A large part of the federal push announced last week to assure that all Americans are vaccinated against Covid-19 is centered around medical facilities that accept Medicare and Medicaid payments. All employees at these facilities will need to be vaccinated in order to remain employed. This particular directive was an expansion of an earlier order issued on August 18, 2021, that limited the requirement to nursing homes and long-term care facilities. Now hospitals and home healthcare facilities that accept either Medicare or Medicaid must also comply.

The question we ask is, in a world where there is already a shortage of qualified medical personnel, and a significant percentage of medical people remain unvaccinated, will this create problems in the availability of timely quality care? As of July, less than 50% of nurses and nursing aides had received “the shot,” with the largest percentage being in long-term care facilities. Recent actions have shown that many of them will capitulate when their employment is threatened, but some will not. In Houston, when the Methodist Hospital mandated vaccination this summer, 150 of their workers chose termination over the vaccine.

And the hospital is struggling with a major labor shortage as a result.

Locally, employee vaccination rates at our own county hospital are reported to be around 70%. While the organization had not yet mandated vaccinations, they were offering significant financial incentives for employees who would agree to be vaccinated. Being an area with a large retirement population, Medicare is a significant source of revenue for the operation. This hospital has already been canceling elective procedures (including yours truly for a second knee replacement) due to increased covid related patient counts. What will the impact be when they must shed some of their staff over vaccination status, especially while the impact of the Delta variant continues?

The workers’ compensation system will not be immune to this effect. Patients being cared for under our system are competing for the availability of these same medical services that may now be more challenged than ever before. Wait times for appointments and other care-related services have already become difficult. These new requirements may mean that what was once merely difficult will soon become interminably long or nearly impossible.  

The workers’ compensation industry showed during the early days of Covid that it could, to the surprise of just about everyone within the system, readily adapt when forced to do so. The same creativity and innovation that allowed the system to continue functioning in most states may once again be relied on to address this challenge. More innovative use of telemedicine and better triage services may be needed to reduce the demand for traditional medical care. 

Much remains to be seen regarding these changes in the days ahead. There will be legal challenges to the new federal requirements. However, our industry would be wise to remain cognizant of the threat. While a shortage of medical personnel is not really a new idea, the implementation of these new mandates could bring an entirely new meaning to the phrase, “You ain’t seen nothing yet.”

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