Category Archives: Healthcare

Is a Healthcare Internship For You?

Have you ever wished that you had a little more say about health-care policy? Or wished that you knew more about the issues that affect nursing? If you have, you may want to consider a stint as an intern with one of the organizations that make or influence health policy. It can be an excellent way to learn firsthand about the issues and how policy is made.

An internship is a period of service during which a nurse or other professional gains practical experience under expert supervision. The intern usually works on a specific project–doing research or collecting data, for example. Internships come in all shapes and sizes–paid and unpaid, formal and informal, long- and short-term. They may involve a definite period of service with a fixed stipend, or they may be open-ended. College credit is sometimes given.

How do you get an internship? First, try to find out who handles internships for the organization you’re interested in, and get in touch with that person either by phone or letter. If you can’t get a name, direct your inquiries to the personnel department.

Some organizations have printed application forms and a long list of qualifications. Others ask only for a letter telling about an applicant’s interests.

Make sure your resume is up to date. Stress any research you have done or projects in which you have participated. List everything you’ve published, even letters printed in newspapers.

Following is a list of internships available with organizations that deal closely with the legislative process. It was compiled by Judi Buckalew, RN, MPH, a special assistant to President Reagan, Yvonne Francis, RN, Jean Johnson, RN, GNP, and Marguerite Ragone, RN.

American Association for the Advancement of Retired Persons, 1909 K St. N.W., Washington, D.C. 20049. Contact: Ms. Monica Brown, (202) 872-4700. Offers six or seven six-month internships for graduate students who have demonstrated interest in issues affecting the aging; $750 a month.

American Hospital Association, 444 North Capitol St., Suite 500, Washington, D.C. 20001. Contact: Ms. Donna Patempkin. (202) 638-1100. Offers 10-week summer internships to candidates with BS degrees: letter stating interests required; background in public policy, liberal arts, English, or writing preferred; no stipend.

American Nurses Association, 1101 14th St. N.W., Suite 200, Washington, D.C. 20005. Contact: Ms. Rose Boroch, (202) 789-1800. Offers two programs: The first is an eight-week formal internship as part of the ethnic and minority program, for candidates in the minority fellowship program; stipend included. There is also an informal, noncompetitive internship of no set length, of benefit to nurses but open to other candidates; no stipend. Non-members qualify for either program.

Congressional Placement Office. Applications available in room 26, Cannon House Office Building in Washington. D.C.. between 10 a.m. and 4 p.m. Offers internships through members of Congress; assignments made in March and April, with occasional vacancies occurring at other times.

Department of Health and Human Services, Public Health Services–COSTEP, Parklawn Building. Room 4-35, 5600 Fishers Lane, Rockville, Md. 20857. Offers summer internships for students working on baccalaureate, master’s, or doctoral degrees in health-related fields; applicants must meet qualifications for appointment in the commissioned corps; stipend included: brochure available on request.

Health Care Finance Administration, HHH Building, Room 310 G, 200 Independence Ave. S.W., Washington, D.C. 20201. Contact: Ms. Maureen Rothermich, (202) 245-8502 Offers one-month, full-time, informal internship to acquaint nurses with workings of major government agencies and healthcare financing. Candidates must have graduate degrees, leadership experience, and demonstrated interest in public policy management, as well as career goals that internship would advance or complement; no stipend.

National Academy of Sciences, Robert Wood Johnson Health Policy Fellowships, Institute of Medicine, 2101 Constitution Ave. N.W.. Washington, D.C. 20418. Contact: Mr. Richard D. Seggel. (202) 334-2330. Offers internship running from September to August primarily for mid-level career faculty in health-related professions; includes annual stipend equal to the intern’s salary prior to entering the program up to $40,000. plus maintenance of existing fringe benefits; applications screened in September and October.

National Advisory Council on Women’s Educational Programs, 425 13th St. NW.. Washington, D.C. 20004. Contact: Ms. Sharon Peterson, (202) 376-1038. Offers internships, usually part time. to college students and involves such women’s issues as re-entry into the job market: college credit available, no stipend.

National Hospice Organization, 1901 N. Fort Meyer Drive, Suite 402, Arlington. Va. 22209. Contact: Mrs. Louise Bracknell. Offers internships, usually without stipend: letter stating interests and availability required.

White House Fellowships, 712 Jackson Place. N.W., Washington, D.C. 20503. Contact: Mr. James C. Roberts. (202) 395-4522. Offers one-year, highly competitive fellowships, open to all professionals, and provides an opportunity to be involved at high government level: stipend included: applications and information booklet available upon request.

State legislators and nursing organizations not mentioned here may be able to offer other suggestions.

Also, many small councils within the government work on issues that may be of particular interest to you–women’s health, aging, and world hunger, for example. They usually have very small staffs and limited work space, and the internships tend to be unpaid. But such a situation may be right up your alley if you have flexible hours, want the experience for college credit, or care to further a cause you feel strongly about.

HCFA Changes Outlier Calculations

Responding to health care industry concern about the outlier calculation in the interim regulations governing the new Medicare prospective pricing system (PPS), the Health Care Financing Administration (HCFA) has substantially revised the provision. And industry leaders appear to be pleased with the outcome.

According to the Zenerx Review, the hospital-specific component of the diagnosis-related group (DRG) prices was to be reduced by 5.7 percent to create an outlier pool. However, the final regulations eliminate that provision, thereby reducing only the federal portion of the prices to provide for outlier payments.

Applauding Health and Human Services (HHS) Secretary Margaret Heckler’s decision, Jack Owen, American Hospital Association executive vice-president, Washington, DC, says “To remove 6 percent from the hospital base to establish a pool for payments for the one out of every 20 Medicare patients who is an outlier would neither have been fair to hospitals nor consistent with the intent of Congress.” It would have been “virtually impossible” for hospitals to receive fair rates for all their Medicare patients if the government had proceeded with its proposal to reduce by 6 percent both the hospital- and federal-specific portions, Owen says.

Albert Baker, deputy director for the Federation of American Hospitals (FAH), agrees with Owen that the final rules eliminate the inequity that would have resulted had all would have resulted had all hospitals been required to contribute to the outlier pool, “when not all hospitals would have had outliers.” The FAH is pleased that HHS Secretary Heckler and HCFA Administrator Carolyne Davis “in most cases reacted favorably” to the industry’s comments, he says.

Although the Healthcare Financial Management Association (HFMA) also is pleased with the change in the outlier calculation, Ronald Kovener, HFMA vice-president, says that there continue to be significant problems in the final regulations. “One problem [in the final regulations] that apparently requires legislative action is the area wage index,” he says. The area wage index methodology remains unchanged from the interim regulations. It fails to differentiate between part-time and full-time employees, and it does not reflect the influence of adjacent urban areas on the level of wage paid in selected rural hospitals.

Rural hospitals adjacent to urban areas are competing in the same labor market, and the wage index doesn’t take this into account, Kovener says. Also, the final regulations exclude federal hospital employees from calculations for the wage index. And there are communities where the salary rates of federal workers heavily influence the wage rates for all hospital workers, Kovener contends.

The organizations noted other “disappointing” elements of the final PPS regulations, including:

* No eppals mechanism for hospitals seeking to challenge their base-year case mix indexes.

* A reduction of the average prospective prices by approximately $10 to $13 per discharge.

* A continuation of the perdiem payment methodology for the transferring hospital, as stated in the interim regulations.