Approaching the Holidays As a Travel Nurse
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life As a travel nurse, we have the unique advantage of having a little more control over our schedule while on assignment. Many travelers use their contracts as a way to get specific time off, and this can include traveling around major holidays. Each manager and unit will have different needs regarding holiday staffing, so going in knowing all of the possible scenarios can help set you up for the best and happiest holiday season. First, be sure to plan ahead when looking for assignments that start around the holidays. When you are needing to make specific scheduling requests, recruiters will typically send these requests in with your original contract. It is also prudent to bring up any requests during your interview, so knowing your plans ahead of time is crucial to making sure you can secure your contract and get the time off you would like. As a traveler, if you forget to get your requested dates off in writing your travel company can do little to support you if the manager decides not to honor your scheduling requests. Even if the manager seems very agreeable to requests, get it in writing before signing your contract. Similarly, if a recruiter tells you to just get a verbal okay from a manager, insist that these requests are added to your contract before signing. On the other hand, you may be one of those travel nurses who would love to work the holidays and make a little extra money. Many times travelers opt to work around the holidays and take some time off before or after to go back home. This can even help move your name to the front of the list when searching for jobs this time of year because managers don’t have to worry about giving you time off during a busy time of year. Another important factor in working the holidays is negotiating a higher hourly rate for holiday pay. Holiday policies may vary between companies, so ask your recruiter for an overview and once again get your holiday rate in your contract. I have also seen companies that offer bonuses for working holidays, so it never hurts to ask if your travel company offers something like that. Also note that your holiday rate should be based on your blended hourly rate, not just off of your taxable rate. If working the holidays is your goal, be sure to check with the hiring manager during your interview to see what the hospital policy is for travel nurses. Because travelers cost the hospital more money, there may be a rule against travelers working for holiday pay. I have actually been moved off of holidays I volunteered to work, so it just depends on how strict the policy is. The last way to approach the holidays is to simply skip working the time around them. In theory, you could finish up a contract the week before Thanksgiving and take about a month off before returning to work after Christmas. While you may get lucky and just happen to have your fall contract end right on this timeline, you can also use extensions to make this happen. Many managers may not be willing to do a short contract upfront, but if you only need a few weeks of work to get you up to the holidays they may be willing to do a short extension. Similarly, they may be more willing to give you time off around the holidays if you are extending and they already know your capabilities and work ethic. Use this to your power when negotiating either a shortened extension or a full extension with time off to go home. You never know unless you ask, and may be able to do some haggling with the manager to meet their needs and your goals. One important thing to keep in mind is if you decide to head back to work around early January is the market will generally be slightly flooded. Many travelers take at least a couple weeks off before Christmas and will be looking for assignments starting the first or second week of January. Have some extra money put aside just in case it takes a bit longer to find something. Generally, the market levels out again by the end of January and you will be fine in the long run. Regardless of how you decide to approach the holiday season as a travel nurse, the beauty is that travel gives you more control than working as a permanent staff nurse. There isn’t a holiday rotation to worry about, you can take off as much or as little time as you want, or you can rake in more cash than you would at a regular job. Feeling empowered to make these decisions is a great feeling, and will ensure you have the best or most lucrative holiday season you could hope for. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << Stranded Off the Highway: My Favorite Travel Nursing Memory
Traveler Tips: Making the Best First Impression on a Travel Nurse Assignment
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life There is the old fashioned saying that you only get one chance to make a first impression. While this is certainly true, I do believe in a normal work setting you end up having plenty of time to gain coworkers’ trust over the course of months and years of working together. As a travel nurse, however, you are under a different kind of pressure to prove yourself right out of the gate. While it is certainly expected that travelers should walk in confident of their skills, coworkers may not realize this or may have had a negative travel nurse experience in the past that makes gaining their trust a little more difficult. 1. If you have already accepted the job, steer clear of people’s opinions before you show up I made the mistake one time of asking another traveler about a hospital after I had already signed my contract. This particular person had absolutely nothing nice to say about the facility and was adamant that I back out of my contract immediately. Due to certain life circumstances, this was not an option for me so I went in absolutely dreading how the assignment would be. Turns out the staff and experience was a very positive one, and I even returned for a second assignment a couple of years later. Bottom line: once you have accepted an assignment it is almost better to go in with a clean slate rather than having others’ judgment cloud yours. By all means, be sure to research before you accept a job, but after you have committed yourself to a location it is probably best to just go in with a positive attitude from the start. 2. Introduce yourself first Many units in need of travel nurses are used to new faces. Between new hires, float staff and previous travelers, you may not be introduced to every new face you meet. Break down this initial barrier by greeting each new person you meet and offering up your name. This helps create a positive first interaction and can help staff start to feel more comfortable around you quickly. This also goes for meeting other travelers at orientation. Be sure to reach out to other travel nurses during hospital orientation even if they won’t be on your unit. Knowing other travelers in the hospital can be helpful if you float or it can be the start of a new friendship for exploring on days off. 3. Be the first to offer help If you are caught up with tasks for your patient and see another nurse drowning in work, offer to help! Staff nurses may be hesitant to ask a travel nurse for help because they are unsure of your skill level. By stepping up in to assist when the opportunity presents itself, you give yourself the chance to show just how much you know. Don’t be offended if other nurses are unsure of what you know how to do at first. Each travel nurse has a slightly different background and as such a different set of skills. Simply step up when you feel confident in your ability to help and reassure the regular staff of your previous experience if needed. 4. Explain your role if needed In the rare instances where permanent staff are not familiar with how travel nursing works, it can be helpful to both you and them to explain their role. I like to give an overview of my background and also the basics of how contracts and orientation work in the travel world. I also like to explain that basic nursing skills and supplies remain the same pretty much everywhere and then give a heads up that my biggest concerns will be hospital-specific policies and where to find things. As you gain more experience you will get better at asking specific questions in orientation, but with only a day or two of orientation, it is inevitable that help will be needed in these areas. 5. Don’t underestimate body language As someone who doesn’t walk around chronically smiling, I have had to remind myself how much our expression affects first impressions. Even if you aren’t super smiley, don’t forget to use simple courtesy and stay positive when interacting with staff. If walking around and grinning isn’t quite your speed, just be aware of how other types of body language cause people to assume if you are approachable or not. Simply being polite, sitting near other staff, or trying to make conversation here and there can make socializing with your new coworkers that much easier. While you don’t have to be best friends with every set of coworkers or prove yourself to be the best nurse on the unit, having a sense of mutual respect and trust can certainly make your experience on a new unit more enjoyable. Simply be aware of subtle things that can make a big difference when being dropped into a well-established unit, and you will find the transition into each new department that much easier. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << Extended Stay Hotels vs. Short Term Rentals: What is The Best Travel Nurse Housing Option?
Perks of Repeating Travel Nurse Assignment Locations
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life Each travel nurse sets out on their journey with a slightly different goal in mind. Some are looking for the best money, while others simply want the means to take extended vacations and explore as much as possible. A lot of travelers are simply trying to see as much as they can while they travel because for many this lifestyle is temporary. Because of this, it may seem absurd to think about taking an assignment somewhere you have already worked as a travel nurse previously. However, I truly believe that your personal happiness and satisfaction is more important than following the idea of what you are “supposed” to do in any given situation. In 2018 my husband and I were lucky enough to score assignments in Phoenix during the high season–meaning we hit the best weather the city had to offer. Later that year when I got an email asking if I would like to return for flu season at my previous assignment, we struggled between the idea of repeating an area “too soon” and going on to explore somewhere new. Ultimately we decided to head back for another beautiful winter in Phoenix, and it solidified our convictions that there is nothing wrong with repeating a location you truly love. In fact, there are some huge perks that come along with doing so. 1. You may have an easy in for a travel nurse job. A lot of hospitals will give preference to travelers who left on good terms previously. I have personally done repeat assignments at two hospitals, and the whole process was much easier than working at a new facility. Your resume typically gets pushed to the top of the pile if you are returning staff, which also means you should get the first choice on shift and floors as well. Conversely, if you did not love your previous assignment you will know what facilities or companies to avoid which can be just as helpful. 2. Housing is less stressful when you know the area. Even if you don’t necessarily want to return to your exact situation as before, it is so much easier to find housing in a city you are somewhat familiar with. You don’t have to worry about safety or traffic or if an area would be a fun place to live because you probably already have an idea. Also, if you connected with anyone in the city during a previous assignment, you can reach out to them for help when looking for housing. 3. You can make time for trips that require a little more planning. Ever get ten weeks into your assignment only to find out about this really cool, amazing adventure that’s only three hours away but requires three months’ notice to book? Or find out about a must-try restaurant two days before you leave town? Despite having three months to explore an area, it is almost impossible to hit every single thing you want to see or do in that time frame. If you circle back to a familiar location you can actually plan ahead for these more hidden gems of trips or activities. In addition, you can ask off for the time needed to explore these areas in your contract. 4. There may be a social circle you can jump back into. Whether you are into church or gym classes or just really loved your coworkers, it can be nice to go back to a place where you already have a small community to jump back into. As travel nurses, we are generally pretty good at making friends with anyone, but getting others to warm up to us can be tricky. When you are already a familiar face walking back in people will typically be a little more open from the beginning, which is comforting. 5. Sometimes it is just nice to be familiar with an area. While travel nurses are great at adapting and learning new cities and units and navigating new people, it can get exhausting at times. If you are feeling emotionally spent or even burnt out, going back to somewhere familiar can lessen your overall stress and prove more relaxing than a brand new city and hospital. Don’t be afraid to circle back to an old location just because it feels like you need an easy thirteen weeks–there is nothing wrong with that! Whether you left an assignment feeling like there was still more to see or you just really really loved a certain area, there is nothing wrong with making a U-turn on your travel assignment every once in a while. The beauty of working as a travel nurse is your path can go in whatever direction seems right for you and your life at any given time. Don’t be afraid to take a little stress off your shoulders and go back to a well-loved assignment if the time feels right. The new and unfamiliar will still be waiting when you get done. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << 5 Reasons Why Travel Nurses Would Actually Want to Work Night Shift
Traveler Tips: Organizing Your Travel Nursing Resumes
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life Organizing a resume is a task that very few people enjoy. Everyone knows their worth, but it can be difficult to communicate that on a piece of paper. In addition, there are tons of rules that vary depending on who you talk to. Should your resume include references? Is one page the maximum limit? What is the best font to catch an employer’s attention? Once you enter the travel nursing world the rules of resume writing change again. Work history grows faster than one page can accommodate and references will change with each new assignment. Simply put travel nursing has a whole different set of guidelines for resume writing than any other type of job application. Staying organized and knowing the best format to use for your work history will help you not only keep your sanity, but it will also give you a leg up when it comes to applying for jobs. Speed is crucial when applying for open jobs in the travel nursing world, so having a well-formatted resume ready to hand to a recruiter at a moment’s notice could make or break your chances of getting into the job opening you really want. List all certifications with expiration dates near the top One thing that can really set you apart from other travelers is your specialty certifications. Managers will spend very little time combing through job applicants, so seeing someone who put the extra effort into getting certifications may catch their eye. Also, some jobs will have non-negotiable certifications they require, so if that is the case, you want to make it clear and obvious you are qualified for the position. List the facility you worked at along with dates Just like with a regular resume, keeping your job history organized by date is easiest. In addition, adding in the specific start and end dates will let employers know if you are likely to extend or not. Some managers will definitely want travelers willing to stay for more than a single contract, but others may not mind if you only work 13 weeks at most facilities. Size of the unit and types of patients cared for are key While working at prestigious medical centers may be a little impressive to potential managers, they are likely more concerned that you will be able to deal with their unit’s specific patient load. Don’t write a huge paragraph for each job, but definitely include how many beds were on the unit and the basic patient population. Don’t get too caught up in the length While keeping a resume as concise as possible is great, doing so as a travel nurse can certainly be challenging. As a general rule aim for two pages or less and simply list the minimal information on older jobs. That way employers can see that you have extensive travel experience and are confident you will be able to transition to the unit quickly and efficiently. Layout and font may not be too important In a lot of cases, recruiters are not actually sending your document to the facility. With more hospitals using a vendor as the middleman between companies and managers, there is likely a program they have to input specific information into. This is also why your recruiter may call during the submission process and clarify details that come up as they are using these programs. Keeping this in mind–be sure to keep your phone close if you give a recruiter the go-ahead to submit you so they can get any extra info they may need! Skip listing references Most travel jobs will require updated references within the last one or two contracts. In addition, each company typically has its own process for gathering references for their travelers. Some will email out a form while others do a quick phone call to check your references. Be sure to get both a phone number and an email address from each person you plan on using as a reference so you can give them whichever form of contact they need. Another great idea is to use a generic reference form and have a supervisor at each assignment fill that out so you can upload it to each company requesting a new reference. In a way travel nurse resumes are a lot easier to put together than a traditional resume. Hiring managers at travel jobs want a quick overview of who you are because they aren’t looking for their next ten-year employee. Different traits will be considered positive for travelers than what they are looking for in permanent staff and your resume format should reflect that. As you move through your travel career you will also learn what each company is asking for and what the common information needed will be. If you work as a recruiter repeatedly you won’t necessarily need to send them an updated resume each time because they may keep an updated version on their end. However, it is still important to keep your own resume updated in the event a dream job opens up for a different company and you want to get your application in ASAP.
Traveler Tips: Setting Realistic Expectations For Your Healthcare Career
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life Working in travel healthcare is a great way to branch out in more ways than one. Traveling allows you to visit new areas, expand your skills as a practitioner and build relationships across the United States. When you first leave your staff job, there is a certain thrill of anticipation that becomes embedded in your soul, and your world is suddenly open to a host of possibilities. As a brand new traveler, it can be hard to balance these great expectations with a small dose of reality. Not every assignment will fulfill every point on your list of assignment goals, but by setting some realistic travel nurse expectations, your career can strike a balance between fun, adventure and regular employment. Know what you want from each assignment A great way to have success in any situation is to set goals. Travel nursing is no different. Before starting your career as a traveler, it is important to sit down and think about what you hope to accomplish by working as a travel nurse. Decide if you have a set amount of time you plan to travel or if you are going to reassess how you feel at the end of each contract. Then, set some financial goals for yourself. One of the most popular reasons to work as a travel nurse is financial security. For a majority of people travel healthcare is more lucrative than working in a permanent position. This could allow you to spend more money on travel between assignments, or give you enough extra cash to save for a large purchase such as a house. During other assignments, you may have the chance to work in a dream location. While you may not earn as much during this time, there should be other positives to focus on during these types of contracts. Every job may not come with a killer location and awesome pay rate, so setting a specific goal for each assignment is a great way to stay focused and keep a positive attitude even if you had to make some compromises on location or unit setting. Decide if there are other “must-haves” for each contract Some travel nurses are very particular about shift while others are happy to work nights or rotate if needed. While it is not impossible to travel as a days-only nurse, it can limit your job options. By limiting your shift preference, you may also limit your location or even pay. Most hospitals do not offer a traditional differential for travelers, but they may set a higher bill rate for a night shift position. The same rule applies to other non-nursing specialties. If you are a therapist, limiting your setting may result in fewer job options. Radiology travelers may have to be willing to work an odd shift or take a little more call than they would like. Each field has different considerations, but being open to new settings or learning new skills is helpful when trying to land a contract. Other things to consider for each contract are time off, holiday schedule, and floating stipulations. Adding a laundry list of requirements to your contract may cause managers to pass you over for more flexible candidates, but do not agree to something you are unable to sustain for your entire contract. Expect a few bumps in the road Anyone who has worked as a travel nurse will have a story or two about a time where almost nothing went according to plan. However, most of these people will also tell you they have stayed in the field and rolled with the punches. Whether your assignment gets canceled, your licensing takes longer than expected, or you have to change housing plans last minute, know that it is all part of the journey and take each hiccup as a learning experience. Keeping an open mind and being flexible is key to working as a traveler. If your experience is wearing you down more than you can handle, do not be afraid to reach out for help or advice. There are some great online communities for travelers to connect, and chances are someone has experienced a similar situation. Don’t be afraid to reassess at the end of each assignment One of the best parts of being a traveler is you do not have to do it for very long. Some people take one assignment and realize the lifestyle is not the right choice for them, while others spend years working travel jobs. There is no one-size-fits-all requirement, and by going in with realistic expectations you can be better prepared to make your experience as a traveler right for you.
FUNemployment: Maximizing Time Off as a Travel Nurse
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life My very first job as a new grad nurse was in one of the lowest-paying areas of the country. While my cost of living was also low, I was still picking up over time and relying on on-call hours to make ends meet. The word “vacation” meant either camping at my parents’ property or a quick road trip a couple of hours away. All of that changed when I finished my first travel nurse assignment. I intentionally took a two-week break between my first and second assignment and although we didn’t do anything crazy, I was able to go home and visit family, spend more quality time with my husband and just disconnect from the stress of working as a nurse. I quickly vowed to never work back to back assignments–meaning I always take at least a week break between one job and the next. This has allowed my husband and I to travel more and visit family regularly, which overall keeps our work-life balance much more, well, balanced. We have embraced this pattern so much in fact that we now have a name for it: Funemployment. This is the term lovingly used for the times we are not working because we choose to wait to start a new job–and this is an awesome, empowering place to be! This time is great for several reasons. First and foremost it allows us more time to see our family. As travelers one of the hardest parts is missing out on time with our loved ones, so we do our best to get home for at least a few days between assignments. By checking in every three months we don’t feel the separation as much and our families really appreciate us checking in. A lot of people assume if you work as a travel nurse you must not be close to your family back home, but for us, that is certainly not the case. Utilizing our time off between contracts to see our loved ones really helps alleviate the struggle we face between living our preferred lifestyle and keeping in touch with our family. The next best thing about taking extra time off is the opportunity for extended travel. Most regular jobs allocate two to three weeks for time off per year. As a travel nurse, you have the luxury of taking as many days off between assignments as you would like. Over the course of one summer I was able to take a month off of work to travel to Mexico, Jamaica, and take a lake trip with my family. A traditional job would never have allowed that much time off consecutively. Many travelers will take even more time off. I have had friends who take three-month trips to Asia or live in Europe for six months. Not only does this save money in the long run because you only have to buy one long-distance flight, but it gives you a more relaxed approach to vacation. When you have a longer amount of time to explore you can really enjoy the places you are visiting instead of feeling rushed to cram as much as possible into your visit. In addition to the travel perks, choosing to have an extended break between assignments can be great for your mental health. Healthcare can be a very taxing field, and travel assignments can vary in their stress level. Depending on where you are currently working you may have a heightened feeling of burnout. If this is the case travel healthcare is a huge blessing because you can step away from the bedside for a bit longer if you need to. While it might not be financially feasible to not work at all, you could pick up part-time work outside of healthcare or even take a break to change specialties if you think that would help. Either way, you have more time to clear your mind and really think about what you want to do than if you were in a standard position where your time off is always limited. Funemployment is certainly appealing to anyone working a full-time job, but it does come with a downside. As travelers, most companies do not offer standard PTO packages so this time off will be unpaid. However most pay packages for travel jobs will greatly exceed what nurses would be making at home. If you are smart and plan for time off it can be much easier to take unpaid time off than it would be at a permanent position. You can save even more by minimizing expenses while you are on assignment, so you can extend your time off in between as much as you’d like. While working 13-week contracts can be stressful for many reasons, the extra time off it will allow you can be a major perk and help you avoid burnout and exhaustion. In addition, you can travel in a way that most professionals only dream of. Whether you are working travel contracts for a short period of time or plan on living the travel lifestyle forever, I highly recommend planning in some extra funemployment between contracts while you can. Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << Travel Nurse Spotlight: The Best of Both Worlds
Insurers Test New Way To Cut Maternity Care Costs: Bundling (KHN)
Carmen Heredia Rodriguez, Kaiser Health News The thrill of delivering newborns helped pull Dr. Jack Feltz into the field of obstetrics and gynecology. More than 30 years later, he still enjoys treating patients, he said. But now, Feltz is also working to change the way doctors are paid for maternity care. Feltz’s New Jersey-based practice, Lifeline Medical Associates, recently partnered with the insurer UnitedHealthcare to test a new payment model. The insurer sets a budget with the practice to pay doctors one lump sum for prenatal services, delivery and 60 days of care afterward. If the costs come in below that amount, the medical practice gets to keep some of the savings. (Hospitals aren’t a part of this contract; the insurer pays them separately for their services.) “We’ve always been taught to take care of patients as if they were our mothers and our daughters,” said Feltz, who also leads a coalition of obstetricians called the U.S. Women’s Health Alliance that advocates for high-quality, affordable care. “But now we have to take care of our patients as if they were our mothers and our daughters, and as if it was our money.” This new program, announced in May, is a first step by the insurer to bundle physician payments for maternity care into a single flat fee that covers all care and procedures. A handful of insurers and state Medicaid programs are experimenting with similar models, sometimes incorporating hospitals and other health providers as well. By moving from paying for maternity care in a piecemeal way to relying on bundled payments, insurers and doctors say they hope to cut costs and improve the quality of care for pregnant women. The lump sums are also seen by doctors and insurers as a possible way to improve outcomes, including driving down the number of cesarean sections in the United States. About one-third of all deliveries in the U.S. occur through C-sections, even though the World Health Organization estimates they are medically required in only 10% to 15% of births. The rate varies dramatically among individual hospitals. These surgeries can increase the risk of infections or other medical problems for the mother and baby. And they are more expensive than a vaginal delivery. “The way we’ve been doing things is just not justifiable,” said David Lansky, a senior adviser at the Pacific Business Group on Health, a San Francisco-based coalition of private and public organizations that collectively purchase health care for 10 million Americans. “The shift we’re talking about is to say someone is accountable for all the care that needs to be provided to support a family through this experience.” The professional association that represents obstetricians, however, is approaching the new payment strategy with caution because it could expose doctors to financial risks. And even fans of such a model acknowledge there are still significant obstacles to be worked out before this sort of flat-fee system could be implemented broadly. The bundled-payment model is relatively new in maternity care, and its structure can differ by insurer. Some insurers could pay a single amount to one doctor, who uses that to cover the hospital care. Other plans can opt to negotiate a separate contract with the hospital. Insurers can choose to pay doctors before or after patients receive services. The length of care, eligibility and services included in the bundle can also vary. Patients generally are not even aware their care is being handled under a bundled payment. In traditional coverage, insurance payments for some women are delivered as bundled payments for portions of their prenatal care, said Suzanne Delbanco, executive director of Catalyst for Payment Reform, an organization that helps advise employers and other organizations that buy health coverage. However, the latest version is different because insurers are adding quality measures that increase accountability and additional services, such as delivery costs, to the bundle. UnitedHealthcare began testing the option with Feltz’s practice and another in Texas. The insurer said it hopes to expand to as many as 20 practices by the end of the year. Cigna and Humana are also piloting bundled maternity care programs. A few Medicaid programs, including those in Arkansas, Ohio and Tennessee, have experimented with it. Expanding the rarely used model to include maternity care could represent a major shift in health care finance. Births were the most common cause of hospitalizations among patients discharged in 2016, according to government data. “Maternity care is kind of the sleeper of health care services,” said Dr. Neel Shah, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. The pivot in payments is being made as the quality of maternity care in the United States comes under renewed scrutiny. An estimated 700 women in the U.S. die each year because of pregnancy-related complications, the federal Centers for Disease Control and Prevention reported. The rate of deaths in the U.S. is worse than that of many other affluent countries, NPR and ProPublica reported in 2017. And C-sections cost more. In the Denver area, for instance, the average vaginal delivery costs $7,716 while the average C-section costs $14,274, according to 2019 data from the Health Care Cost Institute. On average, commercial and Medicaid insurers pay 50% more for C-sections than for vaginal deliveries, according to a 2013 report by Truven Health Analytics, a health industry consulting group. Lansky’s group tested bundled payments for births in 2014 in Southern California. According to their report, the rate of C-sections in first-time, low-risk pregnancies dropped by nearly 20% in less than one year among the first three participating hospitals. However, some of the bundled-payment models fall short of aspirations. Tennessee saved money in 2017 after adopting the payment model for Medicaid beneficiaries. But the rate of C-sections remained unchanged, according to a report by the Medicaid and CHIP Payment and Access Commission (MACPAC), a nonpartisan advisory group for Congress. In Ohio, where the Medicaid program covered complicated pregnancies as well as those that were low-risk, bundling payments into a lump sum
Tips for Paying Off Debt as a Travel Nurse: Minimizing Housing Costs
By Alex McCoy, Contributing Writer, Owner of Fit Travel Life Every individual will have a different reason for choosing the travel nurse lifestyle. Some people want to see the country, some value extended time off between contracts for international travel, and others simply want to avoid the politics that come along with staff nursing. However, one huge draw for many travelers is the increased pay compared to staff pay at home. The pay increase alone is enough to draw parents to work three days away from home and fly back in between, for spouses to leave their partners behind, and for seasoned nurses to leave huge hospital systems with great benefits. Student debt and overall debt is a hot topic these days and with the average college graduate taking on around $30,000 in student loans many people feel behind before they even start working. As a result, there has been a surge in the number of people eager to get out from under this debt as quickly as possible. For many people, travel nursing can be a useful tool for making this happen without sacrificing as much in your day to day life. By increasing income on the road and minimizing expenses, it may be easier to pay down loans and credit cards faster, allowing travelers to have full control of their entire paycheck once this burden is gone. Start by minimizing expenses back home To legally take a housing stipend and per diem, you must maintain a tax home somewhere in the United States. To make sure you are hitting all the requirements for a tax home I highly recommend TravelTax.com or consulting with a tax professional. However, when you are deciding how to maintain your tax home there are a couple of ways to cut back on your rent and expenses. The first way is to rent a room or split the cost of housing with a roommate. If you rent directly from a friend or family member be sure to pay fair market value (you can’t pay mom $100 a month and call it “rent”). Or you could sign a lease with a friend and use this as a place to store furniture and crash when you are home between assignments. If you own a home you can opt to rent a room to a friend or family member while you are away. You must reserve space for yourself to keep it as your “home” so using it as an AirBNB or something similar might be more tricky. Having a friend or family member stay there is also handy because they may be able to do some upkeep and monitor the property while you are away. The other way to minimize expenses at home is to downsize as much as possible. While it may seem tempting to simply rent a storage unit and put all of your belongings there, keep in mind that if you travel for several years the cost of the storage unit may overtake the cost of simply replacing items when you come home. If you don’t have a cheap way to store items back home, try to downsize to the bare minimums or keepsake items and rent the smallest space possible for storage. Next, minimize expenses on the road. Some travelers hate the idea of driving cross country and talk about renting cars or paying for transport, but this is a huge cost that will not be covered by travel companies. I highly recommend driving to save money and to allow you time to explore our country as you drive. Another way to save money on these trips is to camp or stay at KOAs instead of hotels. Most of the time you will only be stopping to sleep, so by pitching a tent or renting a small cabin at a KOA you can easily save money. Also, try to stick to smaller towns where the cost of living is lower than in larger cities. Once you are at your assignment an easy way to pocket extra cash is to share housing with other travelers or opt for a room rental over a private space. There are lots of travel nurse Facebook groups where people are looking for roommates, or sites like AirBNB or VRBO may have room rentals listed where you can negotiate a monthly price. Any bit of money saved on housing can be used to pay off debt! Don’t forget to track your progress. As travelers we often have to drop large amounts of money on deposits, travel expenses, car repairs…the list could go on. When these come up it can start to feel like we are making little progress on our financial goals. This is why it is so important to track how much you are putting towards your debt. When life gets a little crazy or unexpected expenses pop up, don’t forget to go back and reflect on the amount you have put towards your debt and celebrate that success! Working as a traveler is a blessing for anyone trying to get ahead financially. If you manage your expenses correctly, this career path is almost guaranteed to be more lucrative than your typical staff job. Stay focused, remember how great you’ll feel when you are debt-free, and remind yourself that all the cost-cutting measures are temporary. You will feel amazing and so accomplished when you hit your goal! Alex McCoy currently works as a pediatric travel nurse. She has a passion for health and fitness, which led her to start Fit Travel Life in 2016. She travels with her husband, their cat, Autumn and their dog, Summer. She enjoys hiking, lifting weights, and trying the best local coffee and wine. << Stocking Up: How to Save Money on Essentials for Your Travel Nurse Rental Home
Air Ambulances Woo Rural Consumers With Memberships That May Leave Them Hanging (KHN)
Sarah Jane Tribble, Kaiser Health News FORT SCOTT, Kan. — On a hot June day as the Good Ol’ Days festival was in full swing, 7-year-old Kaidence Anderson sat in the shade with her family, waiting for a medevac helicopter to land. A crowd had gathered to see the display prearranged by staff at the town’s historic fort. “It’s going to show us how it’s going to help other people because we don’t have the hospital anymore,” the redheaded girl explained. Mercy Hospital Fort Scott closed at the end of 2018, leaving this rural community about 90 miles south of Kansas City without a traditional hospital. The community has outpatient clinics run by a regional nonprofit health center and — at least temporarily — an emergency department operated as a satellite of a hospital in the next town over. Since the hospital closed, air ambulance advertising has become a more common sight in mailboxes and at least one company’s representative has paid visits to a local nursing home and the Chamber of Commerce, offering memberships. A prepaid subscription would guarantee that if an AirMedCare Network helicopter comes to your rescue, you will pay nothing. Nationwide, though, state insurance leaders, politicians and even one of the nation’s largest air ambulance companies have raised alarms about the slickly marketed membership campaigns. The air ambulance industry expanded by more than a hundred bases nationwide from 2012 to 2017 and prices increased as well, according to a recent federal report. The median price charged for a medevac helicopter transport was $36,400 in 2017 — a 60% increase compared with the roughly $22,100 charged in 2012, according to the March report from the U.S. Government Accountability Office. Insurance seldom covers the trips and consumers often are surprised to get a bill showing they are responsible for the bulk of the cost. However, both Medicare and Medicaid control the price of the service, so enrollees in those government insurance programs face much lower out-of-pocket costs or have none. AirMedCare Network, which includes 340 bases across mostly rural America, has more than 3 million people enrolled in memberships, said Seth Myers, president of Air Evac Lifeteam, one of the medevac companies under the AirMedCare Network umbrella. One brightly colored AirMedCare advertisement mailed in southeastern Kansas promised entry in a summer vacation giveaway as an incentive to sign up. A one-year membership is $85 — unless you are 60 or older, which qualifies you for a discount. Buying multiyear memberships increases the odds of winning that summer trip. “We’re a safety net for people in rural areas,” Myers said. “Generally, if I tell you the names of the towns that most of our bases are located in, you wouldn’t know them unless you lived in that state.” Increasingly, though, state regulators have a skeptical view. North Dakota Insurance Commissioner Jon Godfread called the memberships “another loophole” that air ambulance companies use to “essentially exploit our consumers.” The state banned the memberships in 2017, noting that the subscription plans don’t solve the problem of surprise medical bills as promised. Too often, the company responding to a patient’s call for help is not the one the patient signed up with, Godfread said. North Dakota has nine different air ambulance operators who respond to calls and patients have no control over who will be called, he explained. Air Evac’s Myers said his company, which operates mostly in the Midwest and Texas, doesn’t get many complaints from customers about other companies picking them up. He counted three this year. Texas Rep. Drew Springer, a Republican, introduced a bill passed by the state legislature this year that would require companies to honor the subscriptions or memberships of other air ambulance companies. But Texas Gov. Greg Abbott, also a Republican, vetoed Springer’s reciprocity bill, saying it would unnecessarily intrude on the operations of private businesses. Myers said that AirMedCare Network was “very careful to educate the legislature and the governor’s office” in Texas. A letter signed by Myers and other industry executives noted that the 1978 Airline Deregulation Act — a law created for the commercial airline industry — protects them. The federal law limits states’ ability to regulate rates, routes or services. The law is at the core of the industry’s defense of its prices. Like North Dakota, though, Montana used insurance regulations to limit the memberships. A 2017 law requires air ambulance subscriptions to be certified by the state’s insurance department. As of August, no company had applied for certification — essentially opting out of the state. Air Methods, one of the nation’s largest private air ambulance companies, decided memberships “aren’t right for patients,” according to Megan Smith, a spokeswoman for the company. While membership programs promise customers will avoid out-of-pocket expenses, in reality the contractual fine print “isn’t as cut and dry,” she said in an email. Patients who sign up for memberships and have private insurance would still receive a bill and then must work through their insurance company’s claims, denial and appeal processes. And while Air Evac’s Myers said the AirMedCare Network memberships or subscription fees replace copays and deductibles, Air Method’s email highlighted in bold print that “a membership is not necessary” for Medicare patients because federal law prohibits companies from charging more than copays and deductibles. Myers said having a membership offers peace of mind, particularly to those Medicare enrollees who do not have an added supplemental insurance plan that covers transportation. Also, because the memberships are not officially insurance or a covered benefit, air ambulance companies can end them at any time “without obligation to notify the customer,” stated the Air Methods email. This means a patient could believe his or her emergency air transport was taken care of, only to face a rude awakening when the bill came. Air Methods is the preferred helicopter service for Fort Scott’s dispatch service, according to city officials. Yet, Midwest AeroCare operated the helicopter that dropped in during the Good Ol’ Days festival. Midwest AeroCare is part
2019-2020 Flu Season Predictions
Health officials are already warning that the upcoming flu season could be severe. The season’s first flu-associated death was recently reported at Riverside University Health System in California, according to a press release. The four-year-old patient had underlying health issues but tested positive for influenza. The facility’s Public health Officer, Dr. Cameron Kaiser, said this is a tragic reminder of how deadly influenza can be. The 2018-2019 flu season was reported as “moderate severity” by the Centers for Disease Control and Prevention and lasted 21 weeks (October 2018 to May 2019), which is longer than previous years. While the season started off as more “mild,” the first states that began seeing high levels of flu activity were Louisiana, Georgia, Oklahoma and Utah. The months of February and March of 2019 saw the highest number of widespread cases across the country according to the CDC’s FluView Map. These trends could be important for travelers to note when considering locations for winter and spring assignments. Health officials also look at Australia’s flu season when predicting the upcoming season in the U.S. As Australia’s winter and flu season is coming to an end, the country has experienced a record-high number of flu cases than previous years and the illnesses started earlier than usual. The CDC recommends people 6 months and older to get the flu vaccine every year, ideally by the end of October. Additionally, it’s recommended that all U.S. healthcare professionals get vaccinated annually. Last year, it was reported 78.4% healthcare personnel received flu vaccinations, which included an estimated 90.5% of nurses. Can refusing to get vaccinated for the flu affect your career as a healthcare traveler? Most likely, yes. Travel nurse Alex McCoy shares insights in how declining the flu vaccine could possibly have a negative impact. Read Next: Declining the Flu Shot: How It Impacts Travelers Check back for updates on the 2019-2020 Flu Season and how its affecting the travel healthcare market.