Looking ahead 2016: Workforce takes center stage in healthcare

A remarkable incident happened in healthcare in mid-2014, though little notice was taken of it. Demand for healthcare professionals, which had a slow, jerky rise since the end of the recession, rose precipitously and hasn't stopped.

The past 12 months have seen the largest growth in healthcare employment ever – approximately a half-million new jobs filled.

This trend will continue in 2016. But supply of healthcare professionals will not be able to keep up with this torrid demand. In the year 2016, the healthcare workforce will take center stage, as the struggle to hire quality healthcare professionals and manage the changing workforce becomes the No. 1 challenge for the healthcare industry.

Anatomy of the Healthcare Professional Shortage

When healthcare providers urgently need staff, they pick up the phone and call us: We're the first responders. We saw the surge in demand in mid-2014 when orders for nurses suddenly shot upward, and we immediately knew that predicted changes in workforce supply and demand were getting real.

Soon, data from the US Bureau of Labor Statistics validated what we were seeing:

• Average monthly employment increases in healthcare doubled from 13,000 in 2013 to 26,000 in in 2014, with the biggest numbers coming in the second half of 2014. In 2015, the average monthly employment increase has been 41,000.

• From October 2014 to October 2015, employment in healthcare increased by 495,000 jobs, the largest 12-month healthcare increase since the Bureau of Labor Statistics began providing such data 26 years ago.

• But, job openings are quickly outpacing job hires. As large as job growth may be, the growth in job openings is much larger. At the end of 2015, there are hundreds of thousands of unfilled jobs in the healthcare industry.

This challenge is expected to worsen as demand for the services of healthcare professionals continues to grow:

• About 17.6 million people had gained healthcare coverage due to the Affordable Care Act by March 2015, according to US Dept. of Health and Human Services. The ACA also increased demand by ending denial of care based on pre-existing conditions and lifetime or annual dollar limits on care, and by mandating that large businesses insure employees.

• The nation's population continues to age. The population of Americans age 65 and older will grow from 13% in 2010 to 16% in 2020 to more than 19% in 2030. People over age 65 have nearly three times as many hospital days compared to the general population. For people over 75, the ratio goes up to four times, according to the Centers for Disease Control.

And, shortages of healthcare professionals are getting worse:

• While there are inconsistencies among researchers regarding nursing supply, healthcare staffing companies can attest to the fact that filling nurse orders is becoming increasingly difficult. Nurses are the largest component of the healthcare workforce, so the expanding gap between job openings and job hires in healthcare, shown by Bureau of Labor Statistics data, strongly suggests that nurse shortages are worsening.

• The AMN Survey of Registered Nurses found that that 62% of nurses over age 54 are considering retirement now that the recession is over. And, nearly two-thirds of those say they plan to retire in the next three years. Older nurses make up a disproportionately large segment of the nation's nursing workforce.

• Physician shortages are a long-standing problem, and the problem is getting worse. By 2025 (only nine years from now), the physician shortage will be from 46,000 to 90,000, according to the Association of American Medical Colleges.

• Recent data from the American Physical Therapy Association show rising shortages in physical therapist over the next five years. AMN Healthcare already has seen this supply and demand imbalance in its orders for therapists.

New and Emerging Workforce Roles

The triple aim of healthcare reform – improve quality, control costs and extend the reach of healthcare to populations – is resulting in many new job types and specialties. This is increasing demand for jobs that didn't exist or were much smaller in numbers a decade ago.

The change from volume-based to value-based healthcare is resulting in new payer models such as Accountable Care Organizations (ACO) and reimbursement incentives linked to patient satisfaction and safety and other metrics. Marketplace pressures for change are powerful, too, as healthcare providers compete for patients. These changes also are requiring new types of healthcare professionals.

In its survey of clinical managers and human resource leaders, Emerging Roles in Healthcare 2014 by AMN Healthcare found that while a majority of healthcare professionals are aware of new and emerging workforce roles, hospitals and health systems are not adequately planning to staff these new positions.

The survey showed that much less than half of respondents said they were recruiting or planning to recruit for positions such as care coordinator, health coach, clinical documentation specialist and patient navigator. For new healthcare leadership roles, such as chief patient experience officer, chief population health officer and chief strategy officer, the percentage of providers planning to recruit was very low.

Many existing healthcare workforce roles are taking on new importance due. For example, advanced practice clinical roles such as nurse practitioners and physician assistants are in great demand due to physician shortages and the rise in retail care, urgent care, home healthcare and other treatment settings where their services are needed.

Is Healthcare Ready for Workforce Change?

In 2016 and coming years, hospitals, health systems and other treatment providers will need to come to terms with the growing workforce challenges that will impact the industry for the next decade. The heated competition to recruit quality healthcare professions will grow even more intense as demand for services grows and shortages persist. Providers that are not utilizing cutting-edge recruitment practices, databases and automated systems will be at an increasing disadvantage.

Workforce planning and management is moving beyond assumptions and guesswork toward a strategic enterprise function. Healthcare providers are beginning to adopt standardized practices, advanced labor management procedures and predictive analytics driven by "big data," which can accurately predict patient demand, staffing needs and staff schedules up to 120 days in advance.

Technology-enabled systems for workforce recruitment, engagement and management are becoming the new health IT, providing effective scheduling and staffing to bolster quality patient care, safety and satisfaction – along with financial efficiency.

Considering that the workforce absorbs more than half the budget for nearly every healthcare enterprise, it becomes obvious why these and other advancements in workforce solutions will become necessary in the increasingly complex world of healthcare.

In the past year-and-a-half, we've seen unprecedented growth in demand and increasingly complex changes related to the healthcare workforce. In the year 2016, healthcare will have to come to terms with these enormous challenges.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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