By: John Rossheim, Monster Senior Contributing Writer
Demand for the services of healthcare workers will increase.That much we can say about healthcare hiring in the wake of the passage of the Patient Protection and Affordable Care Act. In its 1,000-plus pages, the reform legislation’s broad-stroke system changes and neuron-numbing details will not only create jobs; the far-reaching plan will also change the career paths of many experienced or aspiring health professionals as the system lumbers toward universal coverage with an emphasis on primary care.
But what clinical positions will healthcare organizations need to fill to meet the increased demand, and when? Much won’t be known for a few years, as the new law’s many provisions make their staged entrances. Still, the legislation’s major emphases will have somewhat predictable effects on the healthcare labor economy.
And what will be the magnitude of job creation? Perhaps not as enormous as some of headline healthcare-reform numbers suggest.
Because Medicare today covers virtually the entire population age 65 and up, nearly all of the estimated 32 million people who will become covered under healthcare reform by 2014 are younger Americans who require fewer healthcare services. And “uninsured Americans already receive about 50 percent of the care they will receive when insured,” says Charles Roehrig, director of the Altarum Center for Studying Health Spending, a research and consulting organization with clients in government and the private sector.
So it turns out the total increase in provided healthcare will be about 3 percent, Roehrig says. And since younger patients use more ambulatory care, outpatient services will see the greatest increase in demand.
A Greater Mix of Providers for Preventive, Primary Care
The reform law’s emphasis on primary care will have cascading effects on several clinical occupations. “Physicians can’t be trained overnight, so healthcare employers will leverage their M.D.’s with nurse practitioners and physician assistants,” says Roehrig. “Everything will be pushed so that everyone is performing right up to their education level.” Along with these licensed providers, demand for medical assistants will see a boost, he adds.
And the pressure to move some tasks off the plates of physicians won’t stop at hospitals and more states will license them to practice on their own,” says John Salerno, DO, a family physician in New York. As the demand for advanced-practice nurses rises, the perennial shortage of bedside RNs will likely intensify.
“With the increased demand for NPs, there will be further demand to backfill for RNs,” says Pete Ferguson, senior vice president for health and life sciences at staffing firm Yoh Services. So savvy healthcare employers are beefing up their perennial efforts to keep students and experienced nurses in the recruitment pipeline, even through this time of tight budgets.
Physician’s assistants in particular will be in greater demand. “The new law promotes models of care such as the patient-centered medical home,” says Cynthia Lord, director of the physician assistant program at Quinnipiac University in Hamden, Conn. The medical-home model often makes use of licensed medical providers other than physicians, such as NPs and PAs.
“Our PA graduates get the attention of physicians in private practice as well as hospitals,” Lord says. Every physician assistant in the class of 2009 who sought a full-time job found one, according to Lord.
Large employers like hospitals offer advantages to in-demand PAs, like relatively rich benefits packages. But smaller employers, such as physicians’ offices, have their own appeal. “I like the autonomy and flexibility of private practice,” says Lord. “And there are more opportunities to develop working relationships with patients and physicians.” Physicians’ offices that can play up these opportunities can compete head-to-head with hospitals and other large employers.
Outlook for Pharmacists and Diagnostic Technicians
Pharmacy is also likely to see increased demand under healthcare reform, though the interplay of supply and demand is complex. “The current situation is that the job market has tightened up a bit -- there’s not as much of a shortage of registered pharmacists,” says Ken Schafermeyer, professor of pharmacy administration at the St. Louis College of Pharmacy. “But when 32 million people get insurance in 2014, there will be a boost in demand and we’ll need more pharmacists and pharmacy technicians. Still, there are more than 100 pharmacy schools today, which is too many schools turning out too many pharmacists.”
A Greater Demand for Technicians
The emphasis of the reform on primary care is also likely to boost demand for diagnostic technicians, among other allied health occupations. “There’s a pretty dramatic shortage of lab techs, not everywhere but in many parts of the country,” says Lorrie Laurin, director of the School of Allied Health at Rasmussen College in Lake Elmo, MN. “Those shortages are likely to continue because enrollments haven’t increased significantly in recent years.”
More funding for prevention will create further job demand. “The law’s prevention measures require that any health plan pay 100 percent of screening such as mammograms,” says Fred Goldstein, president of US Preventive Medicine, which provides health programs to employer groups. “There’s also $200 million in the law for grants to smaller employers to provide prevention programs.” To learn more about this funding for employers with fewer than 100 employees, see the grants section at the Department of Health and Human Services and refer to Section 10408 of the PPACA.
Community Health Initiatives Will Jump-Start PPACA Jobs
The demand for healthcare professionals induced by the addition of 32 million Americans to insurance rolls is likely to be the biggest labor-market effect of healthcare reform, but it won’t be the first.
“Community health funding will hit in 2011, and this may be the initial source of new jobs,” says Roehrig. The legislation also increases funding for the National Health Service Corps, authorizes a grant for school-based health centers and provides funding for nurse-family home visit partnerships, which serve first-time, low-income mothers. The reform law also creates a grant program for nurse-managed clinics, which are primary and preventive care facilities run by nurse practitioners in underserved regions.
Finally, the legislation’s healthcare workforce initiatives bolster scholarship and loan repayment programs in fields including primary care, dentistry, pediatrics, nursing and mental health. Smaller employers can encourage their aspiring healthcare workers to apply for Perkins loans, Stafford loans and loan forgiveness programs to pay for education toward higher credentials. In the ever-escalating campaign to field the best clinical staff in this era of healthcare reform, every recruitment tactic is on the table.