As we leave 2022 behind us, here are seven things healthcare employers should watch for in 2023.

1. Medical Residents and Interns Unionizing.  Yes, you read that right.  2022 saw organizing among these groups on both coasts.  This is happening as we see a resurgence in organizing among graduate students and even undergraduate student employees.  It will be important for employers to include medical residents and interns in their programs addressing employee engagement and wellness.

2. Increased Focus on The Application of Title IX to Medical Residency and Other Educational Programs.  Title IX prohibits discrimination on the basis of sex in federally funded education programs.  We have seen a growing number of claims brought against academic medical centers alleging violations of Title IX.  Therefore, it is prudent for healthcare providers engaged in education programs to be familiar with the current and proposed Title IX regulations.

3. Cybersecurity Threats Continue.  The data is not in yet, but 2022 likely set a new record for cyber-attacks in the healthcare sector.  Back in October, the U.S. Department of Health and Human Services’ (HHS) Office of Civil Rights cited a cybersecurity firm report that found a 69% increase in cyber-attacks targeting healthcare in the first half of 2022 compared to 2021.  Healthcare employers should review their HIPAA and other data security policies, as well as their incident response plans.

4. Regulators Scrutinizing Telemedicine.  In September 2022, HHS’ Office of Inspector General issued a report recommending the Centers for Medicare & Medicaid Services (CMS): “(1) strengthen monitoring and targeted oversight of telehealth services, (2) provide additional education to providers on appropriate billing for telehealth services, (3) improve the transparency of ‘incident to’ services when clinical staff primarily delivered the telehealth service, (4) identify telehealth companies that bill Medicare, and (5) follow up on the providers identified in this report.”  These recommendations highlight the importance of training supervisors on how to respond to reports of improper billing as well as refresher training for the entire workforce on appropriate billing and documentation.

5. Expect a Permanent OSHA Standard Covering COVID-19 for Healthcare Workers.  On December 7, 2022, OSHA sent a draft of the permanent rule to the White House for review.  The text has not yet been released, but the rule is expected to be effective in early 2023. 

6. Expect More Strikes.  One industry publication noted in November that there already had been 18 healthcare worker strikes in 2022.  According to another report, contracts covering at least 1.6 million employees will expire in 2023.  Nothing suggests the factors fueling those 2022 healthcare worker strikes will be remedied soon enough to make 2023 a year of greater labor peace.  Therefore healthcare employers should consider doubling down on efforts to improve employee relations, as well as strike contingency planning.

7. Staffing Challenges Will Continue.  While many healthcare employers report a decreased reliance on temporary staff, recruiting and retaining caregivers remains a challenge.  Recent reports indicate many clinicians are considering leaving healthcare.  This phenomenon means employers will continue to explore alternative ways to maintain staffing levels, including creating in-house staffing agencies as well as going to outside agencies.  In this environment, healthcare employers need to keep their eye on potential changes to the joint employer rule under the National Labor Relations Act and to the standard for determining whether a worker is an employee or “independent contractor” under the federal Fair Labor Standards Act.