Does the Healthcare Educational Market Respond to Short-Run Local Demand?

Affordable Care Act Medicaid expansions and the nurse labor market

“…The larger effects for LPNs are consistent with results from Dillender (2020) that show the expansions led to more vacancies and hiring by providers that employ lower-skilled workers. I do not find evidence of changes in nurse migration to expansion states, and Dillender et al (2019) find little evidence the expansions increased the nursing graduates or licenses. Taken together, this evidence suggests increased demand for nurses from the Medicaid expansions increased nurse supply along the intensive margin.…”

“…Overall, this evidence suggests increased demand for nurses from the expansion of Medicaid under the ACA increased nurse supply on the intensive margin in the short run. I do not find evidence that nurses moved to expansion states, and there is no evidence the expansions increased nursing degrees or licensures (Dillender et al, 2019), consistent with the lack of evidence of increases along the extensive margin of employment. However, a sustained increase in demand may lead to increases along this margin in the longer run.…”

“…For nurse supply to increase on the extensive margin, there must be a sufficient pool of nurses available to hire. The expansions could increase the relative valuing of nursing jobs, drawing workers to nursing occupations from three sources: (1) individuals who are qualified to work as a nurse but currently unemployed or in a non-nurse job; (2) an increase in the number of individuals obtaining a nursing license, although there is no evidence the expansions increased nursing degrees or nurse licenses (Dillender et al, 2019); and (3) nurses who move to expansion states from non-expansion states or abroad. 5 On the other hand, the Medicaid expansions could increase nurse supply on the intensive margin.…”

“…On the supply side, there is evidence the expansion of Medicaid increased wait times for appointments (Miller & Wherry, 2017) and ambulance response times (Courtemanche et al, 2019), and led to more job vacancy postings and hiring by providers that tend to employ lower-skilled workers (Dillender, 2020). Related work by Dillender et al (2019) does not find evidence the Medicaid expansions increased the nurse pipeline, but there remains an open question of how the increased demand for care affected nurse supply more broadly.…”

Configurations of the driving factors promoting China's commercial health insurance: A comparative qualitative analysis based on the technology–organization–environment framework

“…TMC is measured by the number of college students majoring in insurance. Education related to insurance determines professionalism, influencing the promotion efficiency of the technology; hence, the indicator reflects the investment and reserves of professional insurance human resources, which is closely related to the technical management ability of insurance operation [ 51 , 52 ]. This study uses 553.5, 1,000, and 1,446.5 as thresholds for fully out, crossover point, and fully in the TMC set.…”