Is Boston’s Health Care Industry Still Growing? Here’s What the Data Says.

From 1998 to 2018 in Massachusetts, employment in the Health Care and Social Assistance sector grew by 45% and the number of establishments grew by 149%, as seen in Figures 1.a. and 1.b. below. The number of establishments has increased steadily over time with the exception of 2014-2015, while employment growth has fluctuated after the 2008 recession. Generally, year-to-year changes in employment and the number of establishments are positively correlated, with the major exception of the recession in 2008-2010, in which employment in the industry contracted and the number of business establishments grew.

Figure 1.a. The number of employees in the Health Care and Social Assistance industry in Massachusetts over time

Figure 1.b. The number of employers in the Health Care and Social Assistance industry in Massachusetts over time

Between 1998 and 2016, there were 38% more business births than business deaths in the Health Care and Social Assistance industry in Massachusetts (see Figure 2 below). Generally, the level of business turnover has remained a stable percentage of total industry establishments over this period, but the absolute number of firms entering or exiting the market has increased as the industry has grown.

While the number of establishments in this industry generally increased between 1998 and 2016, the industry had a large number of establishments go out of business in 2013 and 2014. This is especially true in Suffolk and Worcester Counties, and the struggles of health care businesses in these areas in 2013 and 2014 may be related to a mini-boom in suburban development as the nation recovered from the 2008 housing crisis. In fact, Nantucket and Dukes Counties saw the largest gains in health care establishments between 2013 and 2018. In 2018, the number of health care establishments in Suffolk County (which includes Boston) remained 10% less than its 2013 peak.

Curiously, the number of new businesses in the Health Care and Social Assistance sector was higher during the Great Recession than in the prior period of economic expansion. This may be attributable to a significant growth in social and health care services targeted at financially struggling families and individuals. In fact, there is another spike in business births in this industry in 2001, also a recession year. A smaller surge in the number of industry births in 2006 notably coincides with a state-level health care reform under Chapter 58 enacted in that year.

The number of business deaths is very stable until 2013. The net business births figure for the industry has proved quite volatile in recent years, with a couple annual swings of over 5,000 net births.

Figure 2: The number of business births and deaths in the Health Care and Social Assistance industry in Massachusetts over time

More information on business trends, whether by industry, geography, or in the aggregate, is available at MassEconomix.com.

Andrew Mikula is the Lovett & Ruth Peters Economic Opportunity Fellow at the Pioneer Institute. Research areas of particular interest to Mr. Mikula include urban issues, affordability, and regulatory structures. Mr. Mikula was previously a Roger Perry Government Transparency Intern at the Institute and studied economics at Bates College.

Pioneer Supports Legal Challenge to Misleading Tax Ballot Language, Releases Video

January 27, 2022

Pioneer Institute supports the diverse and bipartisan group that filed a complaint with the Massachusetts Supreme Judicial Court (SJC) challenging the summary language meant to provide an accurate description of the tax hike amendment to voters. The language was approved by the Attorney General and Secretary of the Commonwealth when a similar amendment was proposed in 2018, and unless the lawsuit is successful, will likely appear on the Massachusetts ballot in November.

https://pioneerinstitute.org/wp-content/uploads/public-statement-1.png 900 1600 Editorial Staff https://pioneerinstitute.org/wp-content/uploads/logo_440x96.png Editorial Staff2022-01-27 11:57:102022-01-28 11:24:17Pioneer Supports Legal Challenge to Misleading Tax Ballot Language, Releases Video

Study Raises Concern That Annual T Fare Evasion Costs Could Rise By More Than $30 Million Under AFC 2.0

January 19, 2022

According to the Federal Transit Administration (FTA), the MBTA’s $935.4 million fare collection system (AFC 2.0) that is scheduled to be implemented in 2023 will reduce fare evasion by $35 million over a decade. But the T announced in 2021 that evasion could actually increase by up to $30 million under AFC 2.0, and now a Pioneer Institute study warns that insufficient fare enforcement could drive that figure even higher under the new system.

https://pioneerinstitute.org/wp-content/uploads/FareEvasionWeb.png 512 1024 Editorial Staff https://pioneerinstitute.org/wp-content/uploads/logo_440x96.png Editorial Staff2022-01-19 06:09:272022-01-19 08:40:42Study Raises Concern That Annual T Fare Evasion Costs Could Rise By More Than $30 Million Under AFC 2.0

Study: Tax Up For A Vote In November Would Ensnare Over Three Times More Taxpayers Than Previously Estimated

January 18, 2022

Analyses from the Massachusetts Department of Revenue (MADOR, 2016) and Tufts University’s Center for State Policy Analysis (2022) dramatically underestimated the number of households and businesses impacted by the constitutionally-imposed tax hike that the legislature is putting before voters in November 2022, according to a new study from Pioneer Institute.

https://pioneerinstitute.org/wp-content/uploads/Understatement-web-post.png 512 1024 Editorial Staff https://pioneerinstitute.org/wp-content/uploads/logo_440x96.png Editorial Staff2022-01-18 06:52:502022-01-18 06:58:42Study: Tax Up For A Vote In November Would Ensnare Over Three Times More Taxpayers Than Previously Estimated

Public Statement on Massachusetts High Technology Council’s Challenge to the Graduated Income Tax Ballot Language

November 19, 2021

The Massachusetts High Technology Council is right to insist on transparency in the language of a tax hike amendment scheduled to appear on the Massachusetts state ballot next year.

https://pioneerinstitute.org/wp-content/uploads/Copy-of-11.-Employees-of-the-Public-Sector-2.png 512 1024 Editorial Staff https://pioneerinstitute.org/wp-content/uploads/logo_440x96.png Editorial Staff2021-11-19 10:49:272021-11-19 10:49:27Public Statement on Massachusetts High Technology Council’s Challenge to the Graduated Income Tax Ballot Language

Study: “Millionaire’s Tax” Would Have Far-Reaching Effects on “Pass-Through” Businesses

November 17, 2021

A proposed graduated income tax that will appear on the statewide ballot in November 2022 will have much more far-reaching implications than most people realize because the surtax also extends to “pass-through” income from entities such as S and limited liability corporations, partnerships, and sole proprietorships that are taxed on individual tax returns, according to a new study published by Pioneer Institute.

https://pioneerinstitute.org/wp-content/uploads/Copy-of-11.-Employees-of-the-Public-Sector-1-1.png 512 1024 Editorial Staff https://pioneerinstitute.org/wp-content/uploads/logo_440x96.png Editorial Staff2021-11-17 05:55:222021-11-17 05:55:22Study: “Millionaire’s Tax” Would Have Far-Reaching Effects on “Pass-Through” Businesses

Study Warns that New Hampshire Tax Policies Would Exacerbate Impacts of a Graduated Income Tax

October 7, 2021

Drawing on migration patterns between Massachusetts and states like Rhode Island and Tennessee, Pioneer Institute is releasing a study showing a direct correlation between personal income tax rates and household domestic migration patterns between 2004 and 2019. The study suggests that instituting a graduated income tax will shrink the tax base and deter talented workers and innovative employers from coming to and staying in the Bay State.

https://pioneerinstitute.org/wp-content/uploads/Red-and-Dark-Sienna-Music-Poster-12.png 512 1024 Editorial Staff https://pioneerinstitute.org/wp-content/uploads/logo_440x96.png Editorial Staff2021-10-07 06:00:242021-10-07 06:00:24Study Warns that New Hampshire Tax Policies Would Exacerbate Impacts of a Graduated Income Tax