Metro North Regional Employment Board – Quarterly Meeting Cambridge, MA June 19, 2013 The Workforce Implications of the Affordable Care Act: Research in.
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Metro North Regional Employment Board – Quarterly MeetingCambridge, MAJune 19, 2013
The Workforce Implications of the Affordable Care Act:
Research in Progress
The Workforce Implications of the Affordable Care Act
• Overview
• Research Questions and Methods
• ACA Breakdown
• Labor and Skills Demand
• Opportunities
• Challenges and Next Steps
• Discussion
EMPLOYER LEADERSHIP OF RESEARCH
OVERVIEW
• High degree of uncertainty – “building the car while driving it”
• Frontline workers essential to Triple Aim
• Demand will increase in both patient and technology-centered positions
• Higher skill expectations: top of the job description, specific skills
• Opportunities for new or expanded roles and advancement
• Challenges, unknowns and cross-cutting trends
AFFORDABLE CARE ACT: A MOVING TRAIN
• Extending care to more patients
• Achieving the triple aim: better care, lower cost, improved healtho Coordination of care (ACOs, Patient-Centered Medical Homes)o Reducing readmissions, focus on “frequent flyers”o Patient follow-up and self-managemento Population health and community-based care
• Implementing electronic health records
AFFORDABLE CARE ACT: BREAKDOWN
How will the Affordable Care Act affect frontline health care workers?
• What are the forecasts of labor demand in the next 10 years?
• How are individual providers preparing for workforce needs?
• What skills will be required of the workforce?
• What are the opportunities for frontline worker advancement?
• What are the best current models of workforce development?
• What are the potential challenges?
RESEARCH QUESTIONS
RESEARCH METHODS
• Scan of literature from health care and workforce
• Analysis of labor market data
• Interviews with key informants
• Interviews and roundtable discussions with providers
LABOR DEMAND
Health Care Subsector Growth 2010 – 2020
0100020003000400050006000
2010
2020
Source: US Bureau of Labor Statistics
LABOR DEMAND
Patient-CenteredPositions
Entry Education # Jobs 2010 Job Growth 2010-2020
Change
Home Health and Personal Care Aides
Less than high school 1,878,700 70% 1,313,200
Registered Nurses Associates degree 2,737,400 26% 711,900
Nursing Aides Post-secondary certificate
1,505,300 20% 302,000
Licensed Practical Nurses
Post-secondary certificate
752,300 22% 168,500
Medical Assistants HS Diploma/ equivalent
527,600 31% 162.900
EMTs and Paramedics Post-secondary certificate
226,500 33% 75,400
LABOR DEMAND
Technology-CenteredPositions
Entry Education # Jobs 2010 Job Growth 2010-2020
Change
Pharmacy Technicians
HS Diploma/ equivalent
334,400 32% 198,300
Radiologic Technicians
Associate's Degree 219,900 28% 61,000
Medical Records & Health Information Technicians
Post-secondary certificate
179,500 21% 37,700
Source: US Bureau of Labor Statistics
LABOR DEMAND: MA HEALTH REFORM
Administrative positions Health care professionals Patient care support All other non-administrative positions
18.4%
2.8%
18.2%
7.6%8.0%
5.9%
11.4%
9.5%
Employment Growth by Occupation 2005-2009
MA Rest of US
SKILLS IN DEMAND
• General: team skills, communication, technology, problem-solving, knowledge of the care transition
• Direct Care (CNAs, PCAs): observational skills, customer service
• Medical Assistants: administrative as well as clinical skills; supervisory skills in some cases
• Patient navigators: assertiveness, cultural competencies
• Health Information/Med Records Techs: medical terminology, data analytics, detail orientation, cross-disciplinary understanding
OPPORTUNITIES FOR FRONTLINE WORKERS
• Expanded responsibilities and skill upgradeso Cross-training for medical assistant and admin (Youngstown,
NYC)o Calling “timeouts” for error reduction (PCAs in Boston)o DCWs assuming routine tasks of RNs (documentation, med pulls)
– Northern VA
• Assuming new roleso Patient navigator (discharge, follow-up)o Health coaches o Care coordinators
CHALLENGES
• No template or standards for new roles – “you can’t download the job description”
• Payment model lagging behind delivery reforms
• Scope of practice restrictions
• Providers’ reluctance – ACA uncertainties, cost concerns
• Potential job reductions with merged positions, shift to primary, use of technology
• More responsibility without compensation
• Potential cutbacks in talent development
NEXT STEPS / DISCUSSION
RANDALL WILSON, SENIOR PROJECT MANAGERJOBS FOR THE FUTURErwilson@jff.org
TEL 617.728.4446 FAX 617.728.4857 info@jff.org
88 Broad Street, 8th Floor, Boston, MA 02110
122 C Street, NW, Suite 650, Washington, DC 20001
WWW.JFF.ORG
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