The sluggish 2013 growth in healthcare employment—which dipped below the annual average of the past 23 years—underscores financial pressure on hospitals to reduce costs by directing care to less-expensive outpatient facilities.
Though the U.S. Bureau of Labor Statistics figures are not yet final and may change significantly, the numbers show healthcare added 271,000 jobs last year to bring the industry's total to 14.57 million. That was about 2% below the annual average since 1990.
Hiring trends across healthcare sectors were mixed in 2013, with anemic job growth among hospitals, nursing homes and residential healthcare facilities as ambulatory-care hiring surged.
David Auerbach, a health economist with the RAND Corp., said the data appear to add to growing evidence, including recent hospital layoffs, that hospitals are scaling back expenses in response to Medicare reductions and the growth of accountable care. “It's all telling the same story,” he said. “There's just a shift of care out of the hospital” as providers seek to treat patients in lower-cost settings.
The year ended with a striking December drop in employment for the healthcare industry, the engine of employment through the recession. Healthcare shed 6,000 jobs in December, with payroll declines in ambulatory care and hospitals, according to preliminary BLS figures. That December decline is only the second time in 23 years of employment tracking that healthcare has shed jobs. The industry last saw a one-month employment decline in July 2003, when healthcare employment shrank by 9,000 jobs.
In 2013 overall, U.S. hospitals added 40,000 jobs, down 30% from the annual average since 1990. Hospitals, which account for roughly one-third of healthcare's employment, ended the year with 4.81 million on the payroll.