Health care workforce rebounded post-COVID, but not equally across sectors

Author(s):

Austin Littrell

Fact checked by:

Keith A. Reynolds

Key Takeaways

Health care employment has rebounded, slightly exceeding pre-pandemic projections, demonstrating resilience against broader economic fluctuations.
Office-based care, especially in physician offices and behavioral health, has surpassed projected employment levels, while hospitals and skilled nursing facilities lag.
The study cautions that headcount recovery may not reflect the necessary skill mix to meet patient needs, highlighting potential gaps in care readiness.
Methodology used does not account for demographic, policy, or care model shifts, but provides a snapshot of health care staffing recovery and persistent shortages.

A new JAMA study shows that, while overall health care employment has recovered from the pandemic, gaps remain in hospitals, nursing homes and intensive behavioral care.

Health care jobs have not only rebounded from the COVID-19 pandemic, but now slightly exceed their pre-pandemic projections, according to a new study published in JAMA. The recovery, researchers say, reflects the health sector’s unique insulation from broader economic fluctuations. But it also masks disparities across settings.

Between the fourth quarter of 2019 and the second quarter of 2020, U.S. health care employment fell by nearly 1.4 million jobs, or 6.9% below projected levels. By the third quarter of 2024, the workforce had returned to 24.4 million jobs, just 0.2% below where it would have been if growth trends had continued uninterrupted.

In contrast, employment across all other industries remained 2.9% below predicted levels, suggesting the health sector’s resilience was partly due to insurance-based financing and sustained demand for care.

Office-based care leads recovery

Recovery, however, varied by subsector. Employment in physician offices rose to 3.02 million jobs — 1.2% above predicted levels. Behavioral health also saw major gains, with office-based behavioral health jobs growing 84% since late 2019, far surpassing projections.

By contrast, skilled nursing facilities (SNFs), hospitals and intensive behavioral health settings lagged. Hospital staffing in Q3 2024 remained 0.7% below projections, while SNF employment was down 0.1% and intensive behavioral health centers trailed by 0.8%.

The study noted that office-based behavioral health settings may have had advantages like reduced COVID-19 transmission risk and increased capacity for telehealth delivery.

Not all recoveries reflect readiness

Although headcounts may be nearing pre-pandemic expectations, the study cautioned that the numbers may not fully represent readiness to meet patient needs.

“The head-count recovery reported in this study may not accurately represent the necessary skill mix of employment to ensure the provision of adequate patient care,” wrote the authors, led by Thuy Nguyen, Ph.D., an assistant professor in the department of health management and policy at the University of Michigan School of Public Health.

The study used data from the U.S. Bureau of Labor Statistics’ Quarterly Census of Employment and Wages from 2016 through 2024, applying regression models to project where employment should have been, absent the pandemic.

Researchers emphasized that the methodology does not account for shifts driven by demographics, policy or changes in care models. Still, the findings offer a clear snapshot of where health care staffing has rebounded, and where persistent shortages may continue to impact care.