Business as usual in the U.S. health care system continues to change dramatically as the provisions of the Affordable Care Act take effect. The biggest shift is taking place in the basic business model, away from fee-for-service toward incentives for reducing costs. The ACA ties profits to providers’ ability to manage expenses, especially in the area of costly hospital and nursing home stays and performance. One result has been increased unemployment at those facilities as fees for services decrease. Combined, hospitals, nursing homes, and residential care account for fifty-five percent of all health care jobs.
Last month, hospitals and nursing homes lost twelve thousand jobs, extending a history of reductions or stagnant staffing levels that has been tracked over the last few years. On the other hand, hiring in the ambulatory care sector—workers in doctor’s offices and home care providers—added twenty-one thousand jobs. Home care providers now account for more than half of ambulatory care’s six point seven million jobs. So overall, health care employment added seven thousand jobs last month, according to federal employment data. You can bet the ACA’s emphasis on accountable care and bundled payments will continue to transform the health care job market as providers change their business practices to new ways of achieving revenue growth.
I’m John Howell for 3BL Media.