The Affordable Care Act has been receiving the lion’s share of the credit (or blame) for shifting patterns in healthcare employment, but there are several other factors at play.
HealthLeaders Media reported earlier this month on an overall trend of slowed hospital hiring that began in 1995, when ambulatory care services reported higher employment numbers than hospitals. Since then, technological advances have further reduced the need for expensive in-patient hospital care in favor of low-cost ambulatory solutions for the same medical issues.
The recession and cuts to federal funding have had a negative effect on hospital employment levels, even discounting the impact of the Affordable Care Act. Hospitals are as governed by supply and demand as other industries; the recession and ensuing slow recovery led to much lower rates of inpatient admission, reducing the need for staff. In addition, this year’s sequester mandated cuts to Medicare and Medicaid that have forced some hospital systems to cut costs in other areas to close the gap.
Another important factor cited is the changing face of hospital systems. As hospitals merge, they eliminate redundant staff in medical departments as well as upper-level administration, contributing to the decline in employment. Further, though many hospitals have acquired physician groups and ambulatory services (and thus, increased their number of “employees”), those operations retain their original labor classifications for reporting purposes.
Hospitals seeking alternative ways to increase their spending power may consider medical receivables factoring to provide the cash lost through federal funding cuts. Factoring provides immediate cash based on accounts receivable that hospitals can then use to manage their payroll and meet other expenses. Ambulatory care services that are experiencing rapid growth can also use medical receivables factoring to take on new patients and acquire the necessary professionals to provide quality care.