'Too Scared to Hire'
Medicare reimbursement cuts, an avalanche of sweeping and complex new federal mandates from meaningful use to ICD-10, the looming shift toward value-based payment models, the sector-wide shift toward out-patient services and population health, and the general uncertainty about how the Patient Protection and Affordable Care Act will play out has led many providers to re-evaluate their hiring practices.
"Everyone is afraid of what will happen and is too scared to hire," says Richard "Buz" Cooper, MD, a healthcare economist at the University of Pennsylvania. "Most are feeling the pressures of reimbursement cuts and are getting rid of employees. In the contest that is unfolding between government, insurers and providers, both government and insurers are mega-sized, while providers are too small to fend them off. No surprise that providers are consolidating."
Add to that, healthcare spending growth is at 53-year low. Actuaries at the Centers for Medicare & Medicaid Services earlier this month said that the 3.7% increase in healthcare spending in 2012 tracked the fourth straight year of relatively slow growth and actually declined slightly as a percentage of the gross domestic product.