MRRN. March 12, Presented to. AHSA E Cherry Bend Rd. Traverse City. MI

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1 Presented to MRRN March 12, 2008 by The American HealthCare Services Association AHSA E Cherry Bend Rd. Traverse City. MI

2 The Association - An Introduction The First and Only National Vendor Management Association in the U.S. AHSA is a Member Medical Facility Association, Representing the Member Facility (AHSA is not a Staffing )

3 Traditional Staffing Model High Fixed Costs Physician Recruiting Allied Health Recruiting Nurse Recruiting Medical Office, IT, Finance/ Accounting Recruiting Redundant Inefficient Confusing Labor Intensive Cumbersome Communication

4 AHSA Model AHSA Member Facility Facility interfaces with only one dedicated service representative Available staff resources are multiplied exponentially More cost effective X 170 plus More simple Streamlined communication

5 Overview The Staffing Dilemma and Industry Trends Physician Staffing - Particularly The Association

6 The Staffing Dilemma Why? Expected Increase in Demand for Health Care Services Largest Aging Population in U.S. History Smaller Age Cohort from whom to Draw in the Future Other, more Attractive Opportunities Available

7 The Staffing Dilemma (continued) Why (continued)? Poor Reimbursement and/or Net Practice Income Down Malpractice Overall Population Increase

8 Staffing Dilemma (continued) With the Current Staffing Shortage, Many Types of Staffing Companies have Emerged While Attempting to Help, this has Further Fragmented the Workforce Driven Direct and Admin. Costs much Higher Put Hospitals into Direct Competition with Agencies for Same Staff in Many Cases

9 Staffing Dilemma (continued) Hospitals Continually Cite Solicitation as a Primary Disruption to Daily Operations Interferes with Core Patient Care Issues and Permanent Recruitment Efforts

10 Staffing Dilemma (continued) More Health Care Professionals are Choosing Off-staff Careers via Staffing Companies Based on Cross-industry Publications, this Trend is Expected to Grow Significantly

11 Staffing Dilemma (continued) With Unprecedented Competition, Quality of Staff being provided has Declined in Many Areas Labor Represents the Single Largest Expense Category for Medical Facilities Approx. 55% of Total Budget per Recent AHA Data

12 U.S. Industry Trends Overall Temporary Staffing Market Value 1990 = $17 billion (est.) 2007 = $73.5 billion (est.) Temporary Agencies are 2 nd fastest growing industry in U.S. Health care staffing industry valued at est. $20.5 billion

13 U.S. Industry Trends (continued) 1 in 8 Americans, will be age 75 or older by the year 2050 Shortfall of RNs in 2020 projected to be 800,000

14 U.S. Industry Trends (continued) Locum Tenens industry valued at est. $4 billion Compared to only est. $500 million in 1997 Shortfall of Physicians in 2020 projected to be 200,000 Even with 15% increase in medical school enrollments

15 U.S. Industry Trends (continued) Per one recent Physician Poll 70% of physicians predict a severe shortage in 5-10 years 50% of physicians are contacted by recruiters 1-3 times every month

16 U.S. Industry Trends (continued) Per U. S. Bureau of Labor, # of Physician Jobs 2005 = est. 727, = est. 887, = est. 964,700

17 Physician Staffing Types Retained: A recruitment firm that usually requires an up-front fee or monthly fee installments from a hospital/practice before the physician is placed Contingency: A recruitment firm that is not paid by the hospital or practice until a physician is placed

18 Physician Staffing (continued) Types (continued) In-house: A department run by the medical facility itself that handles all recruitment for their own organization Locum Tenens: A recruitment firm that provides short-term or temporary placement of physicians

19 Physician Staffing (continued) As of 10/05, about 1/3 of practicing physicians utilized recruitment firms to help them with their job searches While the Locum Tenens concept is only approx. 30 years old Demand has grown by approx. 800% in past 10 years

20 Physician Staffing- Locum Tenens Locum Tenens. What does that mean?! Lots of Telephone calls from staffing companies Actually means, One holding the place (of another) More simply put, A Physician who substitutes temporarily for another

21 Locum Tenens (continued) Average Locum Tenens assignment length today is 4-6 Weeks Compared to 1-2 Weeks 2 Years Ago Largest proportion of Locums workforce today Those physicians with 11 or more years of practice experience

22 Locum Tenens (continued) Top specialties where Locums utilized anesthesiology, radiology, psychiatry, cardiology, gastroenterology, dermatology, pediatrics, general surgery, pathology, emergency medicine, orthopedic surgery, oncology, hospitalists

23 Locum Tenens (continued) Why might I utilize Locums? Bridge gap when trying to fill permanent positions Call coverage Coverage for CME, vacation, medical leave, maternity leave, military service, illness

24 Locum Tenens (continued) Why might I utilize Locums (continued)? Test new market service lines Provide for peak coverage times (flu season, tourist season, seasonality) Time Off has become an important perm. recruitment and retention tool. Now what?

25 Locum Tenens (continued) Why else might I utilize Locums? To avoid closing a unit To avoid scaling back procedures To avoid needing to divert patients

26 Locum Tenens (continued) Why else might I utilize Locums (continued)? To meet access to care requirements and community expectations To reduce stress on over-burdened staff To help assure patient satisfaction

27 Locum Tenens (continued) Is Locum Tenens Cost Prohibitive? All revenue generated by the Locums belongs to the hospital/practice Revenue is lost without physicians in place and it also results in a lack of service for the community

28 Locum Tenens (continued) Is Locum Tenens Cost Prohibitive (continued)? Utilizing a Locum physician may seem costly; however, it may be more costly if you don't Locum Tenens utilization can cost more, but it's less expensive than watching patients go elsewhere say many of those in charge of staffing hospitals and groups

29 Locum Tenens (continued) The Pro s and Con s

30 Locum Tenens (continued) The Con s Cost Unfamiliar with Practice Learning Curve with Equip. and Procedures

31 Locum Tenens (continued) The Pro s Maintain Continuity of Care Prevent Loss of Revenue Immediate Availability Prevent Burn Out of Staff Physicians Recruitment, Advertising, Pre-screening, Placement Services Cost

32 Locum Tenens (continued) What types of sub-services do I get for the cost? Recruitment Search Primary source verification of education and training Verification of any advanced certification and work history Current standing with any specialty boards Status of all medical licenses

33 Locum Tenens (continued) What types of sub-services do I get for the cost (continued)? Investigation of any pending or past malpractice cases filed Review of any disciplinary actions Speak with 4 to 6 professional references that have worked with physician within past 2 years Review privileges with any medical institutions

34 Locum Tenens (continued) What types of sub-services do I get for the cost (continued)? Set up phone introduction/interview Initiation of licensing with state boards if not already in place Coordination of travel, housing, transportation, etc. Facilitation of any on assignment issues if arise Post assignment evaluations

35 Locum Tenens (continued) Why do Physicians choose to do Locums work? Practice on a part-time basis Flexibility in work schedule Reduce administrative responsibilities To travel To pursue other interests

36 Locum Tenens (continued) Why do Physicians choose to do Locums work (continued)? Experience a different practice setting Semi-retire Increase income Evaluate/ try out different post-residency options

37 Locum Tenens (continued) Aren t most Locums those physicians with red flags? Physicians who are not clinically competent or are running from something are less apt to do Locums work Re-credentialed each time they go to a new facility Subject to same internal credentialing for obtaining privileges Evaluated by 2 separate entities staffing company and facility Subject to scrutiny by the other physicians once on the job

38 Locum Tenens (continued) If a need arises, what can I do?

39 Antiquated Staffing Model Physician Recruiting Allied Health Recruiting Nurse Recruiting Medical Office, IT, Finance/ Accounting Recruiting

40 AHSA Model AHSA Member Facility X 170 plus Consolidation = Efficiency

41 Association Benefits Complete Contracting and Vendor Management Single Point-of-Contact Staffing Operations Dedicated AHSA Representative MSR

42 Association Benefits (continued) Significant Reduction in Ongoing Solicitations Broadest Scope of Services Available Simple to Implement and Use

43 Association Benefits (continued) Comprehensive Staffing Resources of More than 170 Top Agencies Improved Staff Quality Significant Time and Administrative Savings Consolidated Invoicing Process

44 Association Benefits (continued) Powerful On-line Staffing Tools A Safety Net that is Always Available as Things Change Proven Solution, with More Michigan Facilities Selected than any other VMS Currently Serve More Than 70 Medical Facilities in 13 States

45 MRRN and the American HealthCare Services Association Thank you for your time today AHSA E Cherry Bend Rd. Traverse City. MI

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