Getting Ready for Expanded Coverage: State Efforts to Understand Health Care Workforce Needs

By 2022, the expansion of health insurance coverage through Medicaid and the health insurance exchanges is expected to insure an additional 21.3 million individuals and drive up the demandfor health care services. This new demand must be met by an adequate healthcare workforce. Between 2010 and 2020, the health care workforce is expected to grow by 5.6 million, but that may not be enough. Predictions indicate the ACA coverage expansion will worsen the primary-care provider shortage from 25,000 to 45,000 practitioners by 2025. Some argue, however, that delivering care more efficiently—designating mid-level practitioners as primary care providers, for example—can improve the provider-to-consumer ratio. Still, the shortage could leave 7 millionAmericans without adequate access to primary care providers.
Although there is broad consensus about the reality of the shortage, state assessments of the health care workforce have found there is insufficient data available to make conclusive findings on provider-scarcity states may face in the years to come. Fragmented data collection and calculation methodologies across states and professional groups also make it difficult to set priorities and identify strategies that could help solve the problem. Some states, as highlighted below, are moving forward with solutions to both the data puzzle and the workforce shortage.
o   Virginia: The Department of Health Professions Healthcare Workforce Data Centeractively collects data on initial licensee applications and certification renewals. The Center produces monthly briefs on trends in the Virginia health employment sector and reports on its findings by professional group annually. The state currently has 20 professional surveys in circulation and ensures the data is publically available for stakeholder use. Future reports will focus on physician assistants, nurse practitioners and other health professionals. The stateestablished the Virginia Health Workforce Development Authority in 2010 which partners with the Data Center and other state initiatives to perform workforce needs assessments and foster innovative workforce development strategies.
o   Oregon: The Oregon Healthcare Workforce Institute was established in 2006 to developprofiles of the Oregon workforce by their economic contributions and profession type. The Institute aims to support workforce expansion, development of public policy, and stakeholder collaboration. In 2010, the state also established the Health Care Workforce Committee to align statewide efforts to improve the capacity of the workforce in the face of health reform. In January 2013, the committee released a five-year strategic plan that used licensing data to project the state will need 76,000 new health care workers, an increase of 48%, between 2010 and 2020. The state hopes to pursue a “grow your own” strategy to produce more primary care providers in Oregon, while improving the state’s external recruitment and aiding rural communities with recruitment efforts already in place.
o   Colorado: Since 2004, the Colorado Health Institute has analyzed data on the state’s health care workforce collected by the Colorado Department of Regulatory Agencies. Thisdata collection has expanded from physician-specific data to include dentists, registered nurses, social workers, psychologists, nurse practitioners, and physician assistants. Last spring, drawing on this information, the Institute reported on access to care and health care workforce issues in Colorado. In December, they released a report on how the distribution of the Colorado workforce affects the health care safety net and access to care.
Other states are also taking on this issue. Montana is considering the use of minimum data sets, which will ensure that enough data is collected to compare information across professions, locations, and time periods. Vermont’s workforce strategic plan recommends the state create a permanent workforce planning workgroup and mandates data collection for licensing, certification and registration of health care professionals. California’s Healthcare Workforce Clearinghousecollects and analyzes data on the state’s educational and employment trends for health care professions, which is used by the Healthcare Workforce Development Division to inform policy and development programs.
Is your state working on how to better collect and use information on the health care workforce? Share your thoughts in a comment below.