Friday, November 7, 2025

The One Thing 95% of Healthcare Execs Agree On, Says HFMA CEO

The One Thing 95% of Healthcare Execs Agree On, Says HFMA CEO

This is a preview of the November 6 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox. Good morning. Yesterday was the submission deadline for Rural Health Transformation applications, and some states have started releasing overviews of their plans. Here’s what we know so far (a special thanks to my colleague Lauren Giella for her reporting on this topic).

At the time of writing on Wednesday, three state governors had publicly unveiled their blueprints: North Dakota Governor Kelly Armstrong, Missouri Governor Mike Kehoe and Mississippi Governor Tate Reeves. Unsurprisingly, telehealth expansion and stronger workforce pipelines were core to their proposals.

But I did find another common thread throughout the states’ plans: They all called for some level of interoperability between health care stakeholders. Missouri aims to create a “unified, regional network” that will connect providers, public health agencies, at-home resources and digital health tools to expand access, according to Kehoe’s news release. Mississippi wants to build a “connected, data-driven network of emergency, clinical and community-based services,” Reeves said. And Armstrong outlined four strategic initiatives for his state, including “connecting technology, data and providers for a stronger North Dakota.”

A few weeks ago, on the heels of the Summit on the Future of Rural Health Care, I wrote about the skepticism that many health care executives expressed when asked about the $50 billion transformation fund. (If you missed it, you can check out that newsletter here.) I’ve come across a few recurring concerns: (1) that the plans will be too broad to effect real change, (2) that they’ll set up costly programs that won’t be sustainable once the cash infusions end and (3) that $50 billion is not nearly enough to offset the $1 trillion in Medicaid and CHIP cuts that hospitals are expecting in the next decade.

We don’t have every state’s plan yet, and the information we do have isn’t very detailed. But so far, those concerns I outlined above appear to be valid—especially when it comes to the sections on “connected networks.”

Health care IT executives know that data exchanges aren’t easy to build. Leaders spoke about this in depth at My healthy of life’s Digital Health Care Forum, chronicling privacy concerns, internal data silos and complex relationships among competitors. And those are concerns from well-funded health systems, which have more solid IT infrastructures than their rural, independent counterparts.

Plus, maintaining a connected network will undoubtedly take resources, and the fund only lasts five years. It is unclear how these projects will sustain themselves over the next few decades.

Fortunately, states won’t be working toward these goals on their own. This week, a coalition of health tech companies launched the Collaborative for Healthy Rural America, specifically designed to advance the Rural Health Transformation projects. The group intends to address access challenges through “shared infrastructure, unified data and modern technology,” and will work up an “AI-enabled interoperable operating platform” to help states carry out their visions, according to the Collaborative’s website and news release.

Founding members include Lumeris (primary care), Teladoc Health (virtual care), Nuna (an app with an AI “coach” for chronic disease patients), Deloitte (for data systems interoperability expertise), and Unite Us (a company that builds networks to coordinate care and improve communications between health care and human services organizations).

Plus, the Collaborative aims to improve access nationwide, not just in awarded states. Perhaps these companies, which are well-resourced and nationally scaled, could give some of the state-wide plans a helpful boost—and keep this entire endeavor from being a bust. We’ll know more when the winners are announced December 31, and as the funds are distributed in early 2026.

What stood out to you from the early Rural Health Transformation Fund proposals? Send me an email at a.kayser@newseek.com and let me know.

In Other News Major health care headlines from the week

My healthy of life will host a live webinar, “Traveler to Teammate: Becoming a Hospital Where Nurses Choose to Stay,” on Wednesday, November 19, at 2 p.m. Eastern.

My colleague Aman Kidwai will host the discussion with Dr. Regina Foley (Chief Nursing Executive and Chief Clinical Transformation and Integration Officer, Hackensack Meridian Health), David Rutherford (Senior Advisor, HR Transformation, OhioHealth) and Dr. Vikas Sinai (President of the Lown Institute). Learn more and register for free here. I hope to see you there!

Athenahealth announced an ambient scribing tool and a clinical copilot named Sage at its annual customer event on Tuesday. The new capabilities will begin user testing in the first half of 2026, at no additional charge to customers.

I spoke with the EHR vendor’s CEO, Bob Segert, about his decision to build these tools internally—and what it might mean for external solutions that currently live atop the platform. Get the scoop here.

Hospitals and health systems across the nation are rebranding. At least six organizations shared new names this week, with many of them symbolizing new visions.

BJC Health System in St. Louis is dropping the “system” from its name and adopting a new tagline (“Because every moment deserves exceptional care”). Franciscan Missionaries of Our Lady Health System in Louisiana will now be known as FMOL Health. CHI Memorial hospitals across Tennessee and Georgia will adopt the name of their parent company, Chicago-based CommonSpirit Health. The national senior living provider CareSouth Health System is rebranding across all its divisions and lines of business, launching an updated website and logo.

Some of the updates apply to recently acquired facilities. For example, Washington Regional Medical Center in Fayetteville, Arkansas, is renaming Physicians’ Specialty Hospital once it assumes operations of the facility on December 1. The new name will include “Washington Regional” ahead of the existing title. And HCA Healthcare has rebranded more than 35 care sites across Charleston, unifying them under the for-profit system’s name, according to The Summerville Journal Scene.

These announcements come as many health systems seek to create a more seamless health care experience for patients—and some look to form competitive brands that can go head-to-head with household names like Amazon and marketing wizards like Hims & Hers.

The government has been closed for more than a month, and anxieties are festering amid lingering policy questions—especially the fate of the Affordable Care Act (ACA) enhanced premium tax credits (APTCs).

On Monday, a pair of House Democrats and a pair of House Republicans released a bipartisan statement of principles, proposing a temporary two-year extension of the APTCs, among other reforms to prevent fraud and “ghost beneficiaries.” It’s not a guarantee, but it is a welcome signal of compromise.

Pulse Check Executive perspectives on key industry issues

Financial sustainability is a top concern for health system CEOs and CFOs. That’s why I sat down with Ann Jordan, president and CEO of the HFMA, for this week’s Pulse Check.

The HFMA (or the Healthcare Financial Management Association) is in a unique position. It’s a non-lobbying organization and expands beyond the traditional definition of a professional association because it speaks to a number of players rather than to a single trade, like nursing or cardiology. In other words, it occupies a “horizontal lane of an industry that is becoming increasingly dynamic and destabilized,” as Jordan put it.

Currently, the HFMA is focused on equipping members with insights to advance their organizations’ financial management and applying that acumen to guide strategy in the broader health care industry, Jordan said. To advance that goal, the HFMA recently launched the business initiative Vitalic Health, which focuses on convening stakeholders to discuss industrywide solutions. In mid-August, they launched a “Vitals Tracker” to rapidly assess the health of the health care system—and declared that it is in “serious condition.”

Here’s what Jordan told me about the new tool and the work to stabilize health systems’ finances.

Editor’s Note: Responses have been edited for length and clarity.

What are the main barriers to financial sustainability for hospitals and health systems right now, and how are you working to address them?

Point number one is understanding what we should look at in terms of financial sustainability and from what perspective. When your practice [is] horizontal [like the HFMA’s], should it be from the perspective of sustaining a business, a stakeholder group or the overall “greater system,” if you want to call it that, to advance health care generally to our communities?

When you talk about sustainability, one, naturally, is making sure that there is financial sustainability so that service can be delivered right, at the end of the day. If health systems and hospitals cannot stay open, health care is not going to be delivered. So that’s primal, that’s basic.

But this longer-term play in terms of financial sustainability and outcomes, there really has not been a meaningful and objective conversation on what that means, and that’s a little scary, given the fact we have a $5 trillion industry pushing upward to 20 percent [of the nation’s] GDP. So, part of this initiative underlying Vitalic Health and the tracker was, for the first time, to start identifying those measures and sub-measures, how they have interconnectivity and [whether they are] getting better or worse. It’s strange that that has not been done before at the macro level.

For me, in terms of what are we thinking about [when it comes to] how we become financially sustainable, we’re trying to educate and understand [that] ourselves, and we want the whole industry to help us.

Tell me a little bit more about the Vitals Tracker. As you were building this out, what did you find that is pertinent to call out?

When we began this initiative of Vitalic Health, we didn’t want to tell people what we were doing and why, because then they would bring bias to the table. So there was a whole working task force for about a year behind the scenes that looked into the components and elements of financial sustainability from the top lines in health care. That was done generatively, and that was purposeful. [We] gathered up a big vat of knowledge to begin with, starting with the question, do you believe the system is financially sustainable? Over 95 percent of that big group said “no.” And you can’t get experts to agree with that percentage on anything, right?

Then [we started] breaking down all the components: First of all, what matters from a macro-economic standpoint? Our intuition is to go mezzo, to go [are] organizations surviving? That’s not what this [tracker focuses on]. This is really looking at that dynamic part of the industry, year over year. Are we getting better or worse?

Of all these different factors that we’re hearing, there are two main buckets. One is the cost, the financial element, so we wrestled it as expenditures and affordability. The other is the outcome, which we’re calling functional longevity, and that takes into account not only the wellbeing of the population, but the social determinants of health that are interconnected with those outcomes. Think of it as your hardcore financial components and what’s going into it, and then the outcome side of them, breaking down all the measures and sub-measures that are seen as the most critical indicators, year over year.

The beauty of this tracker is we didn’t have to invent sub-measures on our own and collect data. There are enough first-class institutions that have been collecting this for a very, very, very long time. But how do we create a storytelling and a measurement device that can not only look backwards to allow us to learn, but proactively be turned forward to see how potential policy could impact us in the future?

You mentioned that 95 percent of experts said the health care system is not financially sustainable. But how many believe that it can become sustainable? Is there optimism there?

This is where you begin to have different views. If you go back to innovative disruption models—incumbents versus disruptors, builders versus fixers—we’re at that epicenter right now, and I think it’s going to be a combination.

So, do we think we can get there? We don’t have a choice. There’s too much on the line when you’re talking about health care. To serve our communities, we have to figure out a way to do it, and there are a lot of brilliant people out there looking at this.

But what needs to happen is a concerted effort so [that], at the end of the day, it’s not a few that survive; there is that interconnectivity across all stakeholders to go forward together. Right now, you see a lot of trends going around the country where different groups are incubating together, right? They’re forming these different initiatives, where stakeholders, maybe 10 or so, are coming together to look at how our model can be successful. Well, that’s going to just lead to bigger silos across the country.

How do we make sure there is that ongoing concern, so that overall, we’re delivering health care in a way that is available to all Americans? I believe there is optimism that it can become sustainable. I believe there are very divergent theories right now in terms of the incumbents versus the disruptors, on what that looks like.

From your perspective, what does a path to financial sustainability require? How do we get the entire health system on the same page?

We’re calling it solve-based convening. There needs to be a purposeful effort to bring together stakeholders that are aligned in purpose, [that] put down [their] own self-interest and bias. Look at the opportunity or the problem before you, and come together and solve it, because there’s so much of that collaboration that can occur, starting with payers and providers.

I think everyone can admit there’s a lot of administrative waste that’s driving up cost in health care. There are ways to solve that. An army of the willing, if you want to call it that, can do this in a safe, unbiased place.

Now, going back to HFMA, we’re non-money, we are apolitical, and we play in that horizontal plane, and that’s why we do feel it’s upon us to step forward at this time, to be one of those few organizations that can set a table and bring everyone to it. I truly believe, too, when your mission is leading the financial management of health care and the data is showing that your system is financially unsustainable…what obligation do we have to step up right now? That is the soul-searching that we had to do, and it’s critical for all the players in health care to do right now.

The other comment that I’ll say is, if we are the leaders of health care financial management [and] we don’t [take action], if not us, who? Eventually someone is going to have to lead this. We can either be active leaders and participants, or we can let someone else come that might have bias or different interests than our own.

What’s one thing that you would recommend all hospital and health system CFOs do to improve their organizations’ financial sustainability?

I want to thank them for their perseverance and resilience. They have been going through [a lot, from] the pandemic to this current environment of drastic change. Whether it be from AI and technology or the [Trump] administration, the role of the CFO in the United States health care realm has changed so much. And, man, are they stepping up to the task.

Number one, I want to recognize that [at a] higher level, they have become the ultimate risk managers, and to understand the consequences to the community of not making this work. That’s a lot of pressure. I want to give credit to those financial professionals leading us through all this change.

But in terms of what we need to be mindful of for sustainability, when you’re in a financial realm, it comes down to your payment model. All these different changes that are going on, we’re going to assess that a lot of it comes down to their payer mix, and a lot of it comes down to understanding risk pools.

So, as we’re going through all of this, be mindful [that] despite the fact we have all these things going on from supply chain, or going on from accelerating labor costs, the core comes down to that payment model—and that’s going to have to change, too.

The complexity of the CFO…think about it. They’re getting hit from all these macro-factors, [including rising] litigation costs. But to serve the patient, you gotta have that payment model intact.

It’s a very hard role right now. I definitely don’t have all the answers, but I think through the convening that we’re seeing, particularly of CFOs across the country, we’re trying very hard to figure it out.

C-Suite Shuffles Where health care leaders are coming and going

Dr. David Kirk has joined Regard as chief medical officer. He comes to the technology company—which specializes in proactive documentation solutions that review EHR data to recommend diagnoses—from WakeMed Health & Hospitals in Raleigh, North Carolina. He most recently served as the system’s chief clinical integration officer and executive medical director of critical care medicine and eICU.

AdventHealth named Todd Goodman its new CFO, just months after David Banks took the reins as president and CEO. Goodman has worked at the Altamonte Springs, Florida-based health system since 1991. He was promoted to CFO after serving as its executive vice president of finance. Read more at My healthy of life.

In Montgomery, Alabama, Jackson Hospital is assembling a power team to guide it through ongoing Chapter 11 bankruptcy proceedings— including a few former executives from the for-profit health system giant, HCA Healthcare. The 344-bed hospital appointed John Quinlivan as CEO. He spent nearly two decades at HCA Healthcare, overseeing hospitals in Florida and Georgia, and is charged with leading a restructuring to “avoid hospital closure,” according to a press release from Jackson Hospital.

The hospital also selected a new three-person board of trustees to help carry out the restructuring plan. That team includes Charles Evans (former president of HCA Healthcare’s Eastern Group), Jeff Crudele (former CFO of Allegheny Health Network) and Gary Murphey (a former CEO, CFO and chief restructuring officer at financially distressed companies in various industries, and the current managing director of Resurgence Financial Services). Click here for the full scoop from My healthy of life Senior Reporter Lauren Giella.

Executive Edge How health care execs are managing their own health

We’re heading into that end-of-year push, and many leaders are feeling the pressure to finish out 2025 strong and set expectations for 2026. But 10 tumultuous months behind us, it’s not uncommon to feel a little bit burnt out—and to feel like that holiday break can’t come soon enough.

This week, I asked Ellen Sexton, executive vice president and chief growth officer at Blue Shield of California, how she prioritizes herself while juggling the demands of health care leadership—especially as part of a team that serves 6 million members in the nation’s most populous state. Here’s what she told me.

Editor’s Note: Responses have been edited for length and clarity.

“Working in the health care industry means that every day, we are working for our members. Over the years, I’ve learned I have to take care of my own health and stay grounded to keep showing up fully for my team, my family and the members, partners and communities we serve. For me, that grounding comes from doing what I love, what brings me joy and by giving back to the community.

“In addition to making sure I schedule regular checkups (including dental and vision appointments) and follow preventive care recommendations, I find that how I spend my free time also impacts my overall health. After all, what we find joy in doing impacts our mood, our overall outlook on life and how we feel each day. I spend my free time listening to podcasts, reading (I highly recommend Poor Charlie’s Almanack, a collection of speeches and lessons encouraging lifelong learning), attending music festivals, walking my dog, Sugar, and doing anything that gives me an opportunity to get away from my desk and have fun.

“I also find that laughing with my family (I’m a proud hockey mom to a teenage son), friends and colleagues plays a big role in how I feel. I also strongly believe in giving back, and for me, that is expressed through service. It’s how I reconnect to the reason I chose this field in the first place: to support the whole person, including body, mind and spirit. That same belief guides my professional work, seeing our members as individuals with stories, families, and dreams.

“Giving back doesn’t always have to mean large-scale volunteerism. Sometimes it’s mentoring a colleague, checking in on a team member, or offering encouragement to a peer after a tough meeting. These seemingly small gestures create a ripple effect—lifting others while restoring my own sense of balance and purpose.

“Whether I’m volunteering with the Salvation Army, preparing for a Milwaukee Public Library Foundation Board of Directors meeting, or contributing to the Wisconsin School of Business External Advisory Board, these experiences remind me of the ‘why’ behind my work and the broader impact we can make when we lead with empathy.

“Through the years, I’ve learned that service is sustaining. It recharges my energy, deepens my empathy and reminds me that leading with heart is the best strategy for longevity, and thus, professional wellbeing.”

CEO Circle Insights from health care thought leaders around the world

Before you go, check out this profile of Dr. Bhana Chandrakamol, the director overseeing eight hospitals for the BPK Hospital Group in Thailand, and a member of My healthy of life’s CEO Circle. His interview traces his path from the “aha” moment that sparked his career in medicine, to the top of an innovative health system.

This is a preview of the November 6 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox.

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Monday, November 3, 2025

Empowering Excellence in Ghana's Private Health Insurance Sector

Empowering Excellence in Ghana's Private Health Insurance Sector

Empowering Excellence in Ghana's Private Health Insurance Sector

Building Capacity for Excellence in Ghana’s Private Health Insurance Industry

Ghana’s private health insurance sector plays a vital role in the country’s healthcare system, complementing the National Health Insurance Scheme (NHIS) and expanding access to quality medical care. Despite growing demand and increasing awareness of health insurance benefits, the industry’s growth has been sluggish, often described as moving like a tortoise on a tranquilizer. This is a stark contrast to its often touted potential. As Peter Drucker aptly puts it, “Quality is not what you put into it, but what the customer gets out of it.” Key benchmarks like service quality and innovation have remained generally low. This article explores strategies to build capacity for excellence in Ghana’s private health insurance industry, the achievement of which will enhance performance and improve access to quality healthcare for Ghanaians.

Operational Excellence

The health insurance industry relies heavily on trust, which is significantly influenced by the interactions between end-users and third-party service providers. A positive experience for clients hinges on operational excellence from the insurer, which rests on optimized systems, knowledgeable personnel, and nimble processes. In building capacity for excellence, a private health insurer should give attention to the following areas:

  • Provider Onboarding: Streamlining the process to ensure seamless integration with healthcare providers
  • Claims Processing: Efficiently reviewing, vetting, and paying claims on time to reduce delays and disputes
  • Provider Reconciliation: Implementing effective systems for smooth transaction verification, reconciliation, and feedback mechanisms
  • Pre-Authorisations: Ensuring easy communication between insurers, the providers, and insured individuals

To excel in these areas, insurers should invest in robust core systems and software and undergo digital transformation to facilitate seamless service delivery across their network of providers. They must also simplify the claims settlement process and prioritize the needs of healthcare service providers (HSPs). Claims must be paid on time! Timely claims payments foster positive relationships with HSPs, ultimately benefiting the insurer.

Effective provider management involves:

  • Digital Enablement: Leveraging technology to enhance information flow and reduce administrative burdens
  • Personalised Relationships: Building strong partnerships with HSPs through regular engagement and support

In addition, insurers must not drop the ball on their comprehensive risk management initiatives, including:

  • Regulatory Compliance: Maintaining adherence to regulatory requirements
  • Capital Reserves: Ensuring adequate reserves to meet financial obligations
  • Policy Clarity: Clearly disclosing key terms and conditions to protect their reputation
  • Cybersecurity: Protecting sensitive data and mitigating cyber threats

By focusing on these areas, insurers can build trust, improve customer satisfaction, and maintain a competitive edge in the market.

Customer Centricity

Private health insurers in Ghana must prioritize customer centricity to deliver value to their clients. While many insurers claim to be customer-focused, few truly are. A customer-centric insurer develops products that meet the actual needs of their customers. As the saying goes, “Customers don’t care about your brand; they care about what you can do for them.” Unfortunately, the established players in the industry often prioritize brand projection over delivering tangible value to customers.

To bridge this gap, insurers must shift their focus from mere brand imagery to meaningful customer-centric engagement. This can be achieved by:

  • Developing tailored products: Designing insurance products that address specific customer needs and preferences.
  • Enhancing customer engagement: Regularly gathering feedback and proactively communicating with customers to improve their experience and consciously removing operational barriers to ensure seamless service delivery and responsiveness to customer needs.

By adopting a customer-centric approach, private health insurers can build trust, loyalty, and ultimately drive business success. They must imbibe a company-wide adoption of the maxim that “Customer service shouldn’t just be a department; it should be the entire company.”

Some potential strategies for implementing customer centricity include:

  • Conducting regular customer surveys: Gathering feedback to understand customer needs and preferences.
  • Implementing customer relationship management (CRM) systems: Utilizing technology to track customer interactions and preferences.
  • Training customer-facing staff: Equipping staff with the skills and knowledge to deliver exceptional customer service.

Innovation

To drive excellence and growth, private health insurers must prioritize innovation. Innovation goes beyond grand ideas; it requires a culture that encourages experimentation, creativity, and collaboration. Companies must foster an environment where innovation is nurtured, incentivized, and embedded in every aspect of the business operations. PHIS companies can achieve this by:

  • Encouraging experimentation: Employees must be encouraged to explore new approaches and learn from failures.
  • Industry-wide collaborations: Players must partner with other private health insurance companies to address common challenges, such as:
  • Telemedicine: Developing shared telemedicine systems to improve access to healthcare.
  • Claims processing: Establishing a common claims processing center to reduce fraud and improve efficiency.
  • Pharmaceutical partnerships: Collaborating to negotiate bulk medication purchases and improve distribution.
  • Data sharing: Players must share data especially on clients with very poor claims ratios to prevent transfer of bad risk from one company to another

Explore cross-industry partnerships: Industry players must also collaborate with companies from other industries to leverage new ideas and technologies. This should include key partners like insurance agents and brokers who may or may not sell health insurance products.

The benefits of innovation include improved customer experience, improved operational efficiency, and enhanced competitive urge over non-innovative players.

Continuous Learning

The private health insurance industry in Ghana must also prioritize continuous learning to stay ahead of the curve. Given the rapidly evolving healthcare landscape, practitioners must adopt an open mindset geared towards ongoing education and skill development. This can be achieved through:

  • Industry-Academia Partnerships: The industry must collaborate with institutions like the National Health Insurance Authority, Universities, and the Chartered Insurance Institute of Ghana to design industry-specific courses and training programs for its members and practitioners.
  • Knowledge Sharing: Practitioners must encourage knowledge sharing among themselves, with researchers, and with industry experts to stay updated on best practices and emerging trends.
  • Professional Development: The industry must provide opportunities for continuous professional development to enhance skills and competencies in areas such as:
  • Health insurance regulations: Staying updated on regulatory changes and compliance requirements.
  • Healthcare trends: Understanding emerging trends and innovations in healthcare delivery.
  • Data analytics: Leveraging data analytics to inform business decisions and improve outcomes.

Professional development courses must become a mandatory requirement by the regulator for principal and other senior officers of Private health Insurance Schemes. By prioritizing continuous learning, the Private Health Insurance industry can enhance innovation, improve service outcomes, and remain competitive in the rapidly changing market.

Mentorship Training

The health insurance industry can also benefit significantly from mentorship programmes that groom young professionals for the future. This can facilitate knowledge transfer, skills development, and networking opportunities, which will ultimately lead to the growth of the industry. Again, partnership with the Universities could be good conduits to achieving these objectives.

Conclusion

Building capacity for excellence in Ghana’s private health insurance industry requires a multifaceted approach that prioritises operational excellence, customer centricity, innovation, continuous learning, and knowledge transfer through mentorship of young professionals. By focusing on these key areas, private health insurers can improve customer satisfaction, reduce costs, and drive growth. The future has to be crafted into existence. As the industry continues to evolve, it is essential for insurers to stay ahead of the curve by embracing new technologies, collaborating with stakeholders, and innovating solutions that meet the changing needs of Ghanaians.

Sunday, November 2, 2025

College staff avoid strike action

College staff avoid strike action

College staff avoid strike action

Health Workers in Tertiary Institutions Continue Operations Amid Ongoing Strike

Health workers in medical centers across universities, polytechnics, and colleges of education in Nigeria have taken a firm stance against the ongoing industrial action declared by the National Association of Resident Doctors (NARD). Operating under the Coalition of Healthcare Professionals in Tertiary Education Institutions in Nigeria, these workers have ensured that all medical facilities under their care remain fully functional despite the strike.

The coalition includes doctors, nurses, pharmacists, and laboratory scientists working in tertiary institution medical centers under the supervision of the Federal Ministry of Education. These professionals are not participating in the strike, emphasizing their commitment to patient care. The 11,000 resident doctors spread across 91 healthcare facilities initiated the industrial action around 12:00 a.m. on Saturday, protesting unpaid arrears, delays in allowances, and other welfare-related issues.

Despite earlier assurances from the government, the striking doctors continue to demand resolution for their grievances. NARD President, Dr. Muhammad Suleiman, stated that the Federal Government owes doctors and other health workers an estimated N38bn in accumulated allowances. However, the National Chairman of the health professionals’ coalition, Musa Shehu, emphasized that their members would not join the strike, highlighting their focus on patient care.

Shehu acknowledged challenges faced by the coalition, including marginalization within the broader health sector, but stressed that these issues would not deter them from performing their duties. “We are health workers working under the Ministry of Education; naturally, we don’t go on strike. Presently, all our medical centers are operational,” he said.

He urged the public to take advantage of medical centers within tertiary institutions during the period of the resident doctors’ strike, noting that these facilities are available in every state and continue to provide essential healthcare services.

Government Takes Steps to Resolve the Strike

The Federal Government has initiated moves to end the doctors’ strike. Less than 24 hours after the commencement of the strike, the government announced it would release N11.995bn within 72 hours for the payment of outstanding arrears, including accoutrement allowances, to doctors and other health workers across the country.

According to a statement issued by the Federal Ministry of Health and Social Welfare, the move is part of ongoing efforts to resolve welfare concerns raised by the doctors and other unions and to reaffirm its commitment to industrial peace and reform in the health sector. The statement reiterated that the assurance was made during a high-level meeting led by the Minister of State for Health and Social Welfare, Dr. Iziaq Salako, between the top management of the ministry and the leadership of NARD.

The government remains committed to ensuring that the welfare, motivation, and stability of the nation’s health workforce serve as the foundation of all health policies and programmes. In collaboration with the Federal Ministry of Finance, the Ministry of Health and Social Welfare commenced the payment of seven months’ arrears of the 25–35 per cent upward review of the Consolidated Medical Salary Structure and the Consolidated Health Salary Structure to all categories of health workers.

Addressing Staffing Challenges

To address the strain caused by brain drain and prolonged working hours, the ministry disclosed that the Federal Government had granted special waivers for the massive recruitment of healthcare professionals across federal tertiary institutions. Over 20,000 health workers, including doctors, nurses, and allied professionals, were recruited across 58 federal health institutions in 2024, while recruitment for 2025 is ongoing, with 15,000 health workers already approved for employment.

The government stated that the recruitment drive is part of a broader strategy to ensure that Nigeria’s health facilities are adequately staffed, safe, and equipped to deliver quality care to citizens.

Ongoing Negotiations and Resolutions

Collective bargaining discussions are ongoing with the Nigerian Medical Association, where NARD is an affiliate, the Joint Health Sector Unions, and the National Association of Nigerian Nurses and Midwives. To deepen dialogue and proffer solutions to controversial issues that arose in the course of the CBA, the ministry has engaged a professional negotiator, Professor of Industrial Relations, Dafe Otobo, to facilitate further constructive engagements between the government and union leaders.

Discussions are progressing on all the points raised by the health unions, including NARD, an affiliate of NMA. Such issues include specialist and other allowances, salary relativity, appointment of consultant cadres in hospitals, and other welfare-related matters.

Addressing Specific Concerns

Regarding the dismissal of five doctors at the Federal Teaching Hospital, Lokoja, the government clarified that three of the affected staff who did not face a properly constituted disciplinary committee have been offered the opportunity to be reabsorbed into service if they wish, while two others who appeared before a disciplinary panel will have their cases reviewed by Prof. Otobo, who is expected to submit a report within four weeks for appropriate administrative action.

On the issue of certificate categorisation, the government explained that the Medical and Dental Council of Nigeria reclassified, rather than downgraded, certificates issued by the West African Postgraduate Medical College from Category B to C. It described this as a routine regulatory adjustment and said consultations are ongoing with the National Postgraduate Medical College of Nigeria to address any concerns arising from the decision.

The ministry also attributed delays in payment and promotions to administrative processes within the Integrated Personnel and Payroll Information System but assured that engagements are ongoing with relevant agencies to fast-track resolutions.

Conclusion

The Federal Ministry of Health and Social Welfare reiterates that these interventions reflect the Federal Government’s unalloyed resolve to safeguard the rights and welfare of health workers, ensure industrial harmony, and uphold the uninterrupted delivery of quality healthcare services to Nigerians. Our health workforce is the bedrock of Nigeria’s healthcare reform. Every policy, investment, and strategy we implement under the Nigeria Health Sector Renewal Investment Initiative is anchored on their well-being, motivation, and professional fulfilment.


Saturday, October 11, 2025

23 Unions Threaten Joint Strike Over Kaiser's Workplace Issues

23 Unions Threaten Joint Strike Over Kaiser's Workplace Issues

The Struggle for Better Working Conditions

“Our patients deserve the best, not mediocrity.” This powerful message has been shared across social media by the Oregon Federation of Nurses and Health Professionals (OFNHP), an affiliate of the American Federation of Teachers. This group of about 6,000 healthcare professionals is currently engaged in a contract dispute with their employer, Kaiser Permanente. The issue at hand is not the quality of the staff themselves, but rather the systemic workplace stressors that are affecting both employees and patients.

This ongoing conflict involves addressing some of the most pressing issues in nursing and healthcare—specifically, chronic understaffing, stagnant pay rates, and a lack of control over work schedules. The union has prioritized these demands in their recent return to contract negotiations.

The OFNHP is not alone in this struggle. It is part of the Alliance of Health Care Unions (AHU), which includes 23 unions representing over 60,000 Kaiser workers across multiple states. A significant portion of the AHU membership is negotiating as a single unit, aiming for better wages and conditions on both national and local levels. Strike action has been authorized, and if management does not return to the table by October 14, a nationwide walkout of more than 40,000 employees could occur.

The Pressure on Healthcare Workers

The strain on healthcare workers has intensified due to the stubborn bargaining position of management. This has led the AHU to take its final step. If the strike proceeds, it would be one of the largest labor actions of the year. This year has seen a rise in nurses' strikes and other health care actions, reflecting widespread and worsening issues facing U.S. hospital staff, both at Kaiser and in many medical facilities across the country.

The challenges faced by healthcare workers include low pay, long hours, burnout, and the stresses of the COVID-19 pandemic. These factors have led to severe strain on remaining employees, which in turn increases turnover and perpetuates the cycle.

In 2021, the AHU had also voted to authorize a strike, but it was called off the night before when management returned to the table. A new contract was negotiated, establishing a staffing committee to address shortages and securing a wage increase. However, structural issues remained unresolved, and wage gains from four years ago have been diluted by inflation.

The Impact of Management Practices

Kaiser Permanente has a largely unionized workforce, represented by the AHU and overlapping memberships like the Coalition of Kaiser Permanente Unions. The company has operated under a version of a labor-management partnership since the late 1990s. This arrangement aimed to avoid a strike by providing notable concessions to labor, including organizing rights and benefits, and securing unions a seat at the bargaining table. In theory, this works to the benefit of all involved.

However, sources say that the process has become less cooperative. Over many protestations, Kaiser administrators have continued to maintain practices that hospital employees find untenable. The decision to call for a strike indicates the severity of these feelings.

Brenda Rowe, a histology technician at Kaiser and an OFNHP member, is part of the technical bargaining unit. Her unit has not yet seen their contract expire and is therefore ineligible to join the strike. However, they are actively involved in negotiations for their renewal next year. Rowe emphasized that Kaiser technicians are proud to stand in solidarity with the strikers in their local counterpart bargaining units and with the multi-state AHU as a whole.

The Challenges of Staffing and Scheduling

Chronic staffing shortages wreak havoc on the complex operations of a hospital. All work is interconnected, and when nurses cannot cover as much, it puts more pressure on lab techs, who are also dealing with staffing shortages. This creates a no-win situation.

Kaiser Permanente responded to the union’s charges of staffing shortages by stating that they meet—and often exceed—mandated nurse-to-patient ratios and staffing standards. They added that they continue to hire, adding over 6,300 new employees in 2024, including nearly 4,700 in care delivery and more than 1,600 in Alliance-represented roles.

Neoma Palmer, a physical therapist with a sports-clinic specialty, has been employed at Kaiser for 12 years. She explained that there is short staffing everywhere, and it has been getting worse. She noted that management started to not replace open positions after the end of June, with hundreds of jobs remaining unfilled.

The Financialization of Healthcare

A likely motivator for the newly uncooperative, profit-focused management is the financialization of healthcare, especially after the intrusion of private equity firms. Many institutions have moved to prioritize profit, often by leveraging their assets to reap returns for investors. This can compromise the original service of treating patients.

Palmer mentioned that more and more managers and directors coming in are bean counters with no experience in healthcare. She said that this approach doesn’t work and that the incentives of profit and control seem to be the prime reason behind these changes.

Uncompetitive Compensation

Perhaps the central concern for labor in the negotiations is that Kaiser’s pay has failed to keep up with inflation. In general, Kaiser’s pay runs low compared to other hospital systems, particularly in the Northwest. One of the main goals in bargaining was to be paid fairly and to be paid for all hours worked.

Palmer described how at Kaiser, it's the norm to consistently get in early, stay late, and/or take on extra work, often multiple hours per week. This is done to keep up with workloads and licensing, but also very often out of a desire to provide patients with more attentive care.

The Use of Travel Nurses

While management regularly acts to ease staffing shortages by recruiting extra help, they do so by bringing on travel nurses. These nurses are paid fairly well, and Kaiser outlays considerable funds to make use of them. However, this major expenditure may not be beneficial from the vantage of pure self-interest.

Litts, a registered nurse and shop steward, expressed uncertainty that management is careless enough to place profit over patient welfare. Still, it appears evident that impersonal, structural pressures are acting upon all involved, with or without their willing complicity.

As of now, it would seem that, if management remains intransigent through October 14, a system-wide strike remains the only recourse for the Kaiser staff of the AHU’s member unions, both to protect their own livelihood and to stem some of the deleterious effects that pressure tactics and profiteering have inflicted on the Kaiser system.