Michigan’s Largest Private-sector Employer Remains Healthcare

Provides Nearly 568,000 Direct Jobs, 219,000 in Hospitals Alone

The Partnership for Michigan’s Health reports healthcare directly employed nearly 568,000 Michigan residents in 2021, demonstrating that healthcare remains the largest private-sector employer in the state despite continued staffing losses attributed to the COVID-19 pandemic. The 2023 release of The Economic Impact of Healthcare in Michigan shows direct healthcare workers in Michigan earned nearly $46 billion that year in wages, salaries and benefits. Hospitals alone employed 219,000 individuals in the state in 2021.

Direct healthcare employment helps create additional jobs that are indirectly related to or induced by healthcare. These indirect, healthcare-supported jobs are held by more than 470,000 people who earned about $28 billion in 2021 in wages, salaries and benefits. Together with their employers, the more than one million workers in healthcare contributed $19.6 billion that year in local, state and federal taxes. These taxes include Social Security, income, motor vehicle, sales, property, corporate and more.

Data from 2021 shows the impact the pandemic had on the healthcare workforce in Michigan. While direct jobs decreased by nearly 4,000 total positions, direct wages increased by 4% year-over-year as labor costs rose due to increased demand. Direct wages in hospitals increased by 6.8%, as many hospitals offered wage adjustments and bonuses to recruit and retain employees, and increased the use of contract labor with staffing agencies. A separate study conducted by the MHA in 2022 showed expenses related to contract labor and recruitment and retention bonuses increased by $516 million from 2020 to 2021. Nursing and Residential Care also experienced a similar trend, as the number of jobs in the category fell by about 8,000 but compensation remained about the same.

The increase in direct wages for hospital employees follows a national trend. A recent American Hospital Association report shows labor costs increased 20.8% between 2019 and 2022. The increase is due in large part to a greater reliance on contract staffing agencies due to staffing challenges and to meet patient demand. Increased labor expenses have a more profound impact on hospitals and health systems, as labor expenses account for more than 50% of total expenses for most hospitals. In addition, healthcare reimbursement is unable to quickly respond to inflationary pressures since rates with commercial payers are negotiated months in advance while Medicare and Medicaid rates are even slower to adjust, presenting additional financial challenges when responding to sudden labor market demand.

The loss of healthcare workers has also had a detrimental impact on physician practices. According to a survey conducted by the Michigan State Medical Society, 86% of participating physician practices experienced a decline in the number of health professionals and administrative staff employed by the practice since the start of the COVID-19 pandemic, including physician assistants, nurse practitioners, registered nurses and medical assistants. In addition, 69% reported staffing shortages led to increased wait times for patients, 55% had to reduce hours or available appointments and 43% experienced an estimated 10-25% reduction in patient revenue.

The report was compiled by the Partnership for Michigan’s Health, which consists of the Michigan Health & Hospital Association, the Michigan State Medical Society and the Michigan Osteopathic Association, all based in the greater Lansing area. It uses 2021 data, which is the most recent available.

“Hospitals rely on many workers in a variety of clinical and non-clinical roles to operate every hour of the day, year-round.,” said Michigan Health & Hospital Association CEO Brian Peters. “This report demonstrates the significant number of people it takes to have a high-quality, functioning healthcare system available to all Michiganders.”

“Healthcare is a key driver of not only physical health, but the economic wellness of Michigan,” said Kris Nicholoff, executive director of the Michigan Osteopathic Association. “The Economic Impact of Healthcare in Michigan shows the extensive value healthcare provides to our state, both as an employer and in providing tax revenue for communities.”

“The same dynamics that are at play in our hospitals affect Michigan’s physician practices, which are also struggling to recruit and maintain physicians and ancillary staff,” said Tom George, MD, Interim Chief Executive Officer of the Michigan State Medical Society. “We encourage students to consider pursuing a profession in healthcare, which offers rewarding and stable careers across a variety of disciplines.”

Demand for healthcare careers remains high. A March survey of Michigan hospitals reported more than 27,000 current job openings, including nearly 8,500 open nursing positions, 4,500 technician openings and 3,000 positions for clinical assistants from the 95% of the MHA membership who participated. The need for healthcare workers is not unique to hospitals, and is shared by physician practices, nursing and residential care facilities, home health services, ambulatory services and other healthcare organizations.

The 18th edition of The Economic Impact of Healthcare in Michigan was compiled using IMPLAN® cloud software to quantify healthcare’s significant economic impact in the state. The data represents direct, indirect[1] and induced[2] healthcare jobs; taxes paid by those workers and their employers; and salaries, wages and benefits earned. The report is an online, interactive tool that allows users to examine these economic impacts from a statewide perspective and by region, county or congressional district. It is available at www.economicimpact.org.

[1] Indirect jobs are those created to support a larger employer or industry (for example, a laundry that cleans linens for a hospital).

[2] Induced jobs are those created by the spending of people who work in the indirect jobs (for example, a restaurant waiter who serves the laundry workers).

Healthcare Remains Michigan’s Largest Private-sector Employer Despite Pandemic Losses

Economic Impact in Michigan infographic

Provides Nearly 572,000 Direct Jobs, 224,000 in Hospitals Alone

Economic Impact in Michigan infographicThe Partnership for Michigan’s Health reports healthcare directly employed nearly 572,000 Michigan residents in 2020, demonstrating that healthcare continues to be the largest private-sector employer in the state despite staffing losses attributed to the COVID-19 pandemic. The 2022 release of The Economic Impact of Healthcare in Michigan shows direct healthcare workers in Michigan earned $44.2 billion that year in wages, salaries and benefits. Hospitals alone employed 224,000 individuals in the state in 2020.

Direct healthcare employment helps create additional jobs that are indirectly related to or induced by healthcare. These indirect, healthcare-supported jobs are held by more than 502,000 people who earned about $28 billion in 2020 in wages, salaries and benefits. Together with their employers, the nearly 1.1 million workers in the healthcare sector contributed almost $15.2 billion that year in local, state and federal taxes. These taxes include Social Security, income, motor vehicle, sales, property, corporate and more.

Data from 2020 shows the early impact the pandemic had on the economic strength of the healthcare sector in Michigan. In particular, the data illustrates the rise in labor costs as many nurses transitioned to contract labor with staffing agencies. Compensation for direct jobs in Nursing and Residential Care rose by about $200 million from 2019 to 2020, although the number of jobs fell by about 11,000. Specific to hospitals, the number of jobs fell by about 7,000 jobs from 2019 to 2020, but total compensation remained about the same.

The loss in jobs represents the initial exit of many healthcare workers due to burnout and stress associated with the pandemic. Both nationally and in Michigan, healthcare experienced a shortage of healthcare employees for several years and the pandemic caused a sudden loss of existing workers. With Medicare beneficiaries in Michigan increasing by more than 8% over the past five years to a total of 2.1 million people, Michigan needs more healthcare workers, now more than ever, to serve the changing needs of the state’s aging population.

The trend of nurses transitioning to contract labor is supported by recent research from the American Hospital Association, which found labor expenses per patient for hospitals increased 19% through 2021 compared to 2019. Increased labor expenses have a more profound impact on hospitals and health systems, as labor expenses account for more than 50% of total expenses for most hospitals. In addition, healthcare reimbursement is unable to quickly respond to inflationary pressures since rates are negotiated months in advance, presenting additional financial challenges when responding to sudden labor market demand.

The report was compiled by the Partnership for Michigan’s Health, which consists of the Michigan Health & Hospital Association, the Michigan State Medical Society and the Michigan Osteopathic Association, all based in the greater Lansing area. It uses 2019 and 2020 data, which is the most recent available.

“This report demonstrates the unquestionable and significant role healthcare, and specifically hospitals, play in Michigan communities,” said Michigan Health & Hospital Association CEO Brian Peters. “Not only have they played a vital role in the care and treatment of patients, but they remain far and away the leading employers and large drivers of economic activity.”

“Healthcare careers are not only extremely rewarding, but crucial to our society,” said Kris Nicholoff, executive director of the Michigan Osteopathic Association. “While healthcare careers remain in high demand, the data shows there are over a million individuals we owe our gratitude toward for providing care during one of the most trying and tumultuous years in modern history.”

“Physicians are and will continue to remain a key driver of healthcare employment and economic growth,” said Julie L. Novak, CEO of the Michigan State Medical Society. “Investing in physician-led team-based care and healthcare careers is key to the economic vitality and health of our state, local communities and residents. Physician practices, hospitals and other care settings offer good paying and stable jobs in careers that truly improve and save lives.”

Hospitals and healthcare providers remain focused on ensuring these jobs meet the needs of their employees, from offering competitive compensation and benefits to ensuring a safe and supportive work environment. The Partnership for Michigan’s Health joined several other organizations in the Healthcare Workforce Sustainability Alliance to advocate for state funding to support the recruitment, retention and training of healthcare workers. These efforts were successful in Public Act 9 of 2022 which allocates $300 million in state funding to support Michigan’s healthcare workforce.

The 16th and 17th editions of The Economic Impact of Healthcare in Michigan were compiled using IMPLAN® cloud software to quantify healthcare’s significant economic impact in the state. The data represents direct, indirect  and induced  healthcare jobs; taxes paid by those workers and their employers; and salaries, wages and benefits earned. The report is an online, interactive tool that allows users to examine these economic impacts from a statewide perspective and by region, county or congressional district. The data from both 2019 and 2020 is provided in two separate data tables. It is available at www.economicimpact.org.