Strategies to Address Healthcare Worker Shortages

In times of economic hardship, people may seek quick reskilling as a path to more stable employment. Whether workers recently graduated high school or are seeking to move up the economic ladder, one area of employment to consider is what are called opportunity occupations: jobs that pay above the median wage but do not require a four-year college degree. Such jobs provide low- and moderate-income individuals opportunities to obtain employment that affords discretionary income, of which the lowest-earning 40% of U.S. households have little to none.

Opportunity occupations can be found in various sectors of the economy; healthcare is an example. A November 2025 St. Louis Fed report, “Health Care Opportunity Occupations and Workforce Strategies in U.S. and Eighth District Hospitals,” highlighted these jobs and certain workforce strategies between 2019 and 2023. This blog post updates the report’s estimates with 2024 data, the most recent available. All data is presented nationally and disaggregated by state and proximity to metro counties, revealing a new key finding. This blog post also examines an example from Kentucky of a collaborative approach to addressing healthcare worker shortages.

The Outlook for Healthcare Positions

By 2030, allied healthcare worker shortages are expected to exceed physician deficits: The U.S. Health Resources and Services Administration (HRSA) projects a 128,000-physician deficit but a nearly 150,000-licensed practical nurse (LPN) deficit. Other opportunity occupations facing shortages include respiratory therapists, laboratory technicians, pharmacy technicians, radiology technicians and registered nurses (RNs).

Without intervention, these shortages are expected to persist. For instance, trained LPNs are expected to go from meeting 80% of employer demand for the role by 2030 to only 72% of demand by 2036. Factors that are expected to contribute to persistent worker shortages in the healthcare sector include an aging workforce and growing elderly population, plus heavy workloads, workplace violence and reduced training programs.

Hospitals, schools and workforce organizations are working to remedy shortages through various strategies, including:

• Providing professional and personal support for clinical and nonclinical employees
• Implementing onboarding and mentoring programs
• Offering financial incentives like permanent contracts
• Monitoring measures such as worker-to-patient ratios and workload

The strategy in a community may vary based on location needs (PDF).

Median Salaries for Opportunity Occupations

Opportunity occupations pay above the national median wage ($50,980 in 2025), to workers with less than a four-year degree. For instance, in 2025, respiratory therapists across the country earned an annual median salary of $82,280, which was up $1,830 from the previous year. (See the table.)

In states that are part of the Fed’s St. Louis-based Eighth District — Arkansas, Illinois, Indiana, Kentucky, Mississippi, Missouri and Tennessee — the median salary of respiratory therapists also exceeded the national median salary for all occupations. Respiratory therapists’ median salary ranged from $63,270 in Mississippi to $84,090 in Illinois. However, as the table shows, not every opportunity occupation pays a salary in Eighth District states that exceeds the national median.

Shift in Healthcare Workforce Trends

The 2025 St. Louis Fed report found that, for all six opportunity occupations, the percentage of hospitals with at least one job opening in the field rose from 2019 to 2023. The largest growth was for respiratory therapists (124.1% nationally, with 83.8% of hospitals having vacancies in 2023) and the smallest was for RNs (3.7% nationally, as demand was already high, with 84.3% of hospitals having vacancies in 2023). However, 2024 data suggest the opposite trend.

The report shows the growth rate in hospitals with a vacant respiratory therapist position quickly increased over five years (2019-23), while the percentage of hospitals with an RN vacancy was relatively stagnant. (See the figure.) The 2024 data, however, indicate that, while most positions continued growing, the share of hospitals with a respiratory therapist opening plummeted and the share with an RN vacancy surged. Only 49.7% of hospitals had a respiratory therapist opening in 2024 — a 34.1 percentage point decrease from 2023, though still above levels prior to the COVID-19 pandemic. Conversely, 93.8% of hospitals had an RN opening, a 9.5 percentage point increase from 2023 and the largest year-over-year increase since before 2019.

While the pullback in respiratory therapist hiring might suggest positions were finally filled, data show the share of hospitals employing at least one person in each occupation changed minimally over the six years. The sudden spike in hospitals with an RN vacancy may reflect nurses approaching retirement age and exiting the workforce. However, there is no clear explanation for the dramatic change in respiratory therapist vacancies.

Workforce Strategies

As hospitals continue to plan ways to grow and maintain their workforces, the American Hospital Association’s annual survey was modified in 2024 to capture additional strategies that align with major challenges and are related to workforce approaches raised in the St. Louis Fed report. These newly documented strategies include hospitals’ adoption of:

• Staff well-being programs
• Workplace violence/deescalation trainings
• Benefits (e.g., tuition remission)
• Transition-to-practice programs
• Professional development for clinical and for nonclinical staff

Nationally, all these activities, with the exception of transition-to-practice programs, were adopted by more than 50% of hospitals. However, there were differences between states and even within states depending on the proximity of a hospital to a metropolitan area. For instance, 66% of hospitals across the country had workplace violence deescalation trainings or programs. All District states were at or above national averages except for Arkansas (38%) and Kentucky (60%).

For most District states, such programs were less prevalent the farther a hospital was from a metro area. For instance, in Indiana, 93% of metro hospitals had a workplace violence deescalation program or training, but the frequency was lower for nonmetro hospitals adjacent to a metro area (82%) and those not adjacent to a metro area (60%). (Adjacency to a metropolitan area was defined by U.S. Department of Agriculture Rural-Urban Continuum Codes.)

In another example, over 70% of hospitals across the country had a partnership with elementary or high schools to foster more interest in healthcare careers. Every state in the District exceeded the national average except for Arkansas (46%). However, there were no clear patterns among hospitals in metro, nonmetro but metro adjacent, or nonmetro and not-metro-adjacent counties that demonstrated any consistent trends, such as fewer strategies potentially having been implemented in rural hospitals.

Local Solutions

Throughout the District, local solutions have emerged to help address healthcare workforce shortages. Two examples previously featured in St. Louis Fed publications are Upskill NWA in Arkansas and the Memphis Medical District Collaborative in Tennessee.

Another example: Universities, colleges and hospitals formed a coalition to address healthcare worker shortages across Kentucky. The coalition does this through increasing the visibility of healthcare fields and offering trainings on the road. HealthForce Kentucky was formed in 2022 and includes pre-K through 12th grade school districts across Kentucky and nine partner colleges and universities:

• Brescia University
• Elizabethtown Community and Technical College
• Henderson Community College
• Hopkinsville Community College
• Kentucky Wesleyan College
• Madisonville Community College
• Owensboro Community and Technical College
• University of Louisville School of Nursing
• Western Kentucky University

In Owensboro, the coalition has a 35,000-square-foot hub for healthcare simulations, education, research and community space. For instance, the hub features a simulated operating room, X-ray lab and inpatient rooms. Additionally, HealthForce Kentucky has two traveling semitrucks equipped with mobile simulation labs to reach rural communities that might not otherwise have access to experiential learning in these fields. The organization offers hands-on instruction at a range of levels, for students first exploring healthcare careers to post-licensure workers advancing their skills.

Looking toward the Future of the Healthcare Workforce

Data from the American Hospital Association’s latest survey show demand within each opportunity occupation may vary from year to year, yet critical workforce shortages remain. Hospitals embracing multifaceted strategies and deepening partnerships with nonprofits and school districts have had some success in addressing these gaps. Sustained collaboration could help the healthcare industry build the workforce it needs.