Staffing Robot - Healthcare Staffing Technology, Design & Marketing Blog

Healthcare Reform, Healthcare Staffing & Civility

Last week Healthcare Reform legislation was finally made into law. It's no secret that I've been a big proponent of this idea and written several blog posts on how healthcare reform will affect healthcare staffing agencies. Although I'm happy this legislation exists and will hopefully continue to improve I am disappointed it didn't go far enough. My hope was that we would have a universal healthcare system with coverage for all. Not yet it seems.

I've already blogged about how I believe healthcare reform will benefit the healthcare staffing industry and mentioned articles where some of the nation's largest medical staffing agency CEOs also state that healthcare reform will benefit the industry. Therefore, there's no reason to repeat myself. Now that the legislation is on the books and more details are known, I'm sticking with my prediction that this legislation will be positive for the healthcare staffing industry.

Of course, how this legislation is carried out will determine the exact changes we all see and feel. There are several sources around the web that have posted summaries on some of the most immediate changes the healthcare reform legislation will make.

To me, the biggest question here is about the cost and potential tax increases we will all face as individuals and businesses. According to this interactive tool from the Washington Post, neither my premiums nor my personal taxes will increase due to healthcare reform. The really good news is that my premiums were expected to rise between 10-15% before "Obamacare," so I'm going to see this as being positive.

For businesses, it now appears that not providing health insurance to your employees will earn you a penalty. It will be interesting to see if this legislation changes the classifications or definitions of employees as to when insurance has to be provided. However, most large companies already provide insurance for all of their internal employees and offer it as a benefit to their field staff who meet qualifying hours. Therefore, there should be no impact to most healthcare staffing agencies in this regard. For new and small healthcare staffing companies (under 50 employees) there is even better news. Not only will these companies avoid potential penalties for lack of employee insurance provisions, they can qualify for stipends to provide insurance to their employees. This will offer tremendous assistance to start-up companies who otherwise couldn't offer coverage.

Unfortunately, big businesses will most likely see a tax increase to help pay for all the new legislation. Although I'm not a fan of paying more in taxes, I'm also not 'anti-tax' across the board. Paying taxes for certain things that benefit society, such as healthcare, is a good thing. I'm one of those crazies that believes in the greater good so I'm willing to pay a little more for it.

Many people disagree with this view completely and feel that healthcare reform is nothing short of socialism and the end of the American Empire. During a recent webinar hosted by the Staffing Industry Analysts, many CEO's of large staffing companies were discussing how detrimental this legislation will be to their business and all the other horrible things healthcare reform will bring. I've even had people on my blog leave comments and send me emails suggesting the same. For example, Randy Mensinger from Custom Healthcare left a comment on one of my healthcare reform blog posts stating he feels this will put the company he works for (and many others) out of business. He was so upset with my opinion that he even followed up on my comment with an email full of obscenities and calling me all kinds of things I won't repeat here.

So obviously not everyone shares my opinion. I'm willing to admit I could be wrong. If I am and businesses have to start carrying such a heavy tax burden that it puts them out of business I'll be right back here advocating against healthcare reform. I completely respect an opposing view and honest debate on healthcare reform. However, there are several things I don't understand, such as:

1. Being disrespectful and unprofessional to each other. It doesn't matter who you are, but, if you work for or represent a staffing company in our small industry I don't think it benefits you in any way to be unprofessional and disrespectful.
2. Where was the vociferous anti-tax movement during the bush years when we were spending trillions of dollars on an unjust war that was started for made up reasons? Perhaps if we hadn't spent so much money then (and now) we'd have money for things like healthcare for our citizens.
3. Many people are up in arms about the mandate that every American will be required to have health insurance. However, the health insurance mandates are actually a Republican idea. These mandates are only going to benefit the health insurance industry and those politicians beholden to this industry. So clearly their outcry is merely political posturing.
4. Even if you're against the new legislation what exactly is getting people so angry about healthcare reform? How is providing health coverage to our citizens something to get violent over?

No matter how you feel, what we all really need is information, facts and a real debate. Much of the information coming from the media is full of sensational, unfounded claims. It's not only irresponsible, it's dangerous. Unfortunately, without reinstating the Fairness Doctrine it's only going to get worse. For example, this video:

I'm all for free speech but when this much hateful, misinformed rhetoric is pumped through the media for several hours a day, every day, it's no wonder people are resorting to violence against members of congress over something like healthcare reform. There are many reasons justifying the call for revolution. However, I assure you, healthcare reform is not one of them.

In summary, I truly believe that healthcare reform will benefit us as individuals and as a country. It will be a huge win for the healthcare staffing industry. That said, I'm not a fan of the government and will watch the outcomes of this legislation closely and with a critical eye. I am also willing to admit when I'm wrong. Therefore, if the sky starts falling or we witness the collapse and devastation of the medical staffing industry, you'll see me at the next tea party rally.

I hope the opposite is also true. If you're an opponent of this legislation and none of these horrible things come to pass it would be great to hear you admit you were wrong someday.

Time will tell.

I Want A Search Engine, Not A Decision Engine

Over the last few weeks I've been to several online marketing conferences that specifically focused on Search Engine Optimization (SEO) and Marketing (SEM) strategies. Bing was a big sponsor of all of these conferences so I got to hear several Bing employees talk about the benefits of their new search engine and I also got to try it out myself.

Bing's marketing campaign is promoting that they are not a search engine, but rather, a 'decision engine.' Bing is focused on better understanding user intent and displaying fewer, but more relevant/accurate results based on your intent. Since their inception, search engines have always been on a mission to better understand user intent and deliver better results so in a sense, this is not new. In addition, with Google's recent introduction of personal search results they too seem to be headed further down this path.

In theory, this all sounds great to me. However, I personally don't like where this could lead. Bing seems to be narrowing the results returned based on the assumption that they better understand your intent. They make it more of an effort to get passed these limited options and expand your search in case they got it wrong.

Others are getting into the game as well. Take a look at this screen shot from Travelocity. In performing a search for a plane ticket I was presented with one option they selected for me based on what they felt was my 'intent.' Not only were they wrong but it is somewhat frustrating and confusing to expand the search results and chose the best flight for my trip.

What was most interesting to me during this process though was how I felt about it. Even if the trip Travelocity presented to me was the cheapest, fastest, best flight available I had one simple problem with the selection presented to me. My problem was that I didn't have choice. Call me old fashion but I'm not yet ready for the machines to start making all of my decisions.

Although the convenience and efficiency of a decision engine is somewhat appealing for many reasons, personally, I want to have the ability to choose for the following reasons:

1. I don't follow the crowd. If the decision engine is presenting options to me based on aggregated user data I can guarantee that 80% of the time it's going to be wrong. I find I tend to not follow the crowd all that often and I don't want to start.
2. Brand trust. I need to have significant trust in a brand before I will allow it to make decisions for me. I assure you, I don't have that trust in Travelocity or Microsoft. In fact, I can't think of any brands I trust this much.
3. The end of discovery. If these decision engines make our choices for us pretty soon all the available tools will have the same problem Apple's app store has. All of the 'popular' items will bubble to the top and new, innovative, exciting options will never get discovered because they never get 'recommended'. Once something is deemed popular it's like trying to beat an incumbent politician. It's somewhat of a frightening prospect to think how limiting search results will stifle information and decision making. Imagine how it would be if every time a hospital searched for 'healthcare staffing agency' they were presented only with the selection of On Assignment. It's great if you're On Assignment, but not so great if you're - any other agency.
4. Choice. Even if the engines are using 'my preferences' to present me with optionsm I still want to have the final decision. In fact, I don't want the results to be skewed in any way toward my previous choices because who's to say my preferences won't change from one day to the next. I certainly don't think the robots know better than I.

Again, I'm all for more accurate and relevant search results being presented to me. However, I want the option to opt in to any decision making functionality each time I engage with the product. Further, I don't want the options presented limited for any reason. I still want to choose. I want a search engine, not a decision engine.

Bankruptcy Possible for Medical Staffing Network

The economy continues to take its toll on the healthcare staffing industry. Even the largest healthcare staffing agencies can't seem to find any shelter.

Yesterday, one of the largest healthcare staffing firms in the nation, Medical Staffing Network Holdings Inc., warned investors that it could file for Chapter 11 in bankruptcy court to fend off its lenders from enforcing a default. MSN also stated that they are continuing discussions with lenders over a default.

MSN's filing with the Securities and Exchange Commission on Wednesday, said it has been out of compliance with the terms of its first lien credit agreement with General Electric Capital Corp. since Dec. 27. MSN's situation was exacerbated by a significant drop in their 2009 revenue.

As of today, Medical Staffing Network has yet to report its full 2009 results. However, in 2009 MSN lost $20 million of revenue in the first three quarters, on revenue of $265.2 million. This was a 37% decline in sales from the same period in 2008.

“The company believes that based on currently projected cash inflows generated from operations, it is possible that the company may be unable to pay future scheduled interest and principal payments due to its senior lenders as such obligations become due,” Medical Staffing Network stated in the SEC filing.

Boca Raton FL-based Medical Staffing Network Holdings ranked No. 4 on Staffing Industry Analysts' list of largest healthcare staffing firms.

Medical Staffing Network also runs a Managed Services Program (MSP) called One Source. Hopefully the staffing suppliers that subcontract with them have their money secured with an escrow account. It would be incredibly detrimental to the industry to have yet another VMS/MSP go bankrupt and leave their staffing suppliers with millions in owed revenue.

Broadlane WFX Rebrands to Prolucent & Some Rebranding Tips

A couple of months ago I wrote about AMN's re-branding campaign. Now, another major player in the healthcare staffing industry has gone through a similar effort. Broadlane's Workforce Management Services has rebranded itself from Broandlane WFX to Prolucent.

If you're considering a rebranding campaign for your staffing agency now is the perfect time to do it. The trends in the healthcare staffing industry have been bleak over the last 1.5 years. However, as things start to pick up again hospitals will be re-evaluating their staffing agency partners. Approaching them with an improved identity, renewed focus and new service offerings can go along way toward keeping the attention of your clients or getting new ones to notice you.

If you do decide to rebrand I offer the following tips:

1. Make sure you understand what all is involved with this effort. A brand is more than a logo. You don't want to simply update your logo or website and overlook the rest of your promotional material. Promoting an inconsistent brand sends a bad message to the market. 
2. If you rename your company or product chose something that's easy to pronounce. Although 'Broadlane WFX' wasn't a great name, I'm not sure the name 'Prolucent' is any better. Many people are going to spend time trying to figure out how to pronounce it or just skip the exercise all together and continue to call them Broadlane. Further, if you change your company name to something in another language (say for example 'Concerro') be sure the name means what you think it does.
3. Do your homework and work with reputable companies that know what they're doing and won't overcharge you. If you don't know where to start contact me and I can help point you in the right direction.

Changing your brand can be tricky and if done incorrectly, it can be disastrous. There is a lot to consider, including the current equity your brand has or doesn't have, before going down this path. However, if AMN can pull it off with all the equity they had in their brand, most likely you can too too.

Favorite Healthcare Nurses Week Video Contest

Favorite Healthcare is sponsoring a contest for National Nurses Week this year. They are asking you to submit a picture or short video of you and your nursing friends. From the submitted entries, Favorite Healthcare will create a video and launch it on YouTube for Nurses Week. 

All participants will be entered in a raffle to win one of three Netbooks.

To participate, submit your pictures and videos by April 23rd, along with your contact information, to YouTube@FavoriteStaffing.com.

To kick it off, Favorite Healthcare has made their own video. You can watch it here.

Revenue Continues to Drop for Major Healthcare Staffing Firms

The top two staffing agencies in the industry continue to see their revenue decline.

Yesterday, Cross Country Healthcare Inc. reported a fourth-quarter revenue decline of 39.7% to $124.1 million from fourth quarter 2008 revenue of $205.9 million. In addition, Cross Country's nurse and allied staffing revenue fell 47.1% on a year-over-year basis to $65.4 million. However, on a slightly positive note, their revenue in this area rose 2.1% sequentially from the third quarter. They also reported fourth-quarter net income of $398,000 compared with a net loss of $161.3 million in the same period in the previous year.

Today, AMN Healthcare announced similar numbers. AMN reported fourth-quarter revenue fell 51.1% on a year-over-year basis to $144.7 million. However, their relative good news was that their gross margins improved, reporting improvements from 25.7% to 28.4% from the previous years quarter. AMN's fourth-quarter nurse and allied healthcare staffing revenue also fell 64.3% to $74.0 million from $207.3 million in the year-ago quarter. Unlike Cross Country, revenue in the segment fell 9.9% sequentially from the third quarter.

"I'm certain most would agree that 2009 represented the most challenging year in the history of the healthcare staffing industry," President and CEO Susan Nowakowski said. "The unprecedented rise in unemployment and severe economic contraction wreaked havoc and resulted in precipitous drops in demand volumes unlike any other time."

Sadly, signs of economic recovery for the healthcare staffing industry still seem distant.