Future of Healthcare Workforce: Demand Forecast and Skill Gaps Through 2028

100,000 healthcare workers will be missing by 2028. That’s not a prediction; it’s a projection. And it won’t wait for your next budget cycle.

The shortage isn’t hitting every state the same. Some places are bleeding talent. Others are barely hanging on. The data is clear, but the headlines don’t tell the full story.

Here’s what’s actually coming. And here’s what you should be doing about it.

What the Healthcare Workforce Demand Forecast Actually Shows

The projected shortage of 100,000 healthcare & nursing service workers by 2028 won’t hit all states equally.

States like California, Texas, and Pennsylvania are expected to hold up better, with supply keeping pace with demand. But New York and New Jersey are flagged for acute shortages.

For OB-GYNs, California faces a projected shortfall of 406, and Texas of 287. For pediatricians, California is looking at a deficit of 732, Massachusetts 512, and Texas 395. 

For family medicine, North Carolina sits at the top of the shortage list by a significant margin, with a projected gap of 1,394, followed by California at 852 and Illinois at 614. 

These aren’t national averages to plan around. They’re location-specific gaps that require location-specific responses.

Healthcare Skill Gaps That Are Getting Worse, Not Better

Healthcare skill gaps don’t hit every role equally, and the nurse assistant situation is one of the most concerning in the data.

For registered nurses, the picture is mixed. A slight national surplus is projected, but New York and other East Coast states still face shortages. A surplus on paper doesn’t help a New Jersey facility already down three nurses on a Tuesday morning.

Physicians are similar; a national surplus of 28,000 doctors sounds good until you break it down. California is projected to be short 2,580, Texas 2,830, and New York 2,706. The national numbers hide what’s really happening state by state.

Nursing Shortage Future Predictions: Why Geography Changes Everything

The conversation around future nursing shortages cannot be separated from geography.

Compensation differences across states and metropolitan areas are expected to drive significant workforce migration before 2028. When a nursing assistant can earn more for the same role in a neighboring state, the decision becomes straightforward. As a result, healthcare organizations will increasingly rely on nurse staffing services to address regional talent shortages, maintain adequate staffing levels, and ensure continuity of patient care.

For facilities in lower-paying states or metro areas, this isn’t just a recruitment challenge. It’s a retention challenge playing out in slow motion over the next two years.

The facilities that figure this out early aren’t necessarily the ones with the biggest budgets. They’re the ones who analyze their occupation-by-occupation supply-and-demand risk by location and make targeted decisions based on that, rather than waiting for the shortage to arrive and then responding to it.

Healthcare Hiring Trends for the Long Term: What Needs to Change Now

The long-term healthcare hiring trends coming out of this data point to a few things that most facilities aren’t doing yet but need to start.

Stop Relying on a Single Sourcing Strategy. 

Job boards worked in 2021. But with a 73,000 national deficit, that won’t cut it now. Build pipelines early, through schools, training programs, and staffing partners with pre-vetted talent.

Treat Retention as a Supply Chain Issue. 

Burnout, pay, and career stagnation are pushing nurses out. Replace experienced staff with new grads, and headcount may look fine, but your actual capacity just shrank.

Map Where Your Specific Risks Actually Are. 

Different states, different shortages. Knowing which roles, in which departments, in which locations are hardest to fill is where everything else starts.

Build Pipelines Before Vacancies Open. 

Facilities that only start recruiting when a seat is empty are always a step behind. The ones building relationships with nursing schools, sponsoring certification programs, and maintaining connections with qualified candidates between hires fill roles faster and pay less to fill them. 

Frequently Asked Questions 

Q1: Which healthcare roles face the biggest shortages by 2028?

Nursing assistants, 73,000 short nationwide, with only 13 states meeting demand. Family medicine physicians are scarce in North Carolina, California, and Illinois.OB-GYNs, along with pediatricians, also face gaps in high-demand states like California and Texas.

Q2: If there’s a projected RN surplus nationally, why is nursing still a problem?

National averages can be misleading. The surplus you’re hearing about masks serious regional gaps. New York, New Jersey, and several East Coast states are still expected to face RN shortages. A surplus in California doesn’t help a facility in New York that’s short on floor nurses right now.

Q3: What should healthcare facilities be doing today to prepare for 2028 workforce gaps?

Three things.

• First, know your local talent gaps; don’t rely on national stats. 
• Second, build pipelines with schools and staffing firms before you’re desperate. 
• Third, hold onto your people with fair pay, flexibility, and real growth.

Facilities losing staff to nearby competitors are digging their own holes faster than any trend.

Key Takeaways

• The US faces a projected shortage of 100,000 healthcare workers by 2028, hitting some states far harder than others
• A national deficit of 73,000 nurse assistants is projected, with only 13 states expected to meet demand
• Physicians show a projected national surplus but critical regional shortfalls in California, Texas, and New York
• Compensation variation across states is expected to drive worker migration, worsening shortages in lower-paying markets
• Facilities that build pipelines and invest in retention now will be significantly better positioned than those waiting for the shortage to arrive

Conclusion

The healthcare workforce demand forecast through 2028 isn’t some far-off warning. It’s a planning tool for decisions that need to happen right now.

The healthcare skill gaps we’re seeing in nursing assistants and specialty physicians aren’t just temporary bumps. They’re structural. They won’t go away without real work, investing in training, keeping good people, and offering pay that actually competes.

Looking at healthcare hiring trends over the long term, one thing stands out: facilities that make workforce planning a daily habit rather than a last-minute scramble will be in much better shape by 2028. The ones still reacting? They’ll be left behind.

Kupplin helps healthcare facilities get ahead of these gaps, whether that’s filling an immediate vacancy or building a longer-term staffing strategy that accounts for where your specific market is headed.