Health care workforce in a reform context: Lessons from AcademyHealth’s ARM 2011

Last week I attended AcademyHealth’s Annual Research Meeting in Seattle. Most of the sessions I attended focused on the implications of health reform for the capacity of our health care system to deliver timely primary care. Although the weather was overcast at times, the conversations were illuminating and provocative. Some recurrent themes overlapped with talk in the pre-meeting Workforce Interest Group.

Health care workforce information and planning will be integral to managing upcoming changes to the health care system.

Speakers on various topics expressed concern about the future supply of health care workers. Unfortunately, data on the health care workforce are fragmented and spotty. For example, in response to a presentation on a recent survey of California’s advanced practice nurses (APNs), one attendee commented how a free-standing survey can be required to obtain a simple estimate of nurse practitioners specializing in primary care. This is especially true in states such as Colorado that do not have an established health care professions monitoring program. (CHI, however, has focused on the health professions for several years and recently surveyed Colorado APNs to gather information on their health care provider role.)

Health care delivery as we know it will change in response to workforce and economic realities, and workforce planning will need to change with it.

Interest is increasing in using models of care such as the patient-centered medical home to foster greater health system efficiency. Enabling the existing workforce to use these models of care requires (1) workforce planning across the professions and (2) an approximation of what the professional mix might look like. While there won’t be a one-size-fits-all model, not even the barest structure has been defined. As one panelist commented, we are building the plane while flying it.

Here in Colorado, CHI is gathering and analyzing information in preparation for anticipated changes related to health care reform. Our website provides workforce data on a broad range of health care providers. In addition to APNs, CHI has surveyed physicians, physician assistants and other workforce professionals to help us assess the primary care workforce across professions. We will link this information to post-reform projections of primary care usage to provide policymakers with Colorado-specific information to inform their efforts.

These resources—even this blog—are part of CHI’s mission to translate research evidence into timely and relevant policy analysis.