While private-sector healthcare employment has grown by 20 percent over the last decade, wages for workers in hospitals and outpatient centers have declined or stagnated, a report from the Center for Economic and Policy Research finds.
The report, Organizational Restructuring in U.S. Healthcare Systems: Implications for Jobs, Wages, and Inequality (70 pages, PDF), found that in response to regulatory reform and financial pressures, healthcare organizations are consolidating even as they decentralize services to lower-cost outpatient care settings, and that hospitals and outpatient clinics account for about 41 percent of all healthcare jobs — including healthcare professionals, social service workers, medical technicians, health aides and assistants, food service workers, and cleaning service workers.
Funded by the W.K. Kellogg and Nathan Cummings foundations, the study found that between 2005 and 2015, real median earnings for full-time workers in the healthcare sector fell, on average, 2.4 percent, increased 3.2 percent for hospital workers, and fell nearly 6 percent for outpatient care centers. Within hospitals, wages increased modestly for social service workers while those of medical technicians and health aides and assistants fell; in outpatient centers, wages fell significantly for African-American female and Latino and Asian-American healthcare professionals, as well as African-American male medical technicians and health aides and assistants. "The unraveling of hospital-based employment systems is associated with greater wage inequality," the report concludes.
"Declining real wages in outpatient services cannot be explained by factors that often influence wage determination: educational level, age, or the share of workers who are part-time or foreign-born," said Eileen Appelbaum, co-author of the report and a senior economist at CEPR. "Educational attainment rose for virtually every occupational group ― in some cases, substantially ― and is higher in outpatient care centers than in hospitals."