COLLEGE FOR AMERICA WORKFORCE TREND REPORT HEALTHCARE NOVEMBER 2014 NONCLINICAL and FRONTLINE HEALTHCARE ROLES CONTINUE to RISE A spotlight on 6 growing roles and the 55 skills they have in common MELISSA GOLDBERG SENIOR WORKFORCE STRATEGIST COLLEGE FOR AMERICA JULIAN L. ALSSID CHIEF WORKFORCE STRATEGIST COLLEGE FOR AMERICA
EXECUTIVE SUMMARY A year after the launch of the federal healthcare exchange, current demand and future projections remain high for frontline and nonclinical healthcare workers whose jobs have been expanded in number and scope by baby boomer retirements, new technologies, and the Affordable Care Act implementation. These catalysts are redefining the nature of the patient care team. This industry report analyzes and outlines growth of six fast-growing nonclinical and frontline positions that require increasingly complex skill sets. The findings reflect labor market data, real-time job listings, and feedback from healthcare administrators nationwide, and the report data has been updated from College for America s original 2013 workforce strategy report, The Rise of the Medical Assistant and five other frontline and nonclinical healthcare jobs that are growing in number, complexity and importance. Report highlights With 21,965,600 workers in the healthcare industry projected by 2022 1, it s the largest segment of the United States economy. Nonclinical, community and social service, and support positions comprise 42 percent of the healthcare workforce. 2 Both frontline and nonclinical workers are expected to operate as a part of a high-functioning team by expertly communicating with patients, families, and peers. The shift to team-based patient care and an increased focus on the patient experience demands more complex skills sets of nonclinical and frontline workers. These professionals need: A more versatile set of skills than were required for these types of positions in the past specifically skills in communication, team collaboration, and information technology fluency. The ability to interface with patients, their families, and the broader communities where healthcare facilities are located. Six of today s fastest-growing frontline and nonclinical healthcare jobs are: medical office specialist, medical assistant, community health worker, medical records technician, office supervisor, and patient representative. The workforce strategies team at College for America has reviewed 250 detailed work activities in these positions and identified 55 that are common to most of these fast-growing positions. 1 U. S. Bureau of Labor Statistics, Employment outlook: 2012 2022, Monthly Labor Review, December 2013, www.bls.gov/opub/mlr/2013/article/industry-employment-and-output-projections-to-2022.htm 2 Based on the author s calculation of Bureau of Labor Statistics data 2
With the Affordable Care Act s healthcare exchanges in full swing for more than a year, the pressure on healthcare systems to be competitive and efficient has been unrelenting. Growth in frontline and nonclinical healthcare jobs has continued, with some roles seeing a steep upward trajectory in demand and others undergoing a slow and steady climb in numbers. With 21,965,600 workers in the healthcare industry projected by 2022 3, it s the largest segment of the United States economy. That figure encompasses not just doctors and nurses, but nonclinical, community and social service, and support positions that comprise 42 percent of the healthcare workforce. 4 This industry report identifies six fast-growing frontline and nonclinical positions that require increasingly complex skill sets, and it outlines common critical competencies that people in these roles need for success in the new, evolving healthcare environment. These findings reflect labor market data, real-time job listings, and feedback from healthcare administrators nationwide gathered by the workforce strategies team at College for America. WORKFORCE IMPLICATIONS OF DELIVERING EXCEPTIONAL PATIENT EXPERIENCES With the industry shifting to deliver patient-centered care and an exceptional patient experience, there s a greater emphasis on the role of healthcare teams and a growing need for frontline and nonclinical workers to develop a more complex set of workplace competencies. 5 Regardless of where in the health system these people are working, they are expected to operate as a part of a high-functioning team and improve the overall patient experience by: Effectively communicating with patients and families Actively listening for the opportunity to provide an empathic response Resolving conflict and deescalating anger Building patient confidence by managing up the organization and its staff Clearly communicating their role, task at hand, and duration Conducting critical conversations in a compassionate way. 3 U. S. Bureau of Labor Statistics, Employment outlook: 2012 2022, Monthly Labor Review, December 2013, www.bls.gov/opub/mlr/2013/article/industry-employment-and-output-projections-to-2022.htm 4 Based on the author s calculation of Bureau of Labor Statistics data 5 Frontline Health Workers Coalition, Frontline Workers: Who They Are, frontlinehealthcareworkers.org. 3
SIX JOBS RAPIDLY GROWING DUE TO THE NEW HEALTHCARE ENVIRONMENT The dramatic changes in healthcare industry have spurred a demand for frontline and nonclinical workers who are tasked with not just patient health, but with taking care of the whole patient meaning making sure that the patient experience is both seamless and satisfactory. Some of the fastest-growing nonclinical positions are office-based: medical office specialists, office supervisors, and medical records technicians. Patient representatives (often known as patient navigators) alleviate stress and improve care by coordinating health services and information for patients. With hospitals looking to bring healthcare services to where patients live, employment of community health workers is surging. Table: Six of the fastest-growing nonclinical or frontline healthcare positions 6 TITLE 2012 POSITIONS PROJECTED OPENINGS BY 2020 PROJECTED NEW GROWTH (2012-2022) MEDICAL OFFICE SPECIALIST 526,000 252,500 36% MEDICAL ASSISTANT 561,000 269,900 29% COMMUNITY HEALTH WORKER 41,000 20,800 25% MEDICAL RECORDS TECHNICIAN 186,000 90,400 22% OFFICE SUPERVISOR 1,418,000 508,000 12% PATIENT REPRESENTATIVE 7 2,363,000 941,600 12% Source: Bureau of Labor Statistics and O*NET 6 According to the Bureau of Labor Statistics, Projected Growth represents the estimated change in total employment over the 2012 2022 period. Projected Job Openings are the total openings due to growth and replacement. 7 Patient Representative is a new title only recently recognized by the Bureau of Labor Statistics. The numbers in the chart are based upon a similar title, Customer Service Representatives. 4
While education and job requirements for these positions vary, healthcare organizations often prefer or require a certificate, associate, or bachelor s degree. Table: Common education requirements and average salary TITLE COMMON EDUCATION ACHEIVEMENT AVERAGE SALARY RANGE MEDICAL OFFICE SPECIALIST CERTIFICATION OR ASSOCIATE S $21,410 $45,860 8 MEDICAL ASSISTANT CERTIFICATION OR ASSOCIATE S $20,880 $40,810 9 COMMUNITY HEALTH WORKER ASSOCIATE S OR BACHELOR S $35,000 $60,000 10 MEDICAL RECORDS TECHNICIAN CERTIFICATION OR ASSOCIATE S $24,000 $45,000 11 OFFICE SUPERVISOR ASSOCIATE S OR BACHELOR S $32,500 $74,360 12 PATIENT REPRESENTATIVE NO DATA YET $35,000 13 Source: Bureau of Labor Statistics and O*NET The unfolding effects of the Affordable Care Act in combination with the pending demographic shifts (i.e. increasing number of aging baby boomers) are leading to a greater demand for two frontline roles in particular: the community health worker (CWH) and the patient representative. Fundamentally, the CHW works to reduce the number of people suffering from preventable diseases, while the patient navigator supports patients who do require treatment (and their families). Today, there are many programs that can train and educate individuals to perform either of these roles. There are currently efforts underway from organizations such as Community Health Worker Network of NYC and Patient Navigator Training Collaborative to standardize the definition and education of the roles. Community Health Worker A CHW serves as a liaison between his or her community and its local healthcare and social services providers. CHWs are responsible for reaching out to individuals and communities to help them adopt healthy behaviors. They may design and facilitate programs in the community that promote, maintain, and improve health and well-being. Some CHWs point people to available resources, offer social support and informal counseling, advocate for individuals and community health needs, and provide services such as first aid and blood pressure screening. Many also collect data to help identify community health needs. 14 8 USNews, Best Health Care Jobs: Medical Secretary, money.usnews.com/careers/best-jobs/medical-secretary 9 USNews, Best Health Care Jobs: Medical Assistant, money.usnews.com/careers/best-jobs/medical-assistant 10 O*NET OnLine, Summary Report for: 21-1094-00 Community Health Workers, www.onetonline.org/link/summary/21-1094.00 11 Recruiter.com, Salary for Medical Records and Health Information Technicians, www.recruiter.com/salaries/medical-recordsand-health-information-technicians-salary 12 Bureau of Labor and Statistics 13 Bureau of Labor and Statistics 14 O*NET OnLine, Summary Report for: 21-1094-00 Community Health Workers, www.onetonline.org/link/summary/21-1094.00 5
Patient Representative The patient representative (also referred to as patient navigator) role is a cross between a customer service representative and a social worker, supporting patients and their families and helping them to navigate the healthcare system. These frontline workers are coordinators who bring together resources and manage paperwork associated with patient care. 15 Primarily, this role is found in hospitals and clinics or nonprofit organizations that serve patients and the people who care about them. Patient representatives often inform patients and their families with research on their particular diseases, help address insurance issues, connect patients with doctors, conduct critical conversations, and help patients understand their options for treatment and care. They also might accompany patients on medical visits. While different in responsibility, these two positions require similar skills and competencies. In fact, there are commonalities between these roles as well as among all of the growing nonclinical and frontline healthcare positions. BROAD SKILL SETS AND SPECIALIZED EXPERTISE LAY THE FOUNDATION FOR A HIGH-FUNCTIONING PATIENT CARE TEAM Interviews of healthcare industry chief learning officers, workforce development professionals, and human resources professionals conducted by College for America s workforce strategy team indicated that frontline and nonclinical workers need broader skill sets specifically ones in technical communication, team collaboration, and information technology fluency. They must also be able to work as part of an agile, high-functioning medical team and to connect with patients, their families, and the broader communities in which healthcare facilities are located. This insight was established in interviews with industry leaders in 2013 and confirmed in conversations in late 2014, echoing consistent feedback following the original release of this report and the rollout of the Affordable Care Act and healthcare exchanges. More diverse, communication- and technology-based skills continue to be highly valued across frontline and nonclinical positions. This view is supported by a review of these roles in the U.S. Department of Labor Occupational Outlook Handbook. For example, the 2000-2001 and 2014-2015 editions of the publication both describe a range of duties performed by medical assistants, from scheduling appointments to taking vital signs. But the medical assistant in the 2012-2013 edition is expected to be fluent in technology and patient confidentiality regulations as well. 16 15 Elisabeth Schuler Russell, Patient Navigators: Who We Are and What We Do, October 18, 2013, patientnavigator.com/blog/2012/08/27/ becoming-a-patient-navigator-august-2012 16 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2014-15 Edition, Medical Assistants, January 8, 2014. www.bls.gov/ooh/healthcare/medical-assistants.htm 6
While frontline and nonclinical positions differ greatly in goals and responsibilities, they share a number of detailed work activities (DWAs) part of an occupational classification system of the U.S. federal government s O*NET program. DWAs describe business work tasks that can be found across multiple occupations and remain constant over time. We ve been able to identify 250 DWAs in the fast-growing positions in this report and 55 DWAs that are common across most of these positions. Table: Examples of shared DWAs for growing frontline and nonclinical healthcare roles (MOS Medical Office Specialist, MA Medical Assistant, CHW Community Health Worker, MRT Medical Records Technician, OS Office Supervisor, PR Patient Representative = present; = not) DETAILED WORK ACTIVITY MOS MA CHW MRT OS PR Answer questions from employees, colleagues, customers, or public Maintain confidentiality of data and information according to procedures Maintain cooperative relationships with clients, vendors, customers and stakeholders Operate computers to enter, calculate, access, and retrieve data Prepare technical, managerial, financial, or informational reports Respond to concerns from workers, parents, or students Advise internal and external clients, customers, and managers on technical matters, problems, procedures, and solutions Collect social or personal information Communicate health and safety information Interview persons to gather required information Maintain cooperative working relationships within community service Maintain relationships with clients Maintain relationships with external agencies, organizations, and communities Monitor use of computer data files to safeguard information Respond to requests for information Review records for accuracy and completeness Review records for accuracy and completeness Schedule meeting or appointments Send/receive work-related email Store data to avoid data loss or ensure data security Type letters, documents, or correspondence 7
IN SUMMARY Today s in-demand frontline and nonclinical healthcare workers need a more versatile set of skills than were required for these types of positions in the past collaborative teamwork abilities, fluency in technology, and an understanding of how to navigate the healthcare system. Six frontline and nonclinical positions medical office specialist, medical assistant, office supervisor, community health worker, medical records technician, and patient representative are projected to add more than two million new job openings this decade. The community health workers and patient representatives are sharpening the focus on caring for a person, not just a patient. While education and job requirements for these positions vary, healthcare organizations often prefer or require a certificate, or associate s or bachelor s degree for today s frontline and nonclinical roles. By focusing on hiring, promoting, and developing workers with cross-role skill sets, healthcare providers will have a solid foundation for agile, highfunctioning, patient-centered care teams that can deliver better care outcomes and an exceptional patient experience. ABOUT THIS REPORT AND COLLEGE FOR AMERICA This report was researched and compiled by the workforce strategies team at College for America at Southern New Hampshire University, which is dedicated to better connecting higher education, workforce research, and labor market needs. We are a nonprofit, accredited school with a mission to radically expand access to and improve the quality of higher education through low-cost, competency-based college degrees that are more applicable in the workplace. College for America currently partners with some of the nation s best and most innovative hospitals and health systems to support the professional and academic development of healthcare workers. The type of workforce data in this report and in our other workforce reports informs the curriculum design of our associate s and bachelor s degrees. FOR MORE WORKFORCE STRATEGY INSIGHTS, VISIT COLLEGEFORAMERICA.ORG/WORKFORCE OR CONTACT US AT 1.855.764.8CFA or INFO@COLLEGEFORAMERICA.ORG 8