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Understanding the Supply/Demand Gap in Michigan Healthcare Occupations

Several healthcare occupations across Michigan are facing immense challenges when it comes to finding and hiring potential employees. The picture is particularly bleak when we look at occupations at the lower end of the wage scale. We took a closer look at eight such occupations requiring a post-secondary certification to see how each fares in terms of workforce supply and demand by calculating their gap ratio. Gap ratios are useful tools to help understand the discrepancies between supply and demand in the labor force. Gap ratios are a quick way to visualize how many potential employees are available to fill available openings in the labor market. A gap ratio of one means one completer for every job posting. A ratio of less than one indicates fewer completers than job openings or less competition for job seekers. A ratio of more than one denotes more completers than job openings, so employers have more potential job candidates.


Gap ratios are calculated by dividing the number of people completing a certificate program (completions data[1]) by the number of job postings for occupations requiring that certification (2021 calendar year job postings analytics[2]). Calculating demand is difficult and costly. Here we rely on job posting data as a proxy for employer demand. While real-time job postings are the best available data to analyze employer demand, it has limitations. For example, physician recruitment does not typically rely on online postings. Further, health systems will often post one nursing position and hire many. This can clearly lead to underestimating demand.


In our analysis below, Nursing Assistants had the highest and EMTs the lowest gap ratio of the occupations we examined. This translates to nearly 50 times more online job postings than there are Nursing Assistants finishing certifications and three times as many online job postings as there are EMTs finishing certifications, with the rest of the occupations falling somewhere in between.



MHC Insight’s Take

Across the board, healthcare occupations have significant gap ratios. Many, such as nursing assistants and phlebotomists, are individually dire. This is largely due to the fact that these occupations are often underpaid – making far less than the 2021 Statewide median of $22.00 – especially compared to other occupations with similar educational requirements.


Because many healthcare occupations are incredibly specialized, the ability to transfer specific degree certifications to other available open positions is not a viable short-term solution. This perhaps opens the door to incentivizing post-secondary healthcare certification programs to become more skill-based. This would potentially allow completers to pursue opportunities across a range of professions. Some health education groups are already attempting this. Futuro Health offers a Human Touch Healthcare course focused on teaching core competencies in interpersonal skills in healthcare, such as empathy and compassion, effective communication, ethics, and integrity.


Moreover, expanding the training options around Michigan will also remedy some of these ratios. Many community college certification programs are extremely regional, which means these gap ratios may be worse in some areas and better in others. There are 21 Nursing Assistant programs in Michigan as of 2021, but very few north of Mt. Pleasant, and only one in the Upper Peninsula. Increasing training opportunities through innovative partnerships and cost-sharing arrangements will be critical to closing some of these gaps and making sure that Michigan has the prepared and educated healthcare workforce it needs to take care of its population.

[1] This includes gender and race/ethnicity data for enrollees by school; graduates by school, Classification of Instructional Program (CIP) code, award level, gender, and race/ethnicity; and data on distance completions, as well as information on tuition and other student fees.

[2] Lightcast gathers and integrates economic, labor market, demographic, education, profile, and job posting data from dozens of government and private-sector sources, creating a comprehensive and current dataset that includes both published data and detailed estimates with full United States coverage.

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