Spooky 2024 Employment Trends

As Halloween approaches, the healthcare industry is witnessing some truly scary times, especially for investigators and auditors within health plans. Since COVID slowed down, constant layoffs (RIFs) and reductions in force have plagued the industry, and it seems more are on the way. We know many talented professionals who have been let go over the last year, some of whom should not have been. It’s a daunting reality, but one that healthcare payers must face head-on.

This week, we’re kicking off our three-part blog series, which will take us right up to Halloween. Each installment will explore key staffing challenges that are haunting healthcare payers in 2024, and how to navigate these shifts in the workforce.

2024 Staffing Challenges:

Healthcare payers are grappling with significant staffing challenges in 2024, driven by evolving industry trends. These challenges are transforming the way health plans hire, manage, and retain their talent, and have created an unpredictable job market. Here are some of the most pressing staffing concerns:

1. Telehealth and Digital Expansion:

The rise of telemedicine and digital health solutions has created a demand for staff proficient in both healthcare and technology. This expansion requires payers to recruit individuals skilled in telehealth management, digital therapeutics, and remote patient monitoring. However, there’s a talent gap in these specialized roles, and finding the right mix of skills has proven difficult.

2. Technology-Driven Roles:

Automation and artificial intelligence (AI) are increasingly being adopted for functions such as prior authorization and payment integrity. This shift requires healthcare companies to hire tech-savvy professionals who not only understand healthcare processes but also possess advanced technological skills. The challenge is that this hybrid expertise is scarce, making these roles hard to fill.

3. Outsourcing and Workforce Optimization:
Financial pressures are forcing healthcare payers to outsource non-core functions like revenue cycle management. However, this approach faces pushback due to concerns over its impact on local employees and the quality of service. Balancing cost-cutting measures with the need to maintain a capable, well-trained workforce is becoming a tightrope act.

Increased Layoffs and Reductions in Force (RIFs):

In 2024, we’re seeing a rise in layoffs across healthcare, primarily driven by financial and operational challenges. Here’s why:

  • Cost-Cutting Pressures:

    Healthcare companies are focusing on reducing operational costs to stay competitive in a tightening market. Major organizations like Elevance Health and CVS Health have already undergone workforce restructuring, and it’s anticipated that more reductions will occur as the year progresses. Rising labor costs, inflation, and declining revenues in some areas are all contributing to this wave of job cuts.

  • Shifts in Market Dynamics:

    Changes in Medicaid enrollments and the evolution of Medicare Advantage are creating uncertainty for healthcare payers. The ongoing Medicaid redetermination process is leading to significant disenrollments, which in turn affects the workforce needed to manage these programs. Companies are consolidating and streamlining operations, triggering more layoffs to reduce costs.

  • Technological and Regulatory Changes:

    As healthcare payers increasingly digitize and comply with evolving regulatory frameworks, they’re reshaping their staffing needs. With more functions becoming automated or outsourced, some roles are being eliminated altogether. Companies expanding their Medicare and Medicaid operations are facing the dual challenge of meeting regulatory requirements while managing the cost of compliance.

 

These challenges will likely extend into 2025, as healthcare payers continue to adapt to new market dynamics, regulatory changes, and financial pressures. The workforce will continue to evolve, and companies that are able to anticipate and react to these changes will be better positioned to thrive in this new landscape. But for now, spooky times lie ahead, and healthcare professionals will need to brace themselves for what’s to come.