ACA Puts Health Care in the Hiring Line

Now that the U.S. Supreme Court has ruled the Patient Protection and Affordable Care Act (ACA) constitutional, the stage is set for the most fundamental shift in the health care industry in a few decades.
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Now that the U.S. Supreme Court has ruled the Patient Protection and Affordable Care Act (ACA) constitutional, the stage is set for the most fundamental shift in the health care industry in a few decades.

Health care staffing providers are tremendously excited by the expected upturn in demand for health care professionals across the board -- from nursing professionals and physician assistants to locum tenens physicians and advanced practitioners. Already battling an estimated 30,000 shortage in trained health care staff, health care providers will now have to recruit the trained professionals needed to care for an additional 30-40 million Americans eligible for health care from January 1, 2014.

The inflection point for health care staffing is also being driven by a parallel development -- the first tranche of over 80 million baby boomers are now retiring and the entering the ambit of federal programs like Medicare and Medicaid. These retirees will peak in the next 10 years. A more long-term forecast brings out even more starkly the need to hire more healthcare professionals. In 2010 the number of Americans aged 65 or older was around 40 million. By 2050 that figure is estimated to double.

There is also an increase in the demand for certain types of health professionals, making them a scarce and valuable resource. This is most noticeable in the case of mid-level practitioners like physician assistants, who increasingly have to fill in the gap caused by the shortage of trained physicians. The Association of American Medical Colleges (AAMC) estimates the country will be short of 62,500 doctors by 2015. The Bureau of Labor Statistics estimates that the number of physician assistants will grow by 39 percent year on year between 2008 and 2018 -- currently there are around 86,000 physician assistants, with 60 percent of them being female.

There will be a knock-on effect of increased health care coverage on the need for trained medical testing professionals. Diagnostic technicians and clinical laboratory specialists will be in high demand to ensure the increased demand for quality testing services is not found wanting due to staffing issues. Substance abuse has also been elevated under the ACA and equated with other chronic illnesses, and its treatment classified as an "essential service. This is likely to propel demand for other skilled professionals like family counselors and helpline counselors.

The need to recruit faster and from a wider pool of resources is where technology is transforming recruitment processes. Interviews over Skype, and use of online assessment tools are now commonplace. Time-to-hire is now an even more sought after metric than the cost-per-hire.

Brian Torchin, who heads Philadelphia-based HCRC Staffing points to addressing compensation issues as key part of solving the recruiting challenge, "Staying knowledgeable on competitive compensation trends is important for health systems to be able to attract the talent and services they need to grow and improve." Physicians like Peter Ubel feel that there is also a skew in compensation, with general physicians being underpaid when compared to specialists in the U.S. who are paid much more than their European counterparts, which could lead to unhealthy shortages in some areas.

Across the Atlantic, the infamous Mid-Staffordshire hospital scandal in the NHS which led to a public inquiry and a £1 million compensation award was found to have been directly attributed to poor staffing levels and staff management. The ACA's promise of quality health care for all could well be subject to a trial by hire.

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