Indeed, the prospect of Medicare cutting 2% across-the-board through sequestration could lead to 766,000 fewer than expected jobs in healthcare and related industries by 2021, according to a study by the American Hospital Association.
Such dire talk doesn't persuade some analysts. Douglas Staiger, a healthcare economist and chairman of the economics department at Dartmouth College in Hanover, N.H., said healthcare seemed unlikely to waver from its quick and dependable growth. “The idea that healthcare employment will continue to gobble up a larger and larger fraction of employment is a pretty good bet, nationally,” he said. “That doesn't mean Detroit isn't going a little too deep. In the specific cities, some may … have to shrink their healthcare sectors at some point.”
Some argue poverty, chronic disease and higher median ages in economically stressed regions are the main factors behind rising demand for healthcare services. “There's no glut of healthcare jobs as I see it,” said Mary O'Shaughnessey, chair and associate professor in the department of healthcare education and services at the University of Detroit Mercy.
Not every metro area with excessive job growth was in decline. Richmond, Va.—which has grown its population since 2003 when its healthcare jobs per capita ranked well below the national average—added healthcare jobs on a per capita basis faster than any other region in the country, according to the Modern Healthcare analysis.
The analysis of Labor Department and census data shows that before the recession, the Richmond metropolitan area—composed of 16 counties and four cities—had an average healthcare job concentration of 46 per 1,000 residents, nearly equal to the national figure. By 2011, the area's intensity of healthcare provider jobs relative to its population had spiked 26.2% to 58, growing faster than the area's above-average 10% population growth.
Hospital executives in the region recognize something may be amiss. Executives with HCA's Capital Division, which is based in Richmond and includes Virginia and three other states, said they've gotten vigilant about not “overhiring” because it adds to the financial burdens on local employers already dealing with high healthcare costs.
Rather than quickly reacting to “outlier” situations by immediately adding staff, as has happened in the past, executives are now trying to make hospital processes more efficient while they evaluate the demands posed by emerging trends, said Jerry Venable, vice president of human resources for HCA's Capital Division. “In our industry and facilities in Virginia, we've seen some incremental growth in market share over the years, but it is tight and measured growth for us,” Venable said. “It's a tightly managed approach to adding labor.”