The Year in Review: Resources for Assessing and Extending the Health Care Workforce

The Affordable Care Act’s signature goal of expanding coverage brings with it a projected increase in demand for health care services. States have long been concerned with improving the capacity of the health care workforce, and are taking steps to meet this increased demand.
In states including Washington and Maryland, committees are meeting regularly to assess workforce issues and identify solutions. Some of these are laid out in the Alliance for Health Reform issue brief “Health Care Workforce: Future Supply vs. Demand” including ideas for recognizing shortages, making care delivery more efficient, and training new providers.
Identifying current and projected shortage areas
One of the first steps in strategically addressing provider capacity is assessing the state of the current health-professional workforce. States and national organizations have developed resources to measure the health care workforce. A report from California estimates both the supply and demand for registered nurses through 2030. The method California used to calculate registered-nurse supply may be useful to other states. Similarly, Colorado recently completed aprofile of the state’s physician assistant workforce. Two briefs from the Kaiser Commission look at the willingness of primary care physicians to serve newly eligible Medicaid enrollees and at therole that nurse practitioners and physician assistants could play in providing primary care to these newly covered patients. Safety net providers will remain an important part of the health care system when the ACA is fully implemented. States including Iowa and North Carolina are taking steps to inventory their safety net infrastructures and make plans to maintain them.
Strategies to extend the current workforce
Extending the reach of providers, in addition to raising the number of providers, is another way to increase health care workforce capacity and meet patient needs. State scope-of-practice laws and licensure requirements can be written to allow all providers to practice to the full extent of their training and licensure. A case study of Pennsylvania describes how one state has addressed this sometimes contentious issue, and a presentation about Colorado outlines scope-of-practice issues as they relate to primary care delivery in that state. Connecticut recently passed legislation that lays out the state’s process for considering requests to change scopes of practice. States are also beginning to consider the roles and training pathways of new provider types: community health workers in Massachusetts, home care aides in Ohio, and other allied health providers in California are a few examples. In addition, states are looking to telehealth as a possible method for extending the reach of the current workforce. This report from the Center for Connected Health Policy shares policy considerations and a model statute to support telehealth.
Training new providers
Improving provider capacity is a long-term endeavor. Training more health professionals now is one way to add capacity in the future. Health professional schools can recruit and train aspiring providers to meet identified areas of need. An issue brief from HealthReformGPS nicely lays out the ACA provisions that deal with education, training, and support of public health and allied health care workers. Colorado recently analyzed the supply of nursing school faculty, and identified promising practices for recruiting and retaining needed faculty who will educate the next generation of nurses.
If your state is thinking about how to meet demand for health care services, the resources shared on State Refor(u)m may help. If your state has already made strides in thinking about these issues, please share them so others can learn from you.