Policy Issue

Policy Watch: Study Highlights Health Care Workforce Challenges in the Era of COVID

April 11, 2023

The Massachusetts Health Policy Commission recently released a report entitled, Health Care Workforce Trends and Challenges in the Era of COVID-19: Current Outlook and Policy Considerations for Massachusetts. The report focused on workforce challenges in nursing, behavioral health and among direct care workers in nursing homes or home care agencies.

The report found that the current workforce challenges across the health care system in Massachusetts stem in part from tighter labor markets, which have increased mobility within the health care field, with workers moving from lower- to higher-resourced care settings or away from patient care. Some care workers, particularly those in lower-wage jobs, are moving away from the field entirely.

Registered nurse vacancy rates in Massachusetts acute-care hospitals doubled from 6.4% in 2019 to 13.6% in 2022. Employment in nursing and residential care facilities has not recovered since 2020 and remained 14% below 2018 levels. In long-term care, the share of hours worked by contracted registered nurses has quintupled, from 4% in 2019 to 19% in 2022.

These trends have important implications for patient care as shortages of workers in post-acute/long-term care and behavioral health settings lead to patients remaining in hospital beds awaiting discharge, boarding in emergency departments, and lacking access to timely and appropriate care.

Among the Commission's recommendations:

  • investments in workforce development and wages;
  • enhanced mentoring and onboarding support;
  • innovations in scheduling and work environments; and,
  • clear and accessible career ladders.


A copy of the full report can be obtained here.

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