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Q: Medical Staff Outsourcing as a Business ( Answered,   1 Comment )
Question  
Subject: Medical Staff Outsourcing as a Business
Category: Health
Asked by: pam_steptoe-ga
List Price: $150.00
Posted: 22 Sep 2003 07:33 PDT
Expires: 22 Oct 2003 07:33 PDT
Question ID: 259049
What are the trends, business models, profit projections for clinical
staff outsourcing in government and private healthcare organizations?

Request for Question Clarification by umiat-ga on 23 Sep 2003 12:30 PDT
pam_steptoe-ga

 I have nearly completed an answer to your question and suddenly
decided I may have misunderstood what you are asking.
 Your reference to "Medical" and "Clinical" Staff led me to focus on
the temporary staffing industry revolving around nurses, doctors, etc.
However, this is not normally considered "outsourcing".
 Outsourcing in the medical industry commonly refers to the relegation
of administrative tasks (such as payroll, billing, insurance claims)
to outside companies.
 Therefore, before I post a totally wrong answer, I need to know if
you are actually referring to administrative outsourcing (not clinical
staff), or the filling of medical postions by outside personnel from
staffing agencies.

umiat

Clarification of Question by pam_steptoe-ga on 23 Sep 2003 16:09 PDT
You are on the right track! I didn't want to limit to just temp or
Locum tenens but to get a feel for any new trends and the companies
that are out in front in this area along with the drivers for the next
5-10 years. Thanks for allowing me to clarify. I hope this helps. -
pam
Answer  
Subject: Re: Medical Staff Outsourcing as a Business
Answered By: umiat-ga on 24 Sep 2003 10:16 PDT
 
Hello pam_steptoe-ga!

 Thank you for your patience! The medical staffing industry is quite
broad and encompasses many spectrums. It took me a bit longer than I
expected to gain a foothold and find some parameters to work within.

 I hope I have managed to condense the following material in a manner
that is comprehensive and understandable without being too scattered!
If I can clarify any issues for you, let me know and I will try my
best to help.



==========================================
OVERVIEW OF THE MEDICAL STAFFING INDUSTRY
==========================================

"The growing trend toward cost containment in the healthcare industry
has placed a greater burden on hospitals and other medical
organizations to effectively manage fluctuations in staffing needs.
The result has been an emerging demand for temporary nurses and
medical staff to allow flexibility, while ensuring staff-to-patient
ratios are acceptably maintained."

"Temporary medical staffing company opens office in WH." Polk Online
http://www.polkonline.com/stories/042199/win_medical.shtml 

==

 According to an article by On-Site Medical Staffing, the healthcare
industry uses temporary workers for several reasons other than
personnel shortages:

1. "Staffing levels can fluctuate greatly depending on the work load.
Temporaries can help fill in the gaps."

2. "Many healthcare facilities use temporary staffing companies to do
all their hiring. The temporary company does all of the recruiting and
places the employee on its payroll. After a period of time, usually
520 hours, the healthcare facility can choose to transfer the
temporary company’s employees to its payroll."

3. "Many healthcare facilities like the simplicity of paying one
hourly fee to a staffing service rather than paying separately for
payroll, workers compensation, unemployment, state and federal taxes
and other administrative tasks."

From "TEMPORARY WORKERS AND HEALTHCARE." On-Site Medical Staffing
http://www.onsitemedicalstaffing.com/articles.html  

==

Medical Staffing even includes Veterinary Technicians!

 Though the shortage of Nurses is well known, temporary medical
staffing includes many other personnel positions. The list from Dental
Medical Staffing Inc. includes:

Dentists, Hygienists, Assistants, Office Managers, Receptionists and
Bookkeepers, Medical Technicians, Assistants, Biller, X-Ray
Technicians, Veterinary Technicians, Transcriptionists, Office
Managers, Receptionists and Bookkeepers.
http://www.dentalstaffinginc.com/about.html

==

TheraTech Staffing even provides Speech-Language Pathologists when
they are needed!

TheraTech Staffing has assignments for:  
Radiologic Technologists 
Occupational Therapists 
Physical Therapists 
Speech-Language Pathologists 
http://www.theratechstaffing.com/gettingstarted.asp 
   
===

J&C Nationwide, which is the "second largest, and fastest growing,
medical staffing company in the industry", reports that its locum
tenens (temporary) staffing division is its strongest revenue
producer.
From "J&C Nationwide," by Calvin Bruce. Physician Recruiter.com.
http://www.physicianrecruiter.com/Dept/trenches/trenches72199.htm
  


==============================================================
GROWTH AND PROFIT PROJECTIONS IN THE MEDICAL STAFFING INDUSTRY
===============================================================

Estimated to be worth 12.9 Billion in 2003
===========================================

"Despite general declines in the staffing industry as a whole, medical
staffing continues to prosper as the shortage of permanent medical
personnel worsens. Staffing Industry Analysts estimate that the
medical staffing industry will be worth $12.9 billion in 2003, up from
$10.6 billion in 2002.

*Two companies - AMN Healthcare Services Inc. and Cross Country Inc.
-dominate the industry.*

Last year, both companies had double and triple-digit percentage
revenue increases. Nurse staffing currently make up about 73% of the
temporary health care niche; other temporary medical professions such
as pharmacy are on the rise. (Source: Staffing Industry Report,
V.XIII, No. 23/24, 20 December 2002

From "Staffing Industry Bulletin." UIC Center for Urban Economic
Development. (Dec. 2002)
http://216.239.53.104/search?q=cache:I1dR5o2IYK0J:www.uic.edu/cuppa/uicued/tempwork/BULLETINS/Staffing/Bulletin%2520PDFs/dec.pdf+medical+staffing+industry&hl=en&ie=UTF-8

* AMN Healthcare
http://amnhealthcare.com/aboutamn.asp

* Cross Country Inc.
http://www.crosscountry.com/ccinc/index.html
===


ANALYSIS of the Healthcare Staffing Industry
--------------------------------------------

The following is from "THE STATE OF THE HEALTHCARE STAFFING INDUSTRY -
4TH QTR 2002." expressFactor.com
http://www.expressfactor.com/CompanyInfo/hcs4q02.asp 


"The healthcare staffing industry has experienced solid and steady
growth during the last decade. The industry should continue to grow at
a strong pace during the short and long term due to its attractive
value proposition and increased demand resulting from both political
developments and demographic changes."

The healthcare staffing industry provides three key benefits to its
stakeholders:

* "Cost savings to healthcare facilities through the use of temporary
and project-based personnel, both of which help minimize labor costs
in response to swings in occupancy rates."

* "Greater access to highly skilled professionals on a short-term
basis, which may help fulfill temporary and specialized needs."

* "Opportunities for medical professionals and highly skilled
technicians to work on a contract or consulting basis, with lucrative
monetary incentives and opportunities to travel."


MARKET OVERVIEW 
----------------

Market Attributes:

"The temporary healthcare staffing industry is highly competitive and
has low barriers to entry. The industry is also highly fragmented,
with the 10 largest companies accounting for less than one-third of
the total U.S. market."


Market Size and Growth: 

"Healthcare stafffing is a $9.1 billion industry. The industry is
experiencing rapid growth. Over a five year period, the industry's
rate of growth increased from 10% in 1996 to over 25% in 2001. The
following chart indicates market size in billions of dollars and
annual percentage growth since 1991."


Year        '91  '92  '93  '94  '95  '96  '97  '98  '99  '00  '01 
Mkt Size    3.3  3.2  3.3  3.5  3.8  4.2  4.9  5.4  6.2  7.2  9.1  
Growth %    NA   -3%   3%   6%  9%   11%  17%  10%  15%  16%  26%  

"The industry has benefited from a lack of employees to meet the
demand of healthcare facilities. For example, over 80% of hospitals
are unable to meet their current nursing needs and more than 125,000
budgeted nursing positions were left unfilled across the U.S. in
2001."

"The population of registered nurses under the age of 30 dropped from
25.1% of the total nurse population to only 9.1% in 2000. Most likely,
this will lead to an environment in which the nursing shortage becomes
more severe over the next ten years."

"The shortage of medical personnel extends beyond nurses and includes
physicians, radiologists, and allied healthcare professionals. Based
on the current supply gap, it is not surprising that the current
pricing environment remains robust, with recent price increases in th
13-15% range."


Market Segments
-------------- 

Nurse Staffing: 

"Nurse staffing is the largest sector within the temporary healthcare
staffing industry. It accounted for approximately 74% of industry
revenue in 2000."

"There are two categories of temporary nurse staffing - per diem and
traveling nurses. Per diem nurse staffing is the largest sector of the
temporary healthcare staffing industry representing $4.1 billion in
revenue, or 57% of industry revenue in 2000. The traveling nurse
market represents approximately 17%, or $1.2 billion, of total
industry revenues in 2000. Traveling nurses are sourced on a
fixed-term contract basis ranging from 8 to 26 weeks, but are
typically 13 weeks long and are usually booked four to five weeks
ahead of time."


Other Medical Staffing: 

"The remaining 26% of healthcare staffing industry revenue - $1.9
billion - was generated from allied healthcare staffing (radiology and
diagnostic imaging specialists, clinical laboratory technicians and
pharmacists), physicians, and med-financial professionals (medical
accounting, billing, and collections)."

LEGISLATIVE DEVELOPMENTS

"Recently, legislation has been enacted on both the federal and state
levels that will have a significant impact on the healthcare industry,
especially the nursing segment. Most significantly, the Nurse
Reinvestment Act was passed to attract more people into the nursing
profession through increased educational funding. However, this
legislation will not have an immediate impact as it may take between
two and four years before newly enrolled students enter the
workforce."

"At the state level, California recently passed legislation that will
require minimum nurse-patient ratios. This legislation has paved the
way for similar legislation in other states and may strengthen demand
for outsourced nurse staffing services. Already, similar legislation
has been introduced in several states including Massachusetts,
Florida, Ohio, Rhode Island, and Illinois."


INDUSTRY OUTLOOK
------------------

Market Size and Growth 

"An aging population and technological advances in healthcare
treatment will create substantial demand throughout the current decade
for healthcare services and medical personnel. This is particularly
true with regard to the registered nursing profession which represents
the single largest occupation in the healthcare industry."

"The percentage of the U.S. population over the age of 55 is expected
to climb from 12.5% in 2000 to almost 15.8% in 2010 and continue to
rise further through 2020, according to the Social Security
Administration. The implications of an aging population are apparent
to agencies such as Medicare and Medicaid, as indicated by a steady
growth in projected Medicaid expenditures from about $200 billion to
almost $445 billion in 2010."


Supply 

"Historically low enrollment rates in nursing schools suggest that new
entrants will not keep up with the large percentage of the current
nursing workforce expected to enter retirement during the next ten
years. As a result, nursing is one of the top ten occupations
projected by the Bureau of Labor Statistics to create the largest
number of new jobs."

"The U.S. Labor Department predicts a shortage of 450,000 nurses by
2080.[12] This shortage is expected to create an environment where
employers will be willing to pay top dollar to find quality labor to
replace skilled nurses leaving the workforce."


Market Growth 

"We expect the market will sustain growth rates in excess of 20% over
the next three to five years, driven by an aging population that
requires more health care, a wealthier population that can afford
better health care, and advances in medical technology that permit
aggressive treatment of an increased number of health problems. The
healthcare staffing market should exceed $10 billion in 2002."


Year           '02E    '03E 
Market Size     10.6    12.9 
Growth %        16.5%   21.7% 


Pricing 

"Long-term secular trends support sustainable annual bill rate growth
in excess of the historical average of 5-7%."
 

CONCLUSION

Allied healthcare, med-financial, and contract nurse staffing
represent substantial growth opportunities for traditional staffing
agencies.




====================================
HOW SERIOUS IS THE NURSING SHORTAGE?
====================================

 The shortage of nurses has forced Washington hospitals to commit even
more money to temporary staffing:

"....hospitals spent $40 million on contract and agency nurses in
1999, almost quadrupling spending in 1995, said Troy Hutson, WSHA's
director of clinical and legal policy. And he believes spending has
risen even more steeply since.

"The average large hospital in Washington probably spends $100,000 a
month on temporary staffing," he said. "Area hospitals are recruiting
nurses from as far away as India and New Zealand. But at local and
national staffing agencies, business is booming."

"A nurse may go through 15 years on the job to get to where they can
take a month off. Those who have the qualifications and skills are
finding out there are many ways to look at money," said Abel Borromeo
III, business development manager for Pro Med staffing agency is
Shoreline.

"Rising demand for agency nurses in the Puget Sound convinced Kelly
Services to open a health-care division in Seattle last month. It
joins 10 other Kelly health-care offices nationwide. "Opportunity for
nurses is huge, said Jayme MacKenzie, state recruiter for Kelly."

On average, Pace Staffing Network pays its RNs about $36 an hour. 

"Nurses with the right experience and background can pretty much name
their price," said Patty Steen, area manager for Pace's health-care
division in Seattle. "It's a nurses' market right now."
...

"Nurses who opt to work through local or national staffing agencies
can choose their shifts, earn higher hourly rates and sign "traveling
contracts" that pay rent for months at a time - even, in many cases,
if a nurse lives within a short commute of the workplace.

"It's way more flexible," nurse Kathy Kennard said of temping. Kennard
left her full-time job at St. Joseph's Hospital in Tacoma last year
for agency opportunities with StarMed Staffing Group in Seattle. She
now works about 32 hours a week and has weekends off. This past
winter, StarMed placed her on a local traveling contract that covered
her rent for 13 weeks."

From "Nurses find silver lining in staffing shortage," by Ari B.
Kramer. Puget Sound Business Journal. (May 2002)
http://www.bizjournals.com/seattle/stories/2002/05/13/focus9.html?page=1


FEELING THE IMPACT DURING WARTIME
==================================

 The State of Texas already feels the nursing shortage but the War in
Iraq is threatening to cut into the temporary staffing industry as
well.

"The state already needs an estimated 40,000 more nurses alone," said
Paulette Standefer, vice president of Dallas-Fort Worth Hospital
Council. "The health care staffing issues have gotten so much more
severe than during the time of Desert Storm. The vacancy rate for
critical care nurses is 16% here (in the Metroplex)."
....

"The $10 billion temporary staffing industry has served as a safety
net for hospitals and medical practices for several years, but many of
those temporaries - estimates are more 30,000 - also are reservists.

"We've had 18 candidates in just the last week or so tell us they are
on ready notice to be called up," said Colin McCall, director of
marketing for Irving-based Med Travelers Inc., which does temporary
allied health staffing. "Half of them are working in hospitals
nationwide now."
.... 

"Rural areas also are expected to be hit hard. "In some rural areas,
the loss of even one physician from a health care network could cut
physician staff by half, while the loss of a single individual with a
specialty skill - such as orthopedics - could result in the loss of
that medical service in an entire community creating a substantial
surgical deficit," said Van Allen, president of TimeLine Recruiting, a
retainer search firm with offices in Frisco and Columbia, Mo."

"Harris Brooks, assistant administrator at Palo Pinto General Hospital
in Mineral Wells, said the expected loss of the one certified
registered nurse anesthetist who also is a reservist will constitute a
third of the department. To avoid being forced to cancel elective
surgeries, the hospital plans to use temporary help."

From "Nurses to be more scarce with war in Iraq, " by Stephanie
Patrick. Dallas Business Journal (January 2003)
http://dallas.bizjournals.com/dallas/stories/2003/01/06/story1.html?page=1




===================================
GROWING FIELDS FOR MEDICAL STAFFING
====================================

Home Health Care and Senior Care
-------------------------------- 

 "Home health is forecasted to grow by over 42% in the next five
years, as key demographic drivers remain in place in this new decade.
At the same time, the number of certified home health agencies
operating in the U.S. has decreased from over 14,000 to less than
8,000; thus significantly decreasing local market competition. This
presents enormous opportunity to forge new client relationships where
entrenched competition was previously present.

In addition, the nation's population continues to age. In 1994,
approximately one in eight Americans was age 65 and older. By 2030,
one in five Americans will be a senior citizen. From 1960 to 1994, the
"oldest" population (persons aged 85 and over) increased by 274%
compared with 100% for those 65 and over. One quarter (8 million) of
the nation's elderly population have some form of disability for which
they require assistance, such as help with bathing, dressing, eating,
preparing meals, or taking medication; by 2020 it is estimated that 15
million will be disabled in some form. And, according to an AARP
survey in 2000, 82% of mid-life and older Americans prefer not to move
from home if they need help caring for themselves.

From "Industry Trends." Interim Healthcare. (2003)
http://www.interimhealthcare.com/franchise/industry_trends.asp

==

"Among other problems, costs continue to rise, doctors and other
medical professionals are in short supply, and healthcare providers
are closing down or restricting services. Since most of the elderly
are on a fixed income, and since they have the biggest need for
medical care, changes in the medical system hit them the hardest.

"If I were going to pinpoint one issue that is affecting the elderly,
I would say access to care," says Shirlee Zane, executive director of
the Council on Aging.

"Seniors also lack long-term care, a term that used to mean nursing
care but now covers a variety of services, including in-home, mental
health, physical therapy, and even food and shopping."

From "Same Old Problems," by Joy Lanzendorfer. North Bay Bohemian. 
http://www.metroactive.com/papers/sonoma/06.26.03/healthcare-0326.html
 


Pharmacists
-----------

"The shortage of pharmacists has become acute, according to the
American Association of Colleges of Pharmacy (AACP). A report last
fall, produced by the Pharmacy Manpower Project Inc., predicted a
shortfall of as many as 157,000 pharmacists by 2020 due to the aging
of baby boomers and other demographic factors."

"Increasingly fueled by the continuing shortage of pharmacy
professionals,

* the demand for temporary pharmacists is outstripping the supply, 

say executives for locum tenens firms. The current shortage is
estimated at 15% to 20%, and the number of retail pharmacies is
increasing as the population ages and as more pharmaceuticals are
used. The temporary staffing industry is growing at an estimated 15%."

"What’s driving the need for pharmacists is the demand for pharmacy
services, and the aging population is serving as the main
contributor," says Jeffrey Jacobsen, executive vice president of
allied staffing for Medical Staffing Network in Boca Raton, Fla. "And
as new drugs come online, we will need more well-trained pharmacists
because so many people are on multiple therapies."

Read "Temps Fill a Growing Need." Quality Indicator.com (Feb 2003)
http://www.qualityindicator.com/cgi-bin/article.cgi?article_id=1359



Staffing Military Treatment Facilities
--------------------------------------

 During wartime, military medical facilities "at home" are hard hit.
Interim Healthcare is one company that has stepped into fulfilling the
needs in that arena.

"Interim HealthCare Inc., the nation's largest combined provider of
home health care and supplemental staffing services, will be playing a
significant role in helping the U.S. Army fulfill civilian medical
staffing needs at Army medical treatment facilities through a new
contractual relationship with Washington, D.C.-based Aliron
International, Inc."

"The company has selected Interim to be the exclusive medical staffing
contractor which means that during these times of world conflict and
heavy Army deployment activity, Aliron's and Interim's contributions
could be critical to the successful accomplishment of the Army's
health care mission, both at home and abroad."

"Interim has been actively working to develop large inventories of
available medical personnel who are eager, ready and willing to serve
in a non-military health care capacity that will not only benefit and
help preserve the health of our American soldiers, but also their
families," commented Michael Schundler, Interim HealthCare President
and CEO."
 
From "Interim HealthCare to Play Important Role in Meeting U.S. Army
Staffing Needs." Interim Healthcare News. (Feb. 2003)
http://www.interimhealthcare.com/news/HtmlNews/USArmyStaffing.asp



Providing Bilingual Interpreters
---------------------------------

 "Recruiting for bilingual positions can be problematic, even for
widely spoken languages such as Spanish. However, there are creative
ways to overcome this gap. For example, foreign-trained health care
workers can be retrained and utilized in professional or
paraprofessional roles. Special programs can assist them to become
certified or licensed in their original profession, or can train them
for other health care roles, such as physician assistant or community
health worker."

"When bilingual providers are not available to care for monolingual
patients, well-trained interpreters can do much to bridge the language
and culture gaps. A variety of hiring approaches are currently used to
obtain professional interpreter services:

* Interpreters are hired as full-time or part-time regular employees -
most common where need for a particular language is high.
 
* Interpreters are hired as hourly, on-call employees or as
independent contractors - most useful where demand for a particular
language is intermittent
 
* In-person interpreter services are obtained through an outside
agency. This agency may specialize in medical interpreting or provide
a spectrum of interpretation specialties.

* Telephone interpretation - also known as remote consecutive
interpretation - can be obtained through outside agencies that
specialize in this service

From "Overview of Models and Strategies for Overcoming Linguistic and
Cultural Barriers to Health Care," by Sherry Riddick. Diversity RX
http://www.diversityrx.org/HTML/MOVERA.htm

== 

"The California Health and Safety Code (HSC) section 1259 states that
"access to basic health care services is the right of every resident
of the state, and that access to information regarding basic health
care services is an essential element of that right." The code
stipulates that when a hospital serves a geographic area or patient
population in which at least 5 percent of the population or patients
speak the same primary language, the hospital must make, to the extent
possible (as reasonably determined by the hospital) interpreters
available on the premises or by telephone 24 hours a day. SHS has met
this criterion for Spanish-speaking patients, and we are approaching
this level in other non-English speaking populations."

 Physicians and other healthcare providers can be encouraged to
sharpen their language skills. "One caveat here, however, is that we
can't ask physicians or nurses to drop their regular duties in order
to serve as interpreters."

Read "Don't Shoot the Interpreter," by Lawrence M. Shuer. Chief of
Staff. Medical Staff Update.
http://www-med.stanford.edu/shs/update/archives/april97/shuer.html

==

"It's not the patients' responsibility to bring along an interpreter.
In fact, according to the state health and safety code, we're required
to provide services unless the patient explicitly refuses and requests
that a family member or friend provide this service," Shuer said."

"But except in unavoidable emergencies, it's not a good idea to use a
family member to interpret medical information," he added. Shuer noted
that physicians can be legally liable for an untoward clinical outcome
if communications difficulties result from nonexistent or inadequate
interpreter services."

"And there are civil rights issues that emerge when a patient whose
English skills are limited is not provided with adequate interpreter
services and health care is therefore compromised," said Linda
Haffner, director of the inter- preter services at Stanford Hospital
and Clinics.

From "Call Interpreters Often and Wisely, Shuer Says." Medical Staff
Update.
http://www-med.stanford.edu/shs/update/archives/june98/intrpret.html 



The Growing Demand for Pediatric Sub-Specialists
-------------------------------------------------

"Almost overnight, pediatric sub-specialists including
anesthesiologists, surgeons, cardiologists, and neurologists, have
become some of the most sought-after and best compensated physicians,"
said Ron Fasnacht, senior vice president and managing principal of
Cejka & Company in St. Louis."

"..the demand for pediatric sub-specialists far exceeds the supply.
"This is partly due to managed care’s emphasis on capitation and
primary care physicians as gatekeepers throughout most of the 1990’s,"
Fasnacht said. "Now that capitation and the gatekeeper concept are on
the wane and open access to specialists is the order of the day, the
market for specialists is in the process of rightsizing itself. But
until it does, pediatric sub-specialists will remain in short supply."

"Fasnacht pointed out over 70 positions for pediatric sub-specialists
are currently posted on Cejkasearch.com, yet in some cases, only 25
physicians will complete their fellowships in a pediatric subspecialty
and enter the job market this year. The competition for those
physicians is such that hospitals will not only hire a firm like Cejka
Search to recruit pediatric sub-specialists from elsewhere, but also
to woo their own graduating fellows, some of whom they may hope to
retain."

Read "Pediatric Sub-Specialties: Once Modestly Paid, Now Command Top
Dollar." In the News. Cejka Search. (Nove 2002)
http://www.cejkasearch.com/content.asp?intPageID=515



Providers of "Staffing Plans"
------------------------------

"Today, more than ever, healthcare providers are depending on
physician staffing plans to help them define the optimum physician
specialty mix they need to support their patient population. However,
physician staffing plans do more than provide a list of needs to
healthcare providers - they also make sure providers are in compliance
with government rules and regulations, identify services which are
critical to the continued success of the organization, identify
geographic areas of strength and areas for development, and provide
prospective candidates with proof that their specialty is in demand in
the given organization and location. Furthermore, healthcare providers
who utilize physician staffing plans demonstrate a commitment to the
community - a desire to fully understand and fulfill the healthcare
needs of the population they serve."

Read "Why Do Healthcare Providers Need a Physician Staffing Plan?" by
By Michael P. Broxterman, CEO, Pinnacle Health Group and Terry Lane,
Editor. (2002)
http://www.phg.com/article_a028.htm


============================
WHAT ARE COMPANIES OFFERING?
=============================

"United Emergency Services Inc." (Founded in 1966)
==================================================
Business description:
"United Emergency Services is a health-care staffing company focused
on providing emergency department physicians and operating room nurses
to hospitals throughout the United States. The company currently has a
total of 372 active traveling nurses, surgical technicians,
independent physician contractors, and physician assistants providing
services under 472 hospital contracts in 42 states. UES is comprised
of two business units: emergency department physician staffing and
traveling nurse staffing.
 * Management believes UES represents the only provider of both ED
physicians and operating room nurse staffing services in its markets.

"UES targets suburban and rural hospitals with 5,000 to 40,000 ED
patient visits per year. Historically, these hospitals have had
difficulty recruiting and retaining qualified ED physicians due to the
difficulty of matching physicians to the demographic characteristics
of the local market, traditionally high turnover of ED physicians, and
the economic challenges unique to ED medicine. Management estimates
that there are 650 hospitals in its target market that use ED staffing
services. TVL is now aggressively growing by entering larger markets."

"In the ordinary course of business, executive management meets with
the CEO or top administrator as well as physicians of each hospital
monthly to identify areas of concern. Management believes that larger,
national competitors are unable to deliver this level of service.
Offering attractive benefits such as major medical, prescription drug
card, life insurance, 401k, dental, AAA, and UES' reputation for being
responsive to medical professionals' needs drives nurse and OR
technician recruitment. TVL pays its nurses weekly and provides
private housing, which is highly attractive to the traveling nursing
community. These benefits have resulted in a 70 percent employee
retention rate from 2000 through 2002 period, which is higher than the
market's estimated rate of 50 percent. The average tenure of an ED
physician and OR nurse with UES is three years and two years,
respectively."

Read More.."CED Participants, T through Z." Triangle Business Journal.
(April 2003)
http://baltimore.bizjournals.com/triangle/stories/2003/04/21/focus5.html?page=3



Interim Healthcare
==================

Interim Healthcare is focused on two healthcare staffing franchises -
Medical Staffing and Home Health Care.
http://www.interimhealthcare.com/franchise/typefranchise.asp

The Medical Staffing franchise "provides per diem, temporary
temp-to-perm, direct hire and Site Solutions nurses and other health
care personnel to hospitals, nursing homes, assisted living centers,
federal, state, county and local governments and commercial clients
such as insurance companies, manufacturers, HMOs, doctors, etc."

The Home Care Franchise Program provides "continuous and intermittent
health care personnel to patients in their homes."

==

 The company has also added a Pediatric Credentialing Program to
enhance "the skills of nurses within its network of nearly 300 offices
in order to provide a higher quality of care to their youngest
patients."

"Commenting on the Pediatric Credentialing Program, Mr. Schundler
states, "Our unique Pediatric Credentialing Program is one more reason
why so many health care professionals are choosing Interim HealthCare
as their employer. Our pediatric nurses are a very dedicated group of
health care professionals and we are proud of their commitment to
improving their skills and providing the highest level of care."

Interim HealthCare is now introducing the Pediatric Credentialing
program to physicians to inform them of the additional level of
training by select Interim HealthCare pediatric nurses. Patients and
family members will also be informed of the program to help reassure
them during their time of need

From "Interim HealthCare's New Pediatric Credentialing Program
Attracts Potential Nurse Recruits." Interim Healthcare News. (Oct.
2002)
http://www.interimhealthcare.com/news/HtmlNews/NewCredProg.asp



AJACom
======
http://www.ajacom.com/Services/SvcHealth.asp

Providers of Temporary, Temporary-to-hire and Direct Hire employees.
See website for the large variety of healthcare positions they fill as
well as support services.
 

Medical Doctor Associates, Inc.
===============================
www.mdainc.com

"Founded in 1987, MDA is one of the largest privately held medical
staffing companies in the U.S., and one of only two that provides
occurrence malpractice insurance. Headquartered in Atlanta, GA with
major offices located in Dallas and Salt Lake City, and satellite
offices located throughout the U.S., MDA provides recruiting expertise
for all physician specialties, allied health and healthcare
professionals.


Dental and Medical Staffing Inc 
===============================
http://www.dentalstaffinginc.com/staffing.html 

==

Also see TheraTech Staffing for an intersting business Model
http://www.theratechstaffing.com/gettingstarted.asp

==

Additional Reading:

"Medical Staffing turns black: earns profit in Q4, '02." South Florida
Business Journal
(Feb. 19, 2003)
http://southflorida.bizjournals.com/southflorida/stories/2003/02/17/daily35.html


Neuropsychiatric conditions are replacing infectious conditions as the
most rapidly evolving cause of disease in the world.
Read "Global Disease Burden," by Dr. Sarina J. Grosswald. Business
Briefing Global Healthcare (2002)
http://www.wmrc.com/businessbriefing/pdf/healthcare2002/reference/23.pdf


==========


 I truly hope this information is helpful. If you need anything
further, please let me know.

 And once again, I truly appreciate your patience!

Sincerely,

umiat

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Comments  
Subject: Re: Medical Staff Outsourcing as a Business
From: drewk05-ga on 09 Mar 2005 12:23 PST
 
I noticed information about New Zealand, this could be helpful aswell: www.nzti.com

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