For years, headlines have focused on the immediate cost of a doctor’s visit or a hospital bill. But a recent analysis published in JAMA Internal Medicine reveals a deeper and more troubling reality: healthcare costs in the United States are not just a one-time problem they quietly accumulate and strain patients and families over the course of their lives.
For healthcare organizations and hospital systems already facing staffing shortages, this long-term financial pressure on patients intersects with another urgent challenge: the need to recruit and retain skilled nurses. At VisaMadeEZ, an immigration law firm dedicated to helping healthcare organizations hire international nurses, we see every day how smart workforce planning and international nurse recruitment can support both patient care and affordability.
Below, we break down the key findings from the study and what they mean for U.S. healthcare employers that rely on international nursing talent.
A Deeper Look at Lifetime Financial Strain from Healthcare
The study, conducted by researchers from Harvard Medical School, CUNY’s Hunter College and Public Citizen’s Health Research Group, used data from the Medical Expenditure Panel Survey between 2018 and 2022. Instead of looking at just a single year of expenses, the researchers followed 12,645 U.S. adults over a four-year period.
They examined three specific indicators of financial strain tied to medical costs:
1. Cost burden
- Out-of-pocket healthcare costs exceeding 10% of a family’s income (or 5% for low-income households).
2. Catastrophic cost burden
- Out-of-pocket costs exceeding 40% of a family’s income left over after basic living expenses (often called post-subsistence income).
3. Foregone care due to cost
- Patients skipping or delaying needed medical care because they cannot afford it.
If a person experienced any one of these three, they were considered to have faced financial strain from healthcare.
Over just four years, more than one in four adults (26.7%) reported either excessive medical cost burdens or avoiding care due to cost. While annual statistics often downplay the problem, this longitudinal analysis shows that unaffordable healthcare is not a rare event. It is a common, recurring reality for a large share of Americans across their lifetimes.
Who Is Most at Risk of Financial Strain?
The study highlighted several groups at greater risk of healthcare-related financial hardship:
- Individuals with low incomes
- People who are uninsured or underinsured
- Adults living with chronic illnesses
- Those who have experienced recent hospitalizations
Among the most sobering findings: of the 2.3% of participants who died during the study period, more than half (53.2%) had experienced financial strain from healthcare in the one to four years before their death.
Lead author Dr. Adam Gaffney, a critical care physician and assistant professor at Harvard Medical School, emphasized that healthcare affordability is not a one-time event but a chronic condition in itself. High medical costs don’t just damage finances they cause people to skip appointments, delay treatments, and avoid essential care, ultimately worsening their health and increasing the burden on the system.
While the study did not factor in insurance premium costs or include nursing home residents, its conclusions still point clearly to a system where medical expenses and access to care are tightly linked and where patients’ financial stability is often fragile.
What This Means for U.S. Healthcare Providers
For hospital systems, long-term care facilities, and other healthcare employers, these findings reinforce something you already see on the ground every day:
- Patients delay care until conditions worsen.
- Preventable complications lead to expensive hospitalizations.
- Chronic understaffing makes it harder to provide proactive, coordinated care.
In a high-cost environment, the role of nurses becomes even more critical. Nurses are often the first line of defense in detecting complications early, educating patients, coordinating follow-up, and helping reduce readmissions. Well-staffed nursing units can improve outcomes and, over time, help reduce unnecessary healthcare spending.
Yet most U.S. healthcare organizations are fighting a parallel battle: a persistent nursing shortage. Domestic nurse supply alone often cannot meet patient demand, especially in high-need areas such as:
- Acute care hospitals
- Long-term care facilities
- Rural health systems
- Community health centers
This is where international nurse recruitment becomes an essential part of a long-term strategy.
How International Nurses Help Support Affordable, High-Quality Care
Internationally educated nurses bring critical skills, diverse experience, and stability to the healthcare workforce. By filling hard-to-staff positions, they help organizations:
- Maintain safe staffing ratios
- Expand services to underserved communities
- Reduce burnout and turnover among existing staff
- Strengthen continuity of care for patients with chronic conditions
Over time, better staffing directly impacts affordability and outcomes:
- Patients receive timely care instead of waiting until conditions become emergencies.
- Hospitals can reduce avoidable ICU admissions and readmissions.
- Care teams can provide more education and preventive care to patients who are already financially vulnerable.
In other words, bringing in international nurses is not just a staffing solution it is a quality and cost-control strategy. When patients are less likely to defer care and more likely to receive the right intervention at the right time, the overall financial strain on individuals and families can be reduced.
Navigating U.S. Immigration Law to Hire International Nurses
Despite the clear benefits, hiring international nurses involves complex immigration and compliance steps. U.S. healthcare employers must navigate:
- Visa categories such as the EB-3 immigrant visa and sometimes temporary options like the H-1B or TN (where applicable)
- Credentialing and licensing requirements, including NCLEX and state board approvals
- Timing issues related to visa processing backlogs and priority dates
- Ongoing regulatory updates that can affect your international nurse recruitment strategy
This is where a specialized immigration law firm for healthcare organizations becomes invaluable.
How VisaMadeEZ Helps Healthcare Organizations Hire International Nurses
VisaMadeEZ focuses exclusively on supporting healthcare employers in building strong, sustainable teams through international recruitment. We work closely with:
- Hospitals and health systems
- Long-term care and skilled nursing facilities
- Rehabilitation centers
- Community and rural providers
Our services include:
- Strategic planning for international nurse recruitment programs
- Immigration case management for EB-3 and other applicable visa categories
- Coordination with foreign-educated nurses, recruiters, and HR teams
- Guidance on compliance, documentation, and timelines
- Ongoing support as regulations and processing times change
By partnering with VisaMadeEZ, healthcare organizations can focus on delivering care while we focus on the legal pathways to bring qualified international nurses to your team.
Why This Matters Now
As the JAMA Internal Medicine study shows, healthcare costs in the United States exert a cumulative and widespread financial pressure on patients over the course of their lives. At the same time, nursing shortages and workforce instability can worsen access, delay treatment, and ultimately increase both medical and financial burdens.
Building a resilient, well-staffed nursing workforce including through international nurse immigration is one of the most practical, long-term ways to:
- Improve patient outcomes
- Support earlier, more affordable care
- Reduce avoidable hospitalizations
- Relieve pressure on patients and families facing rising costs
VisaMadeEZ stands at the intersection of these challenges, helping healthcare organizations navigate the complexities of U.S. immigration law so they can recruit and retain the international nursing talent they urgently need.
Partner with VisaMadeEZ
If your organization is:
- Struggling with chronic nurse vacancies
- Serving populations heavily affected by rising healthcare costs
- Looking to build a reliable pipeline of international nurses
VisaMadeEZ is here to help.
Contact us today to discuss how a tailored international nurse recruitment and immigration strategy can strengthen your workforce and support better, more affordable care for your patients.
