September 15, 2008
Healthcare Traveler Magazine (www.HealthcareTraveler.com)
Joining together
Top executives from several travel healthcare staffing organizations are forming NATHO, a new, non-profit association
Patricia Stille Lederman
Celebrating its 30th anniversary this year, travel healthcare staffing has become a multi-billion dollar industry, with, according to Staffing Industry Analysts, Inc., hundreds of companies and upwards of $5.9 billion in revenue. Now, as then, however, its core objective remains building partnerships—between staffing agencies, nursing and allied health professionals, and contract facilities—so high quality care can be delivered to patients in need.
In response to the industry’s recent growth, and predictions for a massive shortfall of healthcare professionals in all disciplines, top executives from several staffing companies have come together to form a new, non-profit association. The National Association of Travel Healthcare Organizations (NATHO)—to be formally launched at the Staffing Industry Analysts, Inc.’s 2008 Healthcare Staffing Summit in San Francisco this month—promises to provide a forum for travel healthcare staffing firms to exchange ideas, address industry issues, promote ethical business practices and educate NATHO’s audience (travel healthcare firms, travel professionals, and healthcare delivery organizations). By “setting the gold standard for conduct” among member agencies, it is hoped these efforts will enhance customer service, offer greater opportunities to partner, and improve the experiences of travelers and client organizations alike.
In the following pages, Healthcare Traveler invites the Advisory Group members to reflect on the short- and long-term goals of NATHO and how the association may assist the healthcare community in meeting current and future challenges.
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SIDEBAR
NATHO ADVISORY GROUP MEMBERS
SCOTT BECK, group president at CHG Healthcare Services, oversees several operating divisions providing physician and allied health staffing services. Mr. Beck has held numerous leadership positions in both sales and marketing since joining CHG in 1999, including president of the company’s largest sales division, CompHealth Locum Tenens.
CYNTHIA KINNAS co-founded Clinical One (now part of the Vedior group of companies) in July 1993 and currently serves as president of its Travel Division where she oversees all revenue and operating activities. Having begun her career as a healthcare recruiter, Ms. Kinnas has over 19 years of experience in the healthcare staffing industry.
LARRY KRASKA is responsible for the travel operations for Nursefinders, which comprises Club Staffing, Nursefinders Travel, National Healthcare Staffing, and Resources on Call. Mr. Kraska joined Club Staffing as its chief executive officer in November 2001 and has over 20 years of diversified healthcare management experience in the areas of healthcare staffing, hospital administration, physician practice management, recruiting, operations, and outpatient services.
MARK STAGEN is the founder and CEO of Emerald Health Services, established in 2002. He was awarded the Ernst & Young's 2007 Entrepreneur Of The Year® award in the Greater Los Angeles region and was selected as one of 30 national finalists from approximately 300 regional winners. Emerald was recently recognized by Staffing Industry Analysts as the sixth fastest growing staffing firm in the nation.
JONATHAN W. WARD, president of Cross Country Staffing, joined the company in 1993 and has held numerous executive positions including executive vice president of operations for Cross Country Staffing and chief marketing/strategy officer for Cross Country Healthcare, Inc., the corporate parent. Before joining the firm, he spent 3 years at W.R. Grace & Co. as assistant to the chairman and CEO.
STEPHEN M. WEHN joined AMN Healthcare in 1993 and has been senior vice president of corporate and community development since December 2004. Prior to that, he served as senior vice president of client sales and services, vice president of client services, and as national director of client services. Before joining the company, Mr. Wehn worked in various management capacities for Manpower, Inc.
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Please elaborate on how and why NATHO is being founded.
Cynthia Kinnas (CK): Ours is one of the very few industries that did not have its own association. So I think there was just a crying need for it. In the past, company leaders could only connect and communicate at industry functions. We wanted to find a way to keep our discussions going, to have a forum to address issues and to collectively publish some standards, and raise the level of quality in our industry.
At last year’s Healthcare Staffing Summit, Don DeCamp, COO of CHG Healthcare Services Inc., brought up his successes with NALTO, the National Association of Locum Tenens Organizations, and Mark Stagen, with Emerald Health Services, took the ball and ran with it. He set up a draft website for NATHO and called myself and some of the other executives and invited us to be part of the Advisory Group Committee.
Stephen Wehn (SW): The industry has transitioned from largely smaller regionally based entrepreneurial providers of seasonal healthcare staffing to a nationally accepted travel staffing delivery service whose suppliers include large publicly traded organizations as well as highly professional private companies. Like most industries our size, we are at a point where we can benefit from an association’s voice to represent the collective value we bring to healthcare facilities and healthcare providers across the nation in providing quality patient care. Through an association’s voice, we can better educate our policy makers about our industry. I am very pleased that the rubber has finally hit the road and leadership from several different organizations took action to make this association happen.
Jonathan Ward (JW): The industry has changed significantly. A number of companies have entered the market, and new organizations have been formed. Technology is a more prominent element of the business process, and vendor or contract management, whether it be organizations or technologies, are much more prevalent today than they were 5 years ago. Requirements on companies in our industry are certainly more complex today than they were in the past, with standards continuing to improve and increase over time, thanks in part to The Joint Commission’s Health Care Staffing Services (HCSS) Certification Program, launched in October 2004. Plus, there have been considerable changes in the professional liability insurance market and in the structure of other benefits. Facility clients and travel healthcare professionals have become increasingly sophisticated. Given the structure of the industry today, the time was right to create a non-profit association to promote practices that ensure our industry maintains a positive reputation amongst both healthcare professionals and the facilities that contract them.
Scott Beck (SB): NATHO’s formation is a collaborative effort on the part of the leading firms in the industry to professionalize standard business practices within the healthcare staffing industry. It’s driven in part by previous success in the locum tenens physician staffing marketplace and by similar needs in the travel nursing and allied health marketplaces. Our mission is to establish and promote ethical business practices across the board among industry players. We’ve also embraced a code of ethics to raise the bar by which all these companies operate.
Larry Kraska (LK): While travel companies—large and small—will always view each other as competitors in the marketplace, belonging to an association like NATHO will give us more of a non-threatening opportunity to share ideas and to talk about best practices within our industry. Ultimately, we want NATHO to become a gold standard where travel companies want to become members and travelers choose to work with companies that are part of the association because they expect a certain level of service and quality.
Mark Stagen (MS): Since there have never been specific guidelines or a body that developed best practices for travel healthcare organizations, NATHO will establish higher expectations that all agencies can strive to achieve. The Advisory Group Committee—which consists of the largest healthcare staffing firms in the country with many decades of experience and thousands of traveling healthcare professionals as partners—has proposed best practices by which to abide. The resulting Standards of Practice & Procedures for professional conduct and Code of Ethics can be found online at www.natho.org/ethics-standards.php.
By adhering to these guidelines, member agencies can avoid disputes and raise the bar for the entire industry. For when traveling healthcare companies provide excellent service, it improves our business and the ways hospitals and travel healthcare professionals view us, which in turn improves our industry’s reputation.
What are some of NATHO’s standards and how will they benefit travelers, clients, and members?
MS: Nothing is revolutionary. It is all common sense, and most agencies are likely complying with these guidelines already. For instance, member companies should not submit a traveler candidate to a facility for placement unless representatives have obtained the traveler’s permission to do so. And if a traveler has signed up with two companies and they both present the candidate to the same hospital, the agency that receives the actual job offer, regardless of timing of submittals, will represent the traveler.
JW: If a traveler visits the NATHO website, he or she can see the ethics and standards adopted by member companies and know what to expect when working with them. Given the mix of organizations in our industry, this is a good tool for determining where individual agencies stand. In the future, there also will be opportunities for the healthcare professionals to voice any concerns about their experiences with NATHO firms. From the perspective of the traveler, that’s really one of the key benefits.
SB: NATHO members must adhere to Standards of Practice that include performance issues stressing honesty, objectivity, integrity, and competency. Member companies are obligated to conduct business so that their actions reflect positively on the profession and the association. It’s really a win-win-win situation for travelers, clients, and healthcare recruiting firms because satisfied people bring an improved perception to the industry.
What are some specific initiatives and goals on NATHO’s agenda?
JW: The first goal is to invite all companies in the industry to become members. Having large participation is key, but firms must be willing to abide by the ethical, legal, clinical, and quality service standards. Then we can look to a variety of ways to enhance the benefits for travelers and healthcare organizations.
Our hope is to work with vendors that provide services to our types of companies across the country and possibly negotiate volume or membership discounts with those suppliers. Some of those may be services that can be also be passed on to travelers. Another objective will be to provide benchmarking statistics so that there’s more data available as to the size of the market and trends in the marketplace, which can only aid in promotion efforts. We also see benefit in working together to advance particular legislative interests, whether it be at the state level or the federal level. Typically, I would say these would revolve around immigration issues.
SB: Collectively, we want to provide a competitive, high-value, high-quality service to all of our travelers. As NATHO gains momentum and the number of members increase, we’ll form a community that can go out and talk to clients—to try to develop a better understanding of their views and things that the association can do to further improve the industry, both from their perspective and from that of travelers. We’ll be able to share resulting best practices with colleagues without reaching any competitive advantage.
LK: We hope to develop standards in the industry regarding credentialing, tax compliance, and ethical business practices. In addition, the goal is to develop marketing and educational strategies to help NATHO increase hospital and healthcare provider awareness of travel healthcare staffing. We want to advance and continue to improve the perception of the travel healthcare industry, so that we are viewed as partners to our clients and travelers.
MS: Education is one of the key facets of NATHO. We have a very complex industry: We recruit healthcare professionals from all over the country, usually transport them to a different state, put them up in housing, rent them furniture. We have state-to-state issues, federal issues, housing and transportation issues, liability and licensing issues. Our industry has a lot of concerns that other staffing industries just don’t have. It is our hope that agencies can benefit from the added communication, shared resources and services, and benchmarking, and gain awareness of legislative and political issues that only affect companies in this segment of the staffing industry.
SW: NATHO plans to launch the National Clinical Advisory Committee, which will bring clinical leaders from different travel healthcare staffing organizations together under the umbrella of the association. This Committee will focus on clinical and quality issues to further support and enhance the effectiveness of travel healthcare professionals in the clinical setting.
CK: Other items that NATHO likely will address include tax advantage plans, housing, HCSS certification, and increased credentialing requirements by clients.
How will NATHO assist travel healthcare organizations in meeting their top challenges?
CK: The top challenge for healthcare travel staffing firms (and clients), however, is the growing shortage of qualified healthcare personnel, and it is going to remain the Number One issue for several years. Exacerbating this situation is the fact that some professionals have had negative experiences over the past few years, creating a disconnect between those travelers and the staffing industry. Healthcare travel should be an exciting, mutual partnership. If clinicians decide not to become part of the pool that will provide supplemental staffing services to hospitals, the problem is just going to grow exponentially.
What can we do collaboratively to help? I think the major issue is not poor intentions, but rather a lack of knowledge of some of the complex standards and practices, and what goes into running an ethical travel healthcare organization. NATHO’s educational efforts can serve to improve the quality of services provided by agencies and, in turn, enhance the overall travel experience.
MS: By increasing the level of quality of all of our firms, and our industry, we’ll be able to attract more travel professionals because there will be fewer companies that are misinformed about proper procedures. We want travel healthcare professionals to have great experiences and to tell their friends about it.
SW: The industry’s greatest challenge continues to be—and will always be—the supply of qualified healthcare professionals available and willing to travel. The supply constraints prevent us as an industry from meeting the staffing needs of client facilities, which has a direct impact on the quality of care they are able to provide our communities. I believe one of the most important responsibilities of NATHO will be to further educate healthcare professionals on the great opportunities that we offer as an industry for those wanting to travel far or near, expand their skills in various clinical settings, create flexibility and better balance between their career and home life, and increase their satisfaction as professional caregivers.
JW: Getting more nurses or allied healthcare professionals interested in the travel staffing profession is difficult for each individual agency to do. We typically market our companies to attract people who are ready, interested, and in the marketplace looking. NATHO could actually play a collective role in getting more people interested in the traveling as a career or way of enhancing their clinical skills.
How will NATHO assist client facilities in meeting their top challenges?
LK: Prior to joining Club Staffing, my background was in hospital administration, and on many occasions, I used temporary healthcare staffing agencies. I found when I needed temporary clinical staff, the challenge was not only getting clinicians in quickly, but also knowing that I could count on the company to provide high quality staff. Our goal is to establish a reputation where healthcare clients view NATHO members as agencies that consistently provide quality staff and maintain high ethical standards.
SB: Educating clients on how to manage peak staffing levels during high census periods is an issue on which NATHO is focused. Having the flexibility to handle different staffing levels through contingent staffing can benefit long-term permanent personnel as well as become an economic benefit to organizations.
What are some future industry trends that may impact NATHO’s long-term goals?
LK: I believe that the travel staffing industry will continue to grow and there will be an increase in the number of companies providing these services. Therefore, it is important to have an association that focuses on setting standards and tracking industry trends, while educating clients and travelers, so there is some consistency across companies.
SW: Right now, in travel nursing especially, we predominantly staff the nation’s acute care hospitals. As healthcare services and access to care become more diverse, there will be more opportunities for travelers to work in various non-acute care healthcare settings. More travel assignment opportunities in outpatient and specialty clinics, mini-clinics in retail stores, remote and home healthcare opportunities. Our client base will become much more diversified than it is today.
JW: With the concern regarding the nursing shortage, and current immigration laws, immigration legislation will be an important topic for discussion. Also, I think that greater standardization of interfaces between third party vendor management systems and technologies utilized by staffing companies will help to improve efficiencies for clients and agencies alike.
CK: There’s obviously a lot of focus on healthcare politically, as the presidential election approaches. Polls report that it’s the top domestic issue, along with the economy. While all the candidates propose some type of universal health insurance program, not one of them has explained how the system is going to provide services if the 48 million Americans who are uninsured suddenly have improved access to care. Travel healthcare professionals and staffing agencies are going to play an even larger role than they do now in patient care delivery. And we owe it to our key stakeholders—the travelers, clients, and patients—to continually improve the level of service that our industry offers them. We want travelers and healthcare facilities to be able to focus on their core competency—delivering outstanding patient care.
MS: For the future, NATHO has three target audiences: The travel healthcare firms (for membership), the travelers (to increase awareness of our seal of approval and resources available), and the hospitals and vendor management solutions providers. It is our hope that clients will think of us like they view certification by The Joint Commission, and that everyone will realize that NATHO stands for a high level of quality service.
SB: The value of a competitive, collaborative association like this is really phenomenal in regard to professionalizing the industry. Through education and communication, it can elevate the perception and value of healthcare staffing in the marketplace, both today and in the future. I think NATHO can have the same impact in the allied and nursing arenas as NALTO has had in the locum tenens industry. By encouraging collaboration between member agencies and adherence to standard business practices, NATHO will be able to address any future changes or trends in the healthcare staffing industry. HT
PULL QUOTES:
The new association promises to “set the gold standard for conduct” among member agencies.
NATHO will enhance customer service, offer greater opportunities to partner, and improve the experiences of travelers and clients.
Celebrating its 30th anniversary this year, travel healthcare staffing has become an estimated $5.9 billion industry.
WHAT IS NATHO?
- ⦁ Promote benefits of travel healthcare staffing to healthcare industry at large
- Share internal and external resources among member travel staffing firms
- Address industry issues and promote quality through a forum
- Ethics and Standards
- ⦁ Standards of Practice & Procedures
- Code of Ethics
- Maintain peer review process based on excellence, honesty, and fairness
- Offer members formal dispute resolution through arbitration
Source: www.natho.org
- NATHO MEMBERSHIP FACTS
- Must be Joint Commission-certified or in process of gaining HCSS certification
- For travel healthcare companies with proof of insurance coverage
- Initial annual fee is $500 per organization, with revenue tier structure in future
- Associate member category planned for vendors and suppliers
- Annual membership meeting tentatively planned to coincide with healthcare staffing summit
- Fifty applications from travel healthcare firms in first month
Patricia Stille Lederman is group editor of Healthcare Traveler.
