Healthcare Staffing Companies Poised For Growth Amid Nursing Shortage

The United States is currently facing a healthcare staffing crisis, based primarily in a shortage of nurses. There is a growing need for nurses, especially travel nurses, and the problem is anticipated to become more acute in the next year. Since 2006, patients have won significant settlements from hospitals for negligence due to nursing shortage, and as the cost of hiring too few nurses comes to outweigh the cost of adequately employing, healthcare staffing companies should have definite growth.

People who feared that healthcare staffing would slow in today’s shaky economy and sold their shares in such companies now regret the decision, as these businesses have jumped in value. Shares of several companies providing travel nurses and temporary physicians initially fell due to fear in our current recession, but have since rebounded sharply.

According to BMO Capital Markets analyst Jeffrey Silber, “an aging population and advances in medical technology should drive demand, while supply may be constrained as caregivers age with few replacements coming through the pipeline. This should bode well for healthcare staffing supplier stocks.”

Silber estimated a travel-nurse staffing revenue of $2.5 billion annually, which is 21 percent of total healthcare staffing revenue. The growth forecast for travel nurses is set particularly slow as tough times push people towards stable jobs at home. He also pointed out that growth in the travel-nursing segment is estimated at 3.5 percent in 2009, compared with 8 percent in 2006.

This has not, however, affected many healthcare staffing companies. For hospitals to even maintain current (depleted) numbers of nurses, they must continue to hire new nurses on a regular basis. The U.S. Bureau of Labor Statistics reported that the median age of registered nurses (RNs) was 45 years in 2007. Also, another study reported that a third of all current nurses plan to leave their job within the next year.

Furthermore, staffing companies specializing in travel nurses are expected to continue to do well financially because of the nature of the job of travel nurse. These healthcare workers are employed by hospitals from around one to four months, so staffing companies increase their profit margins because of the rise in billed rates.

How Accounting Software Can Reduce Operating Expenses For Healthcare Organizations

Technology is front and center for healthcare organizations in 2010. Especially prominent is the HITECH Act of 2009 and its substantial impact on finances, human resources, Medicare payments, and the technology requirements to support these areas. Increasing federal regulatory compliance, accompanied by a heavy burden of standards and mandates, can make it seem overwhelming to weigh all issues and needs regarding technology for healthcare organizations.

Every industry experiences periods of transformation around their IT infrastructure and the business automation that introduces new efficiencies. The healthcare industry is now in the midst of its makeover. Substantial investments and change have already been made in medical and patient technology; however, the same level of change has not been duplicated in the business infrastructure of many healthcare organizations.

With so many technology demands to consider around electronic health records and healthcare IT, why should finance executives in the healthcare industry scrutinize their accounting software in 2010?

There are four reasons why healthcare organizations should evaluate and implement better accounting software this year in order to establish seamless, automated business processes that connect front office to back office and give healthcare professionals more time and resources to devote to their mission – excellent care for patients:

1. Data Integration Across Systems Helps Deliver Affordable Healthcare

With integrated systems, technology increases efficiencies, maintains quality of care and is not simply a way to cut costs. A typical healthcare organization is bogged down by paper-based data collection and runs dozens of disconnected systems and a plethora of patient billing and records solutions. Good accounting software is able to integrate with these systems to bring the information into the back office. You also need to automate the flow of financial information across internal systems and health plans with insurance claims, including a range of government organizations.

High quality service must remain constant amidst continuously evolving technology, but finding ways to reduce the costs of quality care is also imperative. Accounting software that integrates with other systems can dramatically improve operational efficiencies, reduce administrative costs, and ultimately free up cash for better, more affordable patient care.

Providing high quality healthcare takes a unified team of doctors, nurses, specialists and clinicians. A healthcare organization’s technology platform should incorporate the same collaborative approach so all systems, including accounting software, work together and enable automated business processes that streamline the way information is created, collected, accessed and shared.

2. Improve Operating Efficiencies

Accounting staff in many healthcare organizations today are overburdened with increasing pressures from internal and external demands. As other areas of a healthcare organization or practice advance due to technology investments, the organization now expects quicker turnaround on requests and more financial information. Externally, many of the requirements from HIPPA, Sarbanes-Oxley, and HHS-GIO present challenges that are initially often overlooked for the finance team. Today, a top accounting system can help a small finance staff more efficiently address payroll/HR requests, automate expense reporting and purchase requisitions management, provide a paperless workflow around payables management, and much more.

Many healthcare organizations are only using accounting software as a tool to present their practice to external users for financing, tax returns, and owners, rather than as a system to help improve the quality of patient care, reduce costs, or to increase revenues.

A recent study by Ivans, Inc. concluded administrative inefficiency and redundant paperwork account for 18% of healthcare waste. The study also notes many healthcare facilities still operate with older technology infrastructures, and by updating these infrastructures and operating systems they will experience immediate benefits.[1]

In the same way improved efficiency in medical care drives down costs while maintaining excellent patient care, increased efficiency in your business software and operations enables you to provide improved levels of service to patients with fewer resources.

Today’s accounting software lets you do more with less, with a high and rapid return on your investment.

3. Increasing Need for Business Intelligence

The importance of solid business intelligence and the demand for predictive analytics will grow in healthcare over the next few years in order to respond to the needs to increase revenue, reduce costs and comply with industry regulations and standards.

A 2009 Gartner paper predicted, “Through 2012, more than 35 percent of the top 5,000 global companies will regularly fail to make insightful decisions about significant changes in their business and markets.”[2]

It’s not just about having an abundance of data. Good accounting software reveals relationships between data rather than merely making data more accessible. Your data should provide deeper insight to help you make better business decisions. When electronic health records become more pervasive, healthcare organizations will have the ability to do more complex analysis than ever before. Your accounting software should provide strong reporting features with the ability to report by locations, departments, physicians, and service lines.

4. Good Data Quality and Management Ensures Compliance

It is complex and costly for healthcare organizations to comply with government regulations, industry standards, or corporate quality. Powerful accounting software helps healthcare organizations reduce the cost of regulatory compliance, lessens the risk of compliance failure, and protects company assets. Your accounting system should provide strong financial controls and audit trails, as well as the reporting needed for monitoring critical business processes or company assets. A system with built-in business alerts also reports attempts to bypass internal control procedures.

Why 2010 is the Year for New Accounting Software

Your accounting and business software is at the heart of your organization’s success. Now is an excellent time to take a holistic approach with your software applications so they all integrate as seamlessly as possible and provide the detail-rich, sophisticated data and reporting features you need at the lowest cost.

A stable, scalable accounting platform that is the right solution for your organization quickly demonstrates return on investment, drastically reduces administrative expenses, and increases operational efficiencies. Most important, it enables you to invest necessary, crucial funds in the well being of your patients.

[1] IVANS Healthcare Provider Spot Survey: Healthcare Provider Opinions on Reform, Technology and Proposed Medicare Cuts, November 2009

[2] Gartner Business Intelligence Summit 2009, Analysts Discuss Business Intelligence Challenges and Opportunities, January 20-22, 2009, The Hague, Netherlands

Robert M. Callanan, CPA, is President of Business Ready Solutions, LLC. He is an authority in the design, implementation and support of integrated, multi-user accounting and management reporting systems, and is at the forefront of integrating computers and software into corporate accounting services.

Business Ready Solutions, LLC, located in Durham, NC provides Microsoft Dynamics GP software implementation and support along with business process and accounting consulting. Its team of accountants, CPAs, and Microsoft Certified Professionals has the accounting/finance background and technology expertise to improve your business process and maximize your technology investment.

The Role of a Securities Analyst and Their Biases

It is important to first understand the function of a securities analyst at a brokerage firm. Brokerage firms are Wall Street investment banking firms on the sell side, “selling” investment securities primarily to institutional investors.

Unlike a stock analyst at a mutual fund, bank, or investment management firm, research analysts at a brokerage firm do not cater their research to portfolio managers. Their job is to research a particular industry sector and “sell” their research to the brokerage’s institutional clients.

Analysts narrow their focus on a limited number of companies to track them as thoroughly as possible. They want to be knowledgeable about as many details as possible so they can best assess how both internal and external factors will impact the company.

Having assessed the industry and an individual company’s outlook, analysts must then conclude if the company’s stocks are desirable investments (a Buy rating), have a high probability of devaluation (a Sell rating) or rate them somewhere between, and summarize their conclusions in a research report. All of the companies an analyst tracks must be observed and scrutinized continually, and the assessments communicated to various audiences, including: the brokerage firm’s institutional investor clients, the in-house sales force and traders on the desk, and outside media sources.

Brokerage research analysts do not deal with individual investors or their financial consultants. Rather, they are marketing their views to institutional investors.

The sales force at the brokerage firm caters first and foremost to institutional clients–mutual funds, hedge funds, pension funds, banks, and others. The sales force is continually relaying their analysts’ research to these firms.

While research analysts are required to assign ratings such as “Buy” or “Sell” to investments, institutional investors do not stress these ratings so much as an analyst’s industry knowledge. In fact, the analysts that were ranked highest in an Institutional Investor (II) magazine poll had some of the worst stock picks.

While brokerage analysts typically excel at providing thorough and analytical research about an industry and its companies, their record of rating stocks accurately is mediocre at best. This is because perceptive analysis and an astute understanding of companies and industries have little influence over an analyst’s investment recommendations.

The Wall Street system encourages this trend for five primary reasons:

1. Analyst Compensation. Analysts are compensated for their status on the Street, their access to CEOs, their profile and clout, and depth of knowledge as opposed to the accuracy of their investment ratings. Salaries depend on institutional client polls (e.g. the annual II rankings), their overall influence on the Street, institutional sales and trading evaluations, and generally subjective assessments by research department management.

There are no quantitative performance measurements. Author Stephen T. McClellan of the book “Full of Bull” goes so far as to say to “discount any flamboyant opinion upgrades from April to June” because the timing is suspiciously during when II votes are being angled for.

Consider that in 2006 the mean compensation for an II ranked analyst was $1.4 million versus $590,000 for un-ranked senior analysts. These kinds of incentives tarnish what should be more objective research.

2. Analyst Pressures. Analysts are risk averse to being wrong so they are typically late to change ratings. Brokerage analysts are often harshly critiqued so their reasons for choosing to downgrade a stock from a Hold to a Sell must be nearly unquestionable.

Most choose to ignore negative changes in a company for too long so that by the time the evidence is undeniable, most of a stock’s losses have already happened. For instance, only after Lehman Brothers’ stock fell from $80 per share to $7 did the three largest firms on Wall Street finally downgrade their ratings.

Additionally, brokerage firms realize that a shift of opinion from Hold to Sell will compel only a small portion of stock owners to sell the stock, thereby creating a commission for the firm. On the other hand, an upgrade to a Buy opinion is more easily marketed to all the firm’s investors and will generate vastly more transactions and commissions.

Analysts are therefore incentivized to rate stocks higher than they otherwise might. Consequently, it is virtually impossible to understand how enthusiastic or skeptical an analyst truly is simply from their published ratings.

A rating of Underperform could mean either the analyst suspects the stock will fall within a year or that it will not appreciate as much as its competitors with higher ratings. Conversely, a Hold rating could imply either that the analyst is leaning toward an upgrade to Buy but does not yet have enough evidence or that company’s outlook is poor, but they fear upsetting interested parties by downgrading to a Sell.

3. The Street’s Short Term Bias. Wall Street favors stocks that are rising now, not those that require patience to see significant upside. Just as downgrades are typically late, so too are upgrades to Buy.

Quarterly earnings reports are the Street’s “paramount milestone.” They carry considerable influence over stock valuation and are analyzed critically. Institutions are “trapped on the treadmill of quarterly performance evaluations” with very short investment time horizons.

Individual investors must recognize that analysts are writing for an audience of traders not investors. Analysts are torn between looking at long-term indicators such as earnings estimates or price targets, and the demands of institutional players such as mutual funds who measure performance quarterly and use those figures to compare themselves to the competition.

Consequently, analyst recommendations usually reflect how the stock might perform in a one to five month time span, not one to two years. Lastly, analysts are forced to make quick calls rather than quality ones. Once they have chosen a position, it is more likely they will stick with it even if later evidence suggests something else.

4. The Street’s Positive Bias. This positive bias is analogous to the auto industry. Regardless of the market, auto dealers have a vested interest to always say “buy.”

Similarly, Wall Street has a distorted number of Buy or Hold recommendations. Wall Street does not want to suggest capital preservation or any timely retreat from the market. Even in a deep bear market, brokerage firms need to convince investors to keep buying stocks.

5. The Street’s Big Companies Bias. A final bias is toward big companies/stocks with the greatest market capitalization. These securities are traded most frequently, held most extensively, and have the greatest institutional investor interest.

This also means that large companies tend to be excessively analyzed and reported on. The most researched sectors include technology, telecommunications, and healthcare because research departments place the most analysts where the most trading business is done, not necessarily where the best investment opportunities lie.

Unlike the individual investor, mutual funds and other institutions must purchase substantial volumes of stocks. Because these are a brokerage firm’s key target audience, there is not a sizable enough financial payoff for analysts to recommend smaller stocks.

Given these factors that can distort brokerage analyst’s stock recommendations, individual investors must understand that most ratings cannot be taken as literal advice for a personal portfolio. There is some value in the Street’s securities research for the individual investor, however.

First, research reports are excellent for providing background understanding and the essential business metrics of companies and industries. Figures such as the earnings outlook and profit forecasts are examined as are the business’ operations, management, market, competition, potential challenges, and financial stability.

Secondly, if investors listen in on companies’ public conference calls, they can be attuned to analysts’ questions and executive responses. Analysts have a greater awareness of a company’s culture, goals, and management style, sometimes having direct access to CEOs.

Having more information than those outside of Wall Street, analysts can ask more pointed questions on conference calls and hint at critical issues or what the company may be attempting to cover up. Finally, analysts can offer detached, unemotional observations about how certain events might influence the company’s future.

Wall Street may act as though it is fit to offer investment advice to individuals, but that is not what it is structured to do. The Street is structured to “trade securities, perform securities transactions, distribute and sell securities as a dealer, and do corporate finance deals.

Wall Street is not suited to be an investment manager, financial advisor, or stock selector. These services are a conflict of interest with the bedrock brokerage and banking functions.”

With a better understanding of how research on Wall Street operates, individual investors can employ the following tips for a better investment strategy:

* Look for stocks that are not currently being pushed by analysts or widely recommended, but still show promise and sound financials. Analyst upgrades to Hold are often a good signal to Buy. Any opinion change that involves a downgrade should be read as a literal Sell recommendation.

* Make an early investment in healthy and promising smaller companies not yet over-covered by Wall Street. Small stocks offer individual investors the best opportunity for future upside.

* Because Wall Street is subject to a short-term bias, the best prospects for individual investors involve looking at long-term value versus quarterly performance. Individuals are not judged on a quarterly basis like institutional investors, giving them the potential to realize more substantial gains over the course of two to three years.

* Take note of a “lone wolf analyst,” one who is willing to singularly downgrade their stance. Analysts often mirror each others’ opinions and it takes courage for one to be honest about a negative stance.

* Note an analyst’s level of experience. Younger analysts do not have the same relationships with executives or the seasoned perspective that senior ones do. Look for at least ten years of experience.

* Conference calls offer individual investors the closest to an inside look at a company as they can find. It is helpful to be attuned not only to what is said but to the tone of the call and what is left to be read between the lines. Notice what types of questions analysts are asking the executive.

* Take advantage of being an individual investor who does not have the biases and distractions that analysts on the Street have. Take the time to be like a research analyst independently, listening in on conference calls, reviewing earnings models and examining companies’ financials.

Samantha Johnson is the online content creator for Business Book Summaries. Business Book Summaries (BBS) provides comprehensive, concise summaries of the best business books available. Using stringent criteria, only the top business books published each year are selected to be summarized.

Healthcare Schools Online – Call the Shots on Your Career

As demand for healthcare services continues to increase, it takes a specially trained person to run the oft-overlooked position that some people don’t think much about – that of a healthcare manager. That’s where healthcare schools online come in: they offer courses that train a person to be management material when the time comes for a promotion or a new job. Healthcare managers are the brains behind the operation and they ensure that things run smoothly. Healthcare schools online are a great resource for a person that needs the training, but may not have the convenient hours that other less demanding jobs can afford.

Those in healthcare management keep the day-to-day operations of any type of patient facility running efficiently. They make decisions on patient healthcare and treatment. They also work in conjunction with nurses and other administrative workers to ensure that the quality of healthcare is up to regulations and medical records and reports are accurately kept or given. These men and women must always be ready for new healthcare implementations – anything from new technology to new methods of patient care. They are typically very busy and may be called upon at all hours for advice and/or assistance in a problem. They also travel to attend healthcare conferences, or to meet with the government or private affiliates and owners of a company.

Healthcare managers work in all sorts of environments. Anywhere there is a facility that treats patients, no matter old or young, in-patient or out-patient, there is a manager that makes sure everything is carried out in a respected and efficient manner. Managers can work in hospitals, for example, but there is probably one that works in every ward who also answers to the manager in charge of the entire hospital. In a nursing home, there is one main manager, and a few managerial assistant managers to help keep the workload manageable. This type of management system is seen in all aspects of healthcare.

On a day-to-day basis, the variety of people whom a healthcare manager works with is vast. They work with nurses and nurse’s aides, medical recorders and information analysts. Every day brings a whole pack of problems to solve, but also an equal amount of reward. A great hospital with satisfied patients and workers is a sign of a great healthcare manager, who at the end of the day, is a people-person that aims to make everyone happy while keeping care effective and up to standards. Healthcare managers also have to answer to their own bosses. They must attend conferences that inform and advise them on new and effective ways of managing and on the developments that constantly happen in the healthcare industry.

Getting into this oft forgotten administrative job usually requires a master’s degree at minimum. It can be in healthcare administration, but there is also a combination of other degrees that could put the candidate in the right spot for a promotion. This could be an MBA with combined experience in the nursing field, for example. Another good example is experience and an advanced degree in a specialized field, combined with a graduate certificate in healthcare administration.

5 Job Trends in Healthcare Information Technology

There are many trends in healthcare information technology to cover. With the US government’s economic stimulus package geared to improve heathcare IT, there will be areas were expertise will be greatly needed.

Outlined below will touch on 5 hot trends that will be need qualified professionals to help implement the large efforts of the healthcare industry:

1. EMR (electronic medical records) or EHR (electronic health records) – This is going to a huge effort on the part of many medical establishments. This system will take the “health history” of an individual and create a so called electronic medical record that will follow a patient anywhere for patient safety and more accurate treatments. All of the is over a huge network and storage systems along with integrating several applications.

Job Title Examples: Developers, Programmers, Project Managers, Billing and Coding specialists, systems analysts but most will say EMR or EHR.

2. Informatics – Informatics as it related to healthcare will include using medical information from clinical, nursing, medical, biotechnology and similar disciplines into an electronic format to be either stored, retrieved, shared, analyzed to help make informative medical decisions.

Job Title Examples: Clinical informatics analyst, Informatics consultants, medical informatics – employers may seek specific degrees in the discipline (ie. RN, BSN, Biotechnology )

3. Enterprise Architecture – Enterprise architecture with work within a healthcare organization like in other institutions. It is most commonly used to better outline a method of business and uses tools to understand and best document the structure of an organization. Very much strategic in nature.

Job Title Examples: Almost always will have the terms “enterprise architecture” or “data architecture” or “data modeler” in the title. Usually a mix of SOA, data warehousing, ER modeling, Diagram modeling, frameworks, and strategy.

4. Patient Safety related systems & Quality – This area of healthcare will use systems and applications to reduce with the goal to eliminate medical errors in and efforts to drastically increase healthcare quality and communication.

Job Title Examples: Quality and patient safety will usually be part of the title and are non technical. The technical positions will be developers/programmers or applications tester of these types of applications.

5. Interoperability – Overall this area covers bringing together healthcare information technology systems together and integrating them in order for them to work together across locations and then have the ability to deliver quality useful information to service it’s end user.

Job Title Examples: Project management, software engineer, sometimes within informatics, architect and, analysts.

There is so much to know within each of these 5 but there is much opportunity for one with technical skills to seek out so many facets of healthcare.