Health Care Coverage and the Health Care Industry (original) (raw)

The demand for health care workers post-ACA

International Journal of Health Economics and Management, 2015

Concern abounds about whether the health care workforce is sufficient to meet changing demands spurred by the Affordable Care Act (ACA). We project that by 2022 the health care industry needs three to four million additional workers, forty percent of which is related to demand growth under the ACA. We project faster job growth in the ambulatory care sector, especially in home health care. Given the current profile, we expect that the future health care workforce will be increasingly female, young, racially/ethnically diverse, not US-born, at or below the poverty level and at a low level of educational attainment.

The US healthcare workforce and the labor market effect on healthcare spending and health outcomes

International Journal of Health Care Finance and Economics, 2014

The healthcare sector was one of the few sectors of the US economy that created new positions in spite of the recent economic downturn. Economic contractions are associated with worsening morbidity and mortality, declining private health insurance coverage, and budgetary pressure on public health programs. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. Data are collected for 50 states and the District of Columbia from 1999-2009. Labor market and healthcare workforce data are obtained from the Bureau of Labor Statistics. Mortality and health status data are collected from the Centers for Disease Control and Prevention's Vital Statistics program and Behavioral Risk Factor Surveillance System. Healthcare spending data are derived from the Centers for Medicare and Medicaid Services. Dynamic panel data regression models, with instrumental variables, are used to examine the effect of the labor market on healthcare spending, morbidity, and mortality. Regression analysis is also performed to model the effects of healthcare spending on the healthcare workforce composition. All statistical tests are based on a two-sided α significance of p < .05. Analyses are performed with STATA and SAS. The labor force participation rate shows a more robust effect on healthcare spending, 123 128 L. C. Pellegrini et al. morbidity, and mortality than the unemployment rate. Study results also show that declining labor force participation negatively impacts overall health status ( p < .01), and mortality for males ( p < .05) and females ( p < .001), aged 16-64. Further, the Medicaid and Medicare spending share increases as labor force participation declines ( p < .001); whereas, the private healthcare spending share decreases ( p < .001). Public and private healthcare spending also has a differing effect on healthcare occupational employment per 100,000 people. Private healthcare spending positively impacts primary care physician employment ( p < .001); whereas, Medicare spending drives up employment of physician assistants, registered nurses, and personal care attendants ( p < .001). Medicaid and Medicare spending has a negative effect on surgeon employment ( p < .05); the effect of private healthcare spending is positive but not statistically significant. Labor force participation, as opposed to unemployment, is a better proxy for measuring the effect of the economic environment on healthcare spending and health outcomes. Further, during economic contractions, Medicaid and Medicare's share of overall healthcare spending increases with meaningful effects on the configuration of state healthcare workforces and subsequently, provision of care for populations at-risk for worsening morbidity and mortality.

What Can We Expect of our Health Care System ? Options for expanding the health workforce

2007

Correspondence: Professor Peter M Brooks, Level 1, Edith Cavell Building, Royal Brisbane Hospital, Herston, QLD 4029. p.brooks@uq.edu.au Aust Health Rev ISSN: 0156-5788 1 February 2008 32 1 156-160 ©Aust Health Rev 2007 www.aushealthreview.com.au What Can We Expect of our Health Care System? implemented. Health economies (and with them the health workforce) will continue to expand as the burden of disease increases. The important issue is to expand the current workforce but provide for a generalist stream that allows flexibility and retraining. The future health workforce needs to b able to provide patient-centred care, to have a focus on public health and disease Abstract

Serving the Medicaid and Medicare Populations: Nursing Labor Market Dynamics

Members-only Library, 2018

In this paper we examine the effects of changes in Medicaid and Medicare coverage on the employment of registered nurses, licensed practical nurses, and certified nursing assistants. With estimates using time series data, we find that Medicaid coverage has a significant positive effect on the employment of registered nurses in the short run. A 10 percent increase in Medicaid coverage is associated with a 2.74 percent increase in registered nurse employment. Results also show that a model of monopsony power, previously applied to hospitals, is relevant to nursing homes.