Data guideRead at source, 9 September 2026
The Healthcare Workforce Shortage, by Role: 1.3 Million Openings a Year, and 91% of Them Are Replacements
Almost everything written about the healthcare workforce shortage is about physicians and registered nurses. The federal projections say the pressure is somewhere else. Across the five largest non-physician healthcare occupations, the Bureau of Labor Statistics projects 1,306,100 job openings a year between 2025 and 2035 — and only 121,040 of them exist because the work is growing. The other 1,185,060, or 91 percent, are replacements for people leaving. The single largest line is not nursing: home health and personal care aides need 760,500 people a year, more than four times the 180,800 projected for registered nurses. If you run a home care agency, a skilled nursing facility or a senior living community, that ratio is your hiring problem in one number, and it is a churn problem rather than a pipeline problem.
The five occupations that carry the shortage
These five account for more than eleven million jobs between them, and they are the roles that frontline healthcare employers actually hire. Read the last two columns together: the replacement share is what tells you whether a bigger pipeline would fix anything.
| Occupation | Employed, 2025 | Openings a year | Growth a year | Replacement share | Median pay, 2025 |
|---|---|---|---|---|---|
| Home health and personal care aides | 4,677,100 | 760,500 | 84,730 | 89% | $35,800 |
| Nursing assistants and orderlies | 1,558,700 | 203,300 | 4,110 | 98% | $41,870 |
| Registered nurses | 3,465,400 | 180,800 | 19,470 | 89% | $97,550 |
| Medical assistants | 833,900 | 109,700 | 10,760 | 90% | $45,690 |
| Licensed practical and vocational nurses | 666,900 | 51,800 | 1,970 | 96% | $64,400 |
| All five | 11,202,000 | 1,306,100 | 121,040 | 91% | — |
Three things the table says that the policy literature does not
First, nursing assistants are the tightest occupation on the list and almost nobody says so. BLS projects the occupation to grow 3 percent over the decade — as fast as average, not faster — while still needing 203,300 people a year. Do the subtraction and 98 percent of those openings are replacements. There is no version of that problem that a larger training pipeline solves on its own, because the pipeline is not where the people are going. We take the occupation apart on the CNA shortage.
Second, the aide occupation is four times the size of the nursing one and pays a third as much. Home health and personal care aides are projected to need 760,500 people a year at a median of $35,800, against 180,800 registered nurses at $97,550. Both numbers matter, but they describe different businesses. If your organisation is mostly aides, national coverage of “the nursing shortage” is describing someone else’s problem. Ours on that occupation is the caregiver shortage.
Third, growth and replacement need different money. Medical assistants are the one genuinely expanding role here, at 13 percent over the decade, and even there nine openings in ten are refills. When the openings are refills, a bigger pipeline fills a bucket with a hole in it, and what decides the return on the same budget is how long the people you hire stay. That is why we publish nurse turnover rates and caregiver turnover next to the recruiting pages rather than in a separate section.
What this does not say
It does not say there is no shortage. A replacement opening is just as unfilled as a growth opening, and 1.3 million a year is a real number that has to be met by real hiring. What it says is narrower and more useful: the shortage is overwhelmingly a churn problem, so the interventions that get discussed most — training capacity, visa policy, school places — are aimed at the smaller nine percent, while the ninety-one percent is decided by pay, schedule, supervision and how fast you can refill a seat.
Where each role page is
This page is the arithmetic. The role-level pages are where the hiring detail lives, and they are the ones to read if you are actually filling one of these seats.
| If you are hiring | Start here | And then |
|---|---|---|
| Caregivers and home care aides | Caregiver recruitment strategies | Where to find caregivers and caregiver turnover |
| Home health aides specifically | Home health aide recruiting | Home care agency recruiting |
| CNAs and nursing assistants | CNA recruitment | The CNA shortage and CNA staffing |
| Registered nurses and LPNs | Nursing shortage solutions | Nurse turnover rate and compact nursing states |
| A senior living or assisted living site | Senior living staffing | Assisted living recruitment |
| Shifts rather than seats | PRN and per diem staffing | How to fill open shifts |
| Anything, and it is going badly | Healthcare recruiting strategies | Understaffing and healthcare staffing costs |
What the mix costs to keep full
The reason to look at these roles together rather than one at a time is that they cost wildly different amounts to advertise, and most healthcare employers hire several of them at once. Across the 891 campaigns in our 2026 Social Job Advertising Benchmark, caregiver and home care roles produced applicants at a $3.76 median at a 31 percent apply rate — the best of sixteen role families — while registered nurse campaigns ran $19.08 at 11 percent. That is a five-fold difference in the cost of the same outcome, and it means a single blended advertising budget will always be quietly subsidising the clinical roles out of the aide ones.
Staffing mix planner
Your headcount by role, your own turnover. The cost per applicant is ours.
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Frequently asked questions
How big is the healthcare workforce shortage?
Across the five largest non-physician healthcare occupations, the Bureau of Labor Statistics projects about 1,306,100 job openings a year between 2025 and 2035. Only around 121,040 of those come from the work growing; the other 1,185,060, or 91 percent, are replacements for people leaving the occupation.
Which healthcare role has the biggest shortage?
By volume of annual openings it is home health and personal care aides, at 760,500 a year, more than four times the 180,800 projected for registered nurses. By tightness it is nursing assistants and orderlies, where 98 percent of the 203,300 annual openings are replacements rather than new posts.
Is the healthcare shortage a training problem?
Only for a small share of it. Nine of every ten projected openings across these five occupations are replacements for people leaving rather than new positions, so training capacity addresses roughly the other tenth. What decides the ninety percent is pay, schedule, supervision and how quickly an employer can refill a seat once it opens.
What do frontline healthcare roles pay?
Median annual wages in 2025 were $35,800 for home health and personal care aides, $41,870 for nursing assistants and orderlies, $45,690 for medical assistants, $64,400 for licensed practical and vocational nurses, and $97,550 for registered nurses.
Why do most articles about the healthcare shortage focus on nurses and doctors?
Because those professions have national associations, licensing bodies and academic literature that generate coverage. The aide and assistant occupations are larger by headcount and by annual openings but are far less represented in that literature, which is why an employer whose staff are mostly aides often finds national coverage describes a different problem from theirs.
What does it cost to recruit healthcare staff?
In our 2026 Social Job Advertising Benchmark, caregiver and home care roles produced applicants at a $3.76 median with a 31 percent apply rate, CNA roles at $7.72, LPN and LVN roles at $12.77, and registered nurse roles at $19.08 with an 11 percent apply rate. Those are advertising costs per applicant, not per hire, and the applicant-to-hire ratio is specific to each employer.
Is the nursing shortage getting better or worse?
Registered nurse employment is projected to grow 6 percent between 2025 and 2035, which BLS classes as faster than average, adding 194,700 posts. Against 180,800 annual openings, that means about 89 percent of nursing openings are replacements. The occupation is growing; the difficulty filling it is mostly about people leaving rather than about the number of positions.
How many healthcare workers are needed each year?
For the five largest non-physician occupations, about 1.3 million a year through 2035: 760,500 home health and personal care aides, 203,300 nursing assistants and orderlies, 180,800 registered nurses, 109,700 medical assistants and 51,800 licensed practical and vocational nurses.
A refill problem needs a steady campaign, not a panic.
Bring your headcount by role and your turnover. We will show you what applicant flow costs for each of them in your market, and where the budget is actually going.
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