Health care employment rebounds after the pandemic but staffing gaps remain

The U.S. health care workforce has bounced back from the massive job losses of early 2020, with employment now matching pre-pandemic projections, according to new research from the University of Michigan.

The recovery, however, is uneven with some health care settings thriving while others continue to struggle with severe staffing shortages.

For example, while doctors’ offices have exceeded pre-pandemic employment growth trends since 2023, skilled nursing facilities and intensive behavioral health centers are still dealing with widespread staffing shortages that began during the pandemic.

The study, led by School of Public Health researcher Thuy Nguyen and detailed in a research letter published in JAMA, captured staffing comparisons by analyzing employment data from 2016 through 2024 to track health care sectors’ recovery from the pandemic’s impact.

One of the most striking findings involves mental health services. Office-based behavioral health practitioners such as therapists and counselors working in private practice settings saw their employment numbers skyrocket by 84% from 2019 to 2024. Meanwhile, intensive behavioral health facilities that provide more comprehensive mental health and substance abuse treatment have struggled to rebuild their workforce.

The findings on behavioral health practitioners are significant and can guide policy changes in response to the rise of office-based practitioners amid a prolonged shortage in more intensive care settings that began during the pandemic.”

Thuy Nguyen, U-M assistant professor of health management and policy

The research points to several factors that may explain why some health care settings recovered better than others. Office-based practices may have been seen as lower-risk environments for COVID-19 transmission and offered less stressful working conditions compared to hospitals and nursing homes. The growth in demand for office-based mental health services through traditional and telehealth platforms likely contributed to the expansion of office-based mental health services.

“For patients and families, these employment patterns have real-world implications,” said study co-author Kosali Simon, the Herman B. Wells Endowed Professor in Health Economics at Indiana University. “The continued staffing challenges in nursing homes and intensive mental health facilities could affect access to care and quality of services in these critical health care settings.”

Health care employment dropped by nearly 7% in the second quarter 2020 due to pandemic-related shutdowns. By 2024, however, health care jobs had bounced back to pre-pandemic levels, reaching over 24 million jobs as of September last year. By comparison, nonhealth care employment fell more dramatically—more than 11%—and has been slower to recover, remaining at 3% below expected levels in 2024.

The research used data from the U.S. Bureau of Labor Statistics and compared actual employment numbers to what would have been expected if pre-pandemic trends had continued uninterrupted.

The latest research on the pandemic and health care employment builds on Nguyen’s previous work, which first identified that nursing homes were among the hardest hit by health care employment declines during the pandemic. Her earlier 2023 study found that long-term care facilities were still operating with staffing levels more than 10% below pre-pandemic numbers.

Co-authors include Christopher Whaley of Brown University School of Public Health and Jonathan Cantor of RAND.