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How big can the health care industry in Rochester get?

Construction on the Sands-Constellation Center for Critical Care at Rochester General Hospital.

Construction on the Sands-Constellation Center for Critical Care at Rochester General Hospital.

The University of Rochester and Rochester Regional Health again lead the list as the two largest employers in Rochester, with 29,820 employees and 16,545 employees, respectively. When it comes to large health care organizations, they’re in good company; Lifetime Healthcare Cos. came in eighth on the list with 3,200 employees, and Finger Lakes Health is 14th with 1,740.

It’s a consistent trend: When you’re looking at employment in the Rochester area, health care is king. But it begs a question of just how big the industry can get. Is health care on a constant upward track, or is there a ceiling to all of this industry growth? The answer is complicated, and depends somewhat on your perspective.

The growth in Rochester’s health care industry is hardly out of the norm on a national scale. Health care is booming everywhere, and Rochester is no exception. But the perceived boom in health care is more attributable to a comparably slow-moving regional economy.

“This is not something unique to Rochester; strong growth in the health care and education sector is something seen across the country,” said Richard Deitz, an assistant vice president and senior economist with Federal Reserve Bank of New York. “What makes it a little more unique in a place like Rochester, and this is also true of much of Upstate New York, is that the rest of the economy is not really growing, so it has become a larger and larger share of economic activity.”

The scope of the trend is massive. In January 1990, 9.1 million people across the country were employed in the health care and social assistance sector, according to the Bureau of Labor Statistics. Preliminary numbers for March 2018 show 19.8 million employees in the sector, a 118 percent increase. Between January 1990 and Febuary 2018, the most recent available data, Rochester’s employment in the education and health services sector grew from 65,800 to 132,900, a 102 percent increase. That growth actually trails the nation as a whole, but in context of the area, it’s huge. In that same time frame, total employment grew from 483,700 to 532,000, about 10 percent.

“Health care is certainly one of our key economic drivers in terms of job creation,” said Bob Duffy, president of the Greater Rochester Chamber of Commerce. “If you look at our region as a whole, it’s been driving job growth and economic growth, and will probably continue to do so at a much greater level in the future. Two of our biggest employers are the University of Rochester Medical Center and Rochester Regional Health, then you throw in the health insurance companies and all the other ancillary systems here, and it is a huge driver.”

The numbers themselves don’t show health care growth in the region as an anomaly on a nation scale. In fact, Rochester isn’t even the top of the list for health care occupations among cities named “Rochester”; that distinction goes to Rochester, Minnesota. So the industry is a major economic driver, but not in a way that’s unique to this community.

“As the health care and education sector has continued to grow, now nearly a quarter of Rochester’s jobs are in the industry,” Deitz said. “This growing share has occurred during a time when job growth has been very sluggish in the rest of Rochester’s economy in general. Rochester, like much of upstate New York, has been growing much more slowly than the rest of the nation for the past few decades.”

But it’s not to say Rochester’s health system isn’t of high quality itself. On the contrary, Rochester’s status as a health care city is obvious, and for the community, it means not only jobs, but better access to care. Take the uninsured rate, for example. In the fourth quarter of 2017, it clocked in nationally at 12.2 percent. In upstate and the Finger Lakes, it hovers just below 4 percent.

For Eric Bieber, president and CEO of Rochester Regional Health, it’s not just a matter of creating jobs. RRH has made significant investments into developing its facilities. Take the $250 million Sands-Constellation Center for Critical Care at Rochester General Hospital, or the $26 million Riedman campus on the intersection of North Goodman and East Ridge Road. They’re massive undertakings, and they’re done to improve the quality of care available to the region.

“We’re building for the future,” Bieber said. “It’s possible that if there is a bubble, or things decrease over time, which they may, then what we’d want to do is close down some of the older beds, and we could shrink. But, at the end of the day, we still need what we’re building. We’re building a capability set for today, and tomorrow and the foreseeable future. Now, however long those beds stay in place, whether it’s five years, 10 years, 25 years, or forever, that’s hard to know.”

That’s a key point; while RRH is investing, they’re not necessarily getting bigger in terms of patient support. They’re improving tech, building private beds, improving access to care. But at the end of the day, they are reaching the same number of people, and simply improving support.

“My hope is, as we continue to get better and better at what we do and help our community live better and healthier lives, and then to the extent that we can shrink whatever we have, then we do whatever’s appropriate at that point in time,” Bieber said. “Certainly today, we’re building to the current needs of our community, and the key is that you don’t get stuck. It’s hard to know what it will be like in 20, 30, 40 years, the technology keeps growing at a rapid pace, and you just have to be flexible about it.”

As for the question of just how big health care can get, it’s hard to tell, and it’s certainly not a Rochester-exclusive question. Half of the careers expected to grow most rapidly by 2026 on a national scale are in the health sector. Four million, or one-third of all added jobs, are expected to be in the sector. But even if it’s a major economic driver everywhere, it does not mean that Rochestarians should not value what we do have.

“We sometimes think there is better health care elsewhere, but we are blessed to have it here,” Duffy said. “I see it as a double-edged win for us, it is great care for our citizens, hopefully we’ll prolong lives and keep people healthy, and it will create jobs and economic prosperity here in this region.”

gfanelli@bridgetowermedia.com / 585-653-4022

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