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    Chris Harrop
    Chris Harrop

    As National Nurses Month concludes this month, medical group leaders detailed their evolving efforts to recruit and onboard nurses amid ongoing staffing struggles in the ambulatory care space.

    A May 28, 2024, MGMA Stat poll finds that 22% of medical group leaders say their nurse recruitment and hiring efforts improved in the past year, while the majority (78%) say they have seen little change (43%) or experienced worsened conditions (35%).  The poll had 249 applicable responses.

    These findings come one year after a similar poll found that nearly half (46%) of medical groups reported worsened nurse recruiting and hiring efforts leading to May 2023 — at that time, only 17% of respondents noted improving recruitment efforts, while 37% said they had stayed the same.

    Top challenges in 2024

    The market for nurses remains tight for many medical group practices, with several respondents to this week’s poll citing worker availability as a top challenge in their hiring efforts.

    While some practice leaders noted a smaller pool of candidates in their rural markets, most respondents pointed to tough competition for qualified candidates from hospitals and larger organizations with larger signing bonuses. One practice leader told MGMA that their organization turned to a recruiter for the first time specifically to help with nurse recruitment in the past year.

    What’s working

    Among the respondents who reported improved recruiting efforts, the common factors they shared about their successes included:

    • Building or investing in new graduate programs and/or residencies for RNs to address nearby nursing school capacity limits and prioritizing hiring newly graduated nurses
    • Increasing compensation and benefits to compete more effectively with larger organizations
    • Normalization of labor markets in their areas, especially in markets where more nurses have shifted away from travel work.

    Workforce factors

    Bottlenecks for the next generation of nurses

    The post-pandemic years were brutal for the pipeline of new nurses in the United States, but there are signs of that distress easing slightly:

    • Reports from the American Association of Colleges of Nursing (AACN) since the pandemic showed limited availability to train the number of prospective nurses after the emergence of COVID-19. In 2021, the number of qualified applicants turned away from entry-level baccalaureate nursing programs reached a 20-year high, with more than 76,100 qualified applicants unable to enroll.
    • Since then, the number of qualified applicants turned away eased to 66,261 in 2022 and to 55,111 in 2023.
    • After seeing total enrollment in nursing programs fall in 2022 by 1.4% — the first decline since 2000 — AACN data showed only a 0.6% increase in enrollment last year.
    • These enrollment concerns are compounded by a significant decrease in the number of students in RN-to-BSN degree-completion programs, which has trended down for five consecutive years.

    Nurse mobility post-pandemic

    Despite all the doom-and-gloom predictions of a significant share of nurses leaving the industry in recent years, the reality — though still challenging — has not been as severe as anticipated. The 2023 Definitive Healthcare staffing report estimated that about 34,800 nurse practitioners (NPs) left the workforce in 2021 and 2022. However, it is unclear how many transitioned to travel nurse roles, which have “declined considerably” as the COVID-19 pandemic eased, per Fierce Healthcare.

    A key factor in today’s market for nurses is the continuing expansion of the Nurse Licensure Compact (NLC), in which participating states and jurisdictions accept multistate licenses from providers, who maintain their primary state of resident without the need to obtain additional licenses. As of this writing, 41 states and jurisdictions are part of the NLC, with several others with pending legislation to join the NLC or are awaiting implementation.

    Tracking nurse job growth

    The Bureau of Labor Statistics’ Occupational Outlook Handbook provides annual updates to the total number of nursing jobs and expected job growth in the coming decade. Since 2023, these projections have seen slight changes:

    • RNs: While projected 10-year job growth held steady at 6% from 2023 to 2024, BLS projects only 177,400 new RN jobs through 2032 — compared to last year’s figure of 195,400 through 2031.
    • LPNs and licensed vocational nurses (LVNs): Job growth projections for the coming decade dipped from 6% to 5% this year, with only 34,000 new jobs through 2032 expected compared to the 41,300 estimated last year through 2031.
    • Nurse anesthetists, nurse midwives and NPs: The breakneck 40% job growth estimated last year by BLS eased slightly to just 38% for the 2022-2032 periods, with 123,600 new jobs expected through 2032 — a higher figure than the 118,600 new jobs projected this time last year.

    MGMA data: APP costs

    In economic terms, advanced practice provider (APP) compensation has surged as much as any role within medical group practices during the first years of the COVID-19 pandemic. According to MGMA DataDive benchmarks, median total cost for employing an APP surged 69% from 2020 to 2022 for multispecialty groups. Other specialties also saw significant increases during the same period:

    • Primary care: +37%
    • Nonsurgical specialties: +35.66%
    • Surgical specialties: +22.56%.

    Learn more

    The 2024 MGMA DataDive Provider Compensation data set includes the latest, industry-leading benchmarks for physician and APP compensation across specialties and subspecialties. Existing MGMA DataDive users can explore this new data now, and anyone can download our newly released summary data report on the new data set, Provider Pay and the Dawn of a New Era of Productivity.

    Evolving how nurses work

    Organizational culture

    As  Becker’s Healthcare recently detailed, an “unbossed culture” — in which employees have more autonomy over their duties — can lead to shared governance. According to Lisa Carter, president of Ballad Health Southern Region in Tennessee, this could mean nurse self-scheduling models to boost shift selection, leading to more flexibility and employee satisfaction.

    Join MGMA Stat

    Your contributions are vital to MGMA’s ongoing work to provide great resources, education and advocacy for medical group leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit will be sent to your phone via text message.

    Chris Harrop

    Written By

    Chris Harrop

    A veteran journalist, Chris Harrop serves as managing editor of MGMA Connection magazine, MGMA Insights newsletter, MGMA Stat and several other publications across MGMA. Email him.

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