The state’s health-care workforce is recovering unevenly from the pandemic, with persistently lower employment levels in some areas and robust growth in others.

This mixed pattern complicates the question of what, if anything, Albany policymakers should do about the ongoing labor shortages reported by some providers.

Overall, statewide health-care employment has surged to an all-time high of 1.3 million jobs, 5 percent above its pre-pandemic peak, according to data from the Bureau Labor Statistics. Within that broad upward trend, however, there are stark disparities.

 

Home health employment is booming, especially in New York City – where it's up by 111,000 jobs or 30 percent since 2019.

The nursing home workforce, meanwhile, remains almost 20 percent smaller than it was four years ago – and shows little sign of bouncing back.

Hospital employment has been more stable but varies widely by region: Compared to 2019, the industry's job count is 9 percent higher in New York City, 3 percent higher in the metropolitan suburbs, and 4 percent lower in the rest of the state.

 

These patterns are driven not just by Covid-related disruptions, but also long-term structural changes that state officials should welcome. These include a shift to home-based care instead of nursing facilities for the elderly and disabled, and a shift toward outpatient settings for procedures that used to be done in hospitals.

Where true labor shortages exist, recently enacted minimum staffing laws are likely making things worse – because more people are needed to do the same amount of work. Providers also face increased competition for a limited supply of workers, which drives up wages and makes it more expensive to fill each job.

State policymakers should keep these complexities in mind as they consider the proposals being advanced by various health-care industry groups.

For example, a big across-the-board increase in Medicaid reimbursements, as pushed by an influential hospital alliance, would likely be counterproductive as well as costly.

A disproportionate share of such spending would flow to the relatively well-staffed institutions of New York City – where Medicaid enrollment is concentrated – while upstate areas with more acute hiring challenges would receive relatively less.

New York already spends more per capita on Medicaid than any other state. Pumping billions more into the program should not be Albany's first and only answer to every issue that arises in health care.

 

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

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