“ Around the country , employer-sponsored health insurance plans pay higher rates to health care providers to help subsidize the underpayment of their state ’ s government programs ,” Kaufman says . “ PEIA is particularly problematic in that the program pays providers half of what Medicare pays while in other states their state employee health insurance plans are similar to other employer-sponsored plans .”
Kaufman adds that PEIA currently pays out-of-state hospitals nearly five times more than West Virginia hospitals for the same service . This is because , in West Virginia , policymakers set the payment rate for hospitals and providers , but for out-of-state , PEIA negotiates with providers through United Health Care , the largest insurance company in the nation .
“ This payment differential puts West Virginia providers at a severe disadvantage as these out-of-state providers can recruit our nurses and doctors away by offering higher pay ,” says Kaufman . “ The sad part is they are doing this with West Virginia dollars .”
The problem of a nursing shortage isn ’ t unique to West Virginia , either . Nationally there are more than 250,000 vacant nursing positions , according to Kaufman . As West Virginia competes for the limited number of health care professionals nationally , the state ’ s greater reliance on government payers and what they pay to hospitals limits their ability to offer competitive salaries and benefits .
While the focus has centered around the nursing shortage , Kaufman adds that West Virginia hospitals are also reporting shortages in every clinical and non-clinical area , with shortages in laboratory services , radiology and respiratory therapy , as well as high turnovers in environmental services and food service staff .
“ These areas are particularly important because while a restaurant can limit its hours , a hospital cares and feeds not only its staff , but patients and families , 24 hours a day , seven days a week ,” Kaufman says . “ What this means for patients is longer wait times for services . To put things into perspective , while West Virginia hospitals are licensed for roughly 6,700 hospital beds , in August 2022 , we were only able to staff approximately 4,750 .”
According to Kaufman , even from August 2022 , West Virginia hospitals have seen a decline of roughly 15 % in staffed hospital beds .
In rural West Virginia community hospitals , the strain of the worker shortage hits even harder . As smaller communities continue to see population losses , especially of young people , the staffing issue is especially challenging . Since the staff at these hospitals are much smaller , the loss of just one nurse can have a major impact .
“ This is why we need everyone — caregivers , patients , families and the broader community — to work with health care providers to help us ensure access to care is there for everyone who needs it ,” says Kaufman .
The staffing shortage has meant that patients are waiting longer for services , especially non-emergency services , and the consequences of delays have been felt particularly hard in mental health , especially for children .
“ Over the past few years , we have seen children and teens in our emergency rooms awaiting care and transfer to psychiatric hospitals or community-based services ,” Kaufman says . “ Acute care hospitals generally focus on medical conditions and are not the right place for these children needing mental or behavioral health services . However , because of a national shortage of mental health providers , these children are brought to emergency rooms awaiting care for days and weeks .”
To help address the crisis , hospitals are working with the state to improve the systems of care , expanding the awareness of community resources with an effort to reduce the need for crisis intervention , while also working to expand capacity for pediatric mental health services in West Virginia .
Dr . Angie Settle , CEO , DNP , APRN , BC , FNP , of West Virginia Health Right Inc ., added that the COVID-19 pandemic only exacerbated behavioral and mental health disorders .
“ Those who were controlling their anxiety suddenly found themselves unable to manage due to the overwhelming fear of the unknown caused by the COVID pandemic ,” she says . “ The sky is falling feeling paired with the need for many medical facilities to focus on emergency care only led to feelings of detachment to their medical provider lifelines .”
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