just above baseline in 2022. Rates of discharge to post-acute facilities initially declined and then leveled off at 2% below baseline in 2022. These results suggest that widespread reports of overcrowding were not driven by a resurgence in ED visits. Nonetheless, length-of-stay remains higher, presumably related to increased acuity and reduced available bed capacity in the post-acute care system.
Report: psychiatric hospital operators outsourcing: StatNews investigative reporter conducted 50 interviews about not-for-profit health system operators’ (Mount Carmel, Geisinger, Corewell) contracts with for-profit operators (UHS and Acadia) for their psychiatric hospitals. Despite persistent issues with staffing, patient and staff safety et al, and compliance with state regulations, she reports both operators’ strong financial results. “This fast-spreading model is putting more unsuspecting patients and staff in dangerous environments… Interviews with more than 50 former employees, patients, and industry experts, along with a review of dozens of government investigations and court records, show that these joint venture hospitals have the same fatal flaw as all other investor-owned hospitals: a focus on generating profit for shareholders, at the expense of patients and staff. Though these hospitals usually bear the names of the nonprofits, for-profit companies with dubious track records control day-to-day operations.”
Acadia, UHS scrutinized on psychiatric hospital joint ventures | STAT (statnews.com)
Prospect Medical litigation: The Justice Department opened an investigation into potential fraud at Prospect Medical Holdings, according to recent court filings in a legal battle between Yale New Haven Health and Prospect.
New Haven, Connecticut-based Yale sued Prospect on May 30, alleging the health system should be released from its proposed acquisition of Prospect’s Connecticut hospitals in Manchester, Rockville and Waterbury because Prospect violated the purchase agreement.
Prospect, which is linked to private equity firm Leonard Green & Partners, has been hit with multiple lawsuits over the past year. On June 12, Rhode Island Superior Court Judge Brian Stern ordered Prospect to pay $17.3 million in unpaid bills to vendors. The order followed Rhode Island Attorney General Peter Neronha’s (D) November lawsuit against Prospect, alleging the health system violated the conditional approval terms for Prospect’s 2021 acquisition of Roger Williams Medical Center and Our Lady of Fatima Hospital, both of which are based in Providence. Last month, Neronha conditionally approved the sale of those hospitals to the Centurion Foundation, which works with nonprofits to finance and lease facilities.
Prospect Medical Holdings probed by DOJ | Modern Healthcare
Investors
Pitchbook: Forecast for last half of 2024: “As we pass the six-month mark for 2024, the macro trends investors have been paying attention to have largely carried over from last year.
Labor markets remain strong, stock markets have climbed higher, and all eyes are on the Fed looking for tangible indications of a rate cut. Betting markets have had to reset Fed policy rate expectations since the start of the year due to the strength of the US economy and the stubbornness of inflation data.
With that macro backdrop, dealmaking has yet to kick back into high gear. In particular, the exit market has left much to be desired, and many LPs in private funds are wondering when they will get their capital back from their GPs. Both LPs and GPs are finding creative ways to deal with the distribution drought, finding liquidity from relatively novel sources such as fund secondaries, NAV lending, and other structured solutions.
Meanwhile, traditional exit routes should continue to open up, especially if the economy remains strong and the Fed begins the descent on interest rates. As capital frees up for deployment, investors should ask: “Where are the risks and opportunities across the private market landscape?”
my.pitchbook.com/viewnewsletter/uzMNE-b7Iqo/pevc
Private equity exits: “In the first half of 2024, overall US PE exit value reached $141.2 billion, almost flat from the year earlier; the total exit count showed only a slight year-over-year increase of 1%… Factors hindering the recovery in exit flow include a persistent valuation gap between buyers and sellers, election uncertainty and high interest rates.
Behind the scenes, though, these advisers note signs of increased activity around sale preparations, a motivation to close deals quickly and a willingness among sellers to take on more risk.”
GPs are cooking up a PE exit recovery – PitchBook
Physicians
Study: NextGen ACO effectiveness: The Next Generation Accountable Care Organization (NGACO) model (active during 2016–21) tested the effects of high financial risk, payment mechanisms, and flexible care delivery on health care spending and value for fee-for-service Medicare beneficiaries. We used quasi-experimental methods to examine the model’s effects on Medicare Parts A and B spending. 62 ACOs with more than 4.2 million beneficiaries and more than 91,000 practitioners participated in the model. The model was associated with a $270 per beneficiary per year, or approximately $1.7 billion, decline in Medicare spending. After shared savings payments to ACOs were included, the model increased net Medicare spending by $56 per beneficiary per year, or $96.7 million. Annual declines in spending for the model grew over time, reflecting exit by poorer-performing NGACOs, improvement among the remaining NGACOs, and the COVID-19 pandemic. Larger declines in spending occurred among physician practice ACOs and ACOs that elected population-based payments and risk caps greater than 5%
Study: physician income during covid: “This study linked medical claims from a large national federation of commercial health plans to physician and practice data to estimate pandemic-associated impacts on physician revenue (defined as payments to eligible physicians) by specialty and practice characteristics. Surgical specialties, emergency medicine, and medical subspecialties each experienced a greater than 9% adjusted gross revenue decline in 2020 relative to pre-pandemic baselines. By 2022, pathology and psychiatry revenue experienced robust recovery, whereas surgical and oncology revenue remained at or below baseline. Revenue recovery in 2022 was greater for physicians practicing in hospital-owned practices and in practices participating in accountable care organizations. Pandemic-associated revenue recovery in 2021 and 2022 varied by specialty and practice type. Given that physician financial instability is associated with health care consolidation and leaving practice, policy makers should closely monitor revenue trends among physicians in specialties or practice settings with sustained gross revenue reductions during the pandemic.
Doximity: Impact of Physician Shortage: “A report published by the Association of American Medical Colleges (AAMC) projects that the U.S. will face a physician shortage of up to 86,000 physicians by 2036.7 While this shortage is smaller than AAMC’s 2021 projections (up to 124,000 physicians by 2034), the physician shortage remains a critical patient access issue….Among all physicians surveyed, 88% said that their clinical practice has been impacted by the physician shortage, and 74% described the shortage as “moderate” or “severe.” Only 12% of all physicians surveyed said they have not been impacted by the shortage
| Practice Type | Mild Impact | Moderate Impact | Severe Impact | Not Impacted |
| Health System/IDN/ACO | 16% | 43% | 36% | 5% |
| Hospital | 10% | 42% | 40% | 8% |
| Multi-Specialty Group | 15% | 47% | 29% | 9% |
| Academic | 10% | 49% | 29% | 12% |
| Single-Specialty Group | 19% | 46% | 22% | 13% |
| Solo Practice | 23% | 26% | 20% | 31% |
Doximity Physician Compensation Report 2024, May 2024
Polling
Gallup Poll June 2-23, 2024: 41% of Americans say they are “extremely proud” to be American, the fifth consecutive year this reading has been in the 38% to 43% range. Another 26% of U.S. adults say they are “very proud,” also in line with recent years.
“The 67% combined share of Americans who are extremely or very proud is consistent with readings since 2018 and among the lowest in Gallup’s trend, just four percentage points above the record low of 63% in 2020. From 2001 through 2017, no fewer than 75% of U.S. adults said they were extremely or very proud, including majorities who were extremely proud.”
- 59% of Republicans, 34% of Democrats and 36% of independents say they are extremely proud to be American. The 25-point gap in extreme pride between Republicans and Democrats today is similar to the 28-point average gap since 2001. The latest difference between the two parties is less than half of the record-high gap — 54 points in 2019— when an all-time low of 22% of Democrats expressed extreme pride.
- Meanwhile, Republicans’ current extreme pride is statistically tied with the group’s 58% record low in 2022.Similarly, the percentage of independents with extreme national pride is near last year’s 33%, the lowest for that group.
American Pride Remains Near Record Low (gallup.com)
Pew poll re: healthcare: Per the Pew Research Center survey of 8,709 adults – including 7,166 registered voters – conducted April 8-14, 2024 re: Americans’ views of the role and scope of the federal government::
- 65% of Americans say the federal government has a responsibility to make sure all Americans have health care coverage. Democrats overwhelmingly (88%) say the federal government has this responsibility, compared with 40% of Republicans.
- When asked how the government should provide health coverage, 36% of Americans say it should be provided through a single national program, while 28% say it should be through a mix of government and private programs.
- Democrats continue to be more likely than Republicans to favor a “single payer” government health insurance program (53% vs. 18%).
- 22% of American adults say they trust the government to do what is right always or most of the time, which is up from 16% in June 2023.
- 52% of Americans say the U.S. can’t solve many of its important problems, while 47% say it can find a way to solve problems and get what it wants. Roughly six-in-ten adults under age 30 (62%) say the nation can’t solve major problems, the highest share in any age group and 16 points higher than two years ago.
Role of Government and Where Americans Agree, Disagree in Their Views | Pew Research Center
Prescription Drugs
Medicare drug discount program loses in court challenge: Last Wednesday, a federal judge ruled against Boehringer Ingelheim’s challenge to the new Medicare drug price negotiation program, handing the pharmaceutical industry its latest in a string of legal losses.
The company had argued before the U.S. District Court of Connecticut that the drug pricing law was unconstitutional under four different parts of the Constitution, and also that Medicare officials had violated procedural laws. Judge Michael Shea ruled against Boehringer Ingelheim on each point in a decision published late Wednesday
gov.uscourts.ctd.155664.122.0.pdf (courtlistener.com)
Lilly gets Alzheimers drug approval: “After decades of trying to develop a treatment for Alzheimer’s disease, Eli Lilly has finally won FDA approval for its drug donanemab, which will be marketed as Kisunla. An approval was originally expected late last year, but it was delayed twice, including after regulators called for an 11th-hour meeting to discuss the drug’s safety and efficacy. Last month, that session led an independent advisory committee to vote unanimously that the drug’s benefits outweigh its risks, which include fatal cases of brain bleeding and swelling that occurred in about 1 in 300 patients.
The launch of Kisunla cements a new era for Alzheimer’s patients and their families, who will now have the choice of two treatments designed to clear sticky amyloid proteins in the brain and slow the progression of the disease, albeit modestly. And it kick-starts a competition between Indianapolis-based Lilly, and Eisai and Biogen, which won full approval last year for their treatment Leqembi.”
Eli Lilly wins long-awaited approval for Alzheimer’s drug – Endpoints News (endpts.com)
Workforce
BLS: U.S. labor market: The labor market is showing signs of weakness. “Employers are easing hiring, and the share of jobless Americans is rising. There were 206,000 jobs added to U.S. payrolls last month… but downward revisions to prior months’ data show a more rapid slowdown than previously thought.
The Fed might not be able to continue its inflation fight without risking further weakness in a labor market that is the bedrock of the economy. Today’s jobs numbers in isolation probably aren’t enough to trip alarm bells, but paired with softer readings on inflation and consumer spending, a September interest rate cut now looks more likely than not. Key data from BLS June report released last Friday:
- There were a combined 111,000 fewer jobs in April and May than first estimated.
- That brings the three-month average of job gains to roughly 177,000 — a step down from the 269,000 seen in the first three months of the year.
- Unemployment increased from 4.0% to 4.1%.
- Government employment rose by 70,000– higher than the average of 49,000 over the last year. Government employment was boosted by local government, excluding education and state government.
- Healthcare sector added 49,000 positions, lifted by increased hiring in ambulatory healthcare services and at hospitals.
U.S. Bureau of Labor Statistics: U.S. Bureau of Labor Statistics (bls.gov)
U.S. economy added 206,000 jobs in June (axios.com)
BLS Hospital workforce: Key data:
- In June 2024, hospitals employed: 5.566 million vs. 5.324 million in June 2023 (+4.5%)) and 4.780 (+ in June 2014 (+16.4%).
- Hourly earnings: May 24: 41.87 vs. May 2023: 40.63 (+2.55%)
- % of total healthcare workforce employed in hospitals: 2024: 42.6% vs. 41.5 in ‘20
www.bls.gov/productivity/tables/labor-productivity-detailed-industries.xlsx
Report: the Health Care Workforce: The health care industry employed 16.3 million people in 2022, making it the largest employment sector in the United States. Key data:
Shortages: As of November 20, 2023, approximately 102 million people live in a primary care Health Professional Shortage Area (HPSA), and 77 million people live in a dental health HPSA. A total of 167 million people, almost half of the United States, live in a mental health HPSA.
Supply/Demand: The average age of RNs in the United States is 43.6 years old and 47% of all active physicians in 2021 were age 55 or older. In 2022, 17% of the U.S. population (58 million) was aged 65 and older. In 2050, about 23% (82 million) of the U.S. population will be age 65 and older. Medical school enrollment has increased nearly 6% between the 2018-19 and 2022-23 academic years and the number of female medical students increased by 15% over this same period. Similarly, the number of newly licensed RNs each year increased by 18% between 2018 and 2022.
State of the U.S. Health Care Workforce, 2023 (hrsa.gov)
Health Workforce Research | Bureau of Health Workforce (hrsa.gov)
