Hospitals have grappled with health care workforce shortages long before the pandemic, but two years of providing COVID-19 care have strained provider resources and staff like never before. Health care workers serving on the frontlines of one COVID-19 variant surge after the next are profoundly burned out and exiting hospital employment in record numbers. Some are leaving the field altogether, while others are trading full-time work for more lucrative travel positions. Without policies designed to build and sustain a robust health care workforce, this exodus of skilled professionals from hospital employment could threaten providers’ ability to care for patients.
While much of our attention lately has been focused on the COVID-19 pandemic and related challenges, another crisis has been quietly brewing with the potential to drastically impede health care delivery across Texas. Since last fall, supplement payment programs that raise hospitals’ Medicaid reimbursements closer to the actual cost of care either expired or are still awaiting federal approval. Months have now passed without Medicaid providers receiving these desperately needed funds, as negotiations between the state and federal authorities remain at an impasse. Additionally, the 10-year Medicaid 1115 waiver extension was rescinded last April, and its future remains uncertain. The stress on hospitals responding to the ongoing pandemic is significantly compounded by this absence of funding and lack of clarity over the future of vital payment programs.
Hope was on the horizon as we inched closer to the end of 2021. Powerful tools like vaccines, masks, boosters and testing capabilities were ubiquitous, and the general public was deeply educated about how to protect themselves. A new year brought hope for a new health care environment that perhaps would largely leave COVID-19 in the rearview mirror. But, as the holidays unfolded, so did another serious wave of infections due to the omicron variant. And once again, health care workers and hospitals found themselves under siege as COVID-19 hospitalization trajectories went straight up in Texas and across the nation.