Nursing Home Industry Adds Only 9,300 to the Workforce, While Seeing High Wage, Price Growth

Nursing and residential care facilities had the highest wage growth of any health care setting in April at 4.5% year over year, which was followed by ambulatory health care services at 3.2% and hospitals at 3.1%.

The sector also added 9,300 jobs in April despite a “cool month” for the economy, according to economic indicators briefs published on Wednesday by Altarum. Still, job growth for the sector was 25.5% below the 12-month industry average of 12,500 jobs. The health care industry added 56,200 jobs overall in April, accounting for 32% of all jobs across the economy.

Broken down further, nursing care facilities alone added 3,700 jobs, versus a 12-month average of 5,400, while other nursing and residential care facilities added 5,600, compared to an average of 7,100 in the past year, Altarum reported.


“Employment in nursing and residential care facilities is still 109,700 jobs (3.2%) below pre-pandemic levels,” researchers said in the report. “As described in a recent Altarum analysis, this contraction in employment is likely due to skilled nursing facility closures, lower resident censuses, and staffing shortages.”

The nursing and residential care, hospital, ambulatory industries have seen a steady increase in job growth since April 2022 despite sector-specific drawbacks.

Nursing homes also had the fastest increase when it comes to price growth, jumping by 4.5%, followed by dental care with 4.1% growth, and hospital care with 3.2% growth, according to the report.


Medicaid price growth

Interestingly, Medicaid price growth exceeded other payers in the first four months of the year, increasing by 6.3% year over year, Altarum found. Medicare price only grew by 1.3% while services price growth for private insurance grew by 3.2%.

“Medicaid price growth had typically been the slowest among these three, but its growth rate increased in 2022 and 2023 and then accelerated in 2024,” researchers said in the report. “While Medicaid enrollment has declined in 2024 due to the expiration of the COVID-19 public health emergency and resulting unwinding, overall Medicaid revenues have remained steady or even increased.”

And, while enrollment in Medicaid has fallen, remaining enrollees are likely to be an overall sicker population, according to the report. Such a population drives greater costs per person to cover Medicaid needs and higher prices. This depends on how greater need is reflected in measures of prices versus utilization.

Altarum pulled recent insurer financial reports to contribute to the Medicaid findings.

“At the same time, most states have increased Medicaid rates or enhanced benefits for major components of Medicaid coverage in FY 2023 and 2024, also likely contributing to higher overall prices,” researchers added.

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