The judge upheld the state's requirement that hospitals maintain specific nurse-to-patient ratios at all times. "CHA is very disappointed by today's decision," CHA spokesperson Jan Emerson stated. "The judge's ruling essentially handcuffs a hospital's ability to guarantee access to timely health care services for every patient who needs our care. We will consider all of our options, including a possible appeal of the court's ruling."

Many employers shifting rising health benefit costs to workers
Employer efforts to rein in double-digit increases in health insurance premiums has focused in the past couple of years on increasing patient cost sharing and revising family coverage policies, according to a study released today by the Center for Studying Health System Change. The major employer strategy was to increase employee cost sharing "moderately," by passing on a larger share of premiums to workers or increasing co-payments, deductibles and coinsurance, the study found, noting the increases essentially reduced the level of benefits in exchange for lower premiums. 

Some employers promoted public health insurance as an alternate source of coverage for children of low-income employees, and many modified family coverage or were planning to do so, notes an issue brief on the study, which was based on interviews with health benefit managers of companies with 500 or more workers, health benefit consultants and brokers in 12 representative U.S. communities. The brief can be found at http://www.hschange.org/. 

MA Senate passes budget amendment calling for nurse staffing ratios
In May, the Massachusetts Senate passed an amendment to its version of the state budget that would phase in minimum RN-to-patient ratios at the state's acute-care hospitals over three years. The legislation would establish minimum ratios by hospital unit, similar to California regulations that took effect in January. 

The House version of the state budget instead would create a 23-member commission, that would include the Massachusetts Hospital Association, to study the feasibility of minimum RN-to-patient staffing ratios and report back with legislative recommendations by Jan. 31, 2005. MHA supports the House version. 

The measures now go to a conference committee that will work out a compromise on the budget by July 1, the beginning of the state's fiscal year. Ron Hollander, MHA president, called the Senate amendment "bad public policy." Among other provisions, it would require a minimum of one registered nurse for every four patients in medical/surgical units, a 1:3 ratio generally in the emergency department and a 1:1 ratio for trauma care.

Health care jobs among the largest, fastest-growing occupations in the U.S.
According to Bureau of Labor Statistics projections for 2002-2012, health care jobs are among the largest-growing and fastest growing occupations in the United States. The biggest increase will be for registered nurses, rising from 2.284 million in 2002 to 2.908 million in 2012, a jump of 27 percent. 

The BLS forecasts that medical assistant numbers will climb at a faster rate than any other occupation, from 365,000 to 579,000, up 59 percent. Five other health care occupations are among the 10 fastest-growing: physician assistants, home health aides, medical records and health information technicians, physical therapist aides and physical therapist assistants. Visit www.bls.gov. 

Senators call for increased nurse education funding in FY '05
Forty-one senators have signed a letter urging the Labor-HHS Appropriations subcommittee to increase funding for nurse education and development programs by $63 million in fiscal year 2005, citing the nation's burgeoning shortage of nurses. The letter, spearheaded by Senators Barbara Mikulski (D-MD) and Susan Collins (R-ME), says adequate funding for the programs 
is needed to fulfill the promise of the Nurse 
Reinvestment Act. 

The senators note that nursing programs turned away more than 11,000 qualified students last fall, due in part to a shortage of faculty, and that the Health Resources and Services Administration could fund only a fraction of the applications it received for nursing student loan repayment and scholarships in FY 2003. “Clearly, we must do more to address the current shortage and ensure that there is an adequate and well-educated supply of nurses to meet our future health care needs,” they said.

Increased use of health savings accounts could increase health plan deductibles
"Widespread adoption" of health savings accounts authorized under the new Medicare law could "drive up" health insurance deductibles for workers over the next two years, USA Today reports. HSAs, which allow consumers to save funds tax-free for future medical expenses, are available to members of health plans that have annual deductibles higher than $1,000 for an individual and $2,000 for a family. 

According to a survey of 991 employers conducted by Mercer Human Resource Consulting and scheduled for release this week, 73% will likely offer HSAs to workers by 2006. About 61% of employers surveyed said they would set the individual annual deductible for HSAs at $1,000, compared with 17% at $1,500, 11% at $2,000 and 10% at more than $2,000. 

In addition, according to the survey, 39% of employers would not contribute funds to the HSAs; 24% would contribute $500 per year. As a result of the high percentage of employers that plan to offer HSAs, USA Today reports that workers could face an increase in the average annual health insurance deductible -- currently about $300 for single workers and $600 for families, according to data from Mercer and the Kaiser Family Foundation. "We're looking at a major market change," Linda Havlin, Midwest health care practice leader for Mercer, said. 

Helen Darling, president of the National Business Group on Health, added, "There will be a big jump in interest" in high-deductible health plans among employers. However, Bill Sharon, senior vice president at Aon Consulting said the number of employers that plan to offer HSAs likely will decrease after "they have time to reflect on it and see whether it fits into their own organization" (Appleby, USA Today, 4/26).

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