American Nurses Association Report

Published on May 2016 | Categories: Documents | Downloads: 59 | Comments: 0 | Views: 407
of 2
Download PDF   Embed   Report

AS THE HEALTH ECONOMIST for the American Nurses Association (ANA), I’ve been asked, “What will 2013 bring for RNs? Maybe even beyond 2013?”

Comments

Content


50 American Nurse Today Volume 8, Number 3 www.AmericanNurseToday.com
Issues up close
Economic prospects for RNs: 2013 and beyond
By Peter McMenamin, PhD
AS THE HEALTH ECONOMIST for the American Nurses
Association (ANA), I’ve been asked, “What will 2013
bring for RNs? Maybe even beyond 2013?”
Factors driving future demand
The beyond is the easy part: the future looks bright.
There are many different factors that will increase the
demand for RNs and advanced practice registered
nurses (APRNs). A quick list: baby boomers aging into
Medicare, forthcoming Affordable Care Act (ACA)
health insurance subsidies, private employers buying
workers employment-based coverage that includes ac-
cess to credentialed APRNs, care coordina-
tion, value-based purchasing, and an accel-
erating economic recovery. All of these
factors foreshadow increases in the de-
mand for RNs and APRNs: more jobs, high-
er salaries, more opportunities, and greater
professional satisfaction.
Aging boomers, ACA Medicaid expan-
sions and state health insurance exchanges,
and employers’ moves to secure continued
or improved access to primary care for
their workers—all of these empower pa-
tients with additional insurance or added
options to secure primary and other clini-
cal services from APRNs. There should also
be spillover effects in outpatient clinics,
physician offices, and hospitals, among
other venues, where more RNs will be em-
ployed to meet demand.
Care coordination has long been a ma-
jor component of nurses’ roles. What’s new
is the greater recognition of the importance
of care coordination in assuring quality
and efficiency in delivering clinical servic-
es—a victory for ongoing advocacy by ANA. Direct
Medicare reimbursement for care coordination has
been authorized for 2013. Recognizing (and paying
for) care coordination is in keeping with the spirit of
value-based purchasing—identification and preferential
selection of high-value services. In particular, high pa-
tient satisfaction with hospital care derives from high-
quality nursing services that lead to greater patient
confidence to manage self-care. Medicare will pay
more for that value. Hospital treatments, however, that
must be repeated when patients are readmitted shortly
after discharge, often are a function of missing or re-
duced nurse inputs. Such episodes will result in finan-
cial penalties for hospitals, so paying hospitals for val-
ue increases RNs’ value to hospitals.
Short-run frictional challenges
While the beyond looks good, 2013 may be the rub. The
worst U.S. recession since the 1930s has been accompa-
nied by the most anemic recovery. The post-recession
trends toward increased employment and output have
been positive, but very slow. The healthcare sector has
been first in recent employment gains, but the more im-
portant impacts of the recession on RNs involve changes
in their retirement planning. Many RNs are facing new
economic anxieties, including fears of economic uncer-
tainty, potential loss of a spouse’s income, and/or loss
of the value of retirement investments.
In the short run, many mature RNs have deferred
their retirement. This has kept those nurses active in
their jobs, maintaining the experience levels available
to hospitals and other employers and reducing their
costs due to lower turnover. But there has been a
down side to lower turnover levels in its effects on job
Inside
ANA
prospects for new nursing gradu-
ates, creating a form of friction
that slows down the employment
process.
Based on data from 2004 to
2008, it has been estimated that
nearly 73,000 RNs left the labor
force each year due to death, re-
tirement, child rearing, or career
change. The yearly number of new
RNs (NCLEX passers) joining the la-
bor force grew from 86,000 in 2004
to 128,000 in 2008. Because of
both economic growth and thou-
sands of those new RNs directly pursuing master’s-level
training, there were RN jobs to be had at the beginning
of that timeframe. But retirements started slowing down
just as the flow of newly graduated RNs was increasing.
In fact, funding for RN education increased substantially
near the turn of the 21st century. The Nurse Reinvest-
ment Act of 2002 increased funding through 2005 for Ti-
tle VIII, the major source of government support for
nursing education. Using funds from the ACA, President
Obama increased Title VIII funding by nearly $73 million
to $244 million in fiscal 2010—a 43% increase over the
prior year. More money for Title VIII led to more nursing
students and more new RNs. There were somewhat few-
er than 70,000 new RNs in calendar year 2000. By 2011,
that number had more than doubled.
The official start of the recession was December
2007, and the economy soon was shedding hundreds
of thousands of jobs each month. In 2009 and 2010,
there were numerous stories in the general media
about new nursing graduates taking jobs that were not
in units they had sought, or not in towns where they
had been looking, or taking much longer than antici-
pated to find a job, or not finding a job at all. Such
stories were fewer in 2011 and 2012. At the same time,
hospitals have continued to hire, but they have had
the leeway to be discriminating—holding out for more
experience and/or more education. They could require
a BSN or post ads stating “No new grads need apply.”
Getting away from the bubble
Peter Buerhaus, PhD, RN, FAAN, Valere Potter Distin-
guished Professor of Nursing at Vanderbilt University’s
School of Nursing, has described this situation as a
temporary bubble. Deferred retirements combined with
enrollment and graduation surges in nursing programs
are consistent with a slight surplus today. Buerhaus
hopes the bubble will quickly burst as a robust eco-
nomic recovery soon emerges. Conversely, he fears
the anemic recovery may continue and the bubble will
only slowly leak, leaving modest labor surpluses in
some regions or specialties. This might tend to dis-
suade potential students from pur-
suing a nursing career. Having a
full and growing pipeline of new
nurses today is exactly what is
needed to address the tsunami of
RN retirements that will occur
when the economy starts to get
up to speed. Forty percent of all
U.S. RNs are age 55 or older.
That’s approximately 1 million
forthcoming retirements.
Although it’s unclear whether
the economy will become suffi-
ciently robust in 2013 to drive a
significant increase in new jobs for RNs, the promise of
2014 and beyond, coupled with the genuine need for
many more RNs in the near future, should be the guid-
ing principle. The Bureau of Labor Statistics (BLS) proj-
ects that 712,000 additional RN jobs will become avail-
able between 2010 and 2020. The largest share will be
in hospitals, but high-growth areas include home health
(55% growth), community care facilities for the elderly
(50%), outpatient care centers (45%), and physician
offices (45%). Recent BLS reports showed employment
growth rates in home health and outpatient care exceed-
ing other healthcare components every month in 2012.
RNs with experience caring for the elderly will be in
high demand for decades to come. For prospective and
current nursing students and new graduates, finishing
nursing education and obtaining patient experience will
open up rewards for RNs for many years to come. Not
to make light of the well-justified anxiety and frustration
among new grads who haven’t yet received a job offer,
there is light at the end of the tunnel—and it looks like
it will be a relatively short tunnel.
For RN career opportunities, visit the ANA Career
Center at www.nursingworld.org/careercenter. For
ANA resources on care coordination and reimburse-
ment, visit www.nursingworld.org/care-coordination. O
Peter McMenamin is a senior policy fellow at ANA.
Having a full and growing
pipeline of new nurses
today is exactly what is
needed to address the
tsunami of RN
retirements that will
occur when the economy
starts to get up to speed.
52 American Nurse Today Volume 8, Number 3 www.AmericanNurseToday.com
Registered nurses 2010 to 2020
Percent Employment
increase change
Total employment 26.0 711,900
Source: U.S. Bureau of Labor Statistics
BLS projection of new RN jobs from
2010 to 2020

Sponsor Documents

Or use your account on DocShare.tips

Hide

Forgot your password?

Or register your new account on DocShare.tips

Hide

Lost your password? Please enter your email address. You will receive a link to create a new password.

Back to log-in

Close