California health care trends show a need for qualified nursing professionals.
The Golden State is experiencing tremendous mental health and primary care demand amid a shortage of practitioners. At the same time, a record number of patients are seeking virtual health care.
This blog will explain these trends and the implications for patients and health care providers. It will also look at the bright career outlook for nurse practitioners (NPs) and how NPs are poised to improve California health care.
One trend in California health care is that more residents are using telehealth amid COVID-19.
Over half of Californians surveyed by the University of Southern California (USC) reported having a telehealth appointment during the coronavirus pandemic.
That number is similar to the rate of telehealth use nationwide.
According to a survey conducted by the business consultancy Sykes, the number of Americans using telehealth has tripled.
In March 2021, 61% of Sykes survey respondents said they had participated in a telehealth appointment. Just 20% reported the same a year earlier.
Telehealth use expanded because the coronavirus pandemic threatened the safety of in-person care.
In response, federal and state legislators granted California health care providers “unprecedented flexibility” to practice telehealth. These measures ensured the continuity of care while keeping patients and providers safe.
Data indicates that telehealth use will remain steady because patients are satisfied with their experiences. For example, a recent survey by The Harris Poll showed that approximately 2 in 3 Americans would continue to use telehealth after the pandemic ends.
Budding acceptance has produced an upward trend in the value of the telehealth market. The research company PitchBook estimates that the annual global telehealth market will increase fivefold between 2019 and 2026, topping $300 billion.
What Are the Disparities in California Telehealth?
Variations in telehealth adoption across the state have raised concerns about accessibility.
Telehealth use has spread at higher rates in some areas of the state and among individuals of specific income levels and racial and ethnic groups.
The USC survey revealed that telehealth use varies by region.
Northern California’s Bay Area leads the state with a 58% engagement rate. Los Angeles County has experienced the lowest engagement at 46%.
The top five regions of California by telehealth use are:
- Bay Area
- Inland Empire
- Orange County
- San Diego County
- Central Valley
Race, Ethnicity and Income
Hispanics, Asian and Black respondents to the USC survey reported using telehealth less often than white respondents during the coronavirus pandemic.
But approximately 3 in 4 Californians of color who received health care during the pandemic did so via telehealth. Roughly 2 in 3 residents with low incomes reported the same. That’s according to a survey by the California Health Care Foundation (CHCF).
What's contributing to the differences across racial and ethnic groups? USC attributes them to disparities in income, education and access by racial/ethinic group.
Since 2016, the California Office of Health Equity has led the charge to improve health equity. It manages numerous initiatives that aim to:
- Yield knowledge of the problems and the possibilities through assessment.
- Foster shared understanding through communication.
- Empower residents and their institutions to act effectively through infrastructure development.
Progress updates are available on the OHE website.
What Are the Implications on California Health Care?
When telehealth care is accessible, the use of its services benefits patients and providers alike.
According to the U.S. Centers for Disease Control, telehealth facilitates health care participation by medically and socially vulnerable patients. This is because they can use telehealth to access health care whenever and however they’re able.
The benefits of telehealth, coupled with high patient satisfaction, have led the CHCF to call for investment in telehealth care access.
In the CHCF survey, 7 in 10 respondents with low incomes said they would “likely choose” a telehealth visit instead of in-person care in the future.
The CHCF wants to ensure that “Californians with low incomes have sufficient technology, connectivity and privacy for effective telehealth visits.”
Additionally, Medicare and Medi-Cal, California’s Medicaid health care program, also impact how widely telehealth can be used by the patients who they insure.
Medicare, for instance, made several changes to telehealth coverage in 2020 due to the COVID-19 public health emergency, including:
- Patients can get telehealth services at renal dialysis facilities and at home
- Telehealth services are available for certain emergency department visits at home
- Certain physical and occupational therapy services at home may be covered
- Some services delivered via audio only devices are covered by Medicare
- Virtual check-ins and E-visits can also be covered
Increased access to telehealth also has implications for California health care providers.
Clinicians must know how to deliver quality patient care and education via telehealth. They also need to use telehealth technology, including videoconferencing, store-and-forward imaging and streaming media.
California health care providers must also be prepared to adapt and lead through change. Increased telehealth adoption is just one example of the ever-changing landscape of California health care.
To navigate it, today’s clinicians need advanced clinical expertise, critical thinking and clinical reasoning.
Mental Health Care Demand
Evidence reveals an alarming trend in mental health care demand in California.
The Kaiser Family Foundation (KFF) reported that over a quarter of the state's mental health care needs are unmet.
A KFF analysis of U.S. Census Bureau data shows that approximately 1 in 3 Californians have experienced symptoms of anxiety or depression during the majority of the last seven days. One in 4 of these individuals said they needed counseling or therapy but didn’t receive it in the past four weeks.
A lack of mental health care providers is contributing to the unmet need. Around 24% of California’s population lives in an area with a shortage of mental health care professionals.
What Are the Implications on California Health Care?
California's rising mental health care demand means the state needs a larger mental health care workforce.
Psychiatrists are especially sought-after. The University of California, San Francisco (UCSF) Healthforce Center predicts that the supply of psychiatrists will trail demand by 41% by 2028.
The state can reach more patients in need by having more providers who specialize in mental health be located in the same primary care offices. The CHCF says this approach promotes early intervention, which will benefit Californians' mental well-being.
Primary care providers are often the first clinicians to identify mental health issues in patients. With the growing demand for mental health care, primary care clinicians must leverage their holistic care competencies.
For example, family nurse practitioners are educated to perform mental health evaluations and recognize the signs and symptoms indicative of a change in mental status. They’re also prepared to collaborate with psychiatric health care professionals.
Through their service on the frontlines of health care, primary care clinicians can help improve Californians' mental and physical health.
Primary Care Provider Access
Another trend in California health care is the shortage of primary care providers. A report by the UCSF Healthforce Center projects a statewide deficit of between 78,000 and 103,000 primary care providers by 2030.
As a result, many Californians don’t have to access primary care. Roughly 1 in 5 live in an area designated by the federal government as lacking primary care clinicians.
Two regions of California will likely endure the worst deficits.
In 2030, the Central Valley and Central Coast region and the Southern Border region are estimated to have 18% and 17% shortages, respectively. These figures are almost twice as high as the projected statewide shortfall of 10%.
The state needs more primary care providers because of the increasing demand for primary care.
One factor is the growing aging population. In California, people over age 60 will increase by 166% between 2010 and 2060.
At the same time, chronic disease is becoming more prevalent. Today, 6 in 10 U.S. adults have at least one chronic illness. The top diagnoses in California are cholesterol, hypertension and arthritis.
Both of these trends are putting more pressure on primary care services.
What Are the Implications on California Health Care?
The primary care provider shortage will have lasting effects on California health care. It will diminish care quality, raise health care costs and increase the workload of health care practitioners.
For example, Californians who don’t have a primary care provider may visit emergency rooms for common illnesses, such as the flu and ear infections. These unnecessary emergency room visits are expensive and reduce the efficiency of health care.
To meet the demand for primary care, California needs more primary care clinicians that can practice to the fullest extent of their clinical education.
Nurse Practitioner Career Outlook
California is a fantastic place to work as an NP. Employment and salary are trending upward, while job satisfaction remains solid. Also, motions continue to be made to expand NP practice authority in the state.
What’s the NP Practice Environment in California?
California NPs recently achieved a broader scope of practice. As a result, NPs will help improve California health care by expanding access to primary care services.
In September 2020, California Gov. Gavin Newsom signed into law Assembly Bill (AB) 890, allowing NPs who meet specific criteria to work without physician supervision.
According to the law, there are two categories of NPs—and one group can operate independently if certain criteria is met, such as practicing in good standing for at least three years as an NP, on top of other qualifications.
Previously, California was one of 11 states with a restricted practice environment. These states require NPs to work under the supervision of another health care provider.
AB 890 eliminates this requirement in California.
The California Board of Registered Nursing is currently finalizing NP practice regulations based on the new law. Once these are approved, NPs who meet the appropriate group criteria can practice without physician supervision.
But the California Association for Nurse Practitioners (CANP) is advocating for more changes to the NP scope of practice through AB 852.
AB 852 would modify other state laws that govern health care providers to include NPs.
According to the CANP, the goal of AB 852 is to ensure that California recognizes NPs as independent providers and ensures they can practice to the full extent of their education and training.
AB 852 is currently under review by a California Senate committee.
What Are NP Employment Prospects in California?
Between 2012 and 2019, the employment of California NPs rose by 43%.
The increasing demand for primary care means that NP employment will keep growing.
A report by the Healthforce Center at UCSF projects a statewide shortage of between 78,000 and 103,000 primary care providers by 2030. NPs and physician assistants comprise approximately half of this deficit.
That’s why jobs for California NPs will continue to be readily available.
The U.S. Department of Labor estimates that NP employment will grow by 30% from 2018 to 2028. It projects an average of 1,390 NP job openings per year.
California needs NPs to fill new jobs as well as vacancies. Approximately 20% of California NPs plan to leave their posts in the next five years, citing the following reasons:
- Retirement: 11.5%
- Career Change: 1.4%
- Relocation to Another State: 8.7%
How Has California NP Salary Changed?
The wages of California NPs are growing with employment. The median salary of California NPs increased by over $17,000 between 2012 and 2019, from $112,660 to $129,960.
California is now the highest-paying state for NPs. As of May 2020, the average annual salary was $145,970.
How Satisfied Are California NPs with Their Careers?
Job satisfaction remains steady among NPs in California.
The UCSF Healthforce Center polled California NPs about their career satisfaction in 2010 and 2017. Both years, approximately 82% of NPs working as APRNs reported being “satisfied” or “very satisfied.”
Meet California Health Care Needs as a Nurse Practitioner
California health care trends indicate a tipping point for the state. How it builds on opportunities—and addresses its deficiencies—will decide how health care is delivered for decades to come.
One thing is certain: the quality of care will depend on the practice of advanced clinicians, such as NPs.
Are you ready to shape the future of California health care?
Prepare to become a licensed NP by earning your online MSN-NP degree from Spring Arbor University (SAU), ideal for BSN holders. For RNs without a Bachelor’s degree, see our RN to MSN-NP bridge degree program.
Choose from the following in-demand MSN concentrations to fulfill your calling and grow as a nurse leader:
- Psychiatric-Mental Health Nurse Practitioner
- Family Nurse Practitioner
- Pediatric Primary Care Nurse Practitioner
- Adult-Gerontology Primary Care Nurse Practitioner
As a student in SAU’s online MSN-NP program, you’ll prepare to meet the need for primary care NPs:
- Take just one course at a time and earn your degree without disturbing your current shifts and rotation
- Enjoy a week off in between classes with our flexible 7-1-7 model (7-week courses, 1-week break)
- Join a caring community of students from different backgrounds who share common career goals as you learn from engaged faculty
- Grow professionally, personally, and spiritually through a curriculum rooted in an ethical, Christian perspective
Online MSN-NP graduates are equipped to improve the future health care delivery as primary care providers. At SAU, you’ll enjoy the flexibility and unparalleled support from the start of your journey until graduation.