Modern Healthcare reports that as the nation’s economy improves, the nursing market is returning to its pre-recession tight status:

As the nation’s labor market improves, hospitals that saw demand for nurses erode their margins last fall are now aggressively hiring and targeting turnover in a bid to stem further financial strain.

“It’s always a challenge as the economy gets stronger,” said HCA Chief Financial Officer Sam Hazen. The Nashville-based company has seen more patients visit its clinics, urgent-care centers, freestanding emergency rooms and 167 hospitals. HCA is in 42 U.S. markets, including Colorado, Georgia and Tennessee. Last year, it reported lower third-quarter margins from rising labor costs.

Healthcare hiring slowed in 2013 but rebounded the next year after the Affordable Care Act expanded health insurance subsidies and millions gained coverage. The industry’s hiring accelerated in 2015, adding roughly 470,00 workers to its payrolls. Nursing, the industry’s largest occupation, is projected to grow rapidly in coming years.

Hazen said in some markets, new competitors “are chasing this labor pool.” While HCA saw labor costs creep up slightly from the prior year, it does not expect significant spikes in labor costs in the short term.

As the nursing market tightens, demand for international nurses will no doubt increase as well. Recruitment of international nurses, once robust, has decreased dramatically in recent years due both to economic conditions and a lack of viable visa strategies.

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