Labor Market Information: Win-Win Network Community of Practice

Health Care Workforce Projections

Posted by LMI Win-Win Network - On November 22, 2013 (EST)

Health Care Workforce Projections

State labor market information (LMI) offices have asked the U.S. Employment and Training Administration (ETA) for information about health care workforce projections, in order to enhance the value of the occupational and industry employment projections that the states prepare with ETA funds. Health care jobs are routinely among the fastest growing occupations in the economy. The U.S. Health and Human Services (HHS) Department’s National Center for Health Workforce Analysis is scheduled to release various types of projections in late 2013 and 2014, but has many useful materials available now, described below. HHS expects to publish projections for these health occupations within the next year: primary care practitioners — including physicians, nurse practitioners, and physician assistants (November 27, 2013); more than 40 clinical practice specialties (Summer 2014); nurses (Fall 2014); oral health occupations (Fall 2014); and a cross-occupational group (by an unspecified date in 2014).

HHS vs. BLS Projections

Three differences between the HHS and U.S. Bureau of Labor Statistics (BLS) projections should be kept in mind. HHS projections count people, while BLS counts jobs. Second, BLS covers all health care jobs, by both occupation and industry. HHS only covers selected health care occupations. Finally, HHS’ work is explicitly designed to estimate whether shortages or surpluses will occur by the projected year, while BLS states that its projections cannot be used for this purpose. One similarity of both agencies is that its estimates are projections based on a set of assumptions, NOT forecasts that predict future developments.

For an ETA podcast explaining the basics on employment projections (including a 3-page transcript with links), see National, State and Local Employment Projections: Peering Into the Crystal Ball.  For guidance on how to use workforce data (including projections) to identify growing and in-demand jobs, determine which of them are “good” jobs, and ascertain what preparatory education and training are needed to qualify for them, see ETA’s Webinar on Putting Workforce Data to Work in Employment and Education Programs. For a recent overview of trends affecting the health care workforce, see the slides and audio recording of the November 2013 conference on Redesigning The Health Care Workforce.

GAO Study on Health Workforce Projections

A recent U.S. Government Accountability Office (GAO) study provides relevant background on the Department’s various health care workforce projections endeavors. See Health Care Workforce: HRSA Action Needed to Publish Timely National Supply and Demand Projections. GAO reported, “For over a decade, several government, academic, and health professional organizations have projected national shortages of health care professionals…. However, there is little consensus about the nature and extent of any future shortages.” [p. 1]

The 2009 passage of the Patient Protection and Affordable Care Act (usually referred to as the ACA or as Obamacare) introduced considerable challenges for workforce projections, as its provisions may affect both supply and demand for the health care workforce (the ACA established new health care delivery models). Several private sector researchers have estimated the ACA’s effects on workforce supply and demand. [pp. 9-10, including citations to the studies]

The ACA established the National Health Care Workforce Commission to collect and analyze health care workforce data and evaluate workforce adequacy, but absent Congressional appropriations the Commission has not met. The Act also established the National Center for Health Workforce Analysis (NCHWA) within HHS (under the HHS Health Resources and Services Administration’s Bureau of Health Professions).

National Center for Health Workforce Analysis (NCHWA)

Recent health occupation reports. In 2013 NCHWA has issued reports on two key health care occupations: nurses, and the public health workforce. The U.S. Nursing Workforce: Trends in Supply and Education (revised October 2013, 68 pp.) analyzes the supply of existing and incoming registered nurses and licensed practical nurses. It includes data by state, analyzes patterns for urban vs. rural areas, and provides a wealth of other statistics (including the education and licensure of the workforce both before and after entering the nursing profession). A slide presentation and brief technical documentation report are also available. Note that much of the recent information is based on the combined 3-year U.S. Census Bureau American Community Survey (ACS) sample for 2008-10, although 2010-12 ACS data are now available.

Public Health Workforce Enumeration, 2012 (32 pp.) defines, enumerates, and describes public health workers in Federal, state, and local health departments, and is a follow-up to a 100-page study that attempted to identify the best sources of information on these workers.

Basic background information for projections. Also in 2013, NCHWA issued a 50-page Compendium of Federal Data Sources to Support Health Workforce Analysis, which explains and provides links to 19 Federal surveys on health care workers, encompassing those from HHS, BLS, the U.S. Census Bureau, and the U.S. National Center for Education Statistics. The main Web site for this project, which HHS calls its Health Professions Minimum Data Set, also includes a PowerPoint overview of the project, recommended surveys for 10 health occupations, and other reference materials.

On the main NCHWA Web page, the Center also has county-level “Area Health Resources Files” that consolidate health workforce data from numerous sources for every county (current as well as historic data for more than 6,000 variables). These files have data on health care professions, training, facilities, hospital utilization, hospital expenditures, measures of resource scarcity, health status, economic activity, health training programs, socioeconomic and environmental characteristics, and codes and classifications. State-level data are available for 50 health care professions . This information has also been incorporated into a customized data Health Resources Comparison Tool — for both states and counties — that allows you to compare your area with others, including the entire U.S.

Finally, HHS has funded several Health Workforce Research Centers, operating out of universities, whose function is to support high quality, impartial, policy-relevant research on the health workforce to assist decision-makers at the Federal, state and local levels to better understand health workforce needs.

Health workforce projections. NCHWA’s projections publications are available at Estimates of Supply and Demand. As noted, at this time none of the projections are newer than 2008, but older projections (and newer ones, when issued) are available for medicine, nursing, dentistry, pharmacy, public health, and for the entire health care workforce (some of the publications are not projections per se). The right side of the screen shows the current publication schedule. A useful PowerPoint also explains general health care workforce projections methodologies and challenges.

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