By Bruce Japsen, Contributor, Forbes
12/08/2013 – Doctor and nurse vacancies are approaching nearly 20 percent at hospitals as these facilities prepare to be inundated by millions of patients who have the ability to pay for medical care thanks to the Affordable Care Act.
A survey by health care provider staffing firm AMN Healthcare shows the vacancy rate for physicians at hospitals near 18 percent in 2013 while the nurse vacancy rate is 17 percent. That vacancy rate is more than three times what it was just four years ago when vacancies for nurses were just 5.5 percent in 2009 while vacancies for doctors were 10.7 percent.
“There is a war for talent,” Sean Gregory, president of Health First Holmes Regional Medical Center, a 400-bed hospital in Melbourne, Florida, said in an interview with Forbes.
The employment picture comes as the Affordable Care Act and pressures by insurance companies and employers to control costs creates a shift away from fee-for-service payment of doctors to approaches that emphasize more accountable care.
Most of these new models use primary care doctors as a quarterback of sorts to nurse practitioners and physician assistants who reach out to the patients, making sure they are taking their medications, eating properly and adhering to doctor’s orders. Nurse practitioners and physician assistants are also in short supply with hospital executives seeing a vacancy rate of 15 percent, according to the AMN Healthcare survey.
“We are actively hiring and building up cores of physician assistants and nurse practitioners,” Gregory said.
With accountable care programs, the insurer contracts with some providers that are forming patient-centered medical homes whereby physicians are paid to encourage patients to get medical care upfront in the clinic, health center or doctor’s office where costs are lower than a hospital, particularly an emergency room. Health plans are also linking to accountable care organizations (ACOs), which reward providers for working together to improve quality and to control costs.
To make the ACOs work, hospitals and health systems are hiring dozens of new nurse practitioners.
Most private health insurance companies like Aetna AET -0.49% (AET), Cigna CI -1.14% (CI), Humana HUM -0.2% (HUM), UnitedHealth Group UNH -1.26% (UNH) and most Blue Cross plans are linking with ACOs and patient centered medical homes.
“Cost is the healthcare workforce issue of most concern to hospital executives, though they also find physician/hospital alignment, the move to quality based provider compensation, high vacancy rates, and the influx of insurance patients through the Affordable Care Act to be of concern,” AMN Healthcare said in its report.