By Daniel Payne, Carmen Paun, Evan Peng and Erin Schumaker

A coalition of health-staffing agencies is pushing for the DOL to clarify that most temporary nurses be considered W-2 employees, not independent contractors, of the agency they work through. | Getty Images

The post-pandemic future of traveling nurses — supply, demand and pay — has become a focus not only for health professionals but also for hospitals and other employers.

Now, a new player is being asked to weigh in on their future: the Department of Labor.

A coalition of health-staffing agencies is pushing for the DOL to clarify that most temporary nurses be considered W-2 employees, not independent contractors, of the agency they work through.

That coalition, which includes companies Gale Healthcare Solutions, IntelyCare and others, hopes a statement from the administration would change how their competitors — other agencies that consider nurses 1099 independent contractors — classify workers on their platforms.

The coalition of agencies calling for clarification argues that nurses should be considered W-2 employees based on the degree of control agencies have over the health workers, adding that the designation is needed for nurses’ safety and to reduce burnout.

“We need to have a clear understanding of what a W-2 employee is compared to a 1099 (contractor) because I don't want to be a 1099 (platform), but if they say we can be, I'd have to be,” Tony Braswell, president and founder of Gale Healthcare Solutions, told Future Pulse, suggesting he couldn’t remain competitive if other companies are allowed to keep treating nurses as independent contractors.

But other companies in the health-staffing space say they offer platforms for nurses to find work as independent contractors — arguing their business models comply with the appropriate regulations and are different from competitors that use a W-2 model.

“Some companies offer the services of workers as employees; some companies offer a match to a worker who presents themselves as an independent contractor — and there is no good or bad system,” Camille Olson, a lawyer representing CareRev, a company that provides a platform for health staffing, told Future Pulse.

She added that those types of requests are usually specific to the circumstances of the companies requesting clarification.

“It is a very unusual request,” she said. In her experience, companies typically worry about their own particular circumstances when sending a request to the DOL, rather than arguing for sector-wide changes.

It’s the latest push for Washington to guide the future of the health workforce amid concerns about provider shortages and complaints of skyrocketing labor costs in the sector.

The DOL didn’t respond to a request for comment.

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Intorsura, Romania | Carmen Paun

This is where we explore the ideas and innovators shaping health care.

No-brainer. For the first time, scientists have reconstructed a recognizable song by listening in on people's brainwaves and decoding that brain activity, The Guardian reports.

The tune researchers selected for the study? A three-minute segment of Pink Floyd’s "Another Brick in the Wall."

Share any thoughts, news, tips and feedback with Carmen Paun at [email protected], Daniel Payne at [email protected], Evan Peng at [email protected] or Erin Schumaker at [email protected].

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Today on our Pulse Check podcast, host Katherine Ellen Foley talks with POLITICO's Maya Kaufman, who reports on the shuttering of eight school-based health centers by New York City's Health + Hospitals and the health care system’s shift away from the school clinic model to a broader community-based model.

Surgeons at NYU Langone Health prepare to transplant a pig's Kidney into a brain-dead man in New York on July 14, 2023. Researchers around the country are racing to learn how to use animal organs to save human lives. Shelby Lum | AP

Transplant experts are giving people awaiting kidney transplants in America the hope of one day receiving an organ.

In two nonrelated cases, specialists at the University of Alabama and the NYU Langone Transplant Institute reported on Wednesday developments in transplanting genetically modified pig kidneys to people who were brain dead. The purpose was to determine how the body reacts to the organ and whether a Pig Kidney could provide the same functions as a human one.

Why it matters: Pig kidneys could help ease the shortage of organs in the U.S., where nearly 90,000 people were awaiting a kidney transplant as of January. But only some 25,000 people received a human kidney transplant last year.

Transplant surgeon Jayme Locke and colleagues from the University of Alabama at Birmingham Heersink School of Medicine reported the case of a man in his 50 s who was declared brain dead and who received two genetically modified pig kidneys. The man had chronic kidney disease and hypertension.

For the first time in an experiment involving pig kidneys, the organs filtered out creatinine, a waste product made by the muscle, which is essential in sustaining life, POLITICO’s Helen Collis reports. Previous attempts at pig-to-human kidney transplants have produced urine but failed to remove creatinine, meaning the kidneys weren’t working properly.

Separately, a team at NYU Langone Transplant Institute, led by surgeon Robert Montgomery, reported transplanting a modified pig kidney into a man who was brain dead but kept alive by a ventilator. The transplant took place a month ago, representing the longest time a gene-edited pig kidney has functioned in a human, according to the team, who is authorized to continue for one more month.

“We're excited today to share with you our latest milestone on our journey to create an unlimited and sustainable source of organs for transplantation,” Montgomery told reporters.

Because of a combination of changes to the pig kidney, the man’s body didn’t reject it, Montgomery said.

The team knocked out a gene that encodes a biomolecule known as alpha-gal, which has triggered rejection of pig organs by humans. And the pig’s thymus gland, responsible for educating the immune system, was embedded underneath the outer layer of the kidney to stave off novel, delayed immune responses.

“The pig kidney appears to replace all of the important tasks that the human kidney manages,” Montgomery said.

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Medical breaches have cost the U.S. health care industry more than $39 billion over the last five years, Comparitech estimates. | M. Scott Mahaskey

More than 39 million individual medical records have been compromised in medical data breaches so far this year, according to an analysis by Comparitech, a company that conducts data privacy research.

That’s compared with just over 28 million records during the same period last year.

However, this year has seen a fewer number of distinct breaches compared with the same period last year, indicating that the number of patient records involved in each breach has trended up.

Why this matters: Not only do medical data breaches expose sensitive information that can put patients’ health and finances at risk, but they also incur large — and, according to IBM, growing — recovery costs.

Medical breaches have cost the U.S. health care industry more than $39 billion over the last five years, Comparitech estimates.

Zooming out: Comparitech’s full analysis looked at 5,478 medical breaches recorded from 2009 through July 2023, affecting more than 400 million individual records. Here are some of the findings:

— More than 45 million records were compromised each year between 2019 and 2022.

— Before 2019, aside from one outlier year with a single huge data breach, the highest number of records compromised was in 2016, when under 17 million records were affected.

— Since 2021, specialist clinics have seen the most data breaches. However, clinic networks accounted for the highest number of breached records.

— Hacking has been the most common form of breach since 2021.

Policy connection: The public comment period for a proposed expansion of health data privacy rules by the Federal Trade Commission ended last week. Many comments were supportive, while others were concerned that the FTC was overstepping its authority.

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