Health Care Workforce Trends and Challenges in the Era of COVID-19: Current Outlook and Policy Considerations for Massachusetts

Mar 29, 2023

The Massachusetts Health Policy Commission (HPC) presented an in-depth analysis directed by the legislature into the impact of COVID-19 on the Commonwealth’s health care workforce.

This report takes a high-level perspective on system-wide trends and challenges throughout the workforce life
cycle, as well as contextual factors such as cost of living. The report also examines three priority workforces who provide care in multiple sectors and settings of the health system, and which together make up about two-thirds of the Commonwealth’s health care workforce: registered nurses, direct care workers, and behavioral health care providers.

The (HPC) finds that current workforce challenges across the health care system in Massachusetts stem in part from tighter labor markets, which have increased mobility within the health care field, with workers moving from lower- to higher-resourced care settings and organizations or away from patient care to administration or research. At the same time, some care workers are moving away from health care entirely, particularly among those in lower-wage roles.

The ratio of all workers to the total population in Massachusetts is 5% below the pre-pandemic level, related to reduced labor force participation among older residents.

These trends have important implications for patient care. Shortages of workers in post-acute/long-term care and behavioral health settings, for example, leads to patients remaining in hospital beds awaiting discharge, boarding in emergency departments (EDs), and lacking access to timely and appropriate care.

  • In June 2022, 50% of patients admitted to ED for mental health conditions remained in the ED for longer than 12 hours (i.e. “boarded”), up from 38% in 2019.
  • In September 2022, there were at least 200 patients in Massachusetts hospitals who had been waiting over a month for discharge to a skilled nursing facility.

The full presentations from HPC and their findings are available here.