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Chris Rigsby is SVP, Payer Solutions, for Omega Healthcare.

By helping providers, plans can optimize the functions that support risk adjustment while also building trust and fostering collaboration that support holistic care. 

Three ways payers and providers can improve risk adjustment | Viewpoint

By 2050, it's estimated that 139 million people worldwide will have dementia, but by today's standards, 60% will be undiagnosed. It's clear that there's a significant gap in dementia detection and care, but what can your organization do about it?

Get perspectives from clinical leaders and neuroscience experts about the underlying causes and consequences of these gaps, practical opportunities to address them, and a proven roadmap that shows how leading health systems have successfully transformed their dementia screening and care processes.

Closing the Dementia Care Gap: Expert Insights and Proven Strategies for Health Systems

Undeniably, the healthcare nursing workforce has faced unprecedented stressors exacerbated by the pandemic.

While the majority of research on burnout has focused on nurses and physicians from the clinical perspective and chief executive officers (CEOs) from a leadership perspective, there is a need for more research on the factors that may contribute to the burnout of chief nursing officers (CNOs) and system chief nurse executives (CNEs).

Faced with a heavy burden of stress and needs from their overstretched teams, CNOs and CNEs are a distinctive specialty within nursing that have unique challenges. While many provider organizations have made efforts to help address the wellbeing of front-line nurses, few programs exist that are tailored for the specialized role of these nurse executives.

With the cost of CNO and CNE turnover for health systems at more than $1.5 million per employee, burnout is not only a workforce issue but a financial sustainability challenge that hospital leaders cannot afford to ignore.

 survey of 43 system CNEs with purview over a million nurses focused on staff wellbeing, but as a pulse check asked the CNEs to forecast their own career. 

Fully 27% of respondents forecasted career changes on their horizon, identifying preferment — how members of the workforce decide to spend their time such as transitioning into part-time or consulting roles or teaching, mentoring or volunteering as a way to keep a connection to nursing — or retirement within 12 months.

To help illuminate these factors of burnout, in February 2024 Vizient distributed an additional survey to 694 CNOs who participate in Vizient Member Networks. The study — drawing 106 responses (15% participation rate) of these health executives who oversee 350,000 nurses and nearly 700,000 patients daily in their care — gathered insights on five contributors of burnout, which are based on current literature specific to nurses. Categories are below:

 The burden of leadership results in decreased motivation, loss of purpose and disconnection with their employees.

 The set of observable reactions resulting from working with people who have been traumatized, mirroring the symptoms of post-traumatic stress disorder.

 The mental and emotional distress that can follow when healthcare professionals connect and empathize with patients and other staff.

 The suffering experienced when an employee makes a moral decision and then either does not — or feel that they cannot — follow through with their chosen action because of institutional constraints.

 The result when an employee engages in, fails to prevent or witnesses acts that conflict with their values or beliefs.

When asked to rate these five contributors on a scale from 1 to 10, with 1 being a low contribution to burnout and 10 being the highest contribution, results showed higher levels of leadership fatigue and secondary trauma with over a third of respondents rating secondary trauma a 6-8, giving a glimpse into the serious nature of the burnout experienced by these nurse executives.

While most burnout contributors show a general downward trend across the survey data, secondary trauma and leadership fatigue have a U-shaped pattern of responses, indicating more CNOs suffer from high levels of these contributors when compared to the other three.

The intention of these analyses is to help healthcare leaders create specific interventions to improve wellbeing and retention for nurses and nurse executives.

Consistent with the 2023 survey, the 2024 survey found that the largest drivers of nurse executive turnover are retirement and preferment, identified by 20% of respondents as a reason for leaving their professions., But other drivers exist including emotional distress, challenging work environment, culture of hierarchy and discrimination, or disappointment about the reality of managing nursing at the executive level.

Another common factor noted by respondents was lack of actionable results from verbalizing feedback. While they feel comfortable raising their voice to other leadership regarding problems with patient care, they feel less strongly that their voice is being heard, acknowledged or influences decision-making.

When nurse executives were asked how they invest in their wellbeing and how often, their comments were sorted into four themes: physical wellness, emotional and mental wellness, work-life balance and time off and personal growth and development.

The survey team also examined qualitative comments about specific actions nurse executives take to promote their personal wellbeing:

43% mentioned spending time with family and taking time off as discrete investments in wellbeing.

28% of respondents said they engage in these normal course-of-life activities only one to three times monthly.

The lack of investment in wellbeing activities further exacerbates burnout and can push these leaders toward leaving the profession.

The call to action is clear: reform is needed to mitigate nurse executive burnout. Healthcare executives, including the boards of trustees, should be educated about the specific needs of nurse executives identified in this survey and assess their organizations for cultural norms that either support or hinder their wellbeing, especially in leadership fatigue and secondary trauma.

Additionally, it’s time for intervention. Leaders and executives must develop programs to promote wellbeing with a quality improvement framework. Strategies to help leaders take the initial steps in targeting interventions for specific contributors of burnout and distress include:

Create workplace norms that prioritize work-life integration and model those behaviors.

Adopt policies that protect employees’ abilities to nurture their personal relationships.

Set the organizational example in making social connection a strategic priority at all levels of employees.

Set time to understand the perspectives of your nurse executives and pay attention to leadership fatigue and secondary trauma as unique contributors to their burnout.

By taking action to reduce CNO and CNE burnout, health systems are one step closer to building a better workforce to continue meeting the needs of patients everywhere.

Barbara Seymour, DNP, RN, NE-BC, is assistant vice president, member networks at Vizient

Vizient’s 2024 chief nursing officer wellbeing survey identifies leadership fatigue and secondary trauma as key drivers in burnout and turnover.


Topic

The time is now: Addressing the wellbeing of nurse executives | Viewpoint

Hospitals and health systems are paying more attention to cybersecurity, because they have no other choice.

Hundreds of cyberattacks have taken place this year, including the 

, which disrupted almost all hospitals nationwide. Other health systems have weathered attacks.

Chief Healthcare Executive® has reported extensively on cybersecurity over the past few years, and it looks to be an issue that will garner heavy coverage in years to come. Beyond reporting on the attacks, we’ve shared insights from key cybersecurity experts. Now, we’re looking to do a bit more.

Recently, Chief Healthcare Executive® assembled a panel discussion with three leading cybersecurity experts: John Riggi, national advisor for cybersecurity and risk for the American Hospital Association; Lee Kim, senior principal of cybersecurity and privacy at HIMSS; and Adam Zoller, the global chief information security officer for the Providence health system.

Today, we’re presenting the first of a series of videos from that discussion. 

(Here’s the video. The story continues below.)

Experts from the American Hospital Association, Providence, and HIMSS discuss cyberattacks

Cybersecurity panel discusses attacks on hospitals

In this discussion, the cybersecurity panel looked at the scope of recent attacks.

“Cyberattacks against hospitals and health systems continue to increase at a very alarming rate,” Riggi said. “Last year, in terms of data theft attacks, hospitals and health systems suffered the worst year in terms of data breaches and ransomware attacks. In fact, we ended the year with over 136 million individuals in the United States.”

And the number of victims is almost certain to be higher this year. The Change Healthcare cyberattack alone affected 100 million Americans, according to the U.S. Department of Health & Human Services. It’s being called the most significant cyberattack affecting healthcare in U.S. history. Riggi pointed out that 

a Russian ransomware group, Black Cat, claimed responsibility

“They understood they would be attacking the entire healthcare sector,” Riggi said. “Every hospital and health system in the country was affected either directly or indirectly, by this attack, and it was a very significant disruption.”

The Providence health system constantly defends against cyberattacks, Zoller said.

“This year has been a pretty wild year for healthcare,” Zoller said. “Personally, Providence has been targeted by thousands of attacks, as we are every year. We've thwarted these attacks. We've been able to, knock on wood, stay ahead of these attacks, but the attacks are growing in sophistication. They’re growing in volume.”

A majority of cybersecurity healthcare professionals

 say their organization has experienced a security incident in the past year, according to HIMSS.

When it comes to cyberattacks, Kim said, “It's not a matter of if, but when.”

But Kim said while attacks are becoming increasingly sophisticated, hospitals and healthcare organizations are making strides in cybersecurity.

“I've seen extremely large strides in terms of growth, in terms of cybersecurity maturity, stakeholders getting more on board,” Kim said. “There are a lot more healthcare organizations that are realizing that cybersecurity is part of their business.”

The experts noted that private health information is extremely valuable, which is why ransomware groups are targeting hospitals and other providers. The panel noted that those attacks can threaten patient care, and 

“I think the perception is, rightly or wrongly, that healthcare systems are more willing to pay the criminals,” Zoller said.

Check out the video for more analysis and perspective on cyberattacks in healthcare.

Important note: This is the first video from our wide-ranging conversation. We’ll be publishing other installments over the next few weeks with more perspective from our experts on cybersecurity. Our thanks to these experts for sharing their knowledge and insights on such an important topic for the healthcare industry.

Chief Healthcare Executive hosted a discussion on cybersecurity with leading experts from the American Hospital Association, HIMSS and the Providence health system. They talked about the growing problem of cyberattacks.

Cybersecurity panel: The scope of recent ransomware attacks in healthcare

Hospitals are healthcare organizations have faced the constant threat of cyberattacks in recent years, but 2024 illustrated just how disruptive breaches can be.

So it may not be surprising that our stories of cybersecurity have gained a wide audience. In fact, all five of the most well-read healthcare technology stories over the past year involved cybersecurity and cyberattacks.

Ransomware groups are employing more sophisticated attacks and hospitals are struggling to keep pace, even as more organizations are devoting more resources to cybersecurity, said John Riggi, national advisor for cybersecurity and risk for the American Hospital Association. Riggi and other experts participated in a 

“Cyberattacks against hospitals and health systems continue to increase at a very alarming rate,” Riggi said.

Here’s a look at costly and damaging breaches. It’s a safe bet that cybersecurity is going to remain a top concern of healthcare leaders in 2025.

Kaiser Permanente breach may affect 13 million people: Questions & answers

The California-based health system suffered a breach that affected over 13 million Americans, and it says something that it’s not even the biggest data breach in the healthcare industry over the past year.

Still, a breach of Kaiser Permanente is notable given its wide reach. Kaiser Permanente operates 40 hospitals in several states and its health plan has about 12.5 million members.

Health systems must notify the U.S. Department of Health & Human Services of any breach affecting more than 500 people. Kaiser Permanente told the department 13.4 million were affected, according to the 

Kaiser Permanente said there was no exposure of Social Security numbers, financial account information or credit card numbers.

Kaiser Permanente says online technologies may have sent personal information to other parties, including Google, Microsoft Bing, and X, the social media platform formerly known as Twitter.

Cybersecurity panel: How hospitals can protect their systems and their patients

Hospitals affected by cyberattack of UnitedHealth subsidiary

The cyberattack of Change Healthcare, a subsidiary of UnitedHealth Group, has been 

the most damaging attack ever in the healthcare industry

In February, it became clear that the attack on change healthcare was affecting hospitals and other health providers. It would soon become clear that the breach disrupted providers across America, because Change Healthcare provides services to so many providers across the industry, including billing and prescription services.

 suffered a financial impact from the breach with payments being delayed, according to a survey from the American Hospital Association.

UnitedHealth said the breach affected 100 million people,

 or roughly one in three Americans. In 2023, all of the health data breaches reported that year affected 130 million Americans, according to 

. The Change Healthcare attack approached that figure.

The attack also received heavy mainstream media coverage, shedding more light on the growing problem of cyberattacks in healthcare.

Change Healthcare cyberattack: VA notifies 15 million veterans of breach

The Change Healthcare attack also affected the nation’s veterans.

The Department of Veterans Affairs sent notices to 15 million veterans about the breach. Change Healthcare provides a variety of services for the VA, including filling prescriptions.

Lawmakers have criticized UnitedHealth Group

 for failing to employ sufficient security measures in light of the breach, and have also called on the government to exercise more oversight to ensure there is better cybersecurity in the healthcare sector.

U.S. Sen. Ron Wyden, D-Oregon, is calling on the health department to require healthcare organizations to meet some basic cybersecurity standards.

“It is clear that HHS’ current approach to healthcare cybersecurity — self-regulation and voluntary best practices — is woefully inadequate and has left the health care system vulnerable to criminals and foreign government hackers,” Wyden said in a 

Michigan hospital system suffers cyberattack, again

The McLaren Health Care system confirmed this summer that it had experienced a cyberattack, and unfortunately, it wasn’t the first breach the Michigan system has suffered.

In the fall of 2023, McLaren experienced a cyberattack, so the system suffered two breaches within the space of a year.

Citing limited access to key systems, McLaren said some non-emergency appointments, treatments and tests were postponed and had to be rescheduled. Ambulances were temporarily diverted from McLaren Port Huron Hospital, 

McLaren operates 13 hospitals in Michigan, along with a host of ambulatory surgery centers and clinics. McLaren also operates health plans covering more than 700,000 people in Michigan and Indiana.

The 10 largest data breaches of the first half of 2024

Chief Healthcare Executive® reviewed the 10 largest health data breaches of 2024, and even at the midyear mark, it was clear that the industry was seeing some damaging attacks.

Those 10 breaches alone affected more than 31 million Americans, and it’s worth noting that didn’t include the Change Healthcare breach. While the Change Healthcare ransomware attack had already happened, it wasn’t clear at that point how many people were affected. Given the scope of the Change Healthcare attack, it’s likely that the number of Americans impacted by cyberattack in 2024 will be substantially higher than a year ago.

In the first six months of 2024, there were 341 breaches of health data reported to the U.S. Health Department.

Health systems continue to experience breaches that are costly and hampering patient care. 

Kaiser Permanente, UnitedHealth Group and other cyberattacks: the most popular technology stories of 2024

Bob S. Carter, MD, has been named the new CEO of University of Utah Health.

Carter will take on the new role in February 2025. He will also be the university’s vice president of health sciences.

A neurosurgeon, Carter will lead an academic health system with 17 hospitals and community health centers and $6.3 billion in revenue. The health system also has a research portfolio of nearly $500 million.

He succeeds Michael Good, who has led U of U Health for more than six years.

Carter said he’s been impressed by the system’s “enthusiasm, collaborative spirit and warmth.”

“U of U Health, and its dedicated faculty, staff and students, are at a unique inflection point,” Carter said. “I am impressed by what they have accomplished already as a team. And I am particularly drawn to the vision of the University of Utah as a public university striving to improve every person’s life, and U of U Health’s shared missions of leading-edge health care, curing through discovery and enlightening tomorrow’s leaders.”

Carter currently serves as a professor in neuroscience at Harvard Medical School and is Neurosurgeon-In-Chief at Mass General Brigham, Massachusetts General Hospital and Brigham and Women’s Hospital.

Mercy hospital system appoints physician as COO

For the first time, the Mercy health system has chosen a doctor to serve as the system’s chief operating officer.

John Mohart, MD, has been named COO of the Missouri-based system, which operates 50 hospitals and more than 1,000 physician practices. Mohart joined Mercy in 2012 as a cardiologist, and he most recently served as Mercy’s president of community operations.

“I am devoted to health care and to Mercy’s mission of pioneering new models of care so that health care is accessible, affordable and sustainable,” Mohart said in a statement. “It’s a privilege to serve, lead and grow Mercy’s vision and mission in today’s ever-changing health care landscape.”

Steve Mackin, Mercy’s president and CEO, said the system is putting more doctors in top leadership positions ‘because we believe they are key to getting health care right.”

“Dr. Mohart’s passion as a physician and his strong belief that every co-worker is a caregiver will ensure that we prioritize what’s best for our patients and our team at Mercy as we enter our third century of care,” Mackin said in a statement.

Sean Kamber has been appointed the new chief executive officer of the Menorah Medical Center.

The hospital, based in Overland Park, Kansas, is part of HCA Midwest Health, a division of HCA Healthcare.

Kamber comes to Kansas after working with HCA Healthcare’s North Texas Division, where he has served six years as CEO of Medical City Weatherford. He brings nearly 15 years of experience in healthcare leadership roles.

He said he is honored to lead “a hospital with a rich legacy of serving the community with innovative healthcare solutions.”

“I look forward to working with this dynamic and talented team to continue leading the way to ensure high-quality and compassionate patient care is delivered to the communities we serve and that collaborative, transformative healthcare with state-of-the-art technology and services continues to be the focus of our mission,” Kamber said in a statement.

He worked as vice president of rural and community outreach in HCA Healthcare’s Gulf Coast Division. He also previously served as Medical City Weatherford’s chief operating officer.

Cook Children’s chief medical officer retires, successor named

After 17 years as chief medical officer of Cook Children’s in Fort Worth, Texas, James Cunningham, MD, is retiring.

The pediatric system has named his successor. Jonathan Nedrelow, MD, who most recently served as senior vice president and associate chief medical officer at Cook Children’s, moves into the role of chief medical officer.

Cunningham joined Cook Children’s in 1987, and has held a variety of roles in the organization.

“"This place has been a significant part of my life for a long time. Many of my adult friendships are centered around it, and it's been rewarding to watch its growth,” Cunningham said in a statement.

Nedrelow saluted Cunningham’s service to Cook Children’s.

“His legacy can be found in all the children that had a chance to grow up healthier because of him. Personally, words cannot describe the gratitude I have for the mentorship and friendship he extended to me,” Nedrelow said in a statement.

Cunningham said Nedrelow is “exceptionally qualified” to be the system’s chief medical officer.

“He's highly intelligent, well-respected, and I'm confident that the program is in great hands with him,” Cunningham said.

Mercy names a physician as COO, and other leaders make news.

University of Utah Health hires new CEO, and more | MED MOVES

Just two weeks before telehealth waivers are set to expire, Congress has shown support for an extension of virtual care programs.

 to fund government programs into March, and telehealth advocates said a spending plan included measures to extend telehealth programs.

The package included a two-year extension for most telehealth programs, and a five-year extension for hospital-at-home programs, according to the American Telemedicine Association.

Congress approved broad extensions of telehealth programs early in the telehealth pandemic, but those waivers were set to expire Dec. 31.

Telehealth advocates and a broad array of healthcare providers 

have been pressing Congress and President Biden’s administration

 to approve an extension of telehealth programs. They’ve been increasingly anxious as the end-of-year deadline has approached.

Lawmakers have also been grappling with another pressing deadline, as government agencies will shut down Friday night without new spending legislation. 

Now, uncertainty looms with the collapse of a deal on the overall spending bill. Republicans aren't supporting the temporary spending bill after President-elect Donald Trump and Elon Musk denounced the deal, as 

Kyle Zebley, the senior vice president of the American Telemedicine Association, has called this the “Telehealth Super Bowl,” and he’s hoping for a win, even as the contest moves late into the fourth quarter.

“The extensions in this proposed legislation are very meaningful for countless Americans and would give our healthcare providers and hospital systems some certainty and the confidence needed to continue to invest in needed telehealth services,” Zebley said in a statement.

“This has been years in the making, and we must ensure that these extensions are kept intact as they go to vote in both chambers of Congress and then on to President Biden for signature.”

The measure included language to enable health systems to provide cardiopulmonary rehabilitation services via telehealth to Medicare beneficiaries in their home in 2025 and 2026. The package also included a five-year extension of the Medicare Diabetes Prevention Program Expanded Model through 2030, allowing services to be delivered virtually.

Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association, said the group is “pleased that Congress heeded our call to extend telehealth flexibilities through the end of 2026.” But the group said it’s frustrated that Congress hasn’t averted planned Medicare payment cuts to physicians.

Healthcare providers and trade groups have long expressed optimism that Congress and the Biden administration would ultimately sign off on an extension of telehealth programs. The House & Energy Commerce Committee passed the 

 unanimously with a 41-0 vote in September.

Republicans and Democrats in Congress have both expressed strong support for telehealth programs. But healthcare advocacy groups expected that Congress 

Lawmakers added measures to extend telehealth and hospital-at-health programs to a bill to avoid a government shutdown. But the spending plan fell apart.

Chris Rigsby

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