TUE, SEPT 9 2:15 PM DALLAS BALLROOM BC Keynote Panel Decoding the Drivers of Demand in Healthcare Staffing Moderator: Andrew Braswell, Research Analyst, Staffing Industry Analysts Panelists: Ralph Henderson, President, Healthcare Staffing, AMN Healthcare Ian Morrison, Author, Consultant, and Futurist Stephen L. Newman, M.D., Vice Chairman and COO (retired), Tenet Healthcare Corporation
Healthcare Staffing Market Nearing Historical Peak Healthcare temporary staffing revenue, 1995 2015 ($B) Source: SIA Estimates
Recent and Projected Growth by Segment Temporary staffing revenue by segment, 2011 2015 ($B) Segment 2011 2012 2013 2014(P) 2015(P) Travel Nurse 1.5 1.7 1.8 1.9 2.1 y/y growth 25% 15% 7% 5% 8% Per Diem Nurse 2.7 2.7 2.7 2.8 2.9 y/y growth 6% 0% 2% 3% 5% Locum Tenens 2.0 2.2 2.4 2.6 2.8 y/y growth 9% 11% 10% 7% 8% Allied Health 2.7 2.9 2.8 2.9 3.1 y/y growth 11% 10% 3% 3% 7% Total Healthcare 8.8 9.5 9.8 10.2 10.9 y/y growth 11% 8% 3% 4% 7% Source: SIA Estimates
Insurance Coverage Expansion in Full Swing Change from 2013 Baseline (in millions of non elderly) Source 2014 2015 2016 2024 Medicaid and CHIP 7 11 12 13 Employment Based 2 7 7 Insurance Exchanges 6 13 24 25 Nongroup and Other 1 3 4 5 Total Increase in Insured 12 19 25 26 Source: Congressional Budget Office, April 2014 Update
U.S. Healthcare Expenditure Growth Slowing, but Poised to Reaccelerate Annual Growth in U.S. Health Expenditure, 2002 2018(P) Source: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group
Whither the Nursing Shortage? Projection issued in 2000 for size of RN workforce as of 2012 1 was 2.2M Actual RN workforce in 2012 was 2.7M Annual growth in RN workforce, 1990 2000 was 2.6% Annual growth in RN workforce, 2000 2012 was 2.9% Primary drivers of divergence from forecast: - Influx of new nursing school graduates - Nurses delaying retirement or re entering the workforce 1 Source: Buerhaus PI, Staiger DO, Auerbach DI. Implications of an aging registered nurse workforce. JAMA. 2000;283(22):2948 54.
Whither the Nursing Shortage? Age Distribution of RN Workforce, 2004 vs. 2011 Source: U.S. Census Bureau
Can Advanced Practitioners fill the gap in PC? Projected growth, 2010 2020 - PC Physician Demand: 14% - PC Physician Supply: 8% - Nurse Practitioner Supply: 30% - Physician Assistant Supply: 58% If Advanced Practitioners are fully utilized by 2020 - PC shortfall reduced from 20,400 to 6,400 ( 69%) - Share of PC services provided by physicians decreases from 77% to 72% Source: National Center for Health Workforce Analysis, November 2013
How Will New Payment Models Impact Demand? Shift from fee for service to value based payment models - Bundled Payments - Accountable Care Organizations Volume based payments historically viewed as positive for staffing demand However, nurse staffing levels have been linked to lower readmissions, patient injuries, hospital acquired infections
Medicare Payment Fix an Intractable Problem? One year Sustainable Growth Rate patch passed in April 2014 - The 17 th such delay since 2003 - No debate, nor record of how votes were cast in the House - Avoided 24% cut in physician reimbursement Other important implications of bill - ICD 10 medical coding set implementation delayed one year, to October 2015 - Two midnights rule pushed back to April 2015
Telemedicine Movement Gathering Steam A key component of the effort to improve access to care while lowering total costs Early impacts seen in radiology, pharmacy, dermatology Impediments to greater adoption - Privacy concerns - Intrastate licensing - Billing and reimbursement A risk to traditional temp staffing, but an opportunity for solutions?
New Providers Encroaching Walmart - Six new clinics in TX and SC - $40 NP visits - Dozens of low cost diagnostic tests - Plans to open six more by year end Other retailers moving in: CVS, Walgreens, Target Primarily targeting un and underinsured for now
Questions? Q&A Please wait for the microphone!
Panning for Strategic Gold What is your best advice for positioning a healthcare staffing firm for success in 2015 and beyond?
DIGITAL SURVEYS Decoding the Drivers of Demand in Healthcare Staffing Don t forget to rate this session as you exit.