Insurance, the tax bill, and where we go from here.

By Rich Smith, 12-06-2017

I've been in this industry for 14 years, and I've seen a lot of changes. When I started, it was all about which agencies had the hospital contracts. That drove the business. We faxed profiles to hospitals back then. Email was pretty much just an internal communication device. There was no Facebook. We had the Delphi Forums, but those really didn't help anyone. Heck, there wasn't even a Joint Commission. The company I started with was one of the first in the country to get certified. It was a very different time that formed the industry that we know today. But even with all that, common themes were there. Specifically, loyalty and trust. It wasn't an agency priority, but they were there.

Then came the downturn in 2008. The stock market tanked, and because of that hospitals had less money to spend on traveling nurses. They worked the heck out of their perm staff, and nurse burnout was at its highest ever. Retired nurses re-entered the workforce and cut the need for temporary or contract staff. It didn't look good for our industry. Larger agencies cut internal staff. Many smaller agencies closed.

Luckily, we came out of it. The Obama Administration gave us the Affordable Care Act. Regardless of your political views, the effects of a program like this had a profound impact on the travel nurse staffing industry. Injecting that many people into the healthcare system created a huge need for staff. Data from the US Census Bureau shows that the net number of non-elderly, newly insured rose dramatically from 2009 to 2015. Couple this the retirement of the baby boomer generation and all of a sudden the nurses that were once an asset to the hospital system became a liability. They left care side of the equation, and moved to the need care side. It's effect on the hospital system hits twice as hard.

So what does this mean now? The Senate tax bill has cut out the ACA individual mandate. That doesn't mean anything until it's signed, but you can't just take that many people out of the system once they are in there. Access to quality healthcare is a right, not a privilege. That's not a political statement, it's simply a fact. On the agency side, it means the short term approach is over. The absentee company, high margin smash and grab days are over. Agency success and growth from this point on will be measured by who has the strongest base of nurses traveling for them. The agencies that have earned your trust, and can stay true to who they are as they grow. The ones that take care of you when you are out there taking care of your patients in the hospitals. No bill or government mandate can change that. The world is getting smaller, and with that comes more connections to each other. Nothing can change that either. Loyalty and trust will win.