Since the onset of the Covid-19 pandemic, hospitals have hired huge swaths of travel nurses to help meet the massive spike in demand for care. As the pandemic has left many nurses exhausted and traumatized, more have chosen to make the switch to third-party staffing agencies that offer more flexible working hours and much higher pay—in some cases as high as $10,000 per week.

Travel nurses are typically employed by third-party staffing agencies that a hospital calls on when in need of extra staff for a short period of time (the average assignment length is 13 weeks). An agency matches a hospital with one of their nurses, who usually temporarily relocates to work at the hospital, with travel and housing stipends sometimes provided by the agency.

Now, some health systems have decided to create their own in-house staffing agencies to compete with those third-party agencies and slow the cascade of salaried nurses leaving.

Diving in: A handful of health systems have announced their own agencies, according to Pam Damsky, director at healthcare consulting firm Chartis. However, she noted there’s no data on how widespread the trend has become. Although the pandemic is credited in part with some of these shifts, Henry Ford Health was ahead of the curve with BestChoice Internal Staffing Resource Pool, which launched nearly a decade ago in Detroit.

Saving cash: Health systems generally save money with their internal staffing agencies because they don’t have to pay the fees that the agencies collect for themselves. Staffing agencies typically make a near 15% operating profit margin, according to Axios. At some health systems, like WellSpan, it can be cheaper to use a travel nurse from its internal agency than paying a regular full-time nurse time and a half to cover an extra shift, said Bob Batory, WellSpan’s chief human resources officer. Keep reading here.—MA

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Inflation has hit record levels this year as demand for goods and services far outpaced supply, and many companies are still trying to bounce back from the shutdowns of early 2020.

Health systems, which have razor-thin operating margins even in the best of times, aren’t an exception—and experts told Healthcare Brew they’ll need to get creative to make it through.

“In the past, we’ve always said that healthcare was kind of recession-proof because demand for healthcare keeps going, regardless of what’s happening in the economy,” said Tina Wheeler, leader of consulting firm Deloitte’s US healthcare practice.

But in the last year, inflation hovered around 8% for much of the year, while medical-care prices increased by only 4.8%, according to Wheeler. Since medical costs are negotiated between hospitals and payers years in advance, hospitals can’t just raise their prices now to keep up with the pace of inflation, said Gerard Brogan Jr., senior vice president and chief revenue officer at Northwell Health.

Here’s how badly hospitals could be hurting:

• Inflation could cause an additional $370 billion more in healthcare spending than the expected baseline increase by 2027, according to McKinsey.
• The national health expenditure could grow at a rate of 7.1% over the next five years, compared to the expected economic growth rate of 4.7%, according to McKinsey.
• By the end of 2021, total hospital expenses per adjusted discharge were up 20.1% compared to 2019, according to the trade group American Hospital Association.

Rising interest rates also hurt hospitals since their main access to capital is through issuing tax-exempt bonds, Wheeler said. The rising cost of capital limits hospitals’ ability to fund projects, like opening a new oncology center to treat patients, for example. Keep reading here.—MA

A hot new bombshell has entered the villa: the bivalent Covid booster. And this season, it’s coupling up with the flu shot. At least two major pharmacies—Rite Aid and Walgreens—are seeing a large number of customers opting to get both vaccines at once.

In its latest earnings call, Rite Aid executives said that 40% of people who came to their pharmacies to get a bivalent Covid booster opted to add on a flu shot.

Competitor Walgreens said it’s seeing co-administration rates vary at stores across the country—between 24% and 42% depending on location—and that customers have a higher-than-normal willingness to get dual shots.

CVS declined to give any specific numbers, but spokesperson Matt Blanchette said via email that the pharmacy chain is encouraging customers to get the shots together and that “many opt to get both.”

If you’re worried that two vaccines means double the side effects, Chris Altman, Rite Aid’s director of immunization and clinical programs, said the company isn’t seeing many people report additional symptoms.

“It is entirely safe to be vaccinated both [for] Covid and flu at the same time,” said Kevin Ban, chief medical officer for Walgreens.

But, Ban mentioned that the CDC has warned of a slight increase in side effects, such as redness and swelling at the injection site, fatigue, headache, and muscle pain. All are treatable with over-the-counter medications and resolve quickly, he said.—MA

Today’s top healthcare reads.

Stat: Covid-19 made Pfizer nearly $100 billion, which the company plans to use in part to develop other medications, including a weight loss pill. (Kaiser Health News)

Quote: “We’re starting to get all these weird consults…People have been liberated from anesthesia after surviving Covid, and they’re not waking up.”—Nicholas Schiff, a neurologist at Weill Cornell Medicine, on Covid-19 patients not regaining consciousness as expected after being removed from ventilators (the New York Times)

Read: Federal proposals to ban menthol cigarettes and limit nicotine levels, while allowing the sale of some electronic cigarettes as a smoking alternative, are expected to garner a big public health fight. (the New York Times)

Catch up on the top Healthcare Brew stories you may have missed:

• How Smileyscope’s VR headset could be a medication-free way to alleviate anxiety
• ‘Birthing-Friendly’ designations: How hospitals can earn it, and what the label means
• Companies designing drugs with AI could shave years, millions off development