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Perspectives on Minnesota’s Health Industry Workforce. Minnesota Rural Health Conference July 19, 2005 Duluth, MN. Jay Fonkert Office of Rural Health and Primary Care MN Department of Health.

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slide1

Perspectives on Minnesota’s Health Industry Workforce

Minnesota Rural Health Conference

July 19, 2005

Duluth, MN

Jay Fonkert

Office of Rural Health and Primary Care

MN Department of Health

slide2

Opinions expressed in this presentation are the sole responsibility of the author and do not represent opinions or positions of the Minnesota Department of Health or the State of Minnesota.

slide3

Workforce Analysis Program

Office of Rural Health and Primary Care

Annual surveys of licensed health professionals to better understand workforce demographics and disparities in health care access

slide4

Health care industry accounts for 11 percent of all private sector employee compensation in Minnesota.

Health Services

Other private nonfarm industries

Source: Bureau of Economic Analysis, regional accounts, 2003

slide5

Ambulatory Care employees receive more than half of all health care compensation in Minnesota.

Nursing and residential care facilities

Ambulatory Care

Hospitals

Source: Bureau of Economic Analysis, regional accounts, 2003

slide6

Some counties with high dependence of health care employment

Health care and social services employment as % of wage and salary employment

Olmsted (Rochester) 37%

Wilkin (Breckenridge) 25%

Chisago 22%

Grant 21%

Mille Lacs 20%

St. Louis (Duluth) 20%

Statewide: 13%

Source: U. S. Bureau of Economic Analysis, Regional accounts, 2002

slide7

Minnesota’s Healthcare Workforce

Estimated active at MN sites, 2004

slide8

Minnesota’s Healthcare Workforce

Estimated active at MN sites, 2004

slide9

Largest Minnesota health occupations

Source: Minnesota Department of Employment and Economic Development, 2nd Quarter 2004.

slide10

Half of Minnesota health care workers work outside hospitals or physician offices.

Hospitals

All other sites

Physician and dentist offices

Nursing care facilities

Source: U.S. Census Bureau, County Business Patterns, 2002.

slide11

Male – Female Composition of Workforce

Physicians

Physician assistants

RNs

LPNs

RCPs

Physical therapists

Dentists

Dental assistants

Dental hygienists

Source: MDH, Office of Rural Health and Primary Care, 2004 survey data.

slide12

Dentists, physicians and RNs are older than other practitioners.

Median age of MN practitioners

Physicians

Physician assistants

RNs

Respiratory care practitioners

Physical therapists

Dentists

Dental assistants

Dental hygienists

Source: MDH, Office of Rural Health and Primary Care, 2004 survey data.

slide13

Age composition of workforce…

Physician assistants are significantly younger than physicians or RNs.

< 45 yr.

> 55 yr.

Source: MDH, Office of Rural Health and Primary Care, 2004 survey data.

slide14

The retirement crunch may be more serious for dentists than for physicians.

Dentists enter workforce at slightly younger age than physicians, but may stay in part-time practice a bit longer.

Source: MDH, Office of Rural Health and Primary Care, 2004 survey data.

slide15

Retirement is more imminent for dentists in the most rural areas.

DENTISTS BY AGE

< 45 yrs.

55+ yrs.

slide16

Rural practitioners tend to be a year or two older than urban practitioners.

Median age comparisons

Source: MDH, Office of Rural Health and Primary Care, 2004 survey data.

slide17

Dentists are more geographically dispersed than physicians.

Dentists

Dentists

Physicians

Physicians

Population: 41% rural

RNs 26%

LPNs 52%

RCPs 19%

Physical therapists 29%

Dental assistants 34%

Dental hygienists 33%

Physician assistants 31%

Source: MDH, Office of Rural Health and Primary Care, 2004 survey data.

slide18

Specialist physicians are more concentrated in urban areas than primary care physicians.

Primary care physicians

Other specialties

Source: MDH, Office of Rural Health and Primary Care, 2004 survey data.

Urban = Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington counties, plus Rochester, St. Cloud and Duluth.

slide19

Per 100,000 Population (2000)

* Patient care physicians

Source: HRSA , State Health workforce Profiles.

slide20

Per 100,000 Population (2000)

* Patient care physicians

Source: HRSA , State Health workforce Profiles.

slide21

Minnesota Workforce Mix Ratios

2000 data, HRSA Health Workforce Profiles

slide22

Minnesota is…

  • AVERAGE in number of PHYSICIANS.
  • ABOVE AVERAGE in number of RNs and Dentists.
  • MUCH ABOVE AVERAGE in number of LPNs and Dental hygienists.
slide23

Minnesota has…

  • high ratio of RNs to physicians
  • high ratio of RNs to LPNs

What are the implications?

What changes can be expected?

slide24

Primary Work Sites of MN LPNS

MDH: ORHPC 2004 Licensing Survey

slide25

What kind of problem is it?

Workforce Supply?

Grow Workforce

Weak Market Demand?

Strengthen Markets

Weak Demand = Low Need

slide26

Hospitals and clinics, doctors and dentists…

Aren’t that much different from…

Other professionals or firms.

They set up business where there are enough paying customers to pay the bills.

slide27

DISTANCE = TIME = $

The Rural Health Care Access Challenge:

Get the person to where the health care is or get the health care to where the person is… and find a way to pay for the care.

slide28

All occupations face shortages

ISSUE: How will health care attract its needed share of a limited supply of workers?

  • Challenges:
  • Finding enough employees
  • … with appropriate education and skills

Critical importance of K-12 Education: we will need young people prepared to acquire the KNOWLEDGE, SKILLS and ETHICS necessary for health careers.

slide29

As workers become scarce and expensive…

Incentives to:

1. Use technology to reduce labor need.

2. Redesign way services are delivered to use labor more efficiently.

3. Use different mixes of occupations.

Improve labor productivity

slide30

For more information:

Workforce Analysis Program

Office of Rural Health and Primary Care

Minnesota Department of Health

Jay Fonkert

651-282-5642

Jay.fonkert@state.mn.us

slide31

THE END

Following slides are held in reserve.

slide34

Workforce stories

“It’s physician specialists that help draw patients into your facility.”

Hospital CEO, Marshall MN

Pop: 12,788

Marshall Independent, March 1, 2005

COMMENT: Critical mass affects economic viability. Regional centers will be higher level health care centers.

slide35

Workforce stories

“Going to a small town and having an abundance of patients that you are going to lose money on when you have $180,000 of debt doesn’t make it.”

Rural MN Dentist

Northwest Dentistry

January-February, 2005

COMMENT: Providers need paying customers – whether they be private sector or government.

slide36

Workforce stories

“When those ambulance people come up to your side… you want them to be the best.”

Supporter of higher national EMT standards

“These guys have jobs. They work at the Cenex store, they work at the butcher shop. They’re farmers trying to get their crops in.”

Director of North Dakota EMS Association

COMMENT: Higher professional standards, advanced training requirements and expensive technology tend to favor concentration of health care services in regional centers.

slide37

Health Care in the Minnesota Economy

Share of personal income 9.3%

Share of wages and salaries 10.0%

Percent of employment 10.4%

The health care industry creates jobs and buying power in communities with hospitals, clinics and care facilities.

Source: Bureau of Economic Analysis, regional accounts, 2003. All data reported by place of work.

slide38

Minnesota Health Care Employment

By type of business

Offices of physicians and dentists 44,091 15%

Outpatient care centers 32,513 11%

Home health services 17,855 6%

Other ambulatory care services 14,207 5%

Hospitals 99,990 35%

Nursing care facilities 42,940 15%

Residential MR/MH/substance abuse fac. 22,495 8%

Other residential facilities 15,371 5%

Source: U.S. Census Bureau, County Business Patterns, 2002.