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

You may also like

How a Medicaid ‘Cut’ Could Lead to More Unionization of Home Care Aides

A money-saving maneuver in the newly enacted Medicaid budget could end up increasing costs in the long term – by paving the way for more unionization of the state's burgeoning home health workforce. Read More

Budget Deal Slows Medicaid Growth But Plants Seeds for Future Spending

The growth of New York's Medicaid spending is projected to slow but not stop as Governor Hochul and the Legislature effectively split their differences over health care in the newly enacted state budget. Read More

Albany’s New Health Insurance Tax Comes with Few Limits

The newly enacted state budget imposes a multibillion-dollar tax on health insurance without specifying who must pay how much – leaving those basic details to be decided later by the health commissioner in negotiation wit Read More

One of New York’s Biggest Medicaid Contractors Is Quietly Acquiring a Competitor

Author's note: This post has been updated to correct an error in the second paragraph. As state lawmakers debate the future of Medicaid home care, one of the program's bigg Read More

New York’s Home Health Workforce Jumped by 12 Percent in One Year

New York's home health workforce has continued its pattern of extraordinary growth, increasing by 62,000 jobs or 12 percent in a single year, according to newly released data from the U.S. Bureau of Labor Statistics.  Read More

While New York’s Medicaid Budget Soared, Public Health Funding Languished

Four years after a devastating pandemic, the state has made no major investment to repair or improve its public health defenses. While funding for Medicaid over the past four years Read More

A Medicaid Grant Recipient Sponsors a Pro-Hochul Publicity Campaign

While much of the health-care industry is attacking Governor Hochul's Medicaid budget, at least one organization is rallying to her side: Somos Community Care, a politically active medical group in the Bronx that recently r Read More

New Jersey’s Pandemic Report Shines Harsh Light on a New York Scandal

A recently published independent review of New Jersey's pandemic response holds lessons for New York on at least two levels. First, it marked the only serious attempt by any state t Read More