🔒MHA: Hospital job vacancy rates dropped by 28%

Over the past five years, Massachusetts hospitals and health systems have added approximately 10,000 new jobs to the workforce, according to a report released Monday by the Burlington-based Massachusetts Health & Hospital Association. “On the Mend: Progress and Pressure Points for Massachusetts’ Healthcare Workforce” reports the state decreased its number of vacant hospital roles by 5,400 positions since 2022, decreasing its vacancy rate by 28%. “We are especially grateful that Central Massachusetts hospitals have helped shape our statewide initiatives aimed at drawing people into the healthcare field, using frontline voices to inform healthy work environments, and relieving the pressures on our dedicated care teams,” Sam Melnick, MHA chief communications officer, said in an email to WBJ. Medical/surgical registered nurse roles in acute care experienced the largest vacancy decrease between 2023 and 2024, dropping 14%. This was followed by case management assistants/care transition specialists/care transition specialists, with its vacancy rate dropping 11%, and surgical technician/technologists, at 10%. The other eight patient-facing roles that saw the largest decrease in vacancy rates include patient care navigators, emergency department RNs, physical therapy assistants, cardiac catheter techs, psychiatric RNs, ICU RNs, and certified nurse practitioners. Another area that saw immense progress was the use of travelling nurses, with the state reducing its use of them between 2023 and 2024.

Nursing divide

Traveling nurses, while they support hospitals during critical gaps in care, are a touchy subject in healthcare, notably because travelling nurses are typically paid far more than permanent staff nurses. Travelling nurses are paid up to three times as much as staff nurses, Katie Murphy, president of the Massachusetts Nurses Association labor union, told WBJ in 2023. The need for travelling nurses surged during the COVID-19 pandemic, putting a stark financial strain on healthcare systems throughout the country. In the U.S. in January 2022, the weekly wages of travelling nurses were 148.1% higher than those of staff nurses and 103.3% higher when considering the entire year, according to the Center for Economic and Policy Research, a think tank out of Washington, D.C. That disparity dropped in 2023, yet still remained exorbitant, to 98.22%, when the nominal average weekly earnings for permanent staff nurses was $1,340.60 compared to that of travelling nurses, which was $1,340.6. While these figures are startling, the percentage of hours worked by temporary nurses decreased by 42% between 2023 and 2024, according to the MHA’s report. Still, the need for these professionals remains four times higher than they were in 2019.

Systemic progress, gaps remain

Vacancy rates dropped in all eight registered nursing sectors analyzed by the MHA, including in surgery, operating room, and psychiatric. Labor and delivery registered nursing experienced the lowest vacancy rate in 2024 at only 5.3%, representing a 2.6 percentage point decrease since 2022. On the other side of the spectrum, licensed practical registered nursing experienced the highest vacancy rate at 21.1%, a figure at least 5.7 percentage points higher than the other seven sectors. Still, that demographic experienced the most significant vacancy decrease, with rates dropping just over 35 percentage points from when most LPN jobs, 56.4%, were vacant in 2022. Vacancy rates dropped throughout hospital case management between 2022 and 2024: The vacancy rate for case manager registered nurses fell 3.3 percentage points to 4.4% and the vacancy rate for case management assistants/care transition specialists dropped 10 percentage points to 9.1%. This decrease is mainly due to notable hospital efforts to hire specialists in these particular sectors, according to the report. However, the state still has up to 2,000 stuck patients: those remaining in hospitals past their discharge date, often due to lack of capacity at step-down facilities. While vacancy rates dropped among behavioral health providers in five out of six categories analyzed by the MHA, the sector holds higher vacancy rates than both registered nurses and case management. The vacancy rate for mental health counselors was the lowest in 2024 at 12.1%, representing a 4.8 percentage point decrease from 2022. The vacancy rate amongst licensed clinical social workers dropped the most, 14.2 percentage points, during those two years, yet remained elevated at 15.2%. On the other hand, the vacancy rate rose for sitters/patient observers, ascending 14.5 percentage points to 44.7% in 2024. In fact, the workforce sector experienced the highest vacancy rate of all hospital patient-facing roles and, at 18%, saw the largest growth in vacancy between 2023 and 2024. Behind the sitter/patient observer sector, the mental health worker/technician workforce experienced the second-highest vacancy rate increase at 14%. Patient transport/couriers and speech language pathologists followed, each with a vacancy rate increase of 9%. On the other end of the scale, at just 3%, physician assistants and laboratory assistants had the lowest vacancy rate increase from 2023 to 2024. The overall decrease in behavioral health professional vacancies is due in large part to the state’s $100-million investments in the field, including enhancements to behavioral health loan forgiveness, according to the MHA report.

Moving forward

In order to continue to ameliorate healthcare workforce vacancy rates, the MHA included 15 action items in its report, split into three categories:

• Supporting policy reforms to protect, grow, and innovate the workforce, including those attempting to safeguard employees from workplace violence.
• Create targeted statewide and regional plans to bridge care gaps for key clinical roles, such as advanced practice providers, including foreseeing upcoming demand and creating early college programs
• Provide additional investments and training strategies for patient-facing roles, including finding new funding for clinical training in areas such as apprenticeships, scholarships, and tuition reimbursements

“Even through enormous operational challenges, our hospitals and health systems have devoted a record amount of resources to workforce in recent years,” Valerie Fleishman, MHA’s executive vice president and chief innovation officer, said in a Monday press release. “These investments have made a clear difference, and they deserve to be celebrated as a sign of our commonwealth’s success.” Mica Kanner-Mascolo is a staff writer at Worcester Business Journal, who primarily covers the healthcare and diversity, equity, and inclusion industries.