The Drive to 2020: Experts eye work force as boomers age

By Michaela Morris/NEMS Daily Journal

It doesn’t take a crystal ball to see a bright future in health care over the next decade in Northeast Mississippi.
Hospitals in Tupelo and Starkville are expanding to create larger, more modern patient rooms. Baptist Memorial Hospital-North Mississippi is preparing plans for an entirely new hospital, which will require an estimated $300 million investment.
“Clearly, we believe the future demand is going to be even greater than today,” said Zach Chandler, vice president for Memphis-based Baptist Memorial Health Care, which includes hospitals in Oxford, Booneville and New Albany.
The baby boomers – who started turning 65 this year – certainly weigh heavily in the calculations of future health care services.
“Because of the aging population, health care is going to be a growth industry,” said State Economist Darrin Webb. “It can’t help but grow.”
Educational institutions also are looking to build their capacity to train the health care work force of the future. Itawamba Community College is breaking ground on a state-of-the-art Health Science Education Center on its Tupelo campus, while the University of Mississippi School of Medicine is looking for ways to expand medical education.
“It’s not a question of will it expand,” said Community Development Foundation President and CEO David Rumbarger, who sees health care as both a vital infrastructure for economic development and a productive industry to cultivate.
Particularly in Tupelo and Oxford, where hospitals serve as regional referral centers, health care has become an economic pillar for those communities.
Health care provides more jobs in Lee County than any other sector of the economy – more than 6,800, according to 2009 IMPLAN data.
North Mississippi Medical Center-Tupelo, with its affiliated clinics and services, is the biggest single employer in the county with about 4,000 people on its payroll.
The North Mississippi Health Services system, which also includes five community hospitals and clinics, employees about 6,300 across a 33-county region.
“The health care economy has helped to diversify the local economy,” Rumbarger said.
The quality of health care is a key factor when companies consider moving operations into Northeast Mississippi. Because health care requires a highly trained, technically adept work force, it can lift the median income and educational attainment levels of a community.
Health care provides about 11 percent of Lee County employment, but because of its higher wages it accounts for 17.5 percent of the compensation, said Judith Phillips of the Stennis Institute for Government based at Mississippi State University.
“It’s a tremendous asset to the region,” Rumbarger said. “How much more can that be?”
Although health care isn’t completely recession-proof, it is at least largely protected from outsourcing.
“Health care is local,” Chandler said. “It ultimately has to be delivered face to face.”
Challenges
The rosy outlook for the health care economy doesn’t mean the horizon is clear of unanswered questions.
Apart from congressional repeal efforts and legal challenges, the exact shape of federal health care reform is still evolving.
“There’s a lot of uncertainty,” said John Heer, chief executive for Tupelo-based North Mississippi Health Services, which includes NMMC hospitals in Tupelo, Iuka, Pontotoc and West Point. “There’s still a lot of questions about what that will actually look like and how it will be supported.”
The NMMC system aims to stay focused on its core mission – improving the health of the region with focus on patient care, staff development and clinical quality, Heer said.
The system isn’t rushing into creating accountable care organizations – envisioned as a holistic care model where health care providers have greater responsibility for quality and improved patient outcomes and potentially a share of the savings that come from limiting costly complications – before they are fully defined.
“We want to be on the leading edge, not the bleeding edge,” Heer said. “We’re staying closely connected to grow our business as demand increases.”
Rushing ahead of trends can be dicey territory in health care. In the 1990s, the move toward managed care fizzled.
“The model was supposed to change to be a team environment,” Heer said. “Nurse practitioners are about the only thing we still have” from the managed care era.
As health systems grapple with national matters, they also keep up with local issues and changes.
One of the biggest is anticipating how the new Toyota operation and its suppliers will change demand for health care in Northeast Mississippi, Chandler said.
“We try to stay constantly attuned to their needs,” Chandler said. “What are the needs as Toyota is constructed versus what will be the needs when it is fully operational?”
A number of forces are shaping the future of health care, Heer said. Customer-patient demand is only one of them.
Insurers and government have tremendous influence, and they are watching for evidence that procedures and programs work effectively and efficiently.
“It’s not just all about money,” Heer said. “It’s where they find value.”
It does appear that the move toward outpatient procedures will continue to accelerate.
“Technology has changed what health care providers are able to do,” Chandler said. “We’re able to do so much more on an outpatient basis.”
A heart valve replacement once required five to seven days in the hospital. “Next year,” Chandler said, “it probably will be 24 to 36 hours in the hospital.”
Another concept that seems to be emerging is a focus on centers of excellence, where hospitals and providers could be required to meet volume and quality benchmarks to qualify for reimbursement from insurers.
“The more you do, the better you are,” Heer said.
That could lead to a concentration of highly technical care.
As the baby boomers have greater demand for health care services, their eventual retirements will shrink the medical work force at a critical juncture.
Mississippi is already short on primary care doctors. Other key specialties also are feeling the manpower pinch. Even areas that aren’t at critical staffing levels now – like nursing – could quickly see demand shoot up as the economy recovers and boomers feel more comfortable retiring.
“I think this is the lull before the storm,” said Harold Plunkett, health sciences dean at Itawamba Community College.
Because the whole nation faces the same demographic bubble with the aging of the baby boomers, it will be difficult to substantially recruit health care workers from outside the region.
From techs to nurses to physicians, hospitals and educators are building on more than a decade of strategic alliances in which they have promoted health care careers to students and adults. “Growing our own” has become the mantra for the entire range of health care professionals.
“It’s been a great strategy for us,” said Rodger Brown, vice president of human resources for North Mississippi Health Services. NMMC has promoted programs to expose children to health care careers as well as helping their employees step up through the professional ranks.
“I think we’ve created our own opportunities,” he said.
Competition continues to be tough for slots in the allied health programs. For ICC’s nine allied health programs, each spot has about nine applicants, Plunkett said.
“We have strong students who don’t get in,” Plunkett said.
The spaces in the programs aren’t just limited by the size of classrooms and faculty, but by access to clinical education, which should be eased in part by the new health sciences education center to be located on the Tupelo campus.
“By 2015,” Plunkett said, “we should be in a position where we can increase our capacity.”
ICC is also looking at opportunities to provide dual credentials to help its graduates take advantage of shifting needs.
A person who is dual certified as an occupational therapy assistant and a physical therapy assistant, or a licensed practical nurse with respiratory therapy expertise, may be more attractive to a skilled nursing facility that might need more versatility in its staff, Plunkett said.
“We’re still working through the issues,” Plunkett said. “But we need to start a dialogue.”
Contact Michaela Gibson Morris at (662) 678-1599 or michaela.morris@journalinc.com.

Click here for previous articles in The Drive to 2020 series.