“For primary care, I have a 1 percent vacancy rate, which is incredible. Our specialties are the highest vacancies, but that varies by region,” he added. “Our nurse vacancy rate is about 9.4 percent out of 100,000 RNs, LPNs, CRNAs [certified registered nurse anesthetists], etc., so that’s a pretty good rate, as well.”
Despite overall shortages, especially in rural areas, the VHA also has the nation’s highest growth rate for physicians and other clinical staff.
The VHA also is more susceptible to changing demographics in their patient population than most health care providers. The largest population in VA history – World War II veterans – is almost gone; of 16 million Americans who served in World War II, only about half a million were still alive in mid-2018. The largest group today are those who served in the post-9/11 military; the VA projects that veteran population will be just under 3.5 million by 2019 – and still growing. They have now surpassed the surviving veterans of the Vietnam War (1961-1975), estimated at more than 2 million.
“We are growing every year in terms of the number of veterans we have to care for, plus an aging population with increasing care needs. And as you age, you go to a more geriatric focus, which shifts the demographics of the workforce we need from other specialties. But we are not seeing the same growth in the resources we need,” Perry said.
The VHA also is more susceptible to changing demographics in their patient population than most health care providers.
“In the last 10 years, we’ve grown by 100,000 employees and average 2 to 4 percent growth every year. During that same period, the number of veterans also has increased. Our veteran enrollment projection right now is 3 percent between now and 2026, especially long-term services and support and priority 1-A enrollees. The driver there is the Vietnam veteran population as they age and what gets covered and is considered a service-connected disability.”
Despite growth and shortage rates Perry said compare favorably to the overall health care industry, the VA continues to seek ways to improve its recruitment and retention numbers.
“About 70 percent of doctors receive their residency training in a VA facility, which is our biggest pipeline. Those medical schools are our affiliates, and we work with them to maximize recruitment. We have a targeted focus on mental health and this year have had a positive gain of more than 500 mental health professionals. [From January through August 2018], we have hired 2,400 mental health professionals, including those 500 that are a positive increase. That’s new positions in a very tough recruitment market. In other areas, the number of total hires to new position growth is roughly 2- or 3-to-1.