Q&A: AzHHA President & CEO Ann-Marie Alameddin says workforce and financial stability are biggest issues in Arizona hospitals right now


Soraya Marashi


Ann-Marie Alameddin is the President and CEO of the Arizona Hospital and Healthcare Association (AzHHA). In this Q&A, she discusses her outlook on the future of the COVID-19 pandemic in Arizona and how hospitals are faring as COVID-19 becomes an endemic disease. 


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State of Reform: As community transmission levels begin to decrease, what are Arizona hospitals most stressed and concerned about right now?

Ann-Marie Alameddin: “I think Arizona is much like the rest of the country in that we are really in this new phase of the pandemic. I think it’s a less deadly phase of the pandemic, thanks to widespread vaccinations and boosters. We’ve obviously seen a decrease in hospitalization rates, and that significant, severe stress on the health care system as a whole has subsided.

The biggest issue facing Arizona hospitals right now [continues to be] workforce. The number of positions that remain open is unprecedented. And I think the good news is that we and a lot of our hospital partners, health care partners, and nursing partners have worked with the legislature and the governor’s office to pass some significant funding that’s gonna really help shore up the workforce shortages in Arizona, so that’s what we’re excited about.

We have had this structural problem in our nursing pipeline in Arizona, and I think that is what’s so hopeful about the legislation that was passed and signed by the governor’s office, is that it really deals with a structural problem. We are expanding the number of nursing students and universities and community colleges. We’re going to be training more nurses, having more clinical rotations and hospitals across the state of Arizona. 

And then we’re going to have this innovative transitional practice program for recent nursing graduates to make sure that they are getting the support and the mentorship that they need as they start their career in hospitals so that they stay for their career in hospitals. It’s really a multi-pronged approach with significant investments from the state where we really have this opportunity to invest in that structure so that we are expanding that pipeline.

I’m hopeful in improving over the next couple of years, but that doesn’t diminish the fact that we have issues today. I think hospitals have been innovative in terms of doing teen nursing-type programs, and trying to upskill the nurses they have and really training nurses to be able to practice at a higher level. But it’s a significant issue today, and I think we have the framework of this legislation and the funding in place, but it’s still issue number 1, 2, and 3 for hospitals today.”

SOR: How are Arizona hospitals planning to deal with COVID-19 as an endemic disease that is going to be around for a while?

AA: “A really important issue that we’re focusing on is emergency response and the importance of our supply chain. We saw a lot of weaknesses in the supply chain in Arizona throughout the pandemic, with shortages of PPE and shortages of certain drugs. We’re really looking at our supply chain to understand what we need to do to design a more resilient and a more prepared supply chain. That work is really being done right now to understand what we need to do to prepare for that next emergency, and so that we do not have those supply shortages that we had during the pandemic.”

SOR: How are Arizona hospitals doing in terms of financial stability at this stage in the pandemic?

AA: “Throughout the pandemic, there was significant federal shoring up of the health care system through the CARES Act and provider relief funds, and that has all gone away. So we are in this COVID-19 world without the federal funds to support and strengthen it. We have had significant increases in labor costs, contracted labor, and specifically increasing drug costs. So, the financial stability of hospitals is a concern. We are gathering data right now from Arizona hospitals so that we can really tell that story clearly for Arizona. We need to make sure that hospitals are there to care for patients when patients need it, and a really important part of that is having a solid financial foundation to do so.

Hospitals just can’t sustain this increase in labor and drug costs. Hospitals are like other businesses, so inflation has certainly impacted the bottom line of hospitals like all the other businesses and families in Arizona.”

SOR: How is the new booster vaccine that is supposed to be available this fall expected to impact community transmission levels and thus impact hospitals?

AA: “What we are hoping for and what we’re hearing from the CDC is that this vaccine will be better matched to really be effective against the current variant of COVID. So we’re hopeful vaccines can do what we know vaccines do well, and that is to keep people safe from getting sick with COVID-19. We hope that there will be widespread vaccination, that people will be getting this new booster, and that we can protect people from getting ill and from being hospitalized and really stressing the health care system. We’ve got to be vigilant to try to stay ahead of this, and the way we stay ahead of it is with vaccines, and evolving the vaccines to evolve with a virus so that we can someday get totally ahead of this virus and put an end to COVID-19.”

This interview was edited for clarity and length.