As more conditions are cared for in the community setting rather than in hospitals, the jobs are moving along with the patients. The latest U.S. Bureau of Labor Statistics (BLS) report finds hospital hiring largely flat but physician office hiring up 4,000 jobs from the previous month and up 57,200 jobs from June of last year.

Overall, the ambulatory health care services sector was up 13,100 jobs over the previous month compared to a gain of 2,200 jobs for hospitals. When looking at all health care employment, the increase for June was about 21,000 jobs, which the BLS noted was “about in line with the prior 12-month average gain of 18,000 per month."

Nursing and residential care facilities also had a good month for job growth with about 6,000 positions added.

The shift in care to the outpatient setting is one encouraged by health care reform and various other government initiatives. For example, the latest proposed Medicare Physician Fee Schedule, released the same day as the BLS report, included provisions to help boost income for primary care providers who take on harder-to-treat patients with multiple chronic conditions. The proposed rule creates more flexibility in who can provide disease management services — so that physicians don’t have to do it all — and a new billable chronic care management code that would reimburse $41.92 and could be billed as often as once per month per qualified patient.

This week, the U.S. Department of Health and Human Services (HHS) also announced $100 million in additional Affordable Care Act (ACA) funding for community health centers, which it says will enable the creation of 150 new community health centers across the nation in 2015.

In addition, it announced that it is providing $83.4 million under the ACA to train new primary care providers.