MADISON, Wis. — Wisconsin’s health care workforce is falling behind, as demand for care continues to rise. The Wisconsin Hospital Association (WHA) attributed the increased demand to an aging Wisconsin population, coupled with a lack of population growth, according to a recent report.

The “Silver Tsunami,” or the aging of baby boomer population, has plagued Wisconsin and the nation. Health care industries need to grow at a fast rate as the working population ages out and needs more care.

The industry “will [the impact] feel for decades,” WHA officials said.

Nursing shortages, upticks in seasonal illnesses — such respiratory syncytial virus (RSV) — and supply chain shortages over the last few years have exacerbated the challenge.

“Wisconsin hospitals are working hard to grow, recruit, retain and support the health care workforce necessary to sustain the high-quality health care Wisconsin citizens expect and deserve,” said WHA Senior Vice President of Workforce and Clinical Practice Ann Zenk. “But even with concerted effort, it is unlikely that the health care workforce can grow fast enough to meet the rising health care demand of an aging population.”

Here’s where Badger State’s health care industry is now and what it can do to combat the gaps:

Demographic changes and hiring gaps

Population growth in the state continues to decline. The rate was 40% lower in 2021 than the rate from 2000 to 2010, according to a Dec. 2021 Forward Analytics report.

Young people are being outnumbered by future retirees in Wisconsin. 

Over the next 20 years, this could have effects on the workforce, as the younger population won’t be big enough to replace baby boomers.

By 2023, about one-in-four workers will reach retirement age in Wisconsin — that’s compared to one-in-five nationwide.

Wisconsin still has another decade until the last generation of baby boomers turns 65 in 2032; the growth of retirees will persist.

As the aging population increases, it also will also increase demand for health care and, subsequently, health care workers.

In 2019, people over 65 made up about 20% of the population, but they accounted for 40% of spending in health care. Those younger than 35 made up 40% of the population, yet they accounted for less than 20% of the health care demand.

Keeping up with this demand could be a challenge as the nation's largest employer, the health care industry, faces a hiring gap. 

Between 2019 and 2021, the hiring gap doubled. From 2021 to 2022 it doubled again. 

In order to keep hospital beds open for patients — and enough hospital staff available to care for those in need — Wisconsin health care personnel have had to work overtime and extra shifts; temporary staff has also been brought in.

Occupancy rates stress workforce

High occupancy rates and longer hospital stays are also putting pressure on the health care workforce. Hospital occupancy in the state increased in 2021, after hospitals and health systems deferred care during the beginning of the pandemic. Hospital occupancy remained high in 2022.

The average hospital length stay for Wisconsin patients needing a nursing home bed was higher in 2022 than in 2018. The length of stay, it was 22% higher for Medicare patients in 2022 than it was in 2018, 32% higher for patients with non-governmental payers and 75% higher for Medicaid patients.

Health systems have had difficulties finding care places for patients who no longer need to be hospitalized, but are not ready to go home and still need some form of in-patient care. This, WHA said, contributed the longer lengths of stays. 

This caused Wisconsin hospitals to increase the number of beds available. In 2021, that number rose by over 20%.

When patients stay longer, that means fewer patients can be admitted. Hospitals' bottom lines also takes a financial hit.

WHA said 2022 was the worst financial year for hospitals, since the pandemic began, due to labor expenses and the increased lengths of stay.

Shortages and vacancies add to the challenge

The “Silver Tsunami” and the pandemic created higher vacancy rates in 17 health care professions tracked by WHA. Overall, the vacancy rate jumped to 9.9% from 5.3% the year prior.

The vacancy rate increase was sharpest in nursing and frontline technical positions, which include surgical technicians, respiratory therapists and lab technologists.

Wisconsin also saw a nursing shortage in 2021, for the first time since the early 2000s. Nurse vacancy rates were one of the few positions tracked by WHA that saw double-digit increases; the last time this happened was in 2007.

According to the WHA report, in 2021, Wisconisn's hospitals were actively recruiting for 3,924 open posted positions for registered nurses; hospitals around the state were also recruiting for 1,787 certified nursing assistants open postings in 2021. 

Because of these vacancies, quality of care and the ability of the hospital to provide that care was impacted, according to WHA. 

So, what can be done?

Many hospitals and health systems are already doing important work to support well-being in the workplace, WHA acknowledged.

Since the COVID-19 pandemic, officials said there have been lessons learned to reduce regulatory burdens, such as documentation requirements, billing and coding and more, which cause burnout and inefficiency.

“The past three years have provided the opportunity to rapidly pilot waivers and regulatory flexibilities and see that they’ve worked — it’s okay,” said WHA President and CEO Eric Borgerding. “We need to take the knowledge we’ve gained to make permanent improvements.”

Other suggestions from WHA point to allowing health care professionals to reach their full potential by breaking down training and education barriers. The report acknowledged that Wisconsin 2021 Act 10 was a great example to follow; it allowed health professionals to move into the workforce more quickly amid the COVID-19 pandemic.

WHA also suggested leveraging technology to help relieve burdens in the workforce. An example of this would be to use apps for staff scheduling or IV pumps that beep wherever the clinician is instead of in the patient rooms.

WHA said that in order to keep pace with the industry demand, leaders, educators, policymakers and the workforce must pursue these strategies. It will also be crucial that workplaces consider changing workforce expectations as a younger generation of workers enters the space.

You can view the full list of suggestions and the 2023 report below:

WHA Workforce Report 2023 Web by Aly Prouty on Scribd