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Monday, 30 January 2012 09:21

Nurses needed: Amid talent shortage, health care industry struggles to expand pipeline

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By Mark Sanchez | MiBiz
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GRAND RAPIDS — The health care jobs that are projected to grow the fastest in the years ahead reflect talent demands that are driven by an aging and unhealthy population, as well as changes in how care is delivered.

A need for more nurses easily tops an annual heath care employment outlook for West Michigan issued by Grand Valley State University economists. Using 2008-2018 projections from the U.S. Bureau of Labor Statistics, plus local graduation, retirement and turnover rates, GVSU projects health care providers will hire an average 1,747 nurses annually in the region for the next several years.

The demand is more than twice what local nursing schools graduate annually and requires care providers, as they have for years in the face of an ongoing talent shortage, to continue to recruit hundreds of nurses a year to West Michigan to fill the void.

“It’s a huge shortfall, and it’s a shortfall we have to worry about at some level,” said Paul Isely, economics professor and chair of GVSU’s economics department.

Hari SinghIsley and economics professor Hari Singh presented their annual findings during a recent forum hosted by the GVSU Seidman College of Business and the Alliance for Health. The report — Health Check: Analyzing Trends in West Michigan — heightens awareness and even gives some urgency to key recurring themes from the past two years, most notably talent issues, the changing role of some health professions, the aging population and the growing incidence rates of chronic medical conditions and obesity that largely drive costs.

“Demographics matter and demographics are changing,” Isely said. “The health care needs of the baby boom generation will change dramatically.”

He specifically cites the aging population that will require more age-related care, driving the incidence rate of chronic disease higher and skewing insurance risk pools. The 40-64 and the over-65 age groups are increasing, and the number of people in West Michigan who are 18-34 years old is decreasing, Isely said.

“If you’re in health care, that should be keeping you awake at night a little bit,” he said.

To address talent shortages, nursing schools have expanded programs over the years. Adding even more capacity can help meet the growing demand for nurses, though Singh said that’s not an easy undertaking.

“It’s basically an expensive proposition,” he said.

Cynthia McCurrenExpanding capacity requires colleges to secure more costly clinical training space with partnering care providers, which has its own limitations, GVSU Kirkhof College of Nursing Dean Cynthia McCurren said.

“You can only have so many different student bodies in a site,” she said.

The GVSU outlook overall shows that health care in the four-county West Michigan region — Kent, Ottawa, Muskegon and Allegan — will account for one in four new jobs during a 10-year period through 2018, driven in part by an aging population that consumes more health care.

Along with nursing, GVSU projects “robust and substantial” growth in physician assistants, home heath aides, medical assistants and other positions that are now taking over some elements of patient care that were previously handled by physicians.

“Given the pressure to reduce health care costs, more services and responsibility will evolve to supporting personnel,” states the GVSU report. That evolution will also contribute to a growing talent demand.

One large unknown in the outlook is the federal Affordable Care Act and how it may affect the industry in the coming years, Singh said. Clinical and administrative positions could change as new regulations take effect, changing business operations and care models and altering talent demands, he said.

“That’s always going to be hanging around our heads the next few years,” Singh said.

As care providers adjust to the new regulations, work to drive efficiencies and cope with the talent issues, they also must treat more patients with costly conditions.

The region’s obesity rate has steadily grown over the years to about 30 percent, about five percentage points higher than five years earlier. The diabetes rate now stands at about 9 percent. Based on claims data from Blue Cross Blue Shield of Michigan and Priority Health from August 2010 to July 2011, GVSU economists estimate that diabetes care alone in West Michigan costs $581.2 million annually.

Asthma costs $369.8 million annually, and coronary artery disease costs $278.3 million, according to GVSU.

To emphasize the impact, Isely noted that the costs from diabetes and asthma exceed the annual compensation paid by West Michigan’s furniture industry.

“These are big numbers and they are big enough numbers that we have to worry about how to change them,” Isely said.

Improving the health of the population and reducing the incidence rate for obesity, diabetes and other conditions such as asthma can result in significant savings, according to care providers who peg 70 percent to 80 percent of the cost of care to individual behaviors that lead to poor health.

“That cultural behavior issue is so huge,” said Roger Spoelman, CEO of Mercy Health Partners in Muskegon. “Changing behavior is what’s going to solve the problem.”

Employers for a number of years have steadily migrated to wellness as a way to contain the rising cost of employee health coverage.

Survey data shows many employers that already use incentives to encourage employees to participate in wellness initiatives are beginning to focus more on outcomes. Incentives are increasingly geared toward generating results — such as an employee losing weight or improving his blood pressure reading or cholesterol — and penalizing those who decline to participate.

Health plans are offering more wellness-based policies to drive participation, though federal regulations limit how far they can go to incorporate incentives and penalties into their products, said Jeff Connolly, president in West Michigan for Blue Cross Blue Shield of Michigan.

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