State’s aging population impacting health care workforce

Patients in Wisconsin are spending more time in hospitals after more than a decade of declining hospital stays, according to Ann Zenk, vice president of workforce and clinical practice at the Wisconsin Hospital Association. 

In a recent interview, she highlighted results of a health care workforce report from WHA, noting the impact of the state’s aging population is starting to become apparent. 

“Businesses are feeling the impact of baby boomers retiring every day,” Zenk said. “We’re seeing both in Wisconsin and nationally, gaps in being able to fill positions in our workforce.” 

As the health care field continues to see increasing retirements among older practitioners, Zenk said younger generations can’t keep up with the demands of the workforce. And as the state’s aging population leads to higher health care spending, Wisconsin’s health care system will be tasked with fulfilling greater demand with a shrinking workforce. 

Wisconsin’s over-65 population is expected to double in the next decade, and health care demands are expected to increase by 30 percent, Zenk said. 

“It’s really unlikely our workforce will be able to grow fast enough to meet that increased demand,” she said. “We want to sustain the top-quality health care we provide… We’re going to have to grow the workforce faster, but also more wisely.” 

She says that will mean attracting workers to health professions who will stay in the workforce, particularly in the most high-demand professions. The WHA report shows a lack of access to certain types of care is contributing to longer hospital stays, which in turn ramps up the strain on the overall system. 

As an example, when post-acute beds used for rehabilitation or other purposes aren’t available, patients end up spending more “avoidable days” in hospitals, per the report. In many cases, nursing homes may not have sufficient workers to keep all beds open, or lack certain expertise to admit patients with complex medical needs. WHA estimates patients spent 38,000 avoidable days at Wisconsin hospitals in 2017. 

“Addressing caregiver shortages, allowing hospitals to create transitional care units able to provide complex care, or allocating a part of nursing home funding increases for a ‘complex care rate’ — all have the potential of creating more access to post-acute care,” report authors said. 

Zenk said hospitals and health systems are struggling to fill positions in entry-level jobs, including housekeeping and food service, certain technicians and other roles. These entities are competing for workers with retailers and other places “where you can come right out of high school and get a job.” 

At the same time, higher-level positions like advanced practice clinicians and physicians are also facing difficulties with filling spots. 

“We want to attract more individuals to the health care career pathway and keep investing in that pathway,” she said. “The highest needs are on either end of the career pathway.” 

But Zenk said the biggest challenge both in Wisconsin and nationwide is the growing physician shortage. She notes it takes 12 years to become a doctor, and as many are retiring or otherwise “aging out,” the overall supply of these experts is growing thin. 

In an earlier report from 2011, WHA calculated the state needs 100 new doctors each year to fill demand. Zenk says the state is making progress on that front as a result of new and expanded residency programs. 

“But we can’t grow them fast enough, and shortages persist and even worsen in some areas,” she said. “For example, the psychiatry workforce can only meet 19 percent of the state’s need.” 

She explains that creates bottlenecks for patients, local law enforcement and social services departments as more patients need inpatient behavioral health care than psychiatrists can provide. Zenk pointed to a bill signed this year by Gov. Tony Evers that removes certain certification requirements for telemedicine, saying it would eliminate a burden for the mental health workforce. 

“Everything we can do to leverage technology and stretch the workforce thinner to meet access needs is helpful,” she said.

In the report, WHA calls for expanded interprofessional education efforts to “ensure the future and current workforce is prepared to work within new health care models with more flexible roles and with team members who have varying skills and competencies.” 

Other strategies for bolstering the health workforce include using data to drive the growth of educational programs, with a goal of recruiting the right mix of people to careers with the highest demand. That can include health training grants, as well as public-private partnerships targeted at certain professions. 

Zenk also says the state should aim to streamline licensing processes while maintaining rigorous safety standards. And she said physicians should be better protected from mounting burnout associated with various regulations, electronic health records and other activities that eat up their time. 

See the full report:

–By Alex Moe