Massachusetts hospitals have added 10,000 jobs to the healthcare workforce since 2020, primarily in caregiving positions, according to recently released data from the Massachusetts Health and Hospital Association. They have also reduced industry-wide vacancies by 28%.
But one healthcare watchdog says that growth comes at the cost of other sectors and public priorities, since everyone, from businesses to individuals to taxpayers, covers these expenses.
“We have to look at healthcare as part of the overall economy,” McAnneny said.
The healthcare industry contributes heavily to the Massachusetts economy, which leads the United States in health care affordability and access. Total state health care expenditures in 2023 totaled $78.1 billion.
Vacancies in essential hospital jobs decreased from 19,000 open positions in 2022 to 13,600 openings in 2024, according to the MHHA report. It says that has helped drive the state economy while also addressing the healthcare worker shortage for the past five years.
However, the added expense of those hires can increase healthcare costs. Eileen McAnneny, president and CEO of the Employer Coalition on Health, said that businesses with a small profit margin, like small retailers, and restaurants, are particularly vulnerable to increased healthcare costs, which affects their ability to hire and operate. While she is not surprised that the healthcare workforce is growing, she says it’s one of the only few sectors that is expanding.
“(The healthcare workforce growth) speaks to the overall affordability challenges in Massachusetts. Healthcare costs are a primary affordability concern,” she said.
Valerie Fleishman, executive vice president and chief innovation officer of MHHA, argued that filling vacancies reduces healthcare costs rather than increasing them.
“Reducing staffing vacancies strengthens patient care and access while delivering major economic benefits,” Fleishman said in a statement. “It cuts hospitals’ need for expensive temporary labor, helps prevent care delays that can drive up healthcare costs, and boosts local economies as workers spend and invest in their communities.”
The healthcare industry contributes heavily to the local economy, with total state health care expenditures in 2023 totaling $78.1 billion.
Healthcare vacancies
The median vacancy rate for 56 different healthcare positions totaled 14.2% in 2024, according to the report. The number of jobs being filled increased for the majority of these positions, but workforce gaps expanded for a few roles, including endoscopy, cardiac catheter, and radiologic positions.
When caregiver roles aren’t filled this causes a “ripple effect” in the entire health care system, said Fleishman of MHHA.
“There are fewer beds online, fewer beds available for patients,” she said. “There are wait times that increase, and there are additional strains on caregivers.”
Areas for progress listed included nursing vacancy rates, temporary labor, transitions of care and behavioral health. While “significant strides” have been made in hiring to assist in the patient transition process and free up beds in hospitals, as many as 2,000 patients are “stuck” in hospitals waiting to be discharged, according to the report.
Vacancy rates for nursing roles also decreased by 5%, going from 15% in 2022 to 10% currently. So for every 10 nursing roles available, there is now one vacant role. Five out of the top 10 vacancy rate reductions consisted of nursing related positions.
“There’s still progress to make, but our members, our hospitals, our health systems, are really leaning into solutions to fill those vacancies,” said Fleishman, referring to nursing and caregiver positions.
Earlier this year, 78% of Massachusetts nurses said in a survey that hospital care has declined over the past two years due to understaffing, according to the Massachusetts Nursing Association, which several nurses attributed to workplace violence, being overworked, poor nurse to patient ratios and inadequate pay.
“It’s encouraging, but there’s a lot more work that needs to be done,” said Aaron Winston, a registered nurse and MNA committee co-chair, referring to the new data.
Critical gaps still remain for sitters, community health workers and technician positions whose vacancy rates all exceed 20%, which is above the median vacancy rate, according to the report, which also noted behavioral health and advanced practice as roles facing high turnover rates and shortages in staffing.
MHA listed career ladder programs, partnerships with higher education for training programs, higher salaries, housing and childcare support programs by hospitals, their partners and the state government as contributors to workforce improvements.
To continue the positive momentum moving forward, the report recommended passing legislation to support the workforce, filling care gaps for key roles and focusing on patient-facing roles.
McAnneny said as the population ages, healthcare will need to become more efficient and affordable, since more people will use it. She added that healthcare is only one determinant of health, and access to food and housing and public safety are other areas to focus on.
“The growth demand for [healthcare] service won’t abate anytime soon,” she said.