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2011 Health Care Trends: Home health care hiring and more

Updated: December 15, 2011 11:31AM



How will 2011 healthcare recruitment differ from 2010 healthcare hiring trends? And what will be the healthcare staffing trends?
As the economic recovery gains steam and Patient Protection and Affordable Care Act is deliberated in Washington, 2011 healthcare recruiting will ramp up, with particular emphasis on primary care and other care settings that provide cost-effective alternatives to hospitalization. Indeed, this year will see an acceleration in the long-term trend away from hospital care.
"The rate of growth in hospital employment is likely to stay low," says Charles Roehrig, director of Altarum Institute's Center for Studying Health Spending. Not surprising, given the shrinking of the industry sector: Hospital beds declined from 1.21 million in 1990 to 945,000 in 2007, according to the National Center for Health Statistics' Health, United States, 2009 report.
Still, hospital employment is very large and not stagnant. In 2010 hospitals added 50,000 staff to bring the total to 4.74 million jobs, according to the December employment report of the Bureau of Labor Statistics.
But the emphasis in healthcare recruitment now is on other care settings, from home care, clinics and hiring office staff. "Nursing homes, long-term care facilities, outpatient clinics and private physician offices are all hiring," says Patricia Chute, dean of the New York Institute of Technology School of Health Professions.
Intense Competition for Primary Care Providers
A variety of healthcare providers will redouble their efforts in 2011 to provide more primary care with fewer physicians, lowering costs in the process. "Hospitals and physician groups forming accountable care organizations will be looking more than ever to hire nurse practitioners, registered nurses and physician assistants," says Richard Wagner, managing director of Wagner Healthcare Consulting in Chicago. "Anyone who can deliver primary care at a discount will have a lot of value to their organization."
But providers' ability to hire nurse practitioners, physician assistants and other non-MD primary care practitioners will be constrained by the current and future supplies of these professionals, who require extensive training. "Last year we had 1,700 applicants for 52 spots in the physician assistant program," says Chute.
Home Healthcare is Hiring Rapidly
Recruitment for many occupations in home healthcare will ramp up in 2011, continuing the long-term trend. Home health agencies increased their number from 5,730 in 1990 to 9,024 in 2007, according to the NCHS report.
"As healthcare shifts from hospital to home, and as reimbursement moves from episodic fee-for-service to capitated reimbursement, we'll see increasing need for at-home professionals," says Eric Rackow, M.D., CEO of SeniorBridge, a national home-care provider based in New York. "We're contracting with health plans and physician provider groups to keep patients at home."
In 2010 home healthcare employment grew by 40,000 to 1.09 million. Employment at nursing care facilities grew by a more modest 19,000 to 1.66 million.
"The private-pay market for home healthcare was dampened by the recession in 2009 and 2010," says Dr. Rackow. "But I think the pace of hiring will be higher in 2011." This year SeniorBridge plans to hire RNs, social workers and home health aides, as well as nurse practitioners, nutritional counselors and others.
Healthcare Recruitment Competition in Other Care Settings
Healthcare providers in other settings will boost competition for top clinicians; employment at outpatient care centers grew by 20,000 to 566,000 in 2010. For decades, employment growth has been driven by the explosion of specialized care facilities. From 1900 to 2007, outpatient rehabilitation facilities increased from 186 to 539 and hospices jumped from 825 to 3,255, according to the NCHS report.
Healthcare job recruiters will also face intense competition from providers of care in non-traditional settings in 2011. "Some employers are bringing primary-care physicians into their facilities, to reduce their healthcare costs," says Peter Ferguson, senior vice president of health and life sciences at Yoh, a Philadelphia-based recruitment and staffing firm.
Workplace healthcare is just one of several alternative care settings driving healthcare recruitment. "They're hiring at school-based clinics like those in California," says Chute.
Healthcare Reform: Doubts on Implementation?
As legal and legislative challenges to the historic healthcare reform package play out, most observers believe the main drivers of new hiring will remain in place. "The healthcare reform provisions that focus on accountable care and improving care quality are pretty much going to stay in, no matter what," says Wagner.
Still, if certain key provisions of the PPACA are struck down by the courts or derailed by Congress, much in the healthcare industry could be up for grabs. "The loss of the individual mandate would be a big problem for the health insurance industry," says Dr. Rackow.
Healthcare recruiters, however, are generally confident that their bread-and-butter business is safe. "There are a lot of open positions out there," says Ken Cantin, a senior account executive with Management Recruiters of Colorado Springs, Colo. "There are always enough jobs for nurses, doctors, physical therapists and occupational therapists."

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