Maine’s Health Sector and WorkforceTrends-Projections-Challenges

June 13, 2013

Paul Leparulo, CFAPrincipal Economic Research Analyst

Objectives• Sector overview & trends• Factors affecting workforce supply and demand• Workforce development challenges

Healthcare & Social Assistance is Maine’s largest economic sector, in terms of number of jobs and wages paid.

(Maine employment mix by sector, 2011)

Healthcare; 18%

Maine Health Sector Employment

• 62,000 health occupational workers▫85% employed in health sector▫Healthcare practitioners▫Healthcare support workers

Hospitals, 34%

Ambulatory healthcare services

25%

Nursing and residential care facilities 24%

Social Assistance 18%

Maine’s health sector has been a consistent and significant producer of jobs.

(Healthcare & Social Assistance Employment, 1990-2011)

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

0

20

40

60

80

100

120

Th

ou

san

ds

of

Jobs,

Main

e

80% growth in jobs

From 2001-2011, Maine’s health sector generated more jobs than all other job producing sectors, combined.

(Change in employment by sector, 2001-2011)

Health

care

Admin

istra

tive

Acom

mod

atio

ns

Educa

tion s

vcs

Mgt o

f cos

Public

Adm

in

Prof

& T

ech S

vcs

Arts, E

nterta

inm

ent

Min

ing

Agricultu

re, F

ores

try

Other

Tran

sp.

Real E

stat

e

Utiliti

es

Whol

esal

e Tr

ade

Finan

ce

Info

rmat

ion

Const

ruct

ion

Retai

lM

fg

-25,000

-20,000

-15,000

-10,000

-5,000

0

5,000

10,000

15,000

20,000

Hospitals have been the predominant driver of sector employment growth over the last ten years.

(Contribution to health sector employment growth, 2001-2011)

0%10%20%30%40%50%60%

15%

51%

13%21%

Perc

en

t C

on

trib

uti

on

Employment in health occupations expanded during a period when overall statewide employment contracted.

(Change in employment, 2001-2011)

-20,000

-15,000

-10,000

-5,000

0

5,000

10,000

Ch

an

ge i

n j

ob

s,

20

01

-201

1

Growth in healthcare occupations was broad based, and strong.

(Change in employment, 2001-2011)

10% 20% 30% 40% 50% 60% 70% 80% 90%0

500

1,000

1,500

2,000

2,500

3,000

Series3; RNs

Series3; Phar-macists

Series3; Physical therapists

Series3; Medical assistants

Series3; Medical records and

health info. Tech

Percent Growth in Employment, 2001-2011

Ch

an

ge i

n E

mp

loym

en

t, 2

00

1-

20

11

Bubble size represents 2011 employment

Strong employment growth has helped sustain Maine’s relatively high numbers of healthcare workers per population

compared to the nation.(Healthcare practitioners and support workers per 1,000 population)

2000 2004 2008 20100

5

10

15

20

25

30

35

40

45

5046, ME

37, USA

New EnglandMaineUSA

Healt

h W

ork

ers

per

1,0

00

po

pu

-la

tio

n

As a proportion of private sector employment and wages, Maine’s health sector is the largest in the nation.

(Health sector employment as a percent of statewide employment, 2010)

5% 7% 9% 11% 13% 15% 17% 19% 21% 23%5%

7%

9%

11%

13%

15%

17%

19%

21%

23%

25%

WVRI

ME

VT

PAMA

CT

SD

MT

NH

USA

FL

WY

NV

Health Sector/Statewide Total Employment (private sector)

Healt

h S

ecto

r/S

tate

wid

e t

ota

l w

ages (

pri

vate

secto

r)

Median age of state population, rank (2010):1. ME2. VT3. WV4. NH5. FL6. PA7. CT8. MT9. RI10.MA

Going forward, healthcare is expected to remain as a key driver of statewide employment growth.

(Employment projections, 2010-2020)

▫Health sector employment growth ~16% (est.) Growth rate and number of new jobs projected to

be among the highest of all sectors. Hospital employment expected to increase 30%.

▫Health occupational employment growth ~17% (est.) ~11,000 new jobs Nearly half of the 40 occupations with the fastest

projected rate of job growth in Maine are health occupations.

2000-2010

27% Increase

+13,000 New Jobs

2010-2020 est.

17% Increase

+11,000 New Jobs

However, industry and occupational growth rates are slowing compared to prior years.

Factors Influencing Workforce Supply and Demand

 

Americans Cut Back on Visits to Doctor, July 29, 2010

Americans Cutting Back on Drugs and Doctor Visits, April 4, 2012

Nursing NewsNurses Continue to Delay Retirement, June 10, 2011

‘Huge Increase’ in U.S. Workers Delaying Retirement, February 2013

An aging population will cause the demand for health workers to increase, all else constant.

< 5 5-17

18-24

25-44

45-64

>65

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

Average Health Spending Per Person, by Age Group,

2009

Age, in yearsSource: KFF

0–17 years

18–24 years

25–44 years

45–64 years

65–74 years

75+ years

0100200300400500600700800900

Estimated Requirements for Patient Care, Physicians per 100,000 Population, by Pa-

tient Age

US DHHS

Segments of the population that consume the greatest amount of healthcare (per person) are expected to grow rapidly, while other

age cohorts are expected to decline.(Maine Age Group Projections, 2010-2030)

0-19 20-44 45-64 65-84 85+0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

450,000

20102030

Age Group

Popu

lati

on

The percent of the population above 65 years is expected to grow more rapidly in Maine than the

nation. (Percent of Population Above 65 Years, 2010 and Projected 2030)

2010 2015 2020 2025 2030

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

MaineUSA

% p

op

ula

tion

> 6

5

Population growth—another fundamental driver of demand for health services—is projected to be much

lower in Maine than for the nation.(2010-2030 Population growth projections)

Maine USA-2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

0%

16%

Popu

lati

on

Gro

wth

(est.

), 2

010-

2030

Source: US Census, Governor’s Office of Policy and Management, CWRI

In addition to population demographics and growth, a range of other factors will contribute to new job opportunities for health workers.

New Job Opportunities

Changes in technology

, insurance,

etc.

Health of

population

Economic

growth

New Growth +11,000

Replacement

needs

Total Job

Openings

Job openings are a function of new growth and replacement demand

Population demographics

Economic &

Income

Growth

Changes in

technology

Health of

population

Workforce demographics

Worker

preference

s

Changes in insurance coverage

A meaningful portion of Maine’s health workforce is nearing the age of retirement, creating a sizable need for replacement workers in coming

years. (Percent of workforce over the age 55)

2006-2010 ACS

RNs

Phar

mac

ists

Phys

icia

ns &

Sur

geon

sLP

N

Nur

se P

ract

ition

ers

Dentis

ts0%

10%20%30%40%50%60%

27% 29% 30% 34% 35%

54%

MaineUSA

New Grow

th: +11,0

00

Replacement Needs

: +11,5

00

Total Projected

Job Openings ~22,500

Over half of the job openings in health occupations over the next decade will result from the need to replace workers that are retiring or permanently

leaving the occupation.(Projected Healthcare Job Openings, 2010-2020)

Health Workforce Development Challenges

“Due to the data currently available, it is difficult to offer both a complete forecast of the nation’s health care workforce supply and assess its adequacy for

meeting the demand for services in coming years.”

The Complexities of National Healthcare Workforce Planning, Bipartisan Policy Center

Deloitte Center for Health Solutions

Licensure/survey information

Quantifying skills gaps

Silos of data

Forecasting challenges

Data Issu

es:

Data suppression/workforce distribution

The complexities of forecasting workforce supply and demand

Source: Center for Health Workforce Studies

Conceptual Model of Factors Affecting State RN Supply in One Year

Questions?a.paul.leparulo@maine.gov