The Structure of the Healthcare Sector and Healthcare Occupations in Massachusetts

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The Structure of the Healthcare Sector and Healthcare Occupations in Massachusetts June 26 th, 2007 Jonathan Latner Research and Evaluation Analyst Commonwealth Corporation 617-727-8158 jlatner@commcorp.org

Table of Contents 1. Massachusetts Employment Trends 2. Healthcare Industry 3. Healthcare Occupations 4. Vacancies 5. Connecting Career Centers to Healthcare Page 1

Massachusetts Employment Trends Employment is recovering from recession, but has not equaled its Peak: Feb, 2001 MA is 1 of 6 states that has not reached pre-recessionary employment numbers* 3,500,000 January, 2001 March, 2007 3,400,000 February, 2001 3,372,900 3,300,000 3,200,000 December, 2003 3,167,100 March, 2007 3,273,100 3,100,000 3,000,000 2001 2002 2003 2004 2005 2006 2007 Source: Department of Labor and Workforce Development CES Data, Seasonally Adjusted Data *Massachusetts Budget and Policy Center, State of Working Massachusetts, 9/3/06 Page 2

Do We Have Enough Workers Now? Many people are still seeking work In May 07, 101,300 fewer jobs than at peak Feb 01 From 2000 to 2006, virtually no population growth From Q1 01 to Q1 07: 71,790 more unemployed From 2000 to 2006 21,100 more working part- time 15,200 more marginally attached stopped looking for jobs recently: 3,000 more discouraged 12,200 more stopped due to family or transportation reasons From 2000 to 2004 47,500 more non-employer businesses in 2004 compared to 2000 Note: Based on 12 month averages from Current Population Survey (CPS) Source: BLS (CPS) & Census (Non-employer) Source: Census American Community Survey (ACS) +74,763 (Census-Estimates) Page 3

Number of Massachusetts Workers Employed by Sector, 2005 Employment ( 000) Health Care Retail Manufacturing Education Hotels, Food Services Prof./ Tech. Svcs. Finance-Insurance Admin./Waste Svcs. Construction Wholesale Public Admin. Other Services Information Trans./Warehous. Mgt. of Cos. Arts, Entert. Real Estate Utilities AFF Mining 7 2 13 47 45 66 93 93 177 164 151 133 131 120 234 246 306 303 356 459 Source: Bureau of Labor Statistics Quarterly Census of Employment & Wages Page 4

What is included in the Healthcare sector? Ambulatory Care (Outpatient Treatment) Doctor s Offices Dentist s Offices Home Care Services Outpatient Care Centers Other Health Practitioners Other Ambulatory Care Services Medical laboratories Nursing Care Facilities (Care for the Elderly) Nursing Homes Residential Mental Health Facilities Community Care Facilities for the Elderly Other Residential Care Facilities Hospitals (Inpatient Treatment) General Hospitals Other Hospitals Psychiatric Hospitals Social Assistance (Social Services) Individual & Family Services Child Day Care Services Vocational Rehabilitation Services Emergency & Other Relief Services Source: Bureau of Labor Statistics Quarterly Census of Employment & Wages Page 5

Proportion of Total Massachusetts Workforce Employed by Healthcare Sub-Sector, 2005 Sector 2005 Employment ( 000) Share of Mass. Employment Ambulatory health care services 129 Nursing and residential care facilities 93 Social assistance 63 Hospitals 172 Source: Bureau of Labor Statistics Quarterly Census of Employment & Wages Page 6

Slide 4: Sector Level Employment Trends (2000 2003) Change in Employment 2001-2003 Healthcare Retail Manufacturing Education Hotels & Food Services Prof, Sci., & Tech. Svcs. Finance Administration Construction Wholesale Trade Government Other Services Information Transportation Mgmt. Of Co. Arts & Entertainment Real Estate Utilities AFF Mining Source: DWD Quarterly Census of Employment & Wages -82,643-18,861-23,720-7,921-4,299-6,557-19,955-10,784-10,550-3,111-1,290 146 682 324 13,318 7,672 6,237 8,497 10,221 23,805 Page 7

Slide 5: Sector Level Employment Trends (2003 2005) Change in Employment 2003-2005 Healthcare Retail Manufacturing Education Hotels & Food Services Prof, Sci., & Tech. Svcs. Finance Administration Construction Wholesale Trade Government Other Services Information Transportation Mgmt. Of Co. Arts & Entertainment Real Estate Utilities AFF Mining Source: DWD Quarterly Census of Employment & Wages -20,371-2,419-3,829-4,001-3,887-3,877-802 937 6,664 3,922 13,202-57 7,514 2,159 2,958 820 598 104 126 13,281 Page 8

Healthcare Industry Group Level Employment (2005) and Trends (2001 2005) 2005 Employment ( 000) Change from 2001 ( 000) General Hospitals Nursing Care Facilities Doctor's offices Individual and Family Services Child Day Care Services Dentist's Offices Home Health Care Outpatient Care Centers Res. Mental Health Facilites Other Hospitals Community Care for the Offices of Other Health Practs. Vocational Rehab. Services Psychiatric Hospitals Other Ambulatory Health Other Res. Care facilities Relief Services Laboratories 27 22 20 20 19 17 15 14 11 9 8 6 6 6 4 57 48 151-2 -1 0 0 0 2 1 1 1 0 1 1 0 3 2 3 3 16 Hospitals Ambulatory Care Nursing Care Social Assistance Source: Bureau of Labor Statistics Quarterly Census of Employment & Wages Page 9

Regional Employment in the Healthcare Industry 2005 Employment 16.7% 16.4% 15.1% 14.2% 16.4% 14.8% 14.6% 14.5% 10.2% Berkshire Boston Central Metro SW North East Pioneer Valley South East Cape Cod MA Source: Mass. Department of Workforce Development Quarterly Census of Employment & Wages Page 10

Regional Structure of the Healthcare Industry 100% 75% 50% 25% 13% 10% 19% 59% 14% 20% 28% 38% 0% Berkshire Boston Central Metro SW North East Pioneer Valley South East Cape MA Hospitals Ambulatory Health Care Services Nursing and Residential Care Facilities Social Assistance Source: Mass. Department of Workforce Development Quarterly Census of Employment & Wages Page 11

Healthcare Occupations Comprise 50% of Healthcare & Social Assistance Sector 34% Non-Healthcare Related Occupations 17% 16% Healthcare Related Occupations 13% 8% 4% 4% 3% Healthcare Professionals Admin. Support Healthcare Support Workers Social Services Education Management Food Prep. Other Source: Mass. Department of Workforce Development Industry Occupation Crosswalk Page 12

Industry Sectors and Occupations 86% of Healthcare professionals and 81% of Healthcare support occupations work in the Healthcare sector Share (%) of Employees from Major Occupational Groups Working in Healthcare Industry All Occupations Management Business Fin. Ops. Life, Phy. Soc. Science Community Social Svcs Education Healthcare Professionals Healthcare Support Workers Building Grounds Food Prep. Office & Admin Healthcare 14% 9% 4% 9% 60% 9% 79% 81% 11% 6% 14% Retail 5% 1% Education 5% 2% Govt. 4% 8% Admin. Svcs. 2% 4% Prof. Tech. Svcs. 3% 2% Total 100% 100% Source: Mass. Department of Workforce Development Industry-Occupation Crosswalk Page 13

2001-2006 Occupational Pay Structure 2001 2006 Median Salary % of MA Median Salary % of MA % Increase All Occupations $32,210 100% $37,350 100% 16% Healthcare Professionals $45,250 140% $60,320 161% 33% Healthcare Support Workers $22,590 70% $27,480 74% 22% Source: Bureau of Labor Statistics Occupational Employment Statistics1 Page 14

9% workers are in Healthcare occupations 6% are Professionals, 3 % Support workers Major Occupational Group 2006 Employment ( 000) FFF Legal Life, Physical, and Arts Social Services Protective Service Personal Care Engineering Healthcare Support Repair Maintenance Comp. & Math Construction Transportation Financial Production Management Healthcare Practitioner Education Food Prep. Sales Administrative Source: Bureau of Labor Statistics Occupational Employment Statistics 2,900 24,210 46,750 47,630 58,500 70,080 70,320 74,130 94,700 101,130 105,840 113,890 115,860 165,900 169,230 177,060 185,530 197,320 213,600 261,150 327,560 547,190 Page 15

Healthcare occupations are growing Change in Employment 2001-2006 Administrative Sales Food Prep. Education Healthcare Management Production Finance Transportation Construction Comp. & Math Buildings & Grounds Maintenance Healthcare Support Engineering Personal Care Protective Service Social Services Arts Sciences Legal FFF -55,090-54,750-25,210-9,470-2,150-4,550-7,530-2,500-1,720-2,430 630 2,340 860 11,010 6,270 14,500 3,580 5,510 6,090 7,740 7,130 40,060 Source: Bureau of Labor Statistics Occupational Employment Statistics Page 16

Social Assistance & Nursing Care exhibit a much more diversified workforce 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Other 10% Other Social Services - 6% 21% Administration 28% Healthcare Support Workers 17% Healthcare Practitioners 39% Administration 17% Healthcare Support Workers 12% Healthcare Practitioners 50% Other 24% Other 32% Food Prep 11% Social Services - 7% Administration - 5% Healthcare Support Workers 34% Healthcare Practitioners 19% Management 8% Education 27% Social Services 24% Administration 8% Ambulatory Care Hospitals Nursing Care Social Assistance Source: Mass. Department of Workforce Development Industry Occupation Crosswalk, 2005 Page 17

Half of Healthcare professionals are nurses 77,000 RNs, 17,000 LPNs, Large no. of therapists, technologists, and technicians Registered Nurses Therapists Licensed Practical Nurses Physicians and Surgeons Clinical Laboratory Technicians Health Diagnosing Support Technicians Diagnostic Related Technicians Pharmacists Health Information Technicians Dental Hygienists EMT's and Paramedics Dentists Physician Assistants Other Healthcare Professionals 17,330 16,910 16,090 13,850 11,540 8,440 5,930 5,530 5,480 4,860 2,390 2,060 10,410 76,350 Source: Bureau of Labor Statistics Occupational Employment Statistics Page 18

Who are Healthcare Support workers? Almost half are nursing aides- 41,000 Nursing aides Home health aides Medical assistants Psychiatric aides Dental assistants Physical therapist assistants Veterinary assistants Medical transcriptionists Pharmacy aides Physical therapist aides Medical equipment preparers Occupational therapist assistants Massage therapists Occupational therapist aides Healthcare support workers, all other 9,490 7,260 6,370 1,980 1,830 1,760 1,340 1,140 1,120 970 760 260 3,360 16,750 40,330 Source: Bureau of Labor Statistics Occupational Employment Statistics Page 19

Where are all the registered RNs? RNs Registered in MA = 103,222 RNs working in MA=? RNs working as RNs= 76,350 RNs in Health Care Sector= 65,190 RNs in Hospitals=44,400 RNs in Gen. Medical and Surgical Hospitals=40,070 Source: Massachusetts Department of Workforce Development, Industry-Occupation Crosswalk Page 20

Age of Nursing Professionals & Paraprofessionals 100% 60+, 6% 60 +, 6% 60+, 8% 60+, 7% 50-59 22% 50-59 25% 50-59 17% 50-59 17% 50% 40-49 37% 40-49 33% 40-49 25% 40-49 25% 16-39 35% 16-39 36% 16-39 51% 16-39 50% 0% RN LPN Nurses & Home Health Aides All Occupations Source: 2000 Census Equal Employment Opportunity Tabulation Page 21

Diversity of Nursing Professionals & Paraprofessionals White African-American Hispanic Other 100% 3% 4% 4% 1% 8% 6% 2% 5% 9% 8% 4% 20% 50% 92% 85% 86% 65% 0% RN LPN Nurses & Home Health Aides All Occupations Source: 2000 Census Equal Employment Opportunity Tabulation Page 22

Job Openings Since 2002 Vacancies have increased as the Economy has begun its recovery Healthcare Industry Vacancies All Other Industrial Vacancies 70,146 32,250 42,018 49,787 45,104 56,239 56,610 58,531 13,361 12,530 15,139 13,787 15,695 16,203 15,774 19,150 4th Qtr, 2002 2nd Qtr, 2003 4th Qtr, 2003 2nd Qtr, 2004 4th Qtr, 2004 2nd Qtr, 2005 4th Qtr, 2005 2nd Qtr, 2006 Source: Massachusetts Job Vacancy Survey, 2 nd Quarter 2006, Department of Workforce Development Page 23 Source 2: LAUS, DWD

Critical Healthcare Occupations Occupations Vacancies 2005 Degree/Certificates Granted Registered Nurses 4,581 2,689 Physical Therapists 381 521 Respiratory Therapists 210 58 Veterinarians 70 79 Medical and Clinical Laboratory Technologists 314 18 Medical and Clinical Laboratory Technicians 301 19 Diagnostic Medical Sonographers 94 83 Radiologic Technologists and Technicians 244 177 Licensed Practical Nurses 470 664 Nursing Aides, Orderlies, and Attendants 1,994 20 Physical Therapist Assistants 107 39 Physical Therapist Aides 60 Medical Assistants 292 1949 Veterinary Assistants 97 78 Source: CommCorp analysis of Massachusetts Job Vacancy Survey data Source 2: Commonwealth Corporation analysis of Integrated Post- Secondary Educational Data Systems (IPEDS) data from the National Center for Educational Statistics. Page 24

What Industries are Growing? Where are the Openings? Employment Change Q2, 2005 Q2, 2006 Education & Health Leisure & Hospitality Other Services Construction Financial Activities Government Trade, Transp., & Utilities Information -2,845 Professional & Business -110 10,801 18,381 234 1,370 1,821 2,731 2,157 10,077 Manufacturing -6,552 Source: ES-202, Quarterly Data, 2005 & 2006 Source 2: JVS, Q2, 2006 Source 3: MOSES, DWD Page 25 Healthcare Jobs

What Industries are Growing? Where are the Openings? Education & Health Leisure & Hospitality Other Services Construction Financial Activities Government Trade, Transp., & Utilities Information Employment Change Q2, 2005 Q2, 2006-2,845-6,552-110 Professional & Business Manufacturing 234 10,801 18,381 1,370 1,821 2,731 2,157 10,077 Job Vacancies Q2, 2006 19,150 24,759 2,066 2,330 5,071 1,418 2,296 13,031 15,152 12,850 6,340 Source: ES-202, Quarterly Data, 2005 & 2006 Source 2: JVS, Q2, 2006 Source 3: MOSES, DWD Page 26 Healthcare Jobs

What Industries are Growing? Where are the Openings? Education & Health Leisure & Hospitality Other Services Construction Financial Activities Government Trade, Transp., & Utilities Information Professional & Business Manufacturing Employment Change Q2, 2005 Q2, 2006-2,845-6,552 Source: ES-202, Quarterly Data, 2005 & 2006 Source 2: JVS, Q2, 2006 Source 3: MOSES, DWD -110 234 10,801 18,381 1,370 1,821 2,731 2,157 10,077 Job Vacancies Q2, 2006 19,150 24,759 2,066 2,330 5,071 1,418 2,296 13,031 15,152 12,850 6,340 152 Employer Services Provided by Career Center Staff: FY, 2006 192 164 125 123 226 176 197 138 691 891 Page 27 Healthcare Jobs

What Occupations are Growing? Where are the Openings? Transp. & Material Moving Employment Trends 2001-2006 -9,470 Job Vacancies Q2, 2006 Career Centers Job Postings FY, 2006 Production -54,750 Installation, Maintenance Construction & Repair -7,530-2,150 Administrative Support Sales & Related Service -25,210 5,510 630 7,940 Professional 14,500 65,940 Management -55,090 Source: OES, 2001 & 2005 Source 2: JVS, Q2, 2006 Source 3: MOSES, DWD Page 28 Healthcare Jobs

What Occupations are Growing? Where are the Openings? Employment Trends 2001-2006 Job Vacancies Q2, 2006 Transp. & Material Moving -9,470 3,826 Production -54,750 3,303 Installation, Maintenance -7,530 1,916 Construction & Repair -2,150 1,592 Administrative Support -25,210 9,090 Sales & Related 630 10,848 Service 5,510 7,940 4,050 15,886 Professional 14,500 65,940 8,574 21,363 Management -55,090 5,848 Source: OES, 2001 & 2005 Source 2: JVS, Q2, 2006 Source 3: MOSES, DWD Page 29 Healthcare Jobs

What Occupations are Growing? Where are the Openings? Transp. & Material Moving Employment Trends 2001-2006 -9,470 Job Vacancies Q2, 2006 3,826 Career Centers Job Postings FY, 2006 14,722 Production -54,750 3,303 32,603 Installation, Maintenance Construction & Repair -7,530-2,150 1,916 1,592 7,791 7,235 Administrative Support -25,210 9,090 34,782 Sales & Related 630 10,848 15,895 Service 5,510 7,940 4,050 15,886 3,140 39,844 Professional 14,500 65,940 8,574 21,363 5,140 28,187 Management -55,090 5,848 7,464 Source: OES, 2001 & 2005 Source 2: JVS, Q2, 2006 Source 3: MOSES, DWD Page 30 Healthcare Jobs