Four Ways the ACA Affects Healthcare Staffing

frequency-309372_640The Affordable Care Act (ACA) has a huge impact on healthcare staffing – a trend that will continue into the future. The growth of millions of newly insured patients put tremendous upward pressure on demand for nurses, physicians, allied health professionals and other healthcare workers.

But the workforce impact of the ACA has been amplified by other circumstances that helped create the current transformational environment in the healthcare industry.

The ACA comes at a time when the average U.S. citizen is getting older, a trend that will continue for decades. Since healthcare utilization increases with age, this aging population will need many more healthcare professionals to treat them. Not only are the patients getting older, the health professionals that treat them are as well, which is leading to a wave of retirements just when more clinicians are needed.

Also, the improving economy increases demand for healthcare services, because more people have jobs with healthcare benefits, and they have more money to cover copays and deductibles. Not surprising, with all of these forces combined, we are seeing demand for healthcare services overwhelming the supply of professionals to provide those services. Healthcare staffing companies can all testify to the very real shortages in physicians, nurses and even allied healthcare professionals that have intensified since the enactment of the ACA.

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The ACA has been the major contributor to the workforce supply and demand imbalance in healthcare in four major ways:

  • It added approximately 20 million new patients to the rolls of the insured populace since the act fully went into effect in January 2014. That’s a staggering increase in the number of healthcare consumers, and it quickly resulted in rising demand for healthcare services as the new enrollees began using their insurance. AMN Healthcare saw demand for nurses begin to spike in mid-2014, and that rise in demand has continued. Demand for therapists, technicians, technologists and other allied healthcare professionals also began to rise. The physician shortage has been a problem for years, and recent studies have indicated a widening gap between physician supply and demand. According to data from the U.S. Bureau of Labor Statistics, the gap between healthcare job openings and job hires has been growing since 2014, and currently stands at nearly a half-million unfilled jobs.
  • The increase in patient care demand due to the ACA is not a one-time phenomenon but a long-range obligation. Health insurers refer to customers as “covered lives,” and that’s a significant phrase for the issue of rising clinical workforce demand. Because being insured is now the law of the land, most of the 20 million will be covered for the rest of their lives. So, the rising demand for the services of healthcare professionals will be cumulative — and progressive, too. Today’s new ACA enrollees, like all of us, will grow older and therefore need more care as time goes on. The increase in demand for the services of healthcare professionals, in part created by the ACA, is now embedded into our healthcare system. And the demand for healthcare services by those 20 million will increase as that group ages.
  • The ACA also incentivizes cost containment and population healthcare. And, the healthcare industry is becoming increasingly competitive. These regulatory and market changes are transforming the workforce by creating new roles and raising the profiles of many existing ones. Integrated care is being managed by a new cadre of care coordinators, who are usually registered nurses with degrees and additional training. Home health, the fastest growing industry in the country, needs more home health-experienced nurses and therapists. The health information technology revolution, fomented by both regulatory and competitive pressures, has created demand for medical coders, health information managers and many other technology roles. The rise in team-based care coupled with the extreme shortages of physicians has increased demand for advanced practice registered nurses, such as nurse practitioners, and physician assistant.
  • In today’s competitive landscape, leadership positions have become critical; demand is great to quickly fill openings with interim or permanent hires. At the same time, new leadership positions are being created, such as chief population health officer, chief experience officer and chief clinical transformation officer. It’s widely recognized in the healthcare industry today that a leadership vacancy can be very detrimental to competitiveness, quality and strategic planning at a healthcare enterprise. Like most other professional roles in healthcare, there is rising demand for leaders, too.

While the ACA may have kindled these changes in healthcare staffing, many factors are further magnifying them. Most importantly, though, is that there is no reversal in sight for the rising demand for many types of healthcare professionals – from nurses to hospital CEOs. The forces driving the current healthcare workforce supply and demand imbalance will continue for years to come.

Ralph Henderson

Ralph Henderson
Ralph Henderson is president, Professional Services and Staffing, at AMN Healthcare.

Ralph Henderson

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