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In 2025, 2 in 5 healthcare workers report feeling their role is unsustainable, and 1 in 4 are considering leaving the industry entirely, according to Indeed’s “Pulse of Healthcare 2025” report.

Indeed surveyed 924 U.S. healthcare workers ages 18-65 between July 23 and Aug. 6. Roles included 197 prescribing providers — physicians, nurse practitioners and physician assistants — 75 registered nurses and 74 dental hygienists. Other roles included therapists, dentists, imaging technologists and mental health practitioners.

Here are nine things to know from the report:

Burnout and ineffective initiatives

1. Half of healthcare workers feel exhausted in their current role, and 2 in 3 are unsatisfied in it. Additionally, 36% feel negative toward their job and 33% feel detached from it.

2. While employees acknowledged that their organizations have initiatives to improve working conditions, some said they do not have the bandwidth to participate. Eighty percent said existing well-being solutions at their organizations are ineffective.

3. Staffing constraints were the top reason well-being solutions were ineffective, with 50% of respondents agreeing. Other common reasons included:

• The root causes of burnout are not being addressed (42%)

• Initiatives seem performative, not meaningful (41%)

• Limited availability for all roles (35%)

• Programs are not tailored to the work environment (35%)

Sources of job satisfaction

4. The top sources of job satisfaction were:

• Relationships with patients (50%)

• Consistent and predictable work hours (41%)

• Relationships with co-workers and managers (39%)

• Ability to take time off (36%)

• Flexibility and control over schedule (33%)

5. The most likely reasons for job dissatisfaction were:

• Pay (40%)

• Staffing levels (36%)

• Career advancement opportunities (33%)

• Benefits (31%)

• Employer’s commitment to employee well-being (27%)

6. The top factors contributing to long-term job sustainability were competitive pay (67%), manageable workload (55%), manageable stress levels (48%) and appropriate staffing levels (42%).

7. Healthcare workers said implementing one of the following initiatives would improve working conditions:

• Act on employee feedback, not just collect it (71%)

• Reduce task overload with staffing and technology (67%)

• Reward performance with monetary incentives (67%)

• Offer mental health days separate from other paid time off (66%)

• No nonemergency contact on off days (64%)

• Ensure safe patient-to-provider ratios (61%)

What leaders can do

8. More than 80% of respondents said regular check-ins with leaders affect their well-being. 

9. The most effective leadership efforts to improve working conditions included accountability to create supportive environments (59%), education on how to respond to burnout and other conflict (54%), and internal promotion to ensure leaders understand front-line challenges (52%).

The post 1 in 4 healthcare workers considering industry exit: Indeed appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Several years ago, Boston-based Massachusetts General Hospital recognized it was facing a growing challenge with emergency department boarding, particularly among general medicine patients. Like many hospitals, MGH had an ED-managed observation unit for patients requiring short-term care, typically under 24 hours. But the hospital increasingly struggled with that setup and it began to rethink short-stay care, which ultimately led to the creation of a clinical decision-making unit.

“We had a 31-bed unit managed by the emergency department, but over the years, it went beyond that functionality,” said Peter Dunn, MD, senior vice president of hospital operations. “It became more of an overflow unit, and the length of stay was fairly extraordinary. It was clear that about 40% of the patients in the ED observation unit qualified for inpatient-level care — not necessarily a long length of care, but still inpatient-level care. Yet, they were being placed in the observation unit.”

To address this issue, the hospital took advantage of a newly available clinical space to launch a new model of short-stay care. This allowed MGH to open 19 unlicensed beds adjacent to the emergency department — a significant shift, since the existing observation unit was located on the 12th floor while the ED was on the first.

“Eventually, we decided that co-locating the ED observation unit to truly serve just ED observation — within that less-than-24-hour window — would be the best use of the new space,” Dr. Dunn told Becker’s. “Then we considered what to do with the 31-bed unit. We realized that if the hospital medicine team took care of the medicine patients — who made up the majority of those meeting inpatient criteria — we could create a short-stay unit for medicine patients. These were patients either in the ED observation unit or occupying licensed inpatient beds that we needed for patients currently boarding in the emergency department.”

MGH had already seen success co-locating postoperative patients in short-stay spaces, particularly in perioperative and procedural areas, so the team built on that experience.

To predict which medicine patients would require a short stay, MGH had previously established an operations research team in collaboration with MIT Sloan School of Management in Cambridge, Mass. Using operations research models, they examined historical patient data to identify the best-suited candidates for the new unit.

The model served as an early guide, but operationalizing the CDU required an 18-month planning effort with multiple iterations, Dr. Dunn said.

“By mid-2024, we coalesced around the idea of a short-stay medical service, staffed by hospitalists — physicians and advanced practice providers — a dedicated nursing staff, and enhanced case management,” he added. “A lot of the challenges in efficient care pathways aren’t strictly clinical; they involve broader system navigation. So case management was a key component. We also ensured that other departments — physical therapy, occupational therapy, and others — could prioritize short-stay patients without deprioritizing others.”

The CDU opened Feb. 4 and gradually scaled up to full use of its 31 beds by April.

Nine months in, the unit is helping MGH reduce emergency department boarding times. Within the first six months, the hospital saw a six-hour drop in ED boarding time for general medicine patients — from 19 hours to 13 hours. Among patients transferring to the CDU, boarding time dropped to 11 hours — a 42% reduction.

CDU patients stay an average of 52 hours. About 70% are discharged home or to their referring hospital, while 30% transition to inpatient care.

Dr. Dunn emphasized that these results were driven by strategic structural changes and team alignment.

“ED observation targets have always been 80/20, with lower-acuity patients and stays under 24 hours,” he explained. “There are many ED algorithms to support those goals. Now that our 19-bed ED observation unit is dedicated to that purpose, they’re hitting those exact targets.

“Previously, the unit combined short-stay and ED observation patients, and wasn’t effectively meeting the needs of either group. Separating them has improved performance. We also looked at the length of stay for long-stay patients in the old ED observation unit, reviewed their trajectories, and used prior experience co-locating short-stay patients in procedural or perioperative areas.”

One of the key hurdles was generating buy-in across departments. Dr. Dunn said not all groups had seen the benefits of co-location in past models.

“Medicine patients are more complex than surgical ones, so that added another layer,” he said. “We used predictive models from our healthcare systems engineering collaboration with MIT, but it took time to get everyone aligned.”

Ultimately, he said, teams agreed on the urgency of reducing ED boarding and committed to the CDU model.

“We agreed to try this approach, measure its performance and adjust if needed,” said Dr. Dunn, adding that an oversight committee was created. “If it didn’t work, we’d regroup. But it has worked. There’s now energy and enthusiasm for trying similar efforts — novel ways to tackle capacity issues.”

Beyond the metrics, Dr. Dunn said the CDU has delivered less visible but important workforce benefits. For example, several clinicians have gravitated toward working in the unit due to its distinct focus and workflow.

He also highlighted the benefit of co-location. “We weren’t sure which nursing group would be the best fit initially,” he said. “The ED nurses had staffed the prior ED observation unit, but many patients were inpatient-level. We started with a blend of ED and inpatient nurses. Over time, the inpatient nurses expressed a preference for this unit, and it has become a desirable place to work. It’s a unique care environment — different from both ED and traditional inpatient care.”

His advice for other hospitals: Don’t default to traditional capacity models.

“We need to try new models. It’s not easy, especially in academic medical centers,” he said. “But if you bring the right team together and support the effort with analytics, it can be powerful.”

The post By rethinking short-stay care, Boston hospital cuts ED boarding time by 42% appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

An influenza strain that emerged over the summer is causing unusually early and severe outbreaks in Canada, the U.K. and Japan, prompting warnings from public health experts about what could be in store for the U.S. as flu season kicks into gear, NBC News reported Nov. 12.

The strain is a version of H3N2, a type of influenza A virus. Influenza A strains are generally known to cause more severe illness, particularly in older adults and young children. Over the summer, it acquired several new mutations, meaning “the virus is quite different to the H3N2 strain included in this year’s vaccine,” Antonia Ho, PhD, an infectious diseases consultant and senior lecturer at the University of Glasgow in Scotland, said in a statement. 

The strain is behind early waves in several countries, experts told NBC. In the U.K., flu cases are already triple what they were around the same time last year and are driving up hospitalizations. Meanwhile, Japan is experiencing an “unprecedented” early flu season, with infections nearly six times what they were at this time last year. 

“These are not good signs,” Angela Rasmussen, PhD, a virologist with the University of Saskatchewan in Canada, told the news outlet. 

Experts say the developments abroad raise concern how the respiratory virus season could play out in the U.S. this year, especially amid limited visibility into virus activity and hospitalization trends. The CDC has not published an updated influenza surveillance report since the week of Sept. 20, with data tracking paused during the federal government shutdown. While the shutdown is now over, it could take time for data collection and analysis to ramp back up to normal levels, experts say.

Other factors further complicating the landscape this year are lower vaccine uptake, rising measles outbreaks and disruptions to hospital-at-home programs — a key lever to manage capacity during virus season. Flu vaccination rates are projected to drop 12% this season, with an even steeper decline expected among adults, according to estimates from CSL, a flu shot producer. 

Vaccine strains are typically selected in February; this year’s shots protect against two types of influenza A and one type of B. Even though the shot is not an exact match for the evolving H3N2 strain, experts say vaccination remains key to reducing the severity of illness and easing strain on hospitals as virus season gathers steam.

The post Severe flu outbreaks across globe spur warnings for US appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

The longest government shutdown in American history ended Nov. 12, but the fate of the ACA enhanced premium tax credits — the sticking point for Democrats — will not be decided until December. 

Five things to know:

1. President Donald Trump signed the resolution to fund the government through Jan. 30 after the House of Representatives voted 222-209 to pass the spending package, Politico reported Nov. 12. The bill funds the Department of Agriculture, Food and Drug Administration and Department of Veterans Affairs through the full fiscal year, but all other departments — including HHS — are funded through the end of January. 

2. The spending package also extends Medicare telehealth and the acute hospital care at home programs that lapsed when the shutdown began on Oct. 1, according to the American Telemedicine Association. Those programs will be funded through Jan. 30 and the package allows for retroactive payments for services provided since the waivers lapsed. 

After the shutdown began, 35% of hospital-at-home programs stopped providing care to traditional Medicare patients under the CMS waiver, 20% ended treatment for patients who weren’t covered by the waiver, and 23% shifted all or part of the care to outpatient treatment at home, according to the survey of 140 programs by the Hospital at Home Users Group, which shared the data Oct. 28 with Becker’s.

3. The Senate passed the spending package on Nov. 10. Under the terms of the agreement in the Senate, a vote to extend the ACA subsidies will take place in mid-December, according to Politico. Speaker of the House Mike Johnson, however, was not part of those negotiations and has not promised a similar vote in the House. 

4. The agreement negotiated in the Senate also included a guarantee that the White House would rehire all federal employees who were fired during the shutdown as part of the administration’s reductions in force plan, according to Politico. The White House has also pledged to give all federal workers back pay for the duration of the shutdown. 

5. A spokesperson for the White House’s budget office said that those Supplemental Nutrition Assistance Program benefits will see their accounts fully restored within hours of the government reopening, The New York Times reported Nov. 12. SNAP benefits expired Nov. 1 and have been subject to a legal fight regarding short-term funding.   

The post Government shutdown ends: 5 healthcare notes appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Eleven U.S. hospitals have earned consecutive “A” safety grades from The Leapfrog Group since 2012.

Hospital safety grades are assigned biannually, based on the hospital’s ability to protect patients from medical errors, accidents, injuries and infections, according to a Nov. 13 news release from Leapfrog. 

Read where Leapfrog’s 23 straight “F” hospitals are located here. 

Here are the 11 hospitals with 26 consecutive “A” grades:

Arizona

Mayo Clinic (Phoenix)

California

French Hospital Medical Center (San Luis Obispo)

Kaiser Permanente Orange County-Anaheim Medical Center 

Massachusetts

Saint Anne’s Hospital (Fall River)

Illinois

Endeavor Health Elmhurst Hospital

Northwestern Medicine Central DuPage Hospital (Winfield)

University of Chicago Medical Center

Virginia

Inova Loudoun Hospital (Leesburg)

Sentara CarePlex Hospital (Hampton)

Sentara Leigh Hospital (Norfolk)

Washington

Virginia Mason Medical Center (Seattle) 

The post Where are Leapfrog’s 11 straight-‘A’ hospitals? appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Twenty-three U.S. hospitals received an “F” in The Leapfrog Group’s fall 2025 safety grades — including 11 that were downgraded from a “D.”

Twice a year, Leapfrog evaluates more than 3,000 general hospitals nationwide based on performance across up to 22 measures of patient safety from CMS. The ratings focus on preventable harm, including infections, medication errors and safety-related practices.

Here are the 23 “F” hospitals in fall 2025:

Alabama

Baptist Medical Center South (Montgomery)

Madison Hospital

Huntsville Hospital

Arkansas

White River Medical Center (Batesville)

California

Norwalk Community Hospital

Florida

Delray Medical Center (Delray Beach)

Georgia

St. Joseph’s Hospital (Savannah)

Illinois

West Suburban Medical Center (Oak Park)

Roseland Community Hospital (Chicago)

Weiss Memorial Hospital (Chicago)

HSHS St. Mary’s Hospital (Decatur)

Iowa

UnityPoint Health – Trinity Regional Medical Center (Fort Dodge)

MercyOne Genesis Davenport Medical Center

Mercy Medical Center – Cedar Rapids

Michigan

DMC Sinai-Grace Hospital (Detroit)

DMC Harper University Hospital (Detroit)

DMC Detroit Receiving Hospital

New York

Niagara Falls Memorial Medical Center

Champlain Valley Physicians Hospital (Plattsburgh)

Tennessee

Saint Francis Hospital – Memphis

Texas

Parkland Health (Dallas)

Vermont

Central Vermont Medical Center (Berlin)

West Virginia

Rivers Health (Point Pleasant)

The post Where are Leapfrog’s 23 ‘F’ hospitals? appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

How Healthcare Leaders Can Turn Pilot Projects Into Sustainable, System-Wide Results

AI is no longer a buzzword in healthcare. It now has its own budget line, and it’s already reshaping the way healthcare gets delivered and paid for. More than 80% of healthcare organizations report active AI projects, but only 18% have a mature strategy for scaling and governing them. That gap isn’t just a statistic—it’s the difference between isolated wins and enterprise-wide, sustainable impact. Every missed eligibility check, coding error, or delayed claim puts margin at risk

The good news: AI is already delivering measurable wins in revenue cycle management (RCM) and clinical operations. The challenge? Too many organizations are still stuck in “pilot mode,” with projects that look good on paper but never fully scale. The next 12 to 18 months will determine which leaders turn early experiments into enterprise-wide advantage; and which are left behind.

What’s Working Now

AI’s most meaningful wins aren’t flashy—they’re foundational. In revenue cycle operations, AI is:

• Automating eligibility and benefits verification: reducing missed checks that delay reimbursement and helping providers collect payments up to 30% faster.
• Streamlining prior authorizations: cutting turnaround times from days to hours and improving first-pass approval rates.
• Identifying coding issues before they become denials: lowering denial rates by as much as 20–30% and preventing costly rework.
• Surfacing actionable insights for faster reimbursement: enabling revenue leaders to proactively address underpayments and reduce A/R days.

Healthcare organizations are seeing measurable ROI: shorter days in A/R, fewer write-offs, reduced manual workload, and higher staff satisfaction.

The Barriers Still Holding AI Back

However, even with 80% adoption, most organizations struggle to scale AI effectively. Common challenges include:

• Data readiness: Unstructured inputs and disconnected systems slow progress
• Change management: Staff may resist tools they feel are confusing or disruptive
• Workflow alignment: Even good AI sits unused if it doesn’t integrate seamlessly
• Governance: Lack of standards can leadto compliance risks or poor trust

A Practical Roadmap for Smarter AI

To move from pilot to enterprise-scale success, follow a structured approach:

1. Define Your Objectives: Focus on cash flow, denials, documentation, and patient experience gaps.
2. Clean Your Data: Standardize eligibility, charge, and documentation inputs before scaling.
3. Select the Right Solution for You: Choose tools that fit your workflows and deliver measurable ROI.
4. Pilot and Prove: Start small to demonstrate quick wins and build organizational buy-in.
5. Measure Relentlessly: Track net collections, denial rates, days in A/R, and documentation completeness.
6. Build Long-Term Governance: Ensure models are accurate, explainable, and monitored for performance.

The Payoff

Organizations that get this right are seeing measurable ROI: faster reimbursement, fewer denials, improved staff satisfaction, and stronger patient loyalty. The smartest leaders aren’t asking if they should use AI. They’re asking where it can deliver the most value today and how to make it stick long-term.

Ready to Go from AI Pilot to AI Proof?

AI adoption isn’t optional—it’s imperative for today’s RCM. Every missed eligibility check, coding error, or delayed claim puts margin at risk, and pilot projects that never scale leave money on the table.

 Healthcare leaders who win with AI are those who:

• Optimize Continuously: Measure relentlessly and refine workflows until the gains are baked into operations.
• Earn Team Trust: Pair AI with smart staff augmentation so people focus on exceptions, not rework.
• Govern with Confidence: Monitor models for accuracy, compliance, and ROI over time.

Margins are too thin to stay in pilot mode. The next 12–18 months will determine which organizations turn early wins into sustainable, enterprise-wide results — and which fall behind. Now is the time to move from promising tests to proven outcomes with governance, measurement, and a clear ROI at every step. 

About Access Healthcare

Access Healthcare stands as one of India’s largest and fastest-growing providers of healthcare business processes and technology solutions. Our team of over 27,000 professionals operates from 20 service delivery centers across three countries, emphasizing global delivery, workflow optimization, and our award-winning AI-enabled technology platform.

Since 2011, Access Healthcare has been a trusted partner to the US healthcare sector, leveraging domain expertise, technology, automation, and analytics to enhance clinical outcomes, financial performance, and operations for healthcare providers and payers.

The post The Results Are In: AI in Healthcare is Working appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Wyoming is the most charitable state, with residents spending an average of 29 hours per year volunteering and donating nearly 4% of their adjusted gross income, according to WalletHub.   

WalletHub analyzed the 50 states by comparing them across 17 key indicators of charitable behavior, such as the volunteer rate and share of income donated. The rankings were published Nov. 10. 

Below are the 15 most and least charitable states per WalletHub:

Most charitable 

1. Wyoming
2. Utah 
3. Maryland 
4. Minnesota
5. Virginia
6. Colorado
7. Delaware
8. Maine
9. Pennsylvania 
10. Oregon
11. Montana 
12. Alaska 
13. Connecticut 
14. Washington 
15. New York

Least charitable 

1. New Mexico 
2. Nevada
3. Mississippi
4. Alabama
5. Rhode Island
6. Louisiana
7. West Virginia
8. Arizona
9. Florida
10. Michigan
11. South Carolina
12. North Carolina
13. Oklahoma
14. California 
15. Missouri 

The post 15 most, least charitable states appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

“Access to care” emerged as a top healthcare C-suite buzzword heading into 2025. While much of the conversation has focused on coverage, affordability and capacity, hospital and health system leaders told Becker’s the industry often overlooks the more human elements: trust, navigation and how patients actually experience the care journey.

Here is what four CEOs said when asked: What does healthcare not talk about enough when it comes to access?

Editor’s note: Responses have been lightly edited for clarity and length.

Andrew Goldfrach. CEO of Arrowhead Regional Medical Center (Colton, Calif.): When we talk about access, we often talk about it in general terms — the number of patients seen in clinics or our emergency departments. At the root, access is less about capacity or ease of getting seen; it is more about reducing those barriers within the community, at home or elsewhere that force patients to de-prioritize getting the services they need. A lot of access is related to health equity. It is our responsibility as health systems to think differently about access — understanding the root of why patients aren’t able to be seen timely, then developing strategies that are unique to those circumstances.

For my organization, a big factor is not only the drive times to and from our clinics but also comfortability (or lack thereof) with using digital platforms, assuming they even have appropriate internet connectivity. Most of my patients use prepaid cell phones and don’t have private internet, which creates additional barriers. As healthcare leaders, it is important to remember that healthcare delivery is local, and as such, we need to better position ourselves to meet our patients where they are.

Michelle Joy. President and CEO of Carson Tahoe Health (Carson City, Nev.): When we talk about access, I think we focus too much on the numbers — such as first available appointment, wait times and bed capacity — and not enough on the human side. Access isn’t just about getting in the door; it’s about feeling cared for and supported once you’re there.

What doesn’t get talked about enough is how much access today is dictated by administrative barriers like prior authorizations. Every day, our teams are doing everything possible to get patients the care they need, but denials delay treatment or create frustration for patients who assume it’s the hospital’s or clinic’s fault. It wears on our staff and erodes trust in the system.

When patients lose faith that the system is working for them, it doesn’t matter how many appointment slots we add. Access requires compassion, connection and trust in a system that works both with and for patients and caregivers, not against them.

Jennifer Mendrzycki. President and CEO of TMC Health (Tucson, Ariz.): When we talk about access, we tend to focus on how many providers or clinics exist, but not on how people actually move through the system. For most patients, the hardest part is not the care itself but figuring out how to get there. Navigating referrals, authorizations and appointments can be overwhelming, especially for families trying to coordinate care from a distance.

We also overlook the hidden cost of time. Every delay, phone call or wait for approval takes people away from work and family, and that is a real, measurable cost. If we want to improve access, we have to design around how patients live, not how systems operate. That means rethinking care models, expanding navigation support, integrating technology that connects rather than complicates, and aligning policy to reward coordination instead of volume. Workforce shortages are real, but they cannot be an excuse. The path forward is process redesign that builds access into how healthcare works rather than leaving it up to patients to figure out.

David Walz, BSN, RN. President and CEO of Madelia (Minn.) Health: When we talk about healthcare access, we usually talk about cost and coverage. But what we don’t talk about enough is proximity, trust and continuity.

In rural communities, access means:

Transportation: Can patients actually get to care?
Time: Do they have to take a full day off to see a doctor?
Trust: Do they feel known and heard when they arrive?

At Madelia Health, we see that access is about removing every barrier — not just financial but physical and emotional — so care feels truly within reach.

The post What healthcare CEOs say is missing from the access conversation appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Average nonprofit hospital margins hit 2.3% in September but performance was hampered by increased expenses and drug costs, according to Kaufman Hall’s “National Hospital Flash Report” released Nov. 12.

The report outlines September financial data from 1,300 hospitals across the U.S. based on data from Strata Decision Technology. The margin performance persisted as hospitals navigate federal policy changes and increased expenses mid-year.

Five things to know:

1. Hospital financial performance remains stable. For the month of September, operating margins hit 2.3%, down a percentage point from July and on-par with results from January through May. Year-to-date average operating margins in September hit their highest point since January at 2.9%.

2. Average operating margins in September increased 1 percentage point month over month and are up 31 percentage points compared to September 2022. Operating EBITDA margins were relatively flat year over year and month over month in September.

3. Revenue is growing at the same clip as expenses. Average net operating revenue increased 8 percentage points year over year in September and 4 percentage points month over month. Inpatient revenue per calendar day increased 11 percentage points year over year while outpatient revenue was up 13 percentage points nationally.

4. Non-labor spending increases drove expenses in September. Total expenses increased 8 percentage points year over year with labor increasing just 5 percentage points. Supply expenses per calendar day were up 13 percentage points and drug expenses increased 14 percentage points year over year. Report authors noted hospitals used more advanced pharmaceuticals in the month. Purchased services had slower growth at 8 percentage points.

5. Patient volume increased steadily with discharges per calendar day increasing 4 percentage points year over year. Average length of stay dropped 3 percentage points while the number of ED visits increased slightly. The adjusted patient days per calendar day in September increased 3 percentage points year over year.

The post Hospital margins steady amid disruption: 5 notes appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

As health systems await a federal funding solution for hospital at home amid the government shutdown, healthcare organizations are mixed on the care model’s return on investment.

More than two-thirds of the roughly 20% of health systems that offer hospital at home say the programs increase access to care, boost patient satisfaction, lower lengths of stay, and cut avoidable readmissions, according to an October Sage Growth Partners report that polled 101 hospital and health system C-suite leaders.

However, the financial return is more precarious. Here is how the executives surveyed by the healthcare consulting firm graded their hospital-at-home ROI:

Significant ROI: 13%

Some ROI: 47%

Break even: 20%

Negative ROI: 20%

The post The ROI on hospital at home appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Rural primary care practices deliver a broader range of services than their urban counterparts, even as workforce shortages and federal policy changes strain access and affordability.

These findings were detailed in a Nov. 12 report from the Primary Care Collaborative. The group’s 2025 report found that rural areas have roughly 15% fewer primary care clinicians per capita. Despite this, rural clinicians manage a broader range of patient needs, including chronic disease, behavioral health and referrals to community-based services.

The loss of just one rural family physician can raise health spending by more than $1,300 per patient annually — or $5,200 for a family of four — according to the report. Although the recent passage of H.R. 1 created a $50 billion Rural Health Transformation Program, PCC warned that nearly $1 trillion in projected Medicaid cuts over the next decade may widen disparities.

Case studies in Texas, Oklahoma, New Mexico, Virginia and Idaho highlight how community-driven models are sustaining rural access. The group urged federal and state policymakers to strengthen payment models, workforce programs and oversight to ensure rural investments reach the communities most at risk.

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The U.S. is home to nearly 400 health systems, with most hospitals now part of a larger network. The American Hospital Association’s latest data offers a snapshot of how the system landscape continues to evolve.

Seven things to know:

1. There are 397 health systems in the U.S. These systems include both multi-hospital networks and single-hospital systems with multiple affiliated care sites.

2. 68% of hospitals are system-affiliated. Out of 6,093 hospitals nationwide, 4,157 are part of a health system.

3. 77% of all hospital beds are within systems. That includes 703,731 of the 913,136 total hospital beds across the U.S., according to the AHA.

4. More than half of systems are relatively small. Fifty-three percent of systems operate with 1,000 or fewer beds, while 219 systems have just 1 to 5 hospitals.

5. Only a handful of systems operate at scale.  Just 6 systems have 100 or more hospitals, and only 2% of systems nationally fall into this category.

6. Health system size varies widely. Systems range in size from 1 to 157 hospitals and between 34 to more than 39,000 hospital beds.

7. The number of systems has grown steadily over time:

• In 1940: At least 50 systems existed, all nonprofit or Catholic.
• In 1960: The first investor-owned system emerged.
• By 1980: AHA had identified 267 systems.

Click here for more AHA data on U.S. hospitals and health systems.

The post Nearly 70% of hospitals now belong to a health system — 7 things to know appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Innovation does not have to come with a hefty price tag, according to Thomas Jackiewicz, president of UChicago Medicine.

New research on the 811-bed health system’s patient advocacy program, using six years of data, shows that minor and nonurgent emergency department visit rates decreased by 45% among patients who received appointment scheduling assistance and navigation education, Mr. Jackiewicz told Becker’s.

“Research has shown that roughly 25% of adults between 18 and 64 years old visit EDs for nonurgent reasons,” he said. “If we can reduce even a fraction of those visits, it’s better for our patients and our organization. For me, that’s innovation in action and a substantial return on investment.”

UChicago Medicine’s medical home and specialty care connection program has relatively low operational costs but supports about 17% of patients who pass through its emergency department, regardless of insurance status. Patient advocates typically spend about a week with each patient in person and over the phone, helping them navigate the healthcare system and connect with insurance resources in an approachable way.

“As an academic health system, UChicago Medicine is built for addressing seemingly intractable challenges through innovation,” Mr. Jackiewicz said. “It’s core to our mission. That said, our commitment to research and innovation brings an added degree of complexity. New economic models, changing health policies and decreased government reimbursements challenge our ability to operate on razor-thin margins and invest in innovation.

“Despite these headwinds, we are not straying from our commitment to deliver transformative innovation that aligns with our long-term strategy. Our internal teams have deep experience with driving early experimentation, evaluating implementation and scalability challenges and, also, understanding when external partners are needed.”

Becker’s connected with six other health system leaders who shared innovations their organizations have implemented that created real value — for patients, staff or operations — without requiring major new spending.

Amy Linsin. Executive Vice President and Chief Human Resources Officer of Prisma Health (Greenville, S.C.): Prisma Health launched a team member recognition program in December 2022 using the Achievers platform, quickly increasing engagement through shared appreciation. In 2024, the organization partnered with CipherHealth and Achievers to integrate patient feedback into the system, allowing team members to view recognition from both patients and colleagues in one space. Leaders can enhance these acknowledgments with rewards and celebration notes, and thanks to integration with Workday, recognitions can be included in performance reviews. This innovation required minimal new investment but delivered meaningful value by strengthening employee engagement, reinforcing organizational culture, and deepening team members’ connection to their work. Prisma Health was honored with an Achievers A-List Award for Innovation in recognition of this strategic, high-impact initiative.

Terry Metzger. CFO of ProMedica (Toledo, Ohio): One innovation ProMedica has implemented to drive value is the restructuring of our front-end processes, which has enabled us to better meet patient expectations while maintaining operational efficiency and strong financial outcomes.

Key features of this initiative include expanded payment options, streamlined check-ins, cost transparency, and enhanced digital access for scheduling, medical records, and provider communications.

To support these enhancements, we refined our patient estimate process and established new teams for financial clearance and preregistration — creating a more reliable and seamless experience for patients.

With a centralized preregistration team in place, ProMedica has achieved a 98% preregistration rate, increased pre-service collections by 19%, and reduced the number of registration-related denials.

We accomplished these goals by effectively leveraging existing resources, which included reassigning staff, enhancing training and setting clear performance expectations with incentives.

Pam Oliver, MD. Executive Vice President and Chief Medical Officer of Novant Health (Winston-Salem, N.C.): To deliver best-in-class care, we must also care for our clinicians and keep administrative burden in check. We regularly survey our care teams and act on their feedback. This year, their feedback was clear: eliminating avoidable stressors — like the constant pressure from electronic health record alerts — makes a difference.  

In response, we eliminated 2.4 million noncritical pop-up alerts that were disrupting workflow, which ultimately increased productivity in our electronic health record. 

Thanks to clinician feedback, we’ve implemented changes over the past six years that have eliminated nearly 75 million clicks and saved 105,000 hours — or about 12 years — of administrative work. These are low-cost, high-impact solutions that benefit both patient care and clinician well-being.

Caswell Samms III. Executive Vice President and CFO of Nemours Children’s Health (Jacksonville, Fla.): At Nemours Children’s Health, one of the most valuable innovations came from reimagining how we use what we already have. By building digital care pathways within our existing Epic platform, we standardized care for common conditions like asthma and diabetes, improving outcomes and reducing unnecessary variation, like emergency department utilization, without major new spending. It’s a great example of frontline collaboration, using data and workflow redesign to create real value for patients, our associates and the organization.

Abby Stonecipher. Vice President of Enterprise Business Transformation of Prisma Health (Greenville, S.C.): Our imaging scheduling team has launched a highly successful bidirectional texting program that’s redefining patient engagement. With over 250 daily interactions, it’s driving measurable improvements in access, operational efficiency and patient satisfaction. This scalable platform not only simplifies scheduling, it also enhances communication through reminders, prep instructions and follow-up messaging. While the direct financial return is modest, the value it delivers to patients is significant. 

Laren Tan, MD. Chair of the Department of Medicine at Loma Linda (Calif.) University Health: At Loma Linda University Health, we’ve launched multiple AI initiatives, but one that truly captures our vision is the ambient AI scribe program. As I reflect on where healthcare is heading, I see this not just as an investment in technology but an investment in people and in the future of medicine itself.

Adopting new technology is never without its challenges, yet we’ve chosen to embrace them head-on by extending ambient AI opportunities to more than 1,000 learners and 1,300 clinicians across our system. The impact has been profound, freeing clinicians to focus more on patients and less on documentation, strengthening the human connection that defines our mission, while giving our learners a glimpse into the kind of compassionate, relationship-centered healthcare they will one day lead.

When you look at the continuum of what this truly means is improving patient care, expanding access, and redefining the patient and clinician experience. The impact goes far beyond dollars and data. It’s transformational. 

At Loma Linda University Health, we’re not just investing in innovation; we’re investing in people, the heart of our mission and the academics shaping the future of healthcare. And what’s remarkable is that this transformation hasn’t required major new spending, just vision, intentionality, and a commitment to invest wisely in what truly matters: people and purpose.

The post Hospital innovations creating value — without major new spending appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Health systems are modernizing career advancement programs to build internal pipelines and keep nurses at the bedside.

These programs are being updated to better recognize clinical expertise and support professional growth without requiring nurses to leave direct patient care. Altamonte Springs, Fla.-based AdventHealth, for example, launched a four-level clinical ladder in 2022. Since then, half of its 23,000 eligible nurses have enrolled, and the system credits the program with helping avoid $47.5 million in turnover costs in 2024.

“Historically, to advance, nurses often felt they had to step away from the bedside because those roles didn’t fully recognize the specialized competencies they bring,” Trish Celano, MSN, RN, system chief nurse executive for the system, told Becker’s in October. “The clinical ladder changes that.”

Five chief nursing officers shared with Becker’s how their own programs have evolved and what results they are seeing.

Tamera Dunseth Rosenbaum, DNP, RN. Chief Nursing Executive at UCHealth (Aurora, Colo.): UCHealth measures ROI for its nurse advancement programs through a combination of retention rates, internal mobility, engagement scores and cost savings from reduced turnover, as well as qualitative feedback from nursing staff and their managers. 

For experienced nurses, UCHealth’s professional practice and recognition program, UEXCEL, has supported professional growth for more than 30 years. In July 2025, UCHealth launched UEXCEL NextGen to simplify processes and better align with nurses’ career aspirations. The updated program expands options for demonstrating growth in clinical practice, education, evidence-based practice and leadership. While it’s early to report quantitative outcomes for NextGen, initial feedback has been positive and participation rates in the first cohort exceeded expectations.

For aspiring nurses, the Ascend Career Program helps current UCHealth employees to grow their careers in healthcare through tuition reimbursement and funded educational opportunities. More than 6,600 staff members are taking part, seeking degrees and certifications in a variety of areas, including nursing, behavioral health, public health administration, radiology, respiratory therapy and more. There is high demand for nursing degrees among staff, and the first cohort of nursing students graduated with BSN degrees in August 2025. More nursing programs have been added and could result in nearly 200 nurses graduating with degrees by 2030.

Regina Foley, PhD, RN. Chief Nursing Executive and President of Specialty Hospitals and Clinical Services at Hackensack Meridian Health (Edison, N.J.): At Hackensack Meridian Health, we measure the ROI of our nurse advancement programs through key performance indicators like retention, recruitment pipeline health and vacancy rates. The most significant outcome to date is achieving a low 4% nurse vacancy rate, a 2.5% decrease from last year, which we attribute to a multi-pronged approach. Our 4% nurse vacancy rate is nearly 60% below the national nurse vacancy average.

To build our talent pipeline, we’ve implemented several successful initiatives. Our ABSN Employment Bonus Program, which offers up to $35,000 for a three-year commitment, is constantly growing. Similarly, our OFFER program (ongoing support, financial assistance, flexible schedules, educational counseling, RN mentors) for Patient Care Technicians supports them through nursing school with flexible paid schedules and has 153 current participants. Our RN CAP program provides a formal ladder for advancement, rewarding clinical expertise at the bedside and improving job satisfaction. 

These positive outcomes are shaping our strategy to evolve from a series of programs into a comprehensive and sustainable nursing ecosystem. The success of our current initiatives validates our continued investment, which includes providing around $350k in annual nursing scholarships and partnering with three local nursing schools to strengthen our educational pipeline. We are leaning into proven retention drivers, such as our referral program, which results in new hires who stay for an average of five years or more. Looking forward, we are also in the process of expanding innovative models of care, like our hugely successful virtual nursing program that now covers 147 beds.

By investing heavily in our team members through professional development, internal promotion, and financial support, we have cultivated strong brand loyalty and have the evidence to show our commitment is delivering a powerful return.

Denise Ray, BSN, RN. Chief Nursing Executive at Piedmont Healthcare (Atlanta): Piedmont has a multi-pronged approach to recruitment, retention and nurse satisfaction and how we measure return on investment. We have historically had clinical ladders, and we provide a financial incentive of $3,750 for nurses who complete them. However, that is a small piece of how we determine ROI regarding our retention goals.

We have focused on making sure that we are providing good mentorship through our training residency program for new nurses. Of the 1,291 residents who came through our system in FY 2025, we have a retention rate of 96% — thanks to the residency program, which recently received ANCC accreditation. Based on our low attrition rate through that program, we estimate an ROI of $16 million over the past two years (based on data from the Advisory Board regarding the average cost to replace one staff RN).

Another less direct ROI measure we use regarding retention is through our virtual nursing program. Since launching it in September 2024, Piedmont’s Virtual Nursing Program has improved quality, efficiency, and satisfaction across the system — saving 84,460 hours on discharges alone (not counting hours devoted to admissions and medication reconciliation) that were reinvested back into direct patient care. Eighty-five percent of nurses report loving the program, and 78% say it makes them more likely to stay at Piedmont. This program leads to greater efficiency, greater nurse satisfaction and, as a result, greater retention.

Mandy Richards, DNP, RN. Chief Nursing Executive at Intermountain Health and President of Intermountain Children’s Health (Salt Lake City): When our nurses told us they wanted to grow at the bedside, rather than leave it, we listened. Together, with front-line nurses and educators, we created iAspire, a program that fosters clinical excellence, professional growth and career advancement within direct patient care.

Through iAspire, both new graduates and experienced nurses can refine their expertise, expand their skills, and continue providing exceptional care at the bedside. Early results show stronger engagement and improved retention. This is proof that when we build programs with nurses, for nurses, everyone benefits, especially our patients.  

Gail Vozzella, DNP, RN. Senior Vice President and Chief Nurse Executive at Houston Methodist: The Houston Methodist Clinical Career Path (CCP) was established in 2007 to recognize and support the growth of nurses who provide exceptional bedside care. This four-level advancement program is grounded in Benner’s model of novice to expert and emphasizes clinical excellence, professionalism and meaningful contributions to nursing practice.

In 2022, we collaborated with a dedicated group of Houston Methodist frontline nurse leaders and staff to re-evaluate the CCP. Our efforts were driven by a shared commitment to ensuring the program continues to reflect the evolving needs of our nursing workforce.  

Through this collaborative effort, opportunities were identified to enhance consistency across campuses, strengthen system-wide nursing governance and update criteria to align with current practice environments.

With strong engagement from nursing teams and support from executive leadership, the CCP further empowers nurses and recognizes their invaluable contributions to patient care, their units and hospitals, and our larger community. As part of this enhancement, compensation structures were thoughtfully adjusted to reflect the impact and expertise of our nurses.

Our nursing educators provided comprehensive education on the updated CCP across the system to ensure understanding and adoption. Houston Methodist remains committed to ongoing evaluation of the program, with biannual reviews. This ensures we continue to meet the needs of our nurses and they feel supported and empowered as they deliver unparalleled care to our patients.

The post Systems retool career ladders to retain bedside nurses appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

AI is already transforming the healthcare workforce and the care they deliver, from automated coding to scribing — with many more advances coming soon.

That was the message from Becker’s 13th Annual CEO + CFO Roundtable’s AI Summit, which took place Nov. 5 in Chicago.

Here are 10 of the most memorable quotes from the event:

Sham Firdausi. Deputy CFO of County of Santa Clara Health System (San Jose, Calif.): My revenue cycle team that I oversee is about 400 people, which is relatively large and different from the for-profit entity and private hospital I come from, and that’s kind of what I’m trying to bring there as well. Right now, we are meeting with vendors all across the revenue cycle. We’re even getting to a point where I’m interviewing some autonomous coding [vendors].

Michelle Hatfield. CEO of Kindbridge Behavioral Health (Denver): We’re restricting our AI assistant to providing education, self-help, tools, information, referrals. And then if there is any communication or interaction that might be considered harmful statements, we have human agents on the back end who are able to be alerted and a ticket is generated to have them step in and say, “Can I help with what you’re talking about?”

Rajiv Kolagani. Chief Data and AI Officer of Lurie Children’s Hospital of Chicago: This is probably going to be in the next three to five years, but I think reporting and dashboards and all of that are going to be dead. It’s just going to be AI powering the sites, and you’re going to have agents that will do the automation of the work that the information that’s being used for the reports and dashboards is driving.

Ngan MacDonald. Chief of Data Operations at the Institute for AI in Medicine at Northwestern University (Chicago): There are a lot of pilots that exist, but there’s not a lot of traction yet on production-level systems for a genetic AI [at health systems]. You actually do need to very clearly delineate what your individual functions are and what those workflows look like. There’s easy picking at the bottom, things like scheduling appointments.

Dave Newman, MD. Chief Medical Officer of Virtual Care at Sanford Health (Sioux Falls, S.D.): When is it irresponsible not to use AI, whether it’s in rev cycle, whether it’s in patient engagement or any clinical care? When do we force this upon our physicians? When I go to my accountant, it’s never pleasant, right? But if they were using an abacus to do my taxes, I would ask why they aren’t using a calculator or Excel spreadsheet or something like that? When is it irresponsible to use a stethoscope because an AI algorithm is better?

David Ohm. Chief Strategic Development Officer of MultiCare Health System (Tacoma, Wash.): [AI governance] should have definitely operational folks, somebody from the leadership side, from the administrative side, clinicians, cybersecurity experts for sure, IT for implementation, and then ethicists even, because you can’t underappreciate the amount of bias that’s built into a lot of these data sets. Garbage in, garbage out.

Anil Saldanha. Chief Innovation Officer of Rush University System for Health (Chicago): I will caution you, if somebody is saying everything’s fine and dandy in terms of data and AI, they’re lying to you. It’s not easy to get the right kind of data, even in a large system, to train the [AI]. It’s a work in progress.

Kendle Sims. Vice President of Data and Analytics at Shirley Ryan AbilityLab (Chicago): Nonregulated industries absolutely are investing significantly and doing amazing things [with AI]. That’s what all of our patients and other folks are being exposed to. So from that perspective, it really needs to shift our narrative to say, “How do we get to yes and how do we do these things safely?”

Laren Tan, MD. COO of Loma Linda (Calif.) University Faculty Medical Group: Any of you remember the title of the 1977 “Star Wars”? It’s “New Hope.” That is exactly the way clinicians are seeing the way AI is going. It has provided us a way to think that there is new hope to where we can get back to doing what we love to do: [getting rid of] the documentation, the coding, the compliance, all these added layers that make it harder and harder to be able to practice medicine.

Luis Taveras, PhD. Senior Vice President and CIO of Jefferson Health (Philadelphia): We are looking in the next three years to reclaim 10 million hours for our clinicians across the organization [with AI]. That sounds like a large number, but we’re a very large organization. We have approximately 25,000 clinicians. If we give back one hour to each clinician each day in their shift, that adds up to more than 10 million hours.

The post 10 best quotes on AI from Becker’s CEO + CFO Roundtable appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

A certain level of competition is healthy in hospitals and health systems, as it can lead to improved outcomes, lower costs and spark innovation. But unchecked competition can cross a line, according to healthcare leaders.

Becker’s connected with three executives about where that line is — and how organizations can stay mission driven amid industry pressures and achieve growth.

Competition is a necessity in healthcare, according to Timothy Pehrson, president and CEO of Oklahoma City-based Integris Health.

“It pushes healthcare providers to strive to provide more value and better outcomes for patients,” Mr. Pehrson said. “Lack of competition risks complacency.”

It motivates organizations to improve patient experience and outcomes, innovate with respect to care delivery and establish better care models, control costs and invest in workforce and community health, he said.

“Healthy” competition can spur innovation, and keeps organizations focused on what matters most, according to Warren Moore, executive vice president and COO of Mullica Hill, N.J.-based Inspira Health.

“It can help us make sure we’re dialing into our communities and providing the services they need; otherwise, our competition can step in and do that for us,” Mr. Moore said.

When does it go too far?

Healthy competition is the kind that ultimately benefits patients, according to Brian Sponseller, MD, CEO of Carolina Pines Regional Medical Center in Hartsville, S.C.

“But competition crosses the line when it becomes about market share instead of mission,” Dr. Sponseller said. “If it starts pulling resources away from where they’re needed or disrupting the continuity of care, then we’ve lost sight of what really matters.”

In healthcare — especially in the nonprofit sector — it is important not to make decisions based solely on economics, Mr. Moore said.

“We all know that healthcare dollars are scarce, and it’s a huge part of our economy,” he said. “We need to make sure that we’re not just creating competition and bringing up a rise in costs on consumers. If we’re looking purely at the business standpoint, that’s where we start to potentially slip.”

Mr. Pehrson said that as a nonprofit health system, Integris Health’s mission of partnering with people to live healthier lives drives its decisions.

“Growth is first and foremost focused on community and patient needs,” he said. “However, with the ever-growing dynamics in healthcare, especially in consideration of the negative impacts we expect from the OBBB, health systems must balance their strategies to ensure smart growth in service lines that payments can cover our costs.”

Overly aggressive competition can also erode relationships between providers, Mr. Moore said.

“No matter whether someone is in the world from a for-profit standpoint or a nonprofit standpoint, we’re all in healthcare for the same reason at the end of the day, and that’s to make sure that the communities we serve have access to the best possible care,” he said. “Those relationships are important, because we all need each other, and, more importantly, our patients need all of us in order to have the best access.”

The best safeguard against unhealthy competition is keeping patient focus at the center, Dr. Sponseller said.

“As leaders, it’s our responsibility to make every decision with integrity, transparency and collaboration at the center,” he said. “That means working closely with our staff, partnering with local providers and keeping open communication across the community. When we stay focused on our mission and the people we serve, trust grows and collaboration naturally rises above competition.”

Balancing growth with community mission 

At Carolina Pines, growth must have purpose.

“We don’t expand just to get bigger, we grow when it fills a gap for our community,” Dr. Sponseller said. “That might mean adding a specialist so patients can receive the care they need close to home, or investing in technology that ensures our community has access to the highest quality care. Every decision we make starts with the same question: Does this improve care for our patients? If it doesn’t, we don’t do it.”

Inspira Health benefits from having a board that is highly focused on ensuring resources are allocated to better communities, Mr. Moore said.

“Open and honest communication between leadership and your trustees is critically important,” he said. “As a leadership team, we start every meeting with our mission and our vision, and we take that seriously, because that’s our true north.”

Balancing market expansion with the mission to serve is an area where partnerships can thrive, Mr. Moore said. 

He cited examples such as Inspira’s neurosciences partnership with Camden, N.J.-based Cooper University Health Care, which brings cognitive therapy services closer to its communities, and a joint venture with Atlantic Medical Imaging. The latter has allowed both organizations to function more efficiently, avoid direct competition and expand access by more than 25% over the past two years, Mr. Moore said.

Integris Health’s values — integrity, compassion, accountability, respect and excellence — shape its interactions with patients, caregivers, communities and competitors. 

There are several ways systems can collaborate with competitors, such as policy issues that bring competitors together to work toward solutions in federal and state hospital and medical associations, Mr. Pehrson said.

“We work together on community issues such as schools, roads, public safety, economic and workforce development through our chambers and organizations such as the United Way,” he said. “I also have personal relationships with each competitor leader and have regular interactions with them. I genuinely like and respect each of them.”

The post How much competition does healthcare need? appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Employment in the nation’s private sector climbed by 42,000 jobs in October, with 26,000 added in the education and health services sector, according to an ADP report released Nov. 5.

The October national employment report, produced by ADP Research in collaboration with the Stanford Digital Economy Lab, examines anonymized weekly payroll data from more than 26 million private-sector employees in the U.S.

While October marked a return to job growth, Nela Richardson, PhD, ADP’s chief economist, stopped short of calling the gains widespread.

“Private employers added jobs in October for the first time since July, but hiring was modest relative to what we reported earlier this year,” Dr. Richardson said in a news release. “Meanwhile, pay growth has been largely flat for more than a year, indicating that shifts in supply and demand are balanced.”

The report found that trade, transportation and utilities led growth last month with 47,000 jobs added, followed by education and health services (up 26,000), which includes the healthcare sector, and financial activities (up 11,000).

Overall, U.S. private-sector employment increased by 42,000 in October, reflecting net gains after accounting for job losses in other industries.

Job gains in October primarily occurred at large organizations (those with more than 500 employees) and in the Pacific and Mountain regions.

At the same time, year-over-year pay growth was flat last month from September, at 4.5% for job-stayers and 6.7% for job-changers, according to ADP.

View the full report here.

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A new federal law set to take effect in 2027 is raising red flags for hospitals — particularly safety-net and rural providers — as it introduces sweeping changes to Medicaid eligibility.

The One Big Beautiful Bill Act, signed into law this summer, includes a nationwide Medicaid work requirement that mandates adults ages 19 to 64 work, attend school or volunteer for at least 80 hours per month to maintain coverage. While policymakers aim to reduce long-term dependency, hospital industry experts warn the move could significantly disrupt access to care and hospital finances, according to an Oct. 28 report from Kaufman Hall.

Five things to know:

1. Safety-net hospitals face an up to 30% hit to their operating margins on average, but hospitals in certain states and rural areas could be hit even worse. Hospitals in Medicaid expansion states could see operating margins shrink by up to 13.3% on average under the new work requirements, according to a Sept. 18 analysis by The Commonwealth Fund. Safety-net hospitals may see reductions of up to 29.6%, with some rural hospitals facing even steeper declines.

2. In 2023, Georgia launched its own Medicaid work requirement. While state officials lauded the program, a Government Accountability Office report published Sept. 3 found it led to coverage losses without increasing employment. Many beneficiaries were disenrolled due to difficulties navigating reporting systems, leading to higher uncompensated care costs. Georgia reportedly spent twice as much on administration as it did on enrollee care.

3. Kaufman Hall outlines five major challenges for hospitals:

• Financial exposure from increased charity care and bad debt.
• Operational complexity tied to inconsistent documentation and real-time eligibility tracking.
• Reputational risk from care delays or aggressive collections.
• Policy uncertainty amid expiring ACA subsidies and Medicaid DSH cuts.
• Pre–ACA cycle of coverage loss could return.

4. The new policy could mirror the pre-ACA environment, where millions cycled in and out of coverage. Hospitals would be left managing more last-minute denials, self-pay patients and varying state requirements, according to the report. 

5. Though implementation begins in 2027, Kaufman Hall recommends hospitals and health systems begin preparing immediately. Steps include updating financial assistance policies, shoring up eligibility processes, partnering with community organizations for volunteer-hour tracking, and aligning strategies with boards and community stakeholders.

“Hospitals have a choice: prepare now or pay later,” according to the report. Hospitals and health systems that delay may face higher bad debt, reputational harm and reduced flexibility when the new rules take hold.

Click here to access the Kaufman Hall report. 

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From ECU Health’s plans to reopen a closed North Carolina hospital as a rural emergency facility to a healthcare group aiming to reopen a shuttered Wisconsin hospital, here seven planned hospital reopenings that Becker’s has reported in 2025: 

1. Oxford, Miss.-based Progressive Health Group acquired La Grange, Texas-based St. Mark’s Medical Center and plans to reopen it as Progressive Health of Fayette.  

The hospital closed in October 2023 due to financial challenges. The hospital transitioned to PHG ownership on Aug. 24. PHG said it plans to reintroduce essential services at the facility, beginning with emergency care and expanding to other specialties and programs. The hospital is expected to open in January or early February 2026. 

2. Irving, Texas-based Christus Health shared plans to sell its former San Antonio-based Christus Santa Rosa Hospital—Medical Center to University Health, also in San Antonio, for $71 million.

Christus closed the hospital on April 25 and consolidated services to nearby Christus facilities, after an evaluation of its operations and the community’s evolving healthcare needs. University Health Plans to spend an additional $20 million on equipment and renovations, according to the San Antonio Business Journal. 

3. East Ohio Regional Hospital in Martins Ferry, Ohio, was acquired by 360 Healthcare, which plans to reopen the hospital under its original name in the fall.

Harold Ramsey, president of 360 Healthcare and managing partner of Rising River Capital, is leading reopening efforts for the 140-bed hospital that closed in March. His immediate priorities include restoring power to the hospital, conducting a comprehensive facility cleansing, and maintaining close coordination with Martins Ferry and Belmont County officials.  

4. Greenville, N.C.-based ECU Health is planning to reopen Williamston, N.C.-based Martin General Hospital as the state’s first rural emergency hospital. 

The plan comes after Martin County officials signed a nonbinding proposal with ECU Health in mid-May for the development after the county’s board of commissioners voted in early January to lease or sell the hospital, which shut down Aug. 3, 2023, after it sought Chapter 7 bankruptcy protection. 

5. Southwest Georgia Regional Medical Center in Cuthbert, which closed in October 2020, received funding to reopen as a critical access hospital and eventually transition to a rural emergency hospital. Renovations are expected to take about a year and a half and an exact timeline for reopening has not been finalized. 

6. The Chippewa Valley Health Cooperative — an independent nonprofit organization — finalized a purchase agreement March 13 with Hospital Sisters Health System for the St. Joseph’s Hospital building in Chippewa Falls, Wis.

Last year, Springfield, Ill.-based HSHS closed St. Joseph’s and Sacred Heart Hospital in Eau Claire, Wis., terminating its presence in western Wisconsin. The cooperative has 90 days to complete due diligence to determine the financial feasibility of reopening the facility. If viable, it could welcome patients to the St. Joseph’s campus by winter 2025.

7. Jamestown, Tenn.-based Phoenix Rural Health secured a lease for a hospital facility in Jellico, Tenn., with plans to reopen it as a rural emergency hospital. Since opening in 2020, the Jellico hospital  has closed multiple times and has been managed by three different companies. The hospital ceased operations in March 2024.

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Every state has submitted applications seeking a share of the $50 billion Rural Health Transformation Program, according to CMS. 

Five things to know: 

1. The program — enacted under the Working Families Tax Cuts Act and expanded through the One Big Beautiful Bill Act — aims to improve access, care quality and infrastructure in rural communities. Unlike previous federal relief programs, this one does not provide direct payments to rural hospitals. Instead, states are applying for and managing the funds. States are not legally required to allocate money to rural hospitals specifically. Some policy experts and rural hospital leaders have raised questions about whether the funding will have a substantial effect on rural providers.

2. The application period ran from Sept. 15 to Nov. 5. CMS is now reviewing all submissions to ensure completeness and compliance with the program’s funding requirements. Approved states will receive baseline funding representing 50% of the total funds, which will be distributed evenly.

3. Applications that meet the baseline criteria will then undergo a “rigorous, data-driven merit review” for the remaining 50% of the funds. The review will be led by federal nonfederal rural health experts and overseen by senior federal review directors. 

4. CMS will announce awardees by Dec. 31 and begin disbursing funds on Oct. 1. The funds will be distributed over five years. 

5. As states begin implementation, CMS’ Office of Rural Health Transformation will provide technical assistance and ongoing support to help states “design, launch, and sustain initiatives that best serve their rural communities.”

The post All 50 states apply for $50B Rural Health Transformation Program: 5 things to know  appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

The healthcare industry is buzzing with the transformative potential of artificial intelligence (AI) and machine learning (ML). However, amid the hype, a major sticking point is often overlooked: the integrity of the data feeding these new technologies. In an industry where decisions directly impact lives, throwing data at a model to see what sticks is simply not an option.

So, what will it take to enable effective, trustworthy, data-driven decisions—from care coordination to hospital operations? It starts with a single, reliable source of truth. That’s CareInTelligence.

One person, one record

Most healthcare organizations today are facing an avalanche of fragmented data. Essential information is often siloed in separate electronic health records (EHRs), lab systems and claims databases. When data exists in different formats across disconnected sources, the result is a web of inaccurate, duplicated and incomplete records.

Those inconsistencies make it incredibly difficult to gain a complete, longitudinal view of a patient’s or member’s health journey. This not only hinders care but also decreases trust in the insights meant to improve it; flawed data will inevitably guide flawed decisions. As the saying goes, “garbage in, garbage out.”

This is where CareInTelligence comes in. By unifying clinical, claims and even social data, the data platform bridges siloes to create a clean, comprehensive health record for every individual—no matter the organization’s system of record.

A unified view is key to enable AI, ML and advanced analytics. When organizations don’t have to spend time and resources mashing disparate data sources together for each new use case, they can instead focus on extracting meaningful insights to improve care. This also accelerates the return on investment, as a single data element can then be leveraged for multiple applications, from quality metric reporting to population health initiatives, without the upfront, repeated waste.

Trust through transparency

Bringing data together in a meaningful way is just one half of the equation. Robust governance is also required to build confidence in the data and the insights it powers. To ensure all data elements can be traced and audited, CareInTelligence monitors every transformation of the data and provides access to a detailed record of its source, timestamp and change history. The platform also uses ML to identify data anomalies in real time, detect unusual behavior and alert users to potential policy violations, strengthening security and trust throughout the data ecosystem.

With clean and comprehensive data, organizations can move beyond simply tracking activities (like whether a test was ordered) to more accurately identify at-risk populations, proactively address gaps in care and develop safe and effective personalized treatment plans—all underpinned by insights their teams can confidently rely on.

A clear path to better care

The journey to more intelligent healthcare is not a sprint, but a deliberate process that must be built on a solid foundation. Armed with a single source of reliable truth—fueled by strong governance—organizations can unlock the full potential of their data. That is how we will take AI in healthcare from hype to a tangible reality that drives value, improves operational performance and, most importantly, fosters healthier communities.

Learn more about how CareInTelligence can power your organization with trusted insights, when and where they’re needed, here.

The post Why true transformation requires a single, reliable source of truth appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

As healthcare organizations navigate increasing regulatory scrutiny and mounting administrative burdens, Joint Commission is spearheading an evolution in accreditation and certification. At Becker’s 31st Annual Meeting The Business & Operations of ASCs, Ken Grubbs, DNP, RN, executive vice president, accreditation and certification operations, and chief nursing officer at Joint Commission, detailed how the organization is redefining its approach through the launch of “Accreditation 360: The New Standard.”

During a featured session, Dr. Grubbs drew from his clinical and operational background to outline how Accreditation 360 aims to reduce administrative burden, clarify standards and elevate patient outcomes.

Below are four key takeaways from the session:

Note: Quotes have been edited for length and clarity.

1. Accreditation 360 reflects a shift from box-checking to outcome-driven care

The initiative, which began with listening tours and immersive clinical site visits, is rooted in understanding frontline clinician experiences. “We have a responsibility from an accreditation perspective to reduce burden where we can,” Dr. Grubbs said. His team identified that many organizations misinterpret accreditation standards due to complexity and redundancy.

In response, Joint Commission eliminated more than 700 requirements from the hospital accreditation program, according to Dr. Grubbs.

“Joint Commission accreditation is foundational to safety and quality,” Dr. Grubbs said. “It’s the care that can and should be delivered.”

2. A data-driven future will define certifications and survey cadence

A core element of Accreditation 360 is its embrace of performance metrics and benchmarking. Joint Commission is now making comparative data available to accredited organizations, allowing them to assess performance systemwide.

This shift also supports enterprise-level risk identification. For example, repeated issues in sterilization processes across multiple ASCs could trigger proactive quality improvement long before a formal citation occurs.

3. National Performance Goals and the SAFEST Program emphasize clarity and alignment

To further guide organizations, Joint Commission introduced a new chapter, known as National Performance Goals, that organizes requirements that rise above regulation into measurable, clinically relevant themes such as “Right Patient, Right Care.” These are not intended to replace U.S. Centers for Medicare and Medicaid Services (CMS) requirements, Dr. Grubbs said, but rather reflect current clinical expectations like patient identifiers and surgical site markings.

In 2026, Joint Commission will also launch the new SAFEST program, a performance improvement tool that allows accredited healthcare organizations to share performance strengths observed during surveys — and eventually aggregate best practices.

4. Joint Commission is committed to enabling — not stifling — innovation

Dr. Grubbs underscored that the accreditation and certification processes must evolve to accommodate technologies like artificial intelligence and ambient documentation, which can reduce clinician burden. “We want to be in a space that allows innovation and doesn’t stifle it,” he said.

Looking ahead, he hopes Joint Commission visits won’t prompt anxiety, but rather be seen as opportunities for collaboration and continuous improvement.

Accreditation 360 signals a broader commitment by Joint Commission to transform accreditation and certification into a tool for performance improvement and front-line support, rather than compliance for compliance’s sake.

The post Joint Commission’s Accreditation 360 reimagines healthcare quality through clarity, data and collaboration appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Annual median compensation for physician assistants and nurse practitioners varies across states, from a low of $117,499 for Alabama to as high as $195,603 in California, according to a survey conducted by consulting firm SullivanCotter.

The “2025 Advanced Practice Provider Compensation and Productivity Survey” draws data from 788 health systems, hospitals and physician group practices representing more than 155,000 certified anesthesiologist assistants, certified nurse midwives, certified registered nurse anesthetists, nurse practitioners and physician assistants.

Here is the annual median total cash compensation for NPs and PAs combined, according to survey data shared with Becker’s. The states are listed in alphabetical order.

Editor’s note: The list does not include additional premium-based compensation. Fifteen states and the District of Columbia are not included due to insufficient data available.

Alabama — $117,499 

Arkansas — $126,250 

Arizona — $141,877 

California — $195,603 

Colorado — $151,254 

Connecticut — $148,890 

Florida — $139,318 

Georgia — $144,319 

Illinois — $143,877 

Indiana — $135,867 

Kansas — $133,068 

Kentucky — $127,855 

Massachusetts — $158,823 

Maryland — $141,794 

Maine — $131,997 

Michigan — $134,893 

Minnesota — $150,543 

Missouri — $138,327 

North Carolina — $137,488 

New Hampshire — $140,213 

New Jersey — $156,016 

New York — $161,608 

Ohio — $125,754 

Oklahoma — $151,732 

Oregon — $154,697 

Pennsylvania — $133,794 

Rhode Island — $140,001 

South Carolina — $120,796 

South Dakota — $120,411 

Tennessee — $133,727 

Texas — $145,622 

Virginia — $140,636 

Washington — $161,299 

Wisconsin — $132,248 

West Virginia — $124,197

The post PA, NP median pay by state appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Health system leaders agree on one thing: technology won’t fix healthcare’s biggest problems on its own.

Despite growing expectations that technology can solve the industry’s biggest problems, health IT leaders say the most persistent myth is that innovation alone can fix what’s broken.

“The biggest myth is that technology alone can solve systemic issues in healthcare,” Jordan Ruch, CIO of Atlantic City, N.J.-based AtlantiCare, told Becker’s. “Tools like AI, EHRs, and automation are powerful, but they are not silver bullets. Success depends on thoughtful integration, governance, and collaboration with clinicians.”

That view resonates across organizations of all sizes. Technology, CIOs say, can amplify strong operations, but it can also make weak processes more visible.

“Technology won’t solve broken processes and workflows,” Susan Ibanez, CIO of Southeast Georgia Health System, told Becker’s. “Training for new solutions helps facilitate the value proposition and help ensure the organization is able to take advantage of the technical solution.”

At Gloversville, N.Y.-based Nathan Littauer Hospital & Nursing Home, CIO James Wellman said many in the industry still fall for the allure of quick fixes.

“Quite often technologies, like AI, are sold as the panacea for fixing a problem or problems, when in reality you can make a problem worse, bigger or both unless you address the root cause,” he told Becker’s. “Technology is a tool that can be used to great effect, either positive or negative.”

That gap between promise and reality isn’t about capability — it’s about people. At Baltimore-based LifeBridge Health, Chief Digital and Information Officer Tressa Springmann said lasting change happens only when technology is paired with the right management and engagement strategies.

“Technology alone fixes nothing – the changes come with high adoption which can only be driven by effective change management,” she told Becker’s.

For some leaders, the conversation has evolved beyond systems and software into the realm of leadership and culture. Darrell Bodnar, CIO of North Country Healthcare in Whitefield, N.H., said that real progress depends on alignment and trust, not just digital infrastructure.

“Technology can amplify excellence, but it can’t replace leadership, alignment, or culture,” he told Becker’s. “Our span of influence has expanded into becoming culture shapers, integrators, and trusted system leaders, driving not just digital progress, but the human and operational transformation that makes it meaningful.”

The message from CIOs is clear: technology is a catalyst, not a cure. Its value depends on how it’s integrated, adopted and supported and whether the people behind it are ready to lead the transformation it enables.

The post Tech isn’t healthcare’s silver bullet appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Despite layoffs and a slowing job market, Generation Z employees are still prioritizing work-life balance, The Wall Street Journal reported Nov. 1.

As organizations scale back on hiring or cut jobs, some are cautioning potential new hires about the long hours — and lack of boundaries — ahead, the Journal reported. 

Younger workers remain “more detached” from their employers than older colleagues, a mindset shaped in part by remote work during the pandemic. For some Gen Z employees, recent layoffs have reinforced the view that loyalty to an employer is unlikely to be reciprocated.

“Even though the labor market is tougher, people are still feeling disconnected from their employers,” Jim Harter, chief scientist of workplace management and well-being at Gallup, told the Journal.

At least 87 hospitals and health systems across the U.S. have cut jobs so far in 2025.

More early-career professionals choose work-life balance over compensation as the most important factor when considering a full-time job, according to a recent survey of more than 1,100 interns at KPMG. 

Gen Z workers do not appear to fear that their emphasis on flexibility will jeopardize their employment, according to Marcie Merriman, founder of Ethos Innovation, which helps leaders decode generational differences. The cohort expects to be evaluated more on results than work or effort, she told the Journal.

“Gen X, when times get tough, when there’s uncertainty, when we have fear, what do we do?” Ms. Merriman said. “We work harder, we dig in more, we push, push, push, because that’s how we’ve been conditioned.”

Hospital and health system human resources leaders told Becker’s in August that Gen Z has taught them to emphasize work-life balance, the need for “work-life blend” and well-being, and a focus on mission-driven work.

The post Despite layoffs, work-life balance still top priority for Gen Z appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Bloomington, Ill.-based St. Joseph Medical Center has the lowest rate of complications during delivery of any hospital in the nation, CMS found.

CMS’ Maternal Health-Hospital database collected data on measures such as exclusive breast feeding, serious birth complications, cesarean births, and participation in a state or national perinatal quality improvement collaborative initiative. The data, which was last updated Aug. 14, is intended to drive improvements to maternal health.

As part of the dataset, CMS determined the rate of any serious complications for mothers during delivery, per 10,000 deliveries, in 2023.

Here are the hospitals with the highest and lowest rates:

Lowest

St. Joseph Medical Center (Bloomington, Ill.): 39

St. Cloud (Minn.) Hospital: 40

Baptist Health Louisville (Ky.): 42

Memorial Hospital of Carbondale (Ill.): 44

Self Regional Healthcare (Greenwood, S.C.): 45

St. Mary Medical Center (Galesburg, Ill.): 47

OSF Saint Elizabeth Medical Center (Ottawa, Ill.): 47

Jefferson Hospital (Jefferson Hills, Pa.): 47

Mercy Hospital Northwest Arkansas (Rogers): 48

Mercy Hospital Ardmore (Okla.): 54

Highest

University of Mississippi Medical Center (Jackson): 1,177

UPMC Chautauqua at WCA (Jamestown, N.Y.): 1,043

University Health System (San Antonio): 990

UPMC Hamot (Erie, Pa.): 933

Zuckerberg San Francisco General Hospital & Trauma Center: 906

Hennepin County Medical Center (Minneapolis): 864

Avera St. Benedict Health Center-CAH (Parkston, S.D.): 780

Sutter Maternity & Surgery Center of Santa Cruz (Calif.): 731

Rochester (N.Y.) General Hospital: 721

Alamance Regional Medical Center (Burlington, N.C.): 677

The post 10 hospitals with the highest, lowest rates of birth complications appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Nearly three-quarters of healthcare organizations have experienced a moderate to severe financial impact from cyber vulnerabilities in the past two years, Ernst & Young and KLAS Research found.

Here are the top cyberthreats healthcare organizations have faced in the last 12 months, according to the accounting firm and health IT researcher’s survey of 100 C-suite cybersecurity leaders from provider, payer, pharmaceutical and medical device organizations. Respondents could select all that applied.

Only 3% of those surveyed said they hadn’t dealt with a cyberthreat:

1. Phishing: 77%

2. Third-party breaches: 74%

3. Malware: 62%

4. Data breaches: 47%

5. Ransomware: 45%

6. Business email compromised: 43%

7. IoT-based attack (e.g., medical device): 34%

8. DDoS attack: 33%

9. Credential stuffing: 29%

10. Supply chain: 29%

11. Zero-day exploits: 19%

12. Man-in-the-middle (MitM) attacks: 14%

The post Top 12 healthcare cyberthreats appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

West Virginia topped WalletHub’s 2025 ranking of the most overweight and obese states in the U.S., published Nov. 4, while Colorado is the healthiest-weight state.

The personal finance website compared the 50 states and the District of Columbia across three dimensions: obesity and overweight, health consequences, and food and fitness.

WalletHub evaluated these dimensions using 31 metrics, ranging from share of overweight adults to fitness centers per capita. Each metric was graded on a 100-point scale, with 100 representing the most overweight state. Each state and the District’s overall score was then calculated using the weighted average across all metrics. More information about the methodology is available here.

The most obese and overweight states:

1. West Virginia — 75.24

2. Mississippi — 73.56

3. Arkansas — 70.19

4. Louisiana — 69.50

5. Alabama — 68.16

6. Tennessee — 68.00

7. Kentucky — 66.48

8. Texas — 65.94

9. Delaware — 64.87

10. Oklahoma — 64.86

The least obese and overweight states:

1. Colorado — 43.73

2. Utah — 45.90

3. Massachusetts — 48.50

4. California — 51.16

5. Hawaii — 51.29

6. Minnesota — 51.39

7. Montana — 52.98

8. District of Columbia — 53.02

9. Washington — 53.07

10. Vermont — 54.24

The post 10 most, least overweight and obese states appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

For the first time since 2020, quality of life emerged as the most influential factor in U.S. News & World Report‘s latest rankings of America’s best places to retire.

U.S. News & World Report analyzed more than 850 of the nation’s most populated cities — up from 150 in previous years — based on factors such as quality of life, affordability, healthcare quality, retiree taxes, population, job market and, for the first time, migration trends for retirees age 55 and older. 

Weightings were based on a survey of 3,500 people ages 45 and older about what matters most when choosing where to retire. For the 2025 rankings, quality of life ranked highest at 27%, followed by affordability at 24%, healthcare quality at 16% and retiree taxes at 16%.

Healthcare quality is calculated by data from U.S. News’ Best Hospitals rankings and measures the availability of top-rated healthcare in each city. 

Michigan, Florida and Texas have multiple cities in the top 20. Below are the top 20 cities from U.S. News‘ list, with the complete list in full available here.

1. Midland, Mich. 

2. Weirton, W.Va. 

3. Homosassa Springs, Fla. 

4. The Woodlands, Texas 

5. Spring, Texas 

6. Rancho Rio, N.M. 

7. Spring Hill, Fla. 

8. Altoona, Pa. 

9. Palm Coast, Fla. 

10. Lynchburg, Va.

11. Bismarck, N.D.

12. Victoria, Texas

13. Palm Harbor, Fla.

14. Rochester Hills, Mich.

15. Troy, Mich.

16. Sioux Falls, S.D.

17. Pearland, Texas

18. Naples, Fla.

19. Pensacola, Fla.

20. Conroe, Texas

The post 20 best places to retire: US News appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Health systems might think they’re designing digital tools for Gen Z and millennials when, in fact, it’s their parents or grandparents who are more likely to use them.

At least that’s been the case at Houston-based Memorial Hermann Health System, where baby boomers are the most digitally engaged generation, with 79% of them using the 17-hospital network’s tech-enabled tools.

“When you think about it’s very logical, because they’re at an age to where, like my parents, in their 80s, all I hear about when I call are the list of doctor’s appointments they have, lab results, all those sorts of things, but they’re keeping up with them, which is a good thing,” said Eric Smith, senior vice president and chief digital officer of Memorial Hermann, at Becker’s 10th Annual Health IT + Digital Health + RCM Conference in October. “Because otherwise, very quickly, they could deteriorate and end up in an ED or in a worse situation.”

When developing digital patient experience tools, health systems can’t guess who their end users will be, Mr. Smith said. So Memorial Hermann built a digital consumer analytics engine to measure who was actually taking advantage of these solutions. For instance, 68% of patients in their 60s and 70s interact with the health system’s text messaging platform, compared to 41% of Gen Zers.

“You can make assumptions about audiences, but you actually have to look at the data,” Mr. Smith said. “Then what we’re doing is we’re taking that back, going, OK, what do we need to do to adjust those numbers? Because we need some of those younger folks to engage now, so that way they’re prepared and they’re really taking more active steps in managing their health.”

Memorial Hermann texts patients from their provider’s office’s actual number with appointment reminders and lab results notifications, allowing them to redial and call the practice directly with questions. Only 0.1% of patients opt out.

“It gives us a channel that we can continue to engage patients in a way they’re used to engaging in, and one they obviously are telling us is a positive experience for them,” Mr. Smith said.

The health system also has voice bots that check in with patients after an emergency department visit — with a 35% hit rate there — or a call to the organization’s 24/7 nurse helpline, leveling them up to a human if need be.

Mr. Smith said the next step in digital engagement is to personalize the type, time and tone of outreach that would be most effective for each individual patient.

The post Why baby boomers are the most digitally engaged patients appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Hospitals and academic medical centers are posting a larger share of physician job postings, but financial uncertainty in the market could dampen their recruiting efforts, according to a recent report from AMN Healthcare, a recruiting firm. 

Between April 2024 and March 2025, AMN Healthcare reviewed a representative sample of open positions for 1,420 physicians and advanced practice providers. In this time frame, hospitals posted 481 physician roles, or 34% of the representative sample. Between 2023 and 2024, hospitals represented 28% of physician job searches. 

Academic medical centers also increased in their scope of physician searchers, with 395 job postings (28%) between 2024 and 2025. The previous 12 months saw 22% of these postings originate from AMCs, according to the report. 

In the 2024-25 sample, medical groups posted 345 physician positions (24%); urgent care, home health and health maintenance organizations had 139 job postings (10%); federally qualified health centers, community health centers and Indian Health Services hospitals had 49 searches (3%); and solo practices, partnerships and concierge practice settings had 11 (1%). 

In the next year, AMN Healthcare forecasts “the prevailing mood of uncertainty” and “ongoing financial pressures” will inhibit hospitals’ physician and APP recruiting activity. Similarly, some AMCs have enacted hiring freezes as a result of National Institutes of Health grant budget cuts. 

The post Which healthcare settings are hiring more, fewer physicians: Report appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Fifty-seven percent of healthcare workers feel in control of their careers, compared to 45% of U.S. workers across all industries, according to a recent LinkedIn News survey.

LinkedIn surveyed 14,680 U.S. professionals between June 14 and Sept. 19.

Employees in business development were most likely to feel in control, with 59% of respondents indicating so. Healthcare followed, trailed by accounting (56%), human resources (55%), and real estate (53%).

Industries where employees feel the least control over their careers are customer success and support (33%), media and communication (36%), and marketing, research and administrative fields (39%).

This could highlight uncertainty in these industries as artificial intelligence reshapes roles, according to LinkedIn News. While predictive AI is gaining steam within hospitals, its adoption varies between system-affiliated facilities and independent hospitals, according to a recent federal report.

Nurse informatics leaders told Becker’s in September it is reshaping nurses’ roles, with the most immediate opportunity in easing documentation burdens.

The post Healthcare ranks No. 2 for employee control over career: LinkedIn appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Massachusetts is the best state to find a job and West Virginia is the worst, according to WalletHub’s 2025 ranking, published Oct. 29.  

To determine the most attractive states for employment, the personal finance website compared states on two key dimensions: job market and economic environment. Analysts examined those dimensions using 34 metrics, ranging from employment growth to the average commute time.

Each metric was graded on a 100-point scale, with 100 representing the most favorable conditions for job seekers. WalletHub then calculated a weighted average across all metrics for each state to determine its overall score and ranking.

Below are the 10 best and worst states to find a job, per the analysis, along with their corresponding scores. The full ranking and scoring methodology are available here.

Best states to find a job:

1. Massachusetts — 61.75

2. Connecticut — 61.18

3. Minnesota — 60.94

4. Vermont — 60.16

5. New Hampshire — 60.06

6. South Dakota — 59.81

7. Texas — 59.32

8. North Dakota — 59.12

9. Maine — 58.89

10. Rhode Island — 58.29

Worst states to find a job:

1. West Virginia — 37.93

2. Louisiana — 39.89

3. Kentucky — 43.68

4. Alaska — 43.97

5. Oregon — 44.39

6. North Carolina — 45.21

7. Pennsylvania— 45.22

8. Montana — 45.68

9. Indiana — 45.97

10. Oklahoma — 46.07

The post 10 best, worst states to find a job  appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

When virtual nursing first gained traction during the pandemic, hospitals saw it as a lifeline — a way to maximize staff members time when stretched thin, keep patients connected and maintain safety during a crisis. 

Three years later, the screens are still on. But the question facing health systems now is not whether to have virtual nurses, it is how to make their programs distinct, durable and indispensable.

At Duluth, Minn.-based Essentia Health, the idea began modestly: a handful of nurses experimenting with iPads and Zoom calls. 

“We really took this grassroots approach,” said Adrienne Radovich, BSN, RN, a nursing director who helped lead the rollout. “We used the technology we had and made it work.”

Essentia’s pilot launched in 2023, with nurses testing a basic model for virtual admissions and discharges. By early 2024, it had grown into a full program spanning 22 units across Duluth, Superior, Wis., Detroit Lakes, Minn., and Fargo, N.D.

What makes Essentia’s approach stand out is its focus on people, not hardware. Virtual nurses are not remote; they work on site, supporting colleagues they know by name.

“Our success comes from the staff themselves,” Ms. Radovich said. “They’re engaged, they love it and they keep finding new ways to use it.”

Beyond admissions and discharges, virtual nurses now mentor new graduates — “newly experienced RNs,” as Essentia calls them — walking them through strong admission interviews and discharge education. The results have been positive: Patients say they have never had so much time with a nurse, and staff report leaving on time more often. 

“It’s about augmenting the bedside nurse,” said Melissa Fritz, DNP, RN, who oversees the program for Essentia’s West market. “We’re helping them spend more time with patients, and the patients can feel that.”

If Essentia represents the grassroots end of innovation, Cleveland-based University Hospitals is scaling in the opposite direction: whole-hospital transformation. Its Connected Care Team program, housed under the Veale Healthcare Transformation Institute, has wired every inpatient bed at UH Lake West Medical Center in Willoughby, Ohio, with cameras, microphones and AI-enabled sensors.

“We started with the problem: limited nursing capacity leading to inefficiency and frustration,” said program leader Brian Nelson, BSN, RN. “Could we put a solution in place that acts as a force multiplier for our nursing teams?”

From there, the team built a hybrid staffing model unlike most others in the country: Nurses split their time evenly between the bedside and the virtual hub. 

“A nurse might be a virtual nurse one day and on that same floor the next,” Mr. Nelson said. “Patients see them on the screen one day, then in person the next. It builds trust.”

That structure, he said, has been key to keeping communication seamless and staff invested. His colleague and platform lead Lauren Yanus, MSN, RN, added that the flexibility has allowed nurses to innovate. 

“We give them the space to ask, ‘What else can this technology do?’” That freedom has already led to unexpected breakthroughs, such as virtual triage in the emergency department, where remote nurses now help assess and direct incoming patients before medics even leave the room. At Lake West, early results show higher patient experience scores and improved staff engagement. The hospital is now studying how the technology affects falls, length of stay and discharge times.

At Baltimore-based Johns Hopkins Medicine, virtual nursing was co-designed. When the idea surfaced, Deborah Sherman, RN, director of virtual nursing, convened more than 200 people across six hospitals for a two-day design session.

“It was incredible,” she said. “We had bedside nurses, legal, pharmacy, IT, educators, even members of our patient family advisory councils — everyone in one room, in person, talking about what this should look like.”

From those sessions came a deeply collaborative model. Virtual nurses at Johns Hopkins rotate between the bedside and the screen, balancing direct care with virtual admissions, discharges and education sessions. They also help train new nurses and lead patient education calls that can include family members dialing in from home.

In its first seven units, the program has shown improved throughput, faster discharge times and higher HCAHPS scores among patients who interacted with virtual nurses. Ms. Sherman said what differentiates Johns Hopkins’ approach is its inclusiveness.

“We designed our model together, not from the top down,” she said. “It’s multidisciplinary, it’s evidence-based and it has heart. That engagement is what made it work.”

While Johns Hopkins focused on collaboration, Norfolk, Va.-based Sentara Health has doubled down on infrastructure. The system spent the past year hardwiring cameras and televisions into every inpatient medical-surgical and intermediate care room across all 12 of its hospitals, a level of standardization few other systems have achieved. That decision allowed Sentara to scale quickly, rolling out its program across 73 units in one year.

“This ensures seamless, user-friendly communication in every room,” said Jaime Carroll, RN, vice president of clinical support services and chief nursing officer. In less than 10 months, Sentara’s virtual nurses completed more than 35,000 patient sessions, totaling more than 8,600 hours of care. Patients report feeling more informed at discharge, and staff cite faster workflows and stronger teamwork.

Sentara’s next step is to consolidate systems: transitioning its legacy eICU program to the same platform, eliminating mobile carts and adding virtual sitter services. The goal, Ms. Carroll said, is a single, integrated network for remote care across the enterprise.

“The technology is only part of it,” she said. “It’s about making the experience cohesive for patients and clinicians: one system, one approach.”

Virtual nursing may have started as an emergency measure, but hospitals are turning it into an advantage — a tool to retain nurses, strengthen patient relationships and redefine care in the digital era. As Ms. Sherman put it: “Virtual nursing doesn’t take nurses away from the bedside. It gives them new ways to be there.”

The post Virtual nursing 2.0: How hospitals are moving beyond the pandemic playbook appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Florida has 15 hospitals included on Healthgrades’ Top 50 Best Hospitals for Surgical Care list, the most of any U.S. state. Healthgrades published its 2026 Specialty Excellence Awards Oct. 28.

Healthgrades evaluated about 4,500 hospitals across 31 procedures and conditions for the awards. The Surgical Care Excellence Award specifically evaluates clinical outcomes across 15 in-hospital surgical procedures: back and neck surgery (except spinal fusion), back and neck surgery (spinal fusion), bowel obstruction, carotid procedures, cholecystectomy, colorectal surgeries, coronary bypass surgery, hip fracture repair, peripheral vascular bypass, prostate removal surgery, resection or replacement of abdominal aorta, total hip replacement, total knee replacement, upper gastrointestinal surgery and valve replacement surgery.

In-hospital complications, in-hospital mortality and 30-day mortality are also factored into Healthgrades’ evaluation. Read the full methodology here. 

Here are the top 50 hospitals for surgical care according to Healthgrades, in alphabetical order:

• Blanchard Valley Hospital (Findlay, Ohio)
• Doctor’s Hospital (Augusta, Ga.)
• HCA Florida Bayonet Point Hospital (Hudson)
• HCA Florida Brandon Hospital
• HCA Florida Fawcett Hospital (Port Charlotte)
• HCA Florida JFK Hospital (Atlantis)
• HCA Florida Kendall Hospital (Miami)
• HCA Florida Largo Hospital
• HCA Florida North Florida Hospital (Gainesville)
• HCA Florida Northwest Hospital (Margate)
• HCA Florida Orange Park Hospital
• HCA Florida Osceola Hospital (Kissimmee)
• HCA Florida South Shore Hospital (Sun City Center)
• HCA Florida Trinity Hospital
• HCA Florida Woodmont Hospital (Tamarac)
• HCA HealthONE Swedish (Englewood, Colo.)
• HCA Houston Healthcare Clear Lake (Webster, Texas)
• HCA Houston Healthcare Conroe (Texas)
• HCA Houston Healthcare Kingwood (Texas)
• HCA Houston Healthcare Tomball (Texas)
• Henrico Doctors’ Hospital (Richmond, Va.)
• Intermountain Health McKay-Dee Hospital (Ogden, Utah)
• Kaiser Permanente Moanalua Medical Center (Honolulu)
• Kaiser Permanente Woodland Hills (Calif.) Medical Center
• Lewisgale Medical Center (Salem, Va.)
• Los Robles Regional Medical Center (Thousand Oaks, Calif.)
• Medical City McKinney (Texas)
• Medical City Plano (Texas)
• Menorah Medical Center (Overland Park, Kan.)
• Mercy Hospital Springfield (Mo.)
• MountainView Hospital (Las Vegas)
• Our Lady of Lourdes Memorial Hospital (Binghamton, N.Y.)
• Overlook Medical Center (Summit, N.J.)
• Parkridge Medical Center (Chattanooga, Tenn.)
• Portsmouth (N.H.) Regional Hospital 
• Providence St. John’s Health Center (Santa Monica, Calif.)
• Providence St. Jude Medical Center (Fullerton, Calif.)
• Rapides Regional Medical Center (Alexandria, La.)
• Regional Medical Center of San Jose (Calif.)
• Reston (Va.) Hospital Center
• Ridgeview Medical Center (Waconia, Minn.)
• Riverside (Calif.) Community Hospital 
• Sarasota Memorial Hospital Venice (North Venice, Fla.)
• St. Joseph’s Hospital (Tampa, Fla.)
• Torrance (Calif.) Memorial Medical Center 
• TriStar Hendersonville (Tenn.) Medical Center
• TriStar Skyline Medical Center (Nashville, Tenn.)
• TriStar Stonecrest Medical Center (Smyrna, Tenn.)
• TriStar Summit Medical Center (Hermitage, Tenn.)
• West Hills (Calif.) Hospital and Medical Center

The post Top 50 hospitals for surgical care: Healthgrades appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Hospital leaders are bracing for another wave of consolidation that could eclipse the sweeping changes spurred by the Affordable Care Act more than a decade ago. This time, the forces at play are more intertwined: lingering post-pandemic financial strain, rising labor and supply costs, and the accelerating need for investment in technology and innovation.

“The Affordable Care Act drove a sharp rise in both hospital consolidation and physician employment by health systems,” said Peter Banko, president and CEO of Baystate Health. “I fully expect the One Big Beautiful Bill Act to have an even more profound impact than the ACA on mergers and partnerships over the next three to four years.”

Despite modest recovery in some areas, health system margins remain under pressure. Persistent workforce shortages, higher medical device and supply costs, and escalating labor expenses are fueling concern that expenses will continue to outpace revenue growth. These dynamics, coupled with anticipated Medicaid cuts, have many hospital leaders forecasting years of financial headwinds.

“Over the next three to four years, I expect hospital consolidation to continue, driven by the convergence of structural and strategic factors,” said Mark Whalen, executive vice president and enterprise chief strategy and transformation officer of Jefferson Health in Philadelphia. “Rising costs – particularly labor, pharmaceuticals and supply chain – are pushing systems to seek scale. At the same time, health systems are making significant improvements in technology, especially AI, creating the need to spread the expenditures across large networks.”

Hospitals are also preparing for the impact of planned Medicaid cuts over the next few years, which could result in $25 billion in annual revenue losses due to disenrollment. According to an analysis from Kodiak Solutions, uncompensated care could rise by as much as $63 billion over the next decade, deepening the financial strain for health systems already operating on thin margins.

“For many health systems, there is just not enough population growth, market share movement and cost transformation to overcome coverage losses in Medicaid and ACA contraction, utilization reduction due to Medicaid cost sharing and state-directed Medicaid reimbursement reductions,” said Mr. Banko. “We envision a future at Baystate that requires tripling the size of our health plan and doubling the size of our physician-hospital network through inorganic growth, and aggressively managing systemness and scale from that growth.”

For regional and academic health systems, expanding their footprint offers a path to greater coordination between flagship facilities and community hospitals. That coordination is increasingly vital as 759 hospitals nationwide remain at risk of closure — a trend that leaves patients traveling farther for care, delaying treatment, and arriving sicker when they do seek help.

The challenge is especially acute in states with aging populations and low historical growth, such as Pennsylvania.

“With patients shifting into government-sponsored insurance programs in ever-greater numbers and healthcare expenses continuing to grow, hospitals will continue to explore mergers and affiliations as a matter of survival,” said Imran Qadeer, MD, president and CEO of Allegheny General Hospital in Pittsburgh. “The kinds of technological, capital and personnel investments required to keep acute care facilities afloat in a competitive healthcare landscape will be increasingly inaccessible for independent hospitals or small systems, especially as insurers themselves continue to consolidate and pursue value-based and risk based contractual agreements.”

Still, not all leaders view consolidation as the only solution. Dr. Qadeer sees hospitals and health systems pursuing innovative partnerships with payers, such as Highmark, to create shared value and improve patient outcomes. For some organizations, the right partnership could offer stability and growth without merging into a larger system.

“The future is not about getting bigger, it’s about getting better and more connected to the people we serve,” said Airica Powell-Steed, RN, interim executive vice president and COO of Loretto Hospital Network in Chicago. “As we shift toward keeping communities well and out of the hospital, the demand for inpatient beds will continue to decline while the need for innovative, comprehensive ambulatory and community-based care models will rise.”

As hospitals navigate this next phase of transformation, leaders expect consolidation to become more strategic and mission-aligned. Partnerships will increasingly extend beyond traditional brick-and-mortar facilities, blending scale with purpose.

“The organizations that thrive will be those that choose to strategically integrate with purpose while aligning scale, health equity and innovation to truly transform outcomes and create healthy communities,” Ms. Powell-Steed said.

The post The profound shift ahead for health system C-suites appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Since spring 2025, the U.S. government has rolled out the broadest tariff measures in decades: reciprocal tariffs, expanded duties on steel and aluminum, and ongoing Section 301 tariffs on goods from China. The implementation of tariffs has raised the landed cost of imported assets, materials, and replacement parts across many industries, including healthcare. Healthcare facilities rely on these materials for the construction of buildings, leasehold improvements, and other component parts used in specialized medical equipment, many of which are imported. The volatility related to rapid changes in trade policy has created an environment of uncertainty and unpredictability. While legal challenges and policy shifts continue to create uncertainty, the immediate effect for providers has been higher costs and more complex capital planning decisions. A final ruling from the Supreme Court regarding the legality of certain tariffs is pending, with oral arguments to be heard in November 2025. 

For hospitals and health systems, this isn’t just a short-term budgeting and procurement challenge; these tariffs may cause ripple effects across the entire balance sheet. As construction costs continue to increase, fair market values for used equipment continue to climb, capital expenditure (CapEx) decisions are shifting, and even insurance coverage and property tax values may be impacted. Tariff-driven replacement costs may prompt hospitals to extend the useful life of certain assets—such as imaging systems, diagnostic equipment, and IT infrastructure—beyond traditional depreciation schedules, delaying significant capital expenditures. 

In short, tariffs that increase the cost of a new building or equipment costs can also reshape how you plan, value, insure, and manage the real estate and personal property assets already owned.   

• 2025 Reciprocal Tariffs: A baseline tariff now applies to a wide range of imports, with country-specific rates layered on top. This affects both direct imports and U.S.-assembled equipment that depend on global inputs. 
• Steel & Aluminum Duties Expanded: More vehicle parts, trailers, and appliances are now covered, raising costs for metal-intensive builds such as ambulances, racks, and HVAC systems. 
• China Section 301 Tariffs Raised in 2024: Higher rates remain in place for steel, aluminum products, and key technology inputs. While some exclusions have been extended, they are narrow in scope. 

Even when assets are assembled domestically, critical inputs are often imported or benchmarked globally, including steel castings, semiconductors, rare-earth magnets, and power supplies. Historically, most tariff costs are passed through by construction firms and equipment manufacturers directly to buyers, resulting in higher replacement costs, increased resale values, and supply shortages. 

Healthcare real estate has seen significant cost escalation in recent years. While much of the increase occurred in 2022 due to post-COVID supply chain disruption, tariffs are now creating additional layers of expense. Prices for certain materials, such as steel, aluminum, and copper, have risen above the consumer price index (CPI) over the last 12 months. The Cumming Group states that the increases are “largely due to lingering tariff effects and limited supply from major global producers.” 

JE Dunn created a calculator to estimate the financial impact of tariffs using their cost benchmarks, import data from the Bureau of Economic Analysis, and current tariff rates. As of August 26, 2025, this calculator estimates that a $10 million healthcare project would cost about $573,761 (~5.74%) more because of tariffs, with steel driving $451,000 of that increase.  

In one instance, VMG Health observed a $1.4M (4% of hard costs) “escalation/tariffs” line item in a new-facility construction budget—on top of the typical 3% construction contingency. Additionally, based on conversations with reputable general contractors (GCs), GCs are now reviewing subcontractor bids line by line and requesting justification or support for any price increases attributed to tariffs.  

Conversations with market participants have indicated further anticipation of future price hikes due to tariffs. In an article titled “Logistics and Supply Chain Impact,” JE Dunn notes that warehouse demand surged in Q1 2025, with customs bonded warehouses in especially high demand, as these facilities allow importers to delay tariff payments until goods are sold. VMG Health will continue to monitor these trends. 

To minimize costs where possible, developers and health systems are value-engineering new facilities and delaying or scaling back capital projects. High construction costs, combined with persistently elevated interest rates, have led to higher rental rates for newly constructed facilities, as these rates are typically calculated by multiplying the construction cost by a rent constant.

Higher rates for new construction properties are leading some tenants to seek out second-generation space to save on costs, especially for more traditional clinic space as opposed to higher acuity uses.  

Higher build-out costs have driven up tenant improvement allowances for first-generation space. The demand for relatively modern, existing, Class A medical outpatient space increased rental rates and created record-high occupancy rates in many markets. We are also seeing adaptive reuse projects where medical tenants convert traditional office or retail spaces to fulfill their needs. Higher construction costs coupled with tariffs creates greater demand for high-quality, modern, existing space—apart from certain specialty or higher-acuity facilities, which are still being constructed from the ground up.  

The impact of tariffs varies depending on the category of healthcare asset. Imaging equipment, for example, is highly sensitive to global supply chains. MRI and CT systems rely on semiconductors, rare-earth magnets, and precision components: Even a 10% tariff can add up to $200,000 to the cost of a $1–2M scanner. Rising replacement costs have pushed potential buyers toward the secondary market, increasing demand for refurbished systems and individual replacement parts for existing systems. 

Ambulances and other fleet vehicles have also been affected. Elevated steel and aluminum costs keep replacement costs high, and with limited availability of new vehicles, used pricing remains strong—particularly for newer, low-mileage units. 

Tariffs have also impacted information technology assets, specifically tariffs on semiconductors and electronics, resulting in an increase in cost of PACS workstations, servers, and networking infrastructure, making hospitals more reliant on secondary supply sources. Smaller devices and general office or medical equipment, many of which are subject to Section 301 tariffs, have also experienced cost increases. For smaller practices and clinics lacking the purchasing power of larger health systems, refurbished equipment has become a practical alternative. 

Finally, leasehold improvements have risen in cost as tariffs increase the prices for steel, lighting, HVAC and other core materials, driving up replacement costs. The resulting increase has created a gap between what it would cost to replace these leasehold improvements today and their current accounting value, assuming consistent, expected, depreciable life estimates. 

• CapEx Budgeting: Higher near-term replacement costs may encourage a delay in asset purchases and increase used-equipment demand while impacting used-equipment availability. Equipment service providers could see stronger demand and higher pricing, as facilities maintain assets longer. Real estate investment and new construction will likely be carefully scrutinized, potentially resulting in project delays, scaled-back plans, or project termination. 
• Useful Life & Depreciation: Hospitals may want to review their current useful life policies and consider extending asset life expectations, based on revised capital expenditure budgets and potential changes in expected usage and replacement cycles. 
• Insurance: Depending on the definitions contained in the insurance policy, reliance on traditional cost indices may understate the necessary cost to replace assets in the event of a catastrophic failure. Tariff-driven increases could leave facilities underinsured unless policies are updated to reflect increased costs. 
• Property Tax: Higher secondary-market values can also impact the fair market value opinions that factor into property tax assessments, depending on jurisdiction and valuation method. 

Tariffs are shifting demand toward cost-effective alternatives (e.g., refurbished equipment, adaptive reuse, and second-generation space) while driving interest in existing, modern healthcare assets. The VMG Health team is monitoring these trends closely to help clients navigate this evolving landscape. 

For many smaller healthcare providers, investment in refurbished equipment has become less of a choice and more of a lifeline. As tariffs push the price of new systems up by 15–30%, many clinics and community hospitals simply cannot afford to wait—or pay—for brand-new imaging technology. Instead, refurbished equipment offers a compelling, practical solution at a more cost-effective price point.  

For example, Lake Charles Memorial Health System in Louisiana, facing rapid outpatient growth and capital budgeting constraints, turned to Siemens refurbished imaging systems. These units were fully rebuilt and rigorously tested to original standards, delivering substantial cost savings with no loss in scan quality. One radiologist even said they couldn’t distinguish scans from refurbished units versus new ones.  

Refurbished systems typically cost 30–70% less than new equipment, and clinics can immediately channel savings back into patient care. When both budgets and lead times on new equipment are stretching tight, refurbished equipment means quicker implementation. Clinics can expand diagnostic capacity within existing infrastructure, an ideal option for older facilities or urgent diagnostic needs while avoiding construction costs.  

Refurbished equipment is no longer an alternative, but a strategic choice that allows smaller providers to maintain quality care, control costs, and deliver services without delay or compromise. 

At VMG Health, we understand how tariffs, supply chain dynamics, and shifting market forces influence healthcare facilities. Our Real Estate and Capital Assets teams integrate these realities into every valuation and advisory engagement. We benchmark comparable cost data against tariff-adjusted replacement costs and analyze the impact of warranties, installation, usage hours, and software to account for risks related to useful life, depreciation, CapEx, insurance, and taxes. Our clients receive accurate, defensible fair market value opinions and actionable insights that guide smarter decisions.  

While some of these effects may be temporary or change over time, we closely monitor these developments and their effect on both real estate and capital assets to stay ahead of changing market dynamics. Whether your organization is considering constructing or leasing a new facility, evaluating equipment purchases, or reassessing insurance and tax positions, VMG Health can help you navigate today’s tariff-driven environment with clarity and confidence. 

The post How Tariffs Impact Health Systems appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

If you undergo a surgical procedure or are admitted to a hospital for nearly any serious condition, you are likely to receive various generic injectable drugs. From blood thinners to antibiotics to anesthetics, these essential medicines are used every day in hospitals across the country. Unfortunately, many of these medications are at risk of being in short supply.

For more than 15 years, the traditional model of drug purchasing, manufacturing and supply has been unable to reliably supply these drugs. Reasons are many, including existing manufacturers pulling out of the market because they can’t make enough money manufacturing and selling these “work horse” medicines to keep their own lights on.

That’s why leading U.S. health systems took matters into their own hands to address two problems: chronic drug shortages and the high labor costs and turmoil that come with securing alternative medicines for patients when the standard of care is not available. Together, nine of these health systems and three philantropic organizations led the creation of a non-profit drug company called Civica – which we believe is the only company created with the express purpose of preventing and mitigating drug shortages.

Our founders formed Civica as a member-driven “healthcare utility,” knowing that access to essential medicines is not a competitive advantage for hospitals, but a public good. Their intuition and action have since benefited millions of patients. To date, Civica has delivered nearly 250 million doses of essential medicines to approximately 1,400 hospitals across the country to benefit over 90 million patients.

Civica emphasizes predictable and sustainable pricing. It also invests in quality manufacturing, including a preference for U.S. sourcing, as well as longer-term contracts that bring stability to the market. Civica holds about six months of inventory for each of the 70 drugs it currently provides to buffer disruptions in the market. Civica’s new manufacturing facility, currently in the start-up phase, will add more domestic capacity and much-needed redundancy to the marketplace

For hospitals and health system leaders, the Civica model means fewer disruptions to patient care, greater predictability in pharmacy budgets, and a stronger foundation for long-term planning. It also means that patients and their loved ones never have to wonder if they will be able to get the care they need when they walk through a hospital’s doors in their most vulnerable moments.

None of this progress would be possible without the steadfast commitment of our governing members:

• CommonSpirit Health
• Gary and Mary West Foundation
• HCA Healthcare
• Intermountain Health
• Kaiser Permanente
• Laura and John Arnold Foundation
• Mayo Clinic
• Memorial Hermann Health System
• Peterson Center on Healthcare
• Providence Health
• SSM Health
• Trinity Health

From our organization’s earliest days, they blazed a trail by investing in a new model and helped build something without precedent.

Behind every reliable and affordable dose of medicine are teams and leadership that make it possible. On behalf of the entire Civica team, I thank our Board members, their health systems and all Civica member hospitals. Together they continue to guide Civica’s mission to make essential medicines available and affordable. 

I’m pleased to share that the Civica model is now seven-years tested and proven. Still, there are more patients waiting for more certainty in their care and there are more organizations looking for more operational and financial predictability. We enthusiastically welcome new hospitals to join us. Feel free to reach out to me directly at Ned.McCoy@Civicarx.org. I’m happy to set up a call.

The post U.S. Hospitals Are Leading Efforts to Get Patients the Medicines they Need appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Health systems are increasingly offering concierge medicine, a market predicted to be worth over $13 billion by 2030. 

Globally, the industry is expected to grow from $20.5 billion in 2025 revenue to $44.3 billion in 2034, according to Towards Healthcare, a health strategy firm based in Canada. 

What exactly is concierge medicine, though? 

Concierge medicine is a direct primary care service model in which a healthcare provider offers their services for a fixed periodic fee, often through a membership or retainer fee. The costs and covered services vary widely, and many are out-of-pocket. Some aspects are still billed to insurance, though, including labs and imaging. 

In 2014, the average concierge medicine service charged $1,500 to $1,700 per year. By 2025, the median service rose to cost between $2,000 and $5,000 per year, according to concierge practice PartnerMD. Another estimate said annual fees range between $1,000 and $20,000. 

PartnerMD categorizes concierge services in the above-$10,000 range as VIP or luxury medicine. 

It’s estimated that between 7,000 and 22,000 U.S. physicians participate in concierge medicine. 

Several health systems offer concierge medicine services, including Cleveland Clinic, MetroHealth System in Cleveland, Johns Hopkins in Baltimore, Northwestern Medicine in Chicago, Massachusetts General Hospital in Boston and Rush University System for Health in Chicago, to name a few. 

A recent change

The One Big Beautiful Bill Act, signed into law in July, will allow people with high-deductible health plans and direct primary care arrangements to pay for concierge medicine through their health savings accounts. 

Current tax code disqualifies patients with these arrangements to contribute to a health savings account. Effective Jan. 1, an individual with a direct primary care concierge model that costs less than $150 per month can contribute. 

Controversies

One critique of this model is that it further reduces access to primary care physicians who are already strained by healthcare workforce shortages and burnout. Another sticking point is the sticker price: Since concierge medicine is often out-of-pocket, these services can exclude lower-income patients. 

Moreover, it is unclear whether these bespoke models offer a clinical benefit to patients. One study published in 2023 found no evidence that concierge medicine leads to mortality changes. 

Benefits

Physicians who participate in the boutique healthcare model, though, say they are increasing quality of care by reducing their patient load. Smaller patient panels not only alleviate the physician’s workload but can also improve access to care for participants. Some concierge medicine models offer 24/7 care. 

“It’s a way to practice self-preservation in this field that is punishing patients and doctors alike,” internal medicine physician Shayne Taylor, MD, who recently opened a practice offering direct primary care in Northampton, Mass., told KFF Health News earlier this year. “It’s either we do something like this or we quit.”

Other benefits include longer appointments, shorter wait times for visits, more personalized care, and access to health coaching and wellness programs, according to PartnerMD. 

Concierge here to stay

Regardless of the debate surrounding concierge services, the trend appears to be taking root and growing.  

Joel George, MSN, RN, executive director of retail services at AdventHealth Parks & Training Center in Altamonte Springs, Fla., told Becker’s in 2024 that consumer demand is driving growth in concierge medicine. 

“While efforts to expand coverage and reduce costs are ongoing, the industry is increasingly also witnessing a surge in high-end experiences and catering to consumer behavior in health and wellness,” he said.

Addressing critics of concierge medicine, Mr. George said practices can provide high-end, bespoke service while broadening care access. 

“As an organization dedicated to health equity, we recognize the importance of bridging the gap in healthcare access. To this end, we are creating more accessible care options by focusing on facilities that merge concierge healthcare and after-hours access to the community,” he said. “By extending operating hours and providing affordable, high-quality care in accessible locations, we aim to ensure that more people, regardless of their socioeconomic status, can receive the medical attention they need outside of traditional office hours.”

The post Concierge medicine, explained appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Nearly 60% of Americans are extremely concerned or very concerned about rising healthcare costs, according to a recent survey from The Associated Press-NORC Center for Public Affairs Research.

The results are based on a survey, released Oct. 21, of 1,289 U.S. adults conducted from Oct. 9-13.

Four things to know:

1. Fifty-seven percent of respondents said they were extremely or very concerned about rising costs, while 26% were somewhat concerned and 16% were not concerned.

2. About 4 in 10 were extremely concerned about being unable to afford healthcare or medications (42%), not being able to access care when needed (40%) and losing or not having health insurance (38%).

3. Across all the healthcare questions, women expressed more concern than men. For example, 63% of women said they were very concerned about rising costs, compared to 51% of men.

4. Sixty percent of respondents said the federal government is responsible for ensuring all Americans have healthcare coverage, while 39% disagreed.

The post 57% of Americans ‘very concerned’ about rising healthcare costs: Survey appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Hospitals are racing to integrate AI into daily care, but some nursing leaders worry the pace is outstripping the profession’s ability to understand the technology.

At Akron, Ohio-based Summa Health, Chief Nursing Informatics Officer Marc Benoy, BSN, RN, sees that tension play out every day. “If nurses adopt AI without the right training or education, the risk goes beyond technology — it can quietly reshape how nurses think, act and care,” Mr. Benoy said.

Mr. Benoy describes a more subtle danger than faulty algorithms or data bias: the gradual erosion of clinical judgment. When nurses do not fully understand how a system reaches its conclusions, he said, it becomes easier to overtrust the output.

“AI tools can be wrong, biased or blind to nuance,” he added. “Without the ability to question or verify their results, mistakes can slip through unnoticed.”

Across the country, hospitals are piloting AI in nearly every corner of care — from ambient documentation tools that transcribe patient visits to algorithms that predict deterioration hours before symptoms appear. These tools promise to ease workloads and catch problems early. But in the rush to deploy them, formal training often lags behind.

At Tampa, Fla.-based Moffitt Cancer Center, CNIO Marc Perkins-Carrillo, MSN, RN, sees the same issue from a systems perspective. He’s concerned that clinicians are being handed powerful AI models without transparency into how they were built — or the populations they were trained on. “That can lead to biased or inappropriate recommendations that don’t align with the patients actually being treated,” he said.

It’s a problem many health systems are only beginning to confront. Some are introducing “AI literacy” modules in nursing education, mirroring the rise of evidence-based practice courses years ago. Others are forming interdisciplinary oversight committees to review algorithmic bias and explainability before new tools go live. Still, those efforts are inconsistent, and the technology is advancing faster than governance can keep pace.

Training, Mr. Perkins-Carrillo argues, must go beyond how to click through a dashboard. “Without foundational education in AI literacy or prompt design, clinicians may quickly become frustrated or disillusioned with the technology’s potential,” he said. “You can’t expect people to trust a system they don’t understand.”

Both leaders describe a shared vision for AI in healthcare — one where nurses are not just users but informed collaborators. That means teaching them to ask how a model was trained, what its limitations are and when to override its guidance.

Mr. Benoy believes nurses, in particular, have a crucial role to play in shaping the ethical boundaries of AI. “They’re often the last checkpoint before a decision reaches a patient,” he said. “They need to know enough to say, ‘Wait, that doesn’t look right.’”

Hospitals that get this balance right, he said, will use AI not to replace intuition but to refine it — to give clinicians better information without dulling their instincts.

“AI can absolutely strengthen nursing,” Mr. Benoy said. “But only when nurses have the literacy and technical skill to use it critically. In the end, AI should support, not replace, what makes nursing human.”

The post Nursing leaders urge caution as AI spreads in care appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Becker’s has compiled a list of the hospitals with a CMS five-star rating for quietness.

CMS’ Patient Hospital Consumer Assessment of Healthcare Providers and Systems database is a national, standardized survey of hospital patients about their experience during a recent inpatient stay. The survey was completed between October 2023 and September 2024, and the data was last updated Aug. 6. The five-star rating was based on how quiet patients said their rooms were at night.

Nearly 100 hospitals lost their top star rating this year. In April, 313 hospitals were rated five-star, compared to 225 hospitals in August.

Here are the 225 hospitals, by state, with five-star quietest ratings:

Alabama

Citizens Baptist Medical Center (Talladega)

Coosa Valley Medical Center (Sylacauga)

Fayette Medical Center

Jack Hughston Memorial Hospital (Phenix City)

Lakeland Community Hospital (Haleyville)

Lake Martin Community Hospital (Dadeville)

Northwest Medical Center (Winfield)

Troy Regional Medical Center

Arizona

Mayo Clinic Hospital (Phoenix)

Arkansas

Arkansas Heart Hospital-Encore (Bryant)

Arkansas Surgical Hospital (North Little Rock)

Baptist Health Medical Center-Conway

Chambers Memorial Hospital (Danville)

Fayetteville AR VA Medical Center

Howard Memorial Hospital (Nashville)

Johnson Regional Medical Center (Clarksville)

Unity Health-Newport

California

Naval Hospital Camp Pendleton

Fresno Surgical Hospital

Colorado

Aspen Valley Hospital 

Evans ACH (Fort Carson)

OrthoColorado Hospital at St. Anthony Medical Campus (Lakewood)

St. Anthony Summit Medical Center (Frisco)

VA Eastern Colorado Healthcare System (Aurora)

Vail Health Hospital

Florida

96th Medical Group (Eglin Air Force Base)

BayCare Hospital Wesley Chapel 

HCA Florida South Tampa Hospital 

UCF Lake Nona Hospital (Orlando)

Georgia

Atrium Health Navicent Peach (Byron)

Bacon County Hospital (Alma)

Burke Medical Center (Waynesboro)

Dodge County Hospital (Eastman)

Emanuel Medical Center (Swainsboro)

Emory University Hospital (Atlanta)

Evans Memorial Hospital (Claxton)

Jefferson Hospital (Louisville)

Martin ACH (Fort Benning)

Optim Medical Center-Tattnall (Reidsville)

Phoebe Sumter Medical Center (Americus)

Southeastern Regional Medical Center (Newnan)

St. Mary’s Good Samaritan Hospital (Greensboro)

Idaho

Treasure Valley Hospital (Boise)

Illinois

Midwestern Medical Center (Galena)

Midwestern Region Medical Center (Zion)

Taylorville Memorial Hospital 

Indiana

Cameron Memorial Community Hospital (Angola)

Franciscan Health Orthopedic Hospital Carmel 

Memorial Hospital and Health Care Center (Jasper)

OrthoIndy Hospital (Indianapolis)

Parkview Wabash Hospital

Pinnacle Hospital (Crown Point)

St. Joseph Health System (Fort Wayne)
Unity Physicians Hospital (Mishawaka)

Iowa

Floyd Valley Healthcare (Le Mars)

Iowa Specialty Hospital-Belmond

Van Diest Medical Center (Webster City)

Kansas

Ascentist Hospital (Leawood)

Kansas City Orthopaedic Institute (Leawood)

Kansas Spine & Specialty Hospital (Wichita)

Kansas Surgery & Recovery Center (Wichita)

Manhattan Surgical Hospital

Mitchell County Hospital Health Systems (Beloit)

Summit Surgical (Hutchinson)

VA Eastern Kansas Healthcare System (Topeka)

Kentucky

Blanchfield ACH (Fort Campbell)

Rockcastle County Hospital (Mount Vernon)

Three Rivers Medical Center (Louisa)

Louisiana

Abbeville General Hospital

Acadian Medical Center (Eunice)

Avala (Covington)

Christus Central Louisiana Surgical Hospital (Alexandria)

Citizens Medical Center (Columbia)

Cypress Pointe Surgical Hospital (Hammond)

Franklin Medical Center (Winnsboro)

Lafayette Surgical Specialty Hospital

Lane Regional Medical Center (Zachary)

New Orleans East Hospital 

Ochsner American Legion Hospital (Jennings)

Ochsner St. Anne General Hospital (Raceland)

Ochsner St. Martin Hospital (Breaux Bridge)

Our Lady of the Angels Hospital (Bogalusa)

Southeast Louisiana Veterans Health Care System (New Orleans)

Specialists Hospital Shreveport 

St. Charles Parish Hospital (Luling)

The Spine Hospital of Louisiana (Baton Rouge)

Michigan

MyMichigan Medical Center Gladwin

Sparrow Ionia Hospital
University of Michigan Health-Sparrow Eaton (Charlotte)

Minnesota

CentraCare Health System-Sauk Centre

Chippewa County Hospital (Montevideo)

Essentia Health Moose Lake

Glacial Ridge Hospital (Glenwood)

Hutchinson Health

Mayo Clinic Health System-Fairmont

Meeker Memorial Hospital (Litchfield)

River’s Edge Hospital & Clinic (St. Peter)

RiverView Hospital (Crookston)

Riverwood Healthcare Center (Aitkin)

St. Gabriels Hospital (Little Falls)

St. Joseph’s Area Health Services (Park Rapids)

Stevens Community Medical Center (Morris)

Welia Health (Mora)

Mississippi

81st Medical Group (Keesler Air Force Base)

Baptist Memorial Hospital North (Oxford)

Baptist Memorial Hospital Union County (New Albany)

BMH-Golden Triangle (Columbus)

Crossgates River Oaks Hospital (Brandon)

Merit Health Madison (Canton)

North Mississippi Medical Center-Gilmore Amory

VA Gulf Coast Healthcare System (Biloxi)

Missouri

Barnes-Jewish West County Hospital (Creve Coeur)

Cox Barton County Hospital (Lamar)

Cox Monett Hospital 

Nebraska

Brodstone Healthcare (Superior)

Chadron Community Hospital and Health Services 

Community Medical Center (Falls City)

Methodist Fremont Health

Midwest Surgical Hospital (Omaha)

Nebraska Orthopaedic Hospital (Omaha)

Phelps Memorial Health Center (Holdrege)

York General Health Care Services

New York

VA Hudson Valley Healthcare System (Montrose)

North Carolina

Cape Fear Valley Hoke Hospital (Raeford)

Chatham Hospital (Siler City)

Fayetteville NC VA Medical Center

North Carolina Specialty Hospital (Durham)

Novant Health Medical Park Hospital (Winston-Salem)

Novant Health Mint Hill Medical Center (Charlotte)

Vidant Duplin Hospital (Kenansville)

North Dakota

Fargo VA Medical Center

Jamestown Regional Medical Center

Ohio

88th Medical Group (Wright-Patterson Air Force Base)

Crystal Clinic Orthopaedic Center (Akron)

Holzer Medical Center Jackson

Institute for Orthopaedic Surgery (Lima)

Mount Carmel New Albany Surgical Hospital

ProMedica Defiance Regional Hospital

Surgical Hospital at Southwoods (Youngstown)

Oklahoma

Bailey Medical Center (Owasso)

Chickasaw Nation Medical Center (Ada)

Choctaw Nation Health Services Authority (Talihina)

McBride Orthopedic Hospital (Oklahoma City)

Oklahoma Heart Hospital (Oklahoma City)

Oklahoma Heart Hospital South (Oklahoma City)

Oklahoma Spine Hospital (Oklahoma City)

Oklahoma Surgical Hospital (Tulsa)

Tulsa Spine & Specialty Hospital

Pennsylvania

Advanced Surgical Hospital (Washington)

OSS Orthopaedic Hospital (York)

Physicians Care Surgical Hospital (Royersford)

Rothman Orthopaedic Specialty Hospital (Bensalem)

South Carolina

Columbia SC VA Medical Center 

Mount Pleasant Hospital

South Dakota

Black Hills Surgical Hospital (Rapid City)

Dunes Surgical Hospital (Dakota Dunes)

Sioux Falls Specialty Hospital 

VA Black Hills Healthcare System (Fort Meade)

Tennessee

Highpoint Health-Riverview with Ascension St.Thomas (Carthage)

Lincoln Medical Center (Fayetteville)

Starr Regional Medical Center Athens

Unity Medical Center (Manchester)

Vanderbilt Bedford Hospital (Shelbyville)

West Tennessee Healthcare Henry County Hospital (Paris)

Texas

Baylor Scott & White Hospital Brenham 

Baylor Scott & White Medical Center Pflugerville

Baylor Scott & White Surgical Hospital Fort Worth

Baylor Scott & White Texas Spine & Joint Hospital (Tyler)

Baylor Surgical Hospital at Las Colinas (Irving)

Baylor Scott & White The Heart Hospital Plano

Childress Regional Medical Center 

CHI St. Luke’s Lakeside Hospital (The Woodlands)

Coryell Memorial Hospital (Gatesville)

Darnall AMC (Fort Cavazos)

Foundation Surgical Hospital of San Antonio 

Guadalupe Regional Medical Center (Seguin)

Hill Regional Hospital (Hillsboro)

Kell West Regional Hospital (Wichita Falls)

Legent Orthopedic Hospital (Grapevine)

Memorial Hermann Houston Physicians Hospital (Webster)

Methodist Hospital Atascosa (Jourdanton)

Methodist Hospital for Surgery (Addison)

Methodist McKinney Hospital

Palo Pinto General Hospital (Mineral Wells)

The Physicians Centre (Bryan)

Quail Creek Surgical Hospital (Amarillo)

South Texas Spine and Surgical Hospital (San Antonio)

Texas Health Harris Methodist Hospital Southlake

Texas Institute for Surgery at Presbyterian Hospital (Dallas)

Texas Orthopedic Hospital (Houston)

The Heart Hospital Baylor Denton 

The Hospital at Westlake Medical Center (Austin)

Tops Surgical Specialty Hospital (Houston)

U.S.M.D. Hospital at Arlington 

UT Health East Texas Jacksonville Hospital 

UT Health East Texas Pittsburg Hospital

UT Health East Texas Quitman Hospital

UT of Texas Southwestern University Hospital-William P. Clements Jr. (Dallas)

William Beaumont AMG (Fort Bliss)

Utah

Intermountain Health Heber Valley Hospital (Heber City)

Park City Hospital 

Virginia

Buchanan General Hospital (Grundy)

Fort Belvoir Community Hospital 

Riverside Doctors’ Hospital of Williamsburg

Washington

Tri-State Memorial Hospital (Clarkston)

West Virginia

Boone Memorial Hospital (Madison)

Hampshire Memorial Hospital (Romney)

Valley Health War Memorial Hospital (Berkeley Springs)

Welch Community Hospital

Wisconsin

Black River Memorial Hospital (Black River Falls)

Door County Medical Center (Sturgeon Bay)

Froedtert Community Hospital (New Berlin)

Midwest Orthopedic Specialty Hospital (Franklin)

OakLeaf Surgical Hospital (Altoona)

Orthopaedic Hospital of Wisconsin (Glendale)

Reedsburg Area Medical Center 

Sauk Prairie Hospital (Prairie du Sac)

Southwest Health Center (Platteville)

Tamarack Health Hayward Medical Center

Tomah Memorial Hospital 

Upland Hills Health (Dodgeville)

Vernon Memorial Hospital (Viroqua)

Waupun Memorial Hospital

Westfields Hospital and Clinic (New Richmond)

Wyoming

Star Valley Medical Center (Afton)

The post 225 quietest hospitals appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Hospital labor costs held steady in August, signaling potential stabilization after several years of volatility. Yet new Kaufman Hall data shows that annual growth remains firmly in place, underscoring the lasting effects of a tight healthcare labor market and persistent wage inflation.

Nationally, labor expenses per calendar day were unchanged from July, but up 5% year over year and 5% year to date compared to 2024. The pause in month-over-month growth suggests hospitals may be regaining control over workforce spending though the continued annual increases suggest deeper structural challenges remain in staffing and compensation. More hospitals will likely seek creative partnerships or mergers and acquisitions to lessen the strain.

“Over the next three to five years, hospital consolidation will remain a defining force, though the pace will be shaped more by strategy than scale alone,” Sophia Holder, executive vice president and CFO of Children’s Hospital of Philadelphia, told Becker’s. “Rising labor costs, persistent reimbursement pressures, and the capital intensity of digital health and research investments will push organizations to evaluate partnerships that create durable, system-level value.”

Regional trends

Labor cost trends varied modestly by region, with most seeing flat or declining month-over-month figures but continued annual growth.

1. The West and Midwest both saw 1% month-over-month declines, reflecting early signs of cost containment. Still, labor expenses were up 5% and 4% year over year, respectively.

2. The South held steady month to month, maintaining 4% annual growth, mirroring national patterns.

3. The Northeast and Mid-Atlantic also reported a 1% decline from July and posted the smallest year-over-year increase at 3%, indicating gradual normalization after earlier spikes in staffing costs.

4. The Great Plains region was the exception, with labor expenses up 2% month over month and 6% year over year, reflecting continued staffing pressures in smaller, rural hospital markets where workforce shortages remain acute.

Regional variation suggests that while hospitals in major markets may be stabilizing staffing levels, rural and independent facilities continue to face higher labor costs tied to recruitment difficulties and reliance on premium pay.

“We need to search for true solutions and modern innovations that can address the changes we are seeing in population demographics and a new healthcare workforce,” said Stephen Parodi, MD, executive vice president of external affairs, communications and brand at The Permanente Federation in Oakland, Calif. “Delivering more care into homes through team-based approaches that address social, mental, and physical health will be a critical move necessitated by these emerging realities.”

Hospital size

Labor expense growth also diverged by hospital size, highlighting how both ends of the spectrum remain under the most strain.

Hospitals with fewer than 25 beds saw no change month over month, but labor costs were up 8% year to date — the steepest increase of any size group. Smaller hospitals often face limited staffing flexibility and are more vulnerable to contract labor and overtime pressures, driving faster cost escalation.

At the opposite end, hospitals with 500 or more beds also reported flat month-over-month trends, but expenses rose 7% year over year and 6% year to date. These large facilities continue to feel the effects of wage growth for specialized roles, union agreements and retention incentives, particularly in high-acuity and urban markets.

Mid-sized hospitals, ranging from 100 to 499 beds, generally reported stable month-to-month costs with 4–5% year-over-year growth, signaling improved workforce equilibrium after years of high turnover and aggressive recruiting.

Outlook

The August data provides cautious optimism that hospitals are beginning to contain labor expense growth in the short term. However, the consistent 4 to 6% annual increase across most markets points to lingering workforce pressures — especially in nursing, specialty care, and rural recruitment.

Health systems are adapting with strategies such as flexible scheduling, cross-training, and investment in workforce pipelines, but meaningful relief may require broader labor market stabilization. For now, the industry’s focus is shifting from acute cost control to sustaining staffing levels and building long-term workforce resilience.

“Over the next five years those health center C-Suites that will truly thrive will be marked by leadership stability, a strong sense of mutual trust and by continually bringing the very best out of each other and the entire health center workforce,” said Jeffrey Gold, MD, president of the University of Nebraska System in Lincoln. “The willingness and ability to take appropriate risk and to hold each other to the highest possible standards of patient centered service will ultimately define their future of success.”

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Community hospitals are at a crossroads. Shrinking margins, policy shifts like recent legislation, and mounting Medicaid constraints are stretching organizations thin. Yet one thing hasn’t changed: the communities these hospitals serve still need access to high-quality, local care.

Read more about the ways your organization could leverage tools, resources, and digital solutions from the Mayo Clinic Care Network to improve your bottom line.

Small hospitals are asked to do more with less. Less funding. Fewer staff. More complexity. In today’s environment, operational excellence and high-quality care are essential for survival.

The Mayo Clinic Care Network  helps local hospitals:

• Retain high-value patients who might otherwise seek care elsewhere
• Access innovation and expertise without expensive investments
• Strengthen workforce engagement and retention

And the best part? These benefits are delivered in a way that respects your hospital’s identity and autonomy.

Members across the Mayo Clinic Care Network are seeing results: better patient retention, stronger clinical capabilities, and improved financial performance. Take Hancock Health, for instance, where a collaboration with the Mayo Clinic Care Network meant a significant return on investment. 

Before joining, Hancock often lost patients after referring them out for second opinions. But with access to eConsults and eBoards, they began retaining 80 high-value oncology patients annually, generating $800,000 in revenue. Add brand visibility and direct Mayo Clinic referrals, and the annual impact reached $1.1 million.

“We wanted to find a way to keep patients here,” said Steven Long, CEO of Hancock Health. “Now, they see our name next to Mayo Clinic’s and they stay.”

When patients see their local doctor collaborating with Mayo Clinic specialists, it reinforces trust in their care. That confidence fuels word-of-mouth referrals and draws new patients who previously may have gone elsewhere. Providers also feel empowered knowing they can access peer expertise while maintaining autonomy.

Through the Mayo Clinic Care Network, members have access to:

• eConsults: Providers consult with a Mayo Clinic specialist and receive a fully documented, asynchronous second opinion at no extra cost to patients. 
• AskMayoExpert: For non-urgent cases, providers access Mayo Clinic’s standardized practices on hundreds of medical conditions to determine the need for tests or referrals.  
• Inpatient telephone consultations:  Providers speak directly with a Mayo Clinic specialist over the phone to get on-demand guidance for hospitalized patients in need, or for urgent and semi-urgent intervention. 
• Health Care Consulting: Providers access Mayo Clinic’s practical experience and subject matter expertise through projects and information exchanges.

With this collaboration, it’s possible to build out service-line expertise, boost revenue, and make a real impact on the health of your local community. In this video, Wellstar Health System physicians share just that—their success in launching a left ventricular assist device (LVAD) program with Care Network support. It’s a program that not only brings advanced heart care closer to home but also demonstrates the power of shared expertise.

Local hospitals need a direct, cost-effective way to improve their bottom line when every dollar counts. Mayo Clinic Platform offers a suite of qualified solutions that drive real financial results. Members can:

• Decrease uncompensated care: Utilize artificial intelligence to identify patients who may qualify for additional benefits with an end-to-end benefits navigation solution. 
• Improve coding accuracy: Create a full picture of patient care using a data analytics platform designed to close the clinical insights gaps. 
• Reduce financial burden: A non-disruptive, analytics-driven solution to recover more revenue and preserve patient dignity.

These tools help unlock missed revenue, reduce denials, and support financial resilience, especially for hospitals serving vulnerable populations.

Every hospital leader is asking tough questions right now. But maybe the most important one is this: can we afford not to use every advantage available to us?

The Mayo Clinic Care Network delivers the tools, trust, and transformation that small hospitals need without sacrificing independence or identity. At a time when the stakes couldn’t be higher, the Mayo Clinic Care Network offers a path forward.

Interested in learning more? Reach out to our team .

*Healthleaders Author Bio: Keyoka Kinzy is a senior copywriter at Mayo Clinic Platform, where she helps translate cutting-edge innovation into compelling stories that advance healthcare and inspire a healthier future. Learn more at www.mayoclinicplatform.org.

*Healthleaders Newsletter (CEO) Synopsis: Community hospitals face shrinking margins and rising demands. Discover how the Mayo Clinic Care Network helps organizations stay independent, strengthen care, and improve financial performance through expert collaboration, digital tools, and cost-effective innovation.

Becker’s Synopsis: Your patients want care close to home. See how local hospitals are keeping them local and delivering the best care through the Mayo Clinic Care Network.

The post Beyond the Budget Cuts: How Community Hospitals Can Stop Referring Revenue Away appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Hawaii is the most prepared state to address the healthcare needs of the U.S.’s aging population, while Oregon is the least, according to an analysis by Seniorly. 

Seniorly examined each state across three dimensions — population trends, financial readiness and healthcare capacity — to devise the ranking.

Here are the states ranked from most to least prepared for the impending aging population increase:

Note: This list includes a tie.

1. Hawaii

2. Florida

3. Utah

4. District of Columbia

5. Delaware

6. Massachusetts

7. Alabama

8. New Hampshire

9. Alaska

10. New Jersey

11. Mississippi

12. Vermont

13. Connecticut

14. Arkansas

15. Arizona

16. North Dakota

17. Ohio

18. Nebraska

19. Virginia

20. Minnesota

21. Indiana

22. Kansas

23. Texas

24. Tennessee

25. South Carolina

26. California

27. Pennsylvania

28. Wyoming

29. Maryland

30. Idaho

31. Nevada

32. Iowa

33 (tie). Michigan

33 (tie). Montana

35. West Virginia

36. Georgia

37. North Carolina

38. Wisconsin

39. New York

40. Louisiana

41. Oklahoma

42. Kentucky

43. Maine

44. New Mexico

45. Illinois

46. Washington

47. Colorado

48. Rhode Island

49. South Dakota

50. Missouri

51. Oregon

The post States most, least prepared for aging population: Seniorly appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

In Louisiana, the risk of dying from pregnancy-related causes is more than four times higher than in California, according to a new report from the Commonwealth Fund.

In 2023, Louisiana had one of the highest maternal mortality rates in the U.S., at 41.9 deaths per 100,000 live births. In California, the rate was 9.5 per 100,000 live births. 

The figures are based on final 2023 data from the CDC. For states with fewer than 10 maternal deaths in 2023, the Commonwealth Fund combined 2022 and 2023 data to meet CDC standards for data suppression and ensure comparability. Rates were calculated by dividing the number of maternal deaths by the number of live births and multiplying by 100,000, in accordance with World Health Organization definitions.

Thirteen states and territories — including Alaska, Delaware and Rhode Island —  were excluded from the report due to insufficient death counts, which remained below CDC’s threshold even after combining years.

The report also benchmarks U.S. state-level maternal and child mortality rates against those in 200 countries. California’s maternal death rate is comparable to Canada’s 9.4 and Kazakhstan’s 10.0, while Louisiana falls between Mexico’s 41.7 and the Seychelles’ 42.0.

“Historically, states that invest more in health coverage, reproductive care and social protections tend to have better health outcomes, in some cases on par with high-income countries, while states that invest less and pass more restrictive policies have outcomes similar to low- and middle-income or politically unstable countries,” the authors wrote.

Here are states ranked by mortality rate, from lowest to highest, according to the report:

California: 9.5 deaths per 100,000 live births 

Washington: 9.7

Massachusetts: 14.0

Michigan: 14.1

Oregon: 14.1

Pennsylvania: 15.0

Nevada: 15.4

Connecticut 15.7 

New Jersey: 15.8 

Colorado: 16.1 

New York: 17.7 

Minnesota: 17.8

Iowa: 17.9

Maryland: 17.9 

Florida: 18.1 

Ohio: 18.1 

Virginia: 18.3

Illinois: 18.4 

Wisconsin: 18.4 

Alabama: 19.0 

Georgia: 19.2 

Kansas: 20.4 

Nebraska: 20.6

South Carolina: 20.8 

Idaho: 22.3 

Oklahoma: 22.9 

Mississippi: 23.1 

Missouri: 23.8 

Texas: 24.2 

Arizona: 24.3 

Kentucky: 25 

Indiana: 26.6

North Carolina: 26.6 

Arkansas: 31.2 

Tennessee: 31.3 

Louisiana: 41.9 

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U.S. health systems are making primary care a strategic priority, with most planning to expand their footprint and adopt AI tools to improve operations, according to new research from Bain & Company.

The survey, conducted in June, includes responses from 60 health system executives—most from academic medical centers and hospitals with more than $1 billion in revenue—and was complemented by a separate consumer survey of 500 U.S. respondents conducted in September.

Here are seven key findings from the report:

1. Seventy-seven percent of executives said they plan to add more owned practices and employ additional primary care providers over the next five to seven years.
2. While primary care has long served as a referral engine, health systems increasingly see it as central to patient experience, clinical quality and cost management, according to Bain. The survey found that improving medical cost management and fulfilling community commitments are now key drivers for expanding primary care, while generating specialist referrals has become a lower priority.
3. Most executives said their organizations still rely on fee-for-service reimbursement, though many expect to transition toward population-focused clinics with value-based payment models in the coming years.
4. Workforce shortages remain the top concern for health system leaders, ranking ahead of financial sustainability, patient experience and technology, the survey found. Physician recruitment and retention were cited as the most urgent near-term priorities.
5. AI adoption is expected to reshape primary care operations. Executives anticipate the use of e-prescribing tools will grow from 27% to 55% in the next three years, while appointment scheduling technology is projected to rise from 33% to 63%, and telehealth platforms from 38% to 63%.
6. Patients’ comfort with AI tools is also increasing, though skepticism remains. The share of patients comfortable with AI listening and taking notes rose from 21% in 2024 to 60% in 2025, and more than half said they are comfortable with AI analyzing medical results. Yet only about a third said they would trust AI to make a diagnosis, and fewer—28%—would accept an AI doctor.
7. Despite the momentum around digital tools, in-person visits remain the clear preference. Traditional settings had net preference scores of 49% for sick visits and 63% for chronic condition visits, while AI chatbots and retail or pharmacy-based visits ranked lowest.

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As hospitals across the U.S. continue to grapple with financial challenges, cuts and even closures, the toll on rural communities has also increased. In 2025 alone, Becker’s has reported on 21 hospital closures. The effects of these closures can move beyond healthcare, hurting local economies and eroding the sense of community stability.

Becker’s connected with Marquita Lyons-Smith, DNP, APRN, CPNP-PC, Director of the RN-BSN Program at North Carolina Central University in Durham, to discuss the factors driving these closures, consequences for patients and providers and most promising solutions for preserving care access for vulnerable communities.

Editor’s note: Responses have been lightly edited for clarity and length. 

Question: Becker’s has reported on 22 hospital closures so far this year. What do you feel are some of the factors leading to heightened facility closures?

Dr. Marquita Lyons-Smith: It seems several overlapping factors are driving this troubling trend.

First, financial fragility is a major issue; many rural hospitals reportedly operate on extremely thin margins or at a loss, largely because they must maintain 24/7 emergency capacity while serving small populations. Although inpatient census may drop, fixed costs remain, and the margins collapse even further.

Second, reimbursement challenges continue to erode sustainability. Delayed Medicaid & Medicare payments, and low private-insurer reimbursement rates all cripple rural budgets. Hospitals in states that did not expand Medicaid remain especially vulnerable because of high uncompensated care rendered to community members.

Third, several healthcare colleagues endorse the reports of workforce shortages, especially in nursing and obstetrics. Therefore, hospitals have been forced to reduce or eliminate entire service lines, such as labor and delivery, before closing altogether.

Lastly, it does not seem feasible that small facilities have the negotiating power to compete with healthcare giants.

Q: When a rural hospital closes, what are the biggest consequences for the community’s access to care?

MLS: The effects are immediate and profound. The most visible impact is increased travel time. When a rural hospital closes, patients may have to travel 20 to 40 more miles for emergency or maternity care. For stroke, trauma or childbirth, that delay can be life-threatening.

The second consequence is continuity in care. When hesitant healthcare consumers lose convenient access to obstetrics, behavioral health, and other essential care, it can be deprioritized quickly. Acute issues become chronic, and preventive care becomes illness management. We are already seeing “maternity care deserts” expand over a significant percentage of the U.S., leading to reduced mammograms and reduced opportunity to detect breast cancer early or at all.

Economically, the hospital is often a community’s largest employer. Closure can mean hundreds of job losses affecting local businesses. Research also shows per-capita income tends to decline, and unemployment rises after a hospital closure. Finally, there’s a psychological and cultural toll. A rural hospital is more than a health facility, offering a sense of community and security. Losing it can feel like losing the town’s identity.

Q: What solutions, such as telehealth, mobile clinics, or workforce training, show the most promise in addressing these gaps?

MLS: We are seeing encouraging results from several vendor-agnostic, scalable solutions:

• Telehealth and virtual specialty support are critical for connecting rural providers with specialists. They allow patients to receive consults locally, reduce travel, and extend the reach of scarce clinicians. This works best when broadband infrastructure and reimbursement policies align. Also, vulnerable communities need assistance learning to use these resources effectively. Community involvement can help to fill the digital gap experienced by some elderly healthcare consumers.
• Mobile clinics have proven effective for preventive care, screenings, and chronic-disease follow-up. They literally bring care to where people are, an essential strategy in geographically dispersed counties. The collaboration between NCCU and Duke University School of Nursing is an example of using mobile clinics to meet community needs in rural populations.
• Workforce development and retention programs, such as rural residency tracks, “grow-your-own” pipelines, and loan-repayment incentives through HRSA, if they still exist, help build a more stable workforce. Retaining clinicians who are embedded in the community can be just as important as recruiting new ones.

Alternative facility models, such as the Rural Emergency Hospital designation, are emerging as viable options. These facilities can maintain 24-hour emergency services and observation care without the high overhead of inpatient units, supported by enhanced Medicare payments, when larger hospitals are not receiving these designations seemingly undeservingly.

Q: What policy changes or reforms would most help stabilize healthcare access in rural areas?

MLS: A multi-level policy response (federal, state and local):

• Reimbursement reform: Stabilize Medicare and Medicaid rates for rural providers and explore budget models that give hospitals predictable funding tied to community health outcomes rather than volume alone. It is important to have in-house data review experts to choose a mechanism that can consistently retrieve measurable outcome information.
• Provide capital assistance and technical guidance so hospitals can convert to this new model rather than close outright.
• Workforce incentives: Expand loan-forgiveness, training programs, and retention grants targeted to high-need disciplines such as obstetrics, behavioral health, and emergency medicine.
• Infrastructure investment: Rural health access depends on broadband, EMS, and transportation. Support these recommendations as public-health essentials, not luxuries.
• Equity-focused oversight: Data show that closures disproportionately impact communities with higher proportions of Black residents and lower socioeconomic status. Federal and state programs should prioritize funding where the risk is greatest.

Ultimately, rural healthcare sustainability will depend on balancing innovation with equity and supporting local solutions that preserve access while adapting to modern realities.

The post ‘Immediate and profound’: How hospital closures affect rural communities appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

The Georgia Department of Community Health has approved Wellstar Health System’s application to build a $1.1 billion hospital, the Marietta, Ga.-based health system confirmed to Becker’s Oct. 21.

The 230-bed Wellstar Kennestone Regional Medical Center at Acworth (Ga.) is expected to open in 2031.

Wellstar filed a certificate-of-need application in June for the eight-story, 675,000-square-foot facility, which will include 70 emergency department bays and eight operating rooms.

“Several competing health systems filed objections to Wellstar’s application related to this project,” a system spokesperson said in a statement shared with Becker’s. “However, none of those health systems have the commitment and existing operational abilities to meet the current and future medical needs of residents in Cobb, Paulding, Cherokee and Bartow counties and the future need for improved access to hospital services for the Acworth community.”

In its approval letter, the department said it expects the new hospital “will have a positive relationship to the existing healthcare delivery system in the service area,” according to Wellstar.

The project is expected to create more than 1,500 healthcare and related roles.

The post Georgia greenlights $1.1B Wellstar hospital appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Warwick, R.I., is the safest city in the U.S., according to a new analysis published by WalletHub.

The personal finance company released its 2025 “Safest Cities in America” ranking on Oct. 20. The ranking compares 182 cities across three dimensions: home and community safety; natural-disaster risk; and financial safety.

WalletHub subdivided its dimensions across 41 metrics, ranging from presence of terrorist attacks to share of seriously underwater mortgages.

Each metric was graded on a 100-point scale, with 100 representing the highest safety level. WalletHub then calculated a weighted average across all metrics for each state to determine its overall score and ranking.

WalletHub found that Warwick, R.I., has the third-lowest number of aggravated assaults per capita and the 32nd-lowest number of murders out of the cities in the analysis. Warwick also has the seventh-lowest number of thefts per capita. More information on the study’s methodology and the complete listing from WalletHub is available here.

The 10 safest cities, per the analysis:

1. Warwick, R.I.

2. Overland Park, Kan.

3. Burlington, Vt.

4. Juneau, Alaska 

5. Yonkers, N.Y.

6. Casper, Wyo.

7. South Burlington, Vt.

8. Columbia, Md. 

9. Lewiston, Maine

10. Salem, Ore.

The 10 cities at the bottom of WalletHub’s ranking:

1. New Orleans

2. Memphis, Tenn.

3. Baton Rouge, La.

4. Detroit

5. Baltimore

6. Fort Lauderdale, Fla.

7. Houston

8. San Bernardino, Calif.

9. Philadelphia 

10. Cleveland

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Two in 5 U.S. employees work in a “quality” job — one that allows employees to meet basic financial needs, feel safe and respected, expand their skills, have a voice in decisions affecting them and maintain some control over their work, according to the American Job Quality Study.

The study, led by Gallup, Jobs for the Future, the Families & Workers Fund and the W.E. Upjohn Institute, is touted as the first nationally representative survey to measure workers’ experience and assess U.S. job quality. It surveyed 18,429 U.S. adults between Jan. 13 and Feb. 25. Respondents were ages 18-75 and had worked for pay in the seven days prior to taking the survey.

Here are five things to know:

1. The youngest employees surveyed — ages 18-24 — are the least likely to have quality jobs, with only 29% reporting that they do. Men are more likely than women to have quality jobs, at 45% versus 34%.

2. Nearly 30% of employees said they are struggling financially: “just getting by” or finding it difficult to do so. This aligns with employees in the health and medical field, where 22% saying they are “just getting by” and 8% reported finding it difficult.

3. Many U.S. employees said they strongly or somewhat agree they are treated with respect at work, at 46% and 37%, respectively. These figures are comparable to responses from health and medical workers, at 45% and 39%, respectively.

4. Fifty-four percent of workers across industries said they often or sometimes work longer than scheduled, compared to 53% of those in health and medical roles.

5. Quality jobs are tied to better job and life satisfaction. More than half of those with quality jobs said they are “highly satisfied” at work, compared to 23% of those without quality jobs. Those in quality jobs said they are also more likely to feel happy regularly (47%) and report excellent or good health (49%), compared to 26% and 33%, respectively, among those without quality jobs.

The post 40% of US workers have ‘quality’ jobs: Study appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

The FDA has approved bioLytical Laboratories’ Insti HIV self test. The company touts it as the fastest home-use HIV test available in the U.S., with results in 60 seconds or less.

BioLytical said the test provides a private, portable and highly accurate option for individuals to determine their HIV status without needing appointments or lab visits, according to an Oct. 14 news release.

The single-use test requires one drop of blood and is designed to reduce barriers to HIV screening, particularly for individuals who face stigma, cost or geographic obstacles in accessing care.

BioLytical said the new test supports national goals to reduce HIV infections by 90% by 2030. 

The post FDA approves 1-minute HIV self-test appeared first on Becker’s Hospital Review | Healthcare News & Analysis.

Boston-based New England Baptist Hospital has the lowest unplanned readmission rate in the nation, according to CMS.

CMS’ Unplanned Hospital Visits data is based on provider data for hospital return days, including unplanned readmission and unplanned hospital visit measures after outpatient procedures from July 2023 to June 2024. CMS updated the data Aug. 6.

The national hospitalwide readmission rate was 15. A total of 2,125 hospitals have readmission rates under the national average.

Here are the hospitals with the lowest readmission rates in every state: 

Note: This list includes ties in some states.

Alabama
Marshall Medical Centers (Boaz): 13.3

Alaska
Providence Alaska Medical Center (Anchorage): 13.7

Arizona
Phoenix VA Medical Center: 12.9

Arkansas
Washington Regional Medical Center (Fayetteville): 13.3

California
Providence St. Joseph Hospital (Eureka): 12.5

Colorado
Poudre Valley Hospital (Fort Collins): 12.8

Connecticut
Griffin Hospital (Derby): 13.6

Delaware
Christiana Hospital (Newark): 14.5

Florida
Cleveland Clinic Indian River Hospital (Vero Beach): 13.5

Georgia
Turning Point Hospital (Moultrie): 13.3

Hawaii
Straub Clinic and Hospital (Honolulu): 13.8

Idaho
St. Luke’s Regional Medical Center (Boise): 12.4

Illinois
Proctor Hospital (Peoria): 13.3

Indiana
OrthoIndy Hospital (Indianapolis): 13.0

Iowa
MercyOne Newton Medical Center (Newton): 13.4
Southeast Iowa Regional Medical Center (West Burlington): 13.4

Kansas
Kansas City Orthopaedic Institute (Leawood): 12.9
Kansas Spine and Specialty Hospital (Wichita): 12.9

Kentucky
Spring View Hospital (Lebanon): 14.0

Louisiana
Avala (Covington): 14.0

Maine
Northern Light Eastern Maine Medical Center (Bangor): 13.4

Maryland
University of Maryland Shore Medical Center at Easton: 12.6

Massachusetts
New England Baptist Hospital (Boston): 11.7

Michigan
Trinity Health Muskegon Hospital: 12.9

Minnesota
M Health Fairview Southdale Hospital (Edina): 13.1
Mayo Clinic Health System-Mankato: 13.1

Mississippi
VA Gulf Coast Healthcare System (Biloxi): 13.5

Missouri
Mosaic Medical Center-Maryville: 13.6
Boone Hospital Center (Columbia): 13.6

Montana
Intermountain Health St. Vincent Regional Hospital (Billings): 13.3

Nebraska
CHI Health Nebraska Heart (Lincoln): 13.3

Nevada
Northern Nevada Medical Center (Sparks): 13.9

New Hampshire
Exeter Hospital: 14.0

New Jersey
Chilton Medical Center (Pompton Plains): 13.5

New Mexico
Christus St. Vincent Regional Medical Center (Santa Fe): 13.7

New York
Hospital for Special Surgery (New York City): 11.9

North Carolina
W.G. (Bill) Hefner Salisbury VA Medical Center: 12.8

North Dakota
CHI St. Alexius Health Dickinson: 13.6

Ohio
Selby General Hospital (Marietta): 13.4

Oklahoma
Hillcrest Hospital South (Tulsa): 13.0

Oregon
Sacred Heart Medical Center-RiverBend (Springfield): 12.8

Pennsylvania
WellSpan Ephrata Community Hospital: 13.5

Rhode Island
Westerly Hospital: 13.9

South Carolina
Columbia SC VA Medical Center: 12.8

South Dakota
Black Hills Surgical Hospital (Rapid City): 12.6

Tennessee
Vanderbilt Bedford Hospital (Shelbyville): 13.6

Texas
Baylor Scott & White Texas Spine & Joint Hospital (Tyler): 13.4

Utah
Intermountain Medical Center (Murray): 13.1

Vermont
Northwestern Medical Center (St. Albans): 14.0

Virginia
Inova Alexandria Hospital: 13.1
Sentara Williamsburg Regional Medical Center: 13.1
Sentara Martha Jefferson Hospital (Charlottesville): 13.1

Washington
Providence Holy Family Hospital (Spokane): 12.7

West Virginia
Martinsburg VA Medical Center: 13.7

Wisconsin
ThedaCare Regional Medical Center-Appleton: 13.1

Wyoming
Sheridan Memorial Hospital: 13.9

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