Metro North Regional Employment Board – Quarterly Meeting Cambridge, MA June 19, 2013 The Workforce Implications of the Affordable Care Act: Research in.

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 [email protected]

TEL 617.728.4446 FAX 617.728.4857 [email protected]

88 Broad Street, 8th Floor, Boston, MA 02110

122 C Street, NW, Suite 650, Washington, DC 20001

WWW.JFF.ORG