ACA Increasing Demand for Healthcare Workers

Increased Demand Translates to More Money for Many Clinicians

Physician Salaries for 2015
2016 Physician Salary Survey Results of 2015 Pay. The Medicus Firm

As if healthcare professionals were not already in high demand, many sources are pointing to trends that indicate that the Affordable Care Act (ACA) is even further increasing the need for more healthcare workers. The ACA, also referred to as Obamacare or health reform, is by many accounts increasing demand especially for doctors and nurses, and possibly causing shortages to worsen in some areas of the country, particularly for primary care services.

Reasons Why ACA Is Increasing Demand for Healthcare Workers

One way the ACA is increasing demand is by decreasing the number of people in the country who are uninsured by a healthcare coverage policy. By increasing the insured rate, this, in turn, creates added demand for healthcare services. Some sources, including Bradley University, report the uninsured rate as low as 9.2 percent, which is the lowest rate in 50 years. Their report on the impact of the ACA on the nursing workforce and nursing school student enrollment states that the "implementation of the ACA presents an unprecedented opportunity for APRNs (Advanced Practice Registered Nurses) to take on leadership roles in offering primary care and strengthening preventative services."

Also growing in popularity and demand are doctor of nursing practice programs (DNP), according to the Bradley University infographic. "Doctor of Nursing Practice (DNP) nurses have advanced policy knowledge and advocacy skills," the report states, noting that 18,352 students enrolled in DNP programs in 2013-2014.

Growth in Mental Health Care

In addition to shortages in the field of primary care, mental health care is also feeling the squeeze in the workforce, in the wake of the ACA. To help meet the growing demand, many schools are expanding degree programs in counseling and behavioral health. According to Bradley University, nearly half (47.4 percent) of Americans will experience some sort of mental health issue in their lifetime. The rate of mental illness in the United States is the among the highest in the world, according to the World Health Organization (WHO).

Advanced Practice Clinicians

Many employers and healthcare facilities are turning to advanced practice providers, such as NPs (nurse practitioners) and PAs (physician assistants) to help meet demand in primary care and behavioral health. Advanced practice clinicians are already experiencing a spike in demand and hiring activity, a number of recruiting firms report. For example, The Medicus Firm, a national physician and advanced practice clinician search firm, has shown a sharp increase in placement activity of non-physician providers in 2014 and 2015, according to their annual placement summary report of national recruiting activity. In 2015, placements of advanced practice providers grew to 8.3 percent of total client placements nationwide, up from 6.34 percent the previous year, and 1.32 percent in 2012. In 2015, Physician Assistants were the fourth most frequently placed provider by clients of The Medicus Firm. 

How Increased Demand Impacts Healthcare Compensation for Clinicians

With increased demand and potential shortages comes a trend of increasing salaries also. Demand and salaries for physicians and advanced practice clinicians have been trending upward for several years. Additionally, the prevalence of signing bonuses has caused the perk to have become nearly expected by physicians when being recruited, with at least 70 percent of placements involving a signing bonus. According to The Medicus Firm's placement report, the average physician signing bonus has grown to about $23,663, and some specialists are commanding six-figure signing bonuses of $100,000 to $250,000. 

Recently, signing bonuses for NPs and PAs were virtually unheard of, but more recently the use of signing bonuses to entice advanced practice clinicians to accept a job is becoming commonplace. The average signing bonus for PAs was $6,250 in 2015, more than double the $3,000 average of two years prior.

In addition to signing bonuses, relocation packages are also offered to assist with the cost of relocating to a new community, and student loan repayment is also a popular perk for physicians, who often begin their careers with $150,000 - $250,000 in student loan debt.

Not all of these trends are solely caused by health reform. Due to an aging population and advances in medicine, demand for health care was already on an upward trend, and the implementation of the Affordable Care Act likely exacerbated the demand by enabling more Americans to obtain health insurance coverage. However, for some rural areas, especially in high-demand fields mentioned above such as primary care, and behavioral health, having coverage does not always guarantee access to a physician, due to shortages in many areas and some specialties. Therefore, expanding the scope of advanced practice clinicians as well as finding other ways to extend the reach of providers (telemedicine, etc.) is paramount to meeting the demand for health care services.

Physician Salaries Trend Upward

Physicians' salaries showed an increase in most specialties for 2015, according to 2016 reports. The Medical Group Management Association (MGMA), as well as several recruiting firms, reported a trend of increasing physician salaries in most specialties from 2014 to 2015. 

The Medicus Firm's salary results showed an increase across the board for the first time ever, according to Jim Stone, president. "All specialties reported an increase from 2014 to 2015, which is a first for our annual survey," he stated. "While salaries have, for the most part trended upwards over the past few years of our annual salary survey, there were few years that showed a slower rate of growth, and even declines reported in some specialties sporadically. This is the first year I recall all specialties reporting solid increases in pay," Stone concluded.

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