Health Care Workforce
A dominant issue for hospitals continues to be the availability of skilled health care professionals. Studies continue to show that shortages in the health care workforce has the ability to impact the delivery and quality of care provided, and will continue to challenge hospitals from both a budgetary and a quality standpoint for the foreseeable future.
If current trends continue, the health care industry will experience a serious shortage of physicians, advanced practice nurses (APNs) and physician assistants (PAs) during the next two decades, according to a study published in the Journal of the American College of Surgeons. More than two-thirds of advanced clinicians are physicians, and the U.S. is training fewer physicians per capita annually. The national physician shortage increases 7 to 8 percent each annually. Although training programs for APNs and PAs are expected to grow continually, there is little evidence that the same will be true for physicians. Yet, if physician training programs are not expanded, the current shortages are expected to expand to 20 percent by 2025 and not meet demand, especially in light of greater access to care due to health care reform.
MCHC is committed to providing physicians in the metropolitan Chicago region with invaluable educational programs as the role of the physician leader becomes increasingly essential in today’s market. MCHC, in partnership with the American College of Physician Executives (ACPE), is hosting a series of physician leadership programs. The programs are designed to enhance physician and nursing leaders’ leadership and management skills to succeed in a post-health care reform environment. MCHC will offer ACPE educational sessions quarterly for the next two years covering such topics as health care finance, negotiation skills, conflict management and strategic planning.
MCHC also is committed to providing the latest information about current practices regarding advanced practice registered nurses (APRNs) and physician assistants (PAs). MCHC has built the largest database in the U.S. containing information about APRN and PA credentialing, privileging, competency assessment, orientation, billing and reimbursement processes. MCHC’s core and specialty privilege database represents over 1,400 APRNs and 700 PAs in 50 different specialty areas in over 100 organizations.
The physician shortage is due to the current freeze on the number of training slots that Medicare supports; the graying of the profession; the retirement of the baby boomers generation; the increasing demand due to the overall rise in population growth; and younger physicians working fewer hours.
By 2020, the growing and aging population is expected to increase the demand for all specialties. Today, 12 specialties continue to experience physician shortages, including cardiology, radiology and several pediatric and surgical sub-specialties.
In addition to the physician shortage, the shortage of registered nurses (RNs) is expected to increase. Despite a recent strengthening of the RN workforce, the U.S. will have to prepare for an aging population of RNs over the next 20 years as the size of the workforce shrinks due to large numbers of RNs retiring. Because the demand for RNs is expected to increase steadily during this same period, a large shortage of RNs is expected to develop in the latter half of the next decade, threatening access to care and increasing health care costs.
The metropolitan Chicago region, like the rest of the U.S., is experiencing a significant health care workforce shortage that is expected to grow dramatically through 2020 if actions are not taken. The shortage includes nurses, therapists and technicians. Currently, the nursing shortage is estimated at 2,500 in the metropolitan Chicago region alone and is expected to increase to 21,000 nurses statewide by 2020. The workforce shortage is caused largely by the aging and growing population; a shortage of educators; and a lack of physical space in which to educate health care professionals.
MCHC continues to play a leadership role on behalf of its members on the nursing workforce shortage. MCHC has implemented the Illinois Clinical Scheduler, which uses a database that houses clinical availability at participating clinical facilities. Educators are able to search for active nursing student placements by category type, health care facility, day of the week and shift times, student ability level and other factors. The program will streamline the placement process resulting in a decrease in the faculty and clinical staff hours currently used to process placements; a decrease in the costs associated in placing requests; and an increase in the number of sites available by creating new opportunities for clinicals.
Additionally, MCHC and Instituto del Progreso Latino – a non-profit educational center that seeks to develop Latino immigrants and their families through education, training and employment – worked together to develop the Instituto Health Sciences Career Academy (IHSCA), which is a high school that will prepare students for successful college careers, while providing them with industry-recognized credentials in the health care sector. IHSCA, which opened in 2010, is currently serving 600 students as it adds classes over the next four years. The high school will focus on math, science and English courses leading to entry into a college health occupation program. MCHC continues its involvement with the school throughout the academic year by facilitating partnerships between IHSCA and MCHC members to provide students with an array of educational experiences.
Expanding the health care workforce in the metropolitan Chicago region and throughout Illinois will require fundamental adjustments in the way hospitals operate; how the educational system prepares students; and the nature of government regulations for health professionals and educators.
The increase in the number of Americans who will receive medical insurance through health care reform will put further strain on the physician shortage. In order to address the physician shortage, the Patient Protection and Affordable Care Act (PPACA) includes, but not limited to, the following provisions: will give a 10 percent Medicare incentive payment to eligible primary care physicians (PCPs); will require that states’ Medicaid programs pay PCPs at a rate of at least equal to that of Medicare for primary care and some preventive health services; and will expand primary care residency slots, implementing teaching health centers that are community-based and also redistributes unused residency positions to primary care.
Under health care reform, the nursing community will receive support to care for medically underserved populations and funding to increase the number of positions at nursing schools. Reauthorized by the Patient Protection and Affordable Care Act (PPACA), the U.S. Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) awarded $71.3 million in grants for nursing workforce development programs. Illinois has been awarded more than $1.5 million in grants for offering partial student loan forgiveness for graduates that serve as full-time nursing faculty; preparing registered nurses (RNs) to become advanced nurse specialists; and funding traineeships for RNs and nurse anesthetists.