Federal Reserve Bank of Atlanta

07/31/2024 | Press release | Archived content

Atlanta Fed President Visits Jacksonville to Discuss Healthcare

August 8, 2024An array of moments from Atlanta Fed president Raphael Bostic's recent visit to Jacksonville to discuss healthcare. Jacksonville Branch regional executive Michelle Dennard is center in the lower-left photo. Photo by Stephen Nowland

Healthcare leaders in Jacksonville, working during a transformative era in the delivery of medical services, recently took some time to discuss their rapidly evolving industry with Atlanta Fed president Raphael Bostic.

While gathered around a table with them in May, Bostic asked them to look down the road and describe the healthcare ecosystem they foresee. He also invited them to reflect on issues such as service delivery, the cost structure of services, and the demand for services. The conversation was part of Bostic's series of regional listening tours, which allow him to hear from local leaders about the economy they are experiencing and, in turn, to provide them with his insights on a variety of Fed matters.

The healthcare sector is vital to the economy of the Jacksonville region, home to about 1.7 million residents. In 2023, job categories in the healthcare sector employed 10.8 percent of the workforce in metro Jacksonville's five core counties, plus adjacent Putnam County. Healthcare's future is bright there, as evidenced by the continuing construction of medical facilities. Projections call for job growth in the healthcare sector to exceed the 9.8 percent rate predicted for all occupations in metro Jacksonville by 2031.

Dr. Kent Thielen, chief executive officer of Mayo Clinic Florida (left), talks with with Raphael Bostic, president of the Atlanta Fed, during Bostic's recent visit to Jacksonville, Florida. Photo by Stephen Nowland

Many of these jobs pay well. As of 2022, mean wages for the healthcare category, which includes practitioners and technical occupations in the five core counties, were substantially higher than the mean for all occupations in the metro area. However, wages for healthcare support, jobs such as nursing assistants and orderlies, were below the mean wage for the region.

The healthcare group with whom Bostic met was well positioned to talk about the current healthcare economy as well as their expectations for it. The institutions they represent provide care to people with a wide range of age, income, injury, and disease.

The executives of these facilities told Bostic about their cutting-edge efforts to incorporate artificial intelligence, telemedicine, and data privacy-in addition to breakthroughs in research, treatment, and technology-into their work to further their goal of providing patient-centered care. They noted that fostering a system of ethical and equitable healthcare is complicated by staffing challenges created by the retirement of older workers at a time when younger workers have become difficult to attract and retain.

Bostic started the conversation by setting the baseline in the present before turning to the future. He noted the national healthcare sector was slow to rebound after the COVID-19 pandemic. However, the rebound is under way, Bostic noted, and he asked the group if they expect the recovery to continue. The group predicted the momentum will continue even as the labor landscape evolves. For example:

  • Demand for healthcare service is expected to rise as current residents develop age-related health concerns and Florida continues to attract retirees;
  • No slowing is evident in the pent-up demand for service that appeared as the pandemic waned and patients sought to resume medical procedures and in-office check-ups;
  • A scarcity of workers contributes to wait times for service; and
  • Because some workers are interested mainly in wages, not benefits, employers are motivated to offer flexible forms of compensation.

The group told Bostic about a variety of regional efforts to improve public health by promoting healthy lifestyles. One such program is the Blue Zones Project Jacksonville, which is a local affiliate of a national program-federally funded and serving the uninsured and medically vulnerable-devoted to the discovery and adoption of lifestyle characteristics. These characteristics include access to healthy food, physical activity, opportunities for social connections, and the ability to live with purpose. In Blue Zones, researchers have found that people live longer and have lower rates of chronic disease than is common across the United States.

The Blue Zones Project is one way to enhance equity in access to healthcare, according to a CEO of a healthcare facility who was present at the meeting with Bostic. These centers provide comprehensive care in underserved areas on a sliding-fee scale. The CEO said the Blue Zones Project helps providers "meet this population where they are."

This approach helps overcome challenges to serving lower-income people, including difficulties in scheduling and attending appointments when they work multiple jobs. Once patients do arrive at an appointment, staffing can be slim because some healthcare centers might not be able to afford the salaries required by some doctors and the growing proportion of clinicians who have advanced training. Overcoming these myriad obstacles to improving the health of a population across the socioeconomic continuum presents "a broad stroke that has to be addressed, and we all have to address it based on the population that we serve," the CEO said.

One member of Bostic's team posed a question about the return on investment in such programs, and one healthcare official replied that there is indeed a return on this type of investment. In a year-long evaluation of their own insured employees, the facility found that programs promoting a holistic approach to self-care, including increased education about diet and wellness, provided a 2:1 year-over-year return on health plan costs, even including the 35 percent of participants who dropped out during the year.

When Bostic turned the conversation to investments in technology, COVID-19 was a big topic because of the significant shifts it caused in the delivery of healthcare. The use of telemedicine generally grew, and some healthcare providers plan to deliver more treatments (such as chemotherapy) in patients' homes in the future. Other technologies being expanded include:

  • Bluetooth-enabled devices that monitor pregnant women for onset of diabetes;
  • The combination of telehealth and virtual reality to conduct in-home rehabilitation treatments;
  • The combination of virtual reality and high-tech, robot-controlled exoskeletons so patients can practice movements at home and have the resulting data transmitted to a healthcare facility; and
  • Next-generation AI-powered language translation programs already on the horizon to facilitate communication among speakers of all languages. "That's going to be a big deal in Florida," one healthcare official observed.

Although the Federal Reserve doesn't deal directly with public health, Bostic observed, "healthcare affects things that we care about." Examples he gave are people whose poor health keeps them out of the workforce or causes them to struggle in school, potentially limiting their future economic mobility. In addition, community health can be a marker of other factors that detract from economic wellness.

"I've actually done a lot of work on the social determinants of health," Bostic told the group. "I was on the housing side, and we found out that housing affects health and health affects housing. If you don't have those two connected, things fall apart."

The conversation in Jacksonville yielded insights that augment what Bostic has gathered elsewhere in the Sixth District. Since the pandemic ended, Bostic and local civic and business leaders have explored public health topics including turnover in the ranks of nurses in Brevard County, Florida; sanitary sewer and safe drinking water systems in rural Hale County, Alabama; and the variety of healthcare training programs in Mobile, Alabama.

David Pendered

Staff writer for Economy Matters