Health Care Matters | September 6, 2024
Anticipated Health Care Workforce Shortage
A recently released report by Mercer projected that, if the current workforce trends continue, there will be a nationwide shortage of over 100,000 health care workers within the next five years. The shortage will not apply uniformly across states with a projected surplus of 16,591 workers in California, and a deficit of 61,473 workers in New York by 2028. Significant variation also exists by clinician type with a severe shortage of Nursing Assistants predicted – only 13 states are expected to meet or exceed expected demand. Conversely, large shortages for physicians were not projected but vary greatly between primary care and specialists.
Why It Matters
The COVID-19 pandemic placed significant stress on health care workers. In 2022 the U.S. Surgeon General issued an advisory regarding health care worker burnout. As demand increases with an aging population, supply side shortages will cause increasing pressure on the workforce. In addition, advanced primary care relies on team based care that places increasing obligations on primary care practices to serve as quarterback for patients across social, behavioral and medical needs.
The Mercer report cites disparities in pay between primary care and other specialties that continue to exacerbate shortages. Pay scales also vary widely across geographies and strategies focused on compensation, benefits and flexible scheduling may help employers attract talent from less constrained labor markets. The report notes that in lower skilled positions like nursing assistants, employers are competing not just with other health systems but also other industries. It will be important for individual employers to understand the labor market for the specific health care roles that they are trying to fill when attracting talent. State and federal policymakers also have a role to play and should factor on-the-ground realities of workforce shortages into other policies and regulations that they pass.
Legal Challenges from FTC’s Noncompete Rule
On August 30, Health Affairs published an analysis of the FTC’s Noncompete final rule which was initially published on April 23rd of this year. The rule declares all new noncompete clauses as unfair competition and unenforceable except for prior contracts with senior executives in policy making positions. When published, the FTC predicted that the ban on non-competes would lead to reductions of between 74 and 194 billion dollars in health care costs. Since the rule was enacted, three lawsuits were filed challenging its validity. Two of them were preliminarily resolved in favor of the plaintiffs including an August 2024 Texas ruling that invalidated the FTC rule and issued a nationwide injunction. A similar case in Pennsylvania denied the request for a preliminary injunction. The current split among jurisdictions around the validity of the rule may eventually require Supreme Court intervention. Until then, legal uncertainty around whether these agreements are enforceable will remain.
Why It Matters
Business owners justify non-competes as necessary to protect business interests and investment in employee training. More specifically in health care, it enables health systems and practice owners to retain control over patient panels and referrals as patients tend to follow their physicians when they move practices. With the FTC rule in a place of legal uncertainty, states can play a crucial role in expanding and supplementing with legislation. Four states currently ban non-competes for all workers and fifteen states have rules around certain physician specialties. The FTC rule does prevent states from passing even stricter rules. For instance, the FTC rule exempts non-profits including non-profit hospitals. Health care consolidation has led both the FTC and state governments to examine non-competitive behavior in health care more closely. With the recent FTC rule nationwide injunction, the Health Affairs piece posits and we agree that more state action is likely.
What We Are reading
Regs & Eggs
Jeff Davis and the McDermott Plus crew break down the MIPS Performance Year 2023/Payment year 2025 payment adjustments and what to expect going forward.
what we are excited about
The Future of Telehealth and Its Impact on Primary Care
Join Health Affairs Tuesday, September 24, for a virtual event examining the future of telehealth and its impact on primary care. Be sure to register here!
