under the Affordable Joanne Spetz, UC San Francisco Bianca Frogner, George Washington University Stephen T. Parente, University of Minnesota

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1 Job Growth Projections under the Affordable Care Act Joanne Spetz, UC San Francisco Bianca Frogner, George Washington University Stephen T. Parente, University of Minnesota

2 Importance of the health workforce Health care is provided by the health workforce 12% of total labor force of the U.S. Growing demand for health services will lead to greater need for health workers Health care is fastest growing g labor sector Rapidly increasing needs for aging population Health care employment is an economic development strategy Health occupations unemployment rate is less than half the national unemployment rate

3 Purpose of this study Identify health care sectors that will grow the most Identify health care occupations that will grow the most Measure the share of growth that will be driven by the Affordable Care Act (ACA) 3

4 Methods Industry-Occupation Projections from U.S. Bureau of Labor Statistics (BLS) Completed after ACA, but exact methodology of accounting for policy changes not published 4

5 Methods Microsimulation model of demand growth due to ACA Use the ARCOLA model to estimate insurance enrollment under the ACA Use insurance claims data to measure health service use by insurance type Project growth in health service demand Multiply insurance growth by service use rates Project growth in occupation demand Use BLS Industry-Occupation matrices 5

6 Health Care Industry Categories Offices of health care practitioners Physicians i Dentists Chiropractors Optometrists Other offices of health care professionals Outpatient care centers Medical & diagnostic labs & other ambulatory Home health care services Hospitals (state, t local, l and private) Nursing care facilities Residential care facilities Derived from 2007 North American Industry Classification System (NAICS) codes

7 Key Occupations Health Care Practitioners and Technical Occupations Health Care Support Occupations Selected relevant occupations: Life eand Physical ysca Sce Scientists tsts Medical and Health Services Managers Personal Care Aides Information and Records Clerks Secretaries and Administrative Secretaries Medical, Dental, and Ophthalmic Laboratory Technicians Derived from 2000 Standard Occupational Classification (SOC) codes

8 National Job Growth Projections, Total Share overall Share overall percent change in employment growth from health care related jobs growth from ACA (ARCOLA) Offices of physicians 28% 61% 15% Offices of dentists 28% 67% 17% Offices of chiropractors 28% 51% 15% Offices of optometrists 28% 62% 16% Other offices 51% 63% 15% Outpatient care centers 53% 53% 14% Labs/Other ambulatory 36% 64% 15% Home health 60% 57% 12% Hospitals 14% 71% 12% Nursing care facilities 19% 64% 13% Residential care 29% 46% 13%

9 National Growth Overall in the Largest Occupations ( ) 2020) Dental hygienists i Physical therapists EMTs/paramedics Pharmacists Dental asst's Health care managers Clin lab techs Pharmacy techs Recreation workers Diagnostic techs Medical assistants Support techs Social workers Physicians LPNs Personal care aides Home health aides Nursing aides RNs 37.7% 7% 39.0% 33.3% 25.4% 30.9% 22.4% 13.0% 32.4% 19.0% 29.9% 30.9% 29.6% 24.8% 24.4% 22.4% 20.1% 26.0% 70.5% 69.4% 0% 20% 40% 60% 80%

10 Share of Occupation Growth Due to ACA ( ) 2020) Dental hygienists Physical therapists t EMTs/paramedics Pharmacists Dental asst's Health care managers Clin lab techs Pharmacy techs Recreation workers Diagnostic techs Medical secretaries Medical assistants Support techs Social workers Physicians LPNs Personal care aides Home health aides Nursing aides RNs Non-ACA ACA -200, , , , ,000

11 Conclusions Health care could add 4.6 million jobs, or 31% increase from current employment levels Impact of the ACA varies by sector Greatest impact in offices of practitioners Lowest impact for hospitals, home health Impact of the ACA varies by occupation Greatest growth for RNs, Medical Assistants, Technicians Job losses for physicians/surgeons, LPNs, clinical lab techs

12 Policy Recommendations Need to prepare for increased demand Technician occupations Assistant occupations Engage in national planning Fund the National Health Workforce Commission Funding to Bureau of Health Professions Strategies to grow the workforce Educate youth about health care job opportunities Community college funding On-the-job training programs Mid-career guidance and mentorship Financial aid to aspiring students

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