What will the National Healthcare Workforce Commission do? A lot.

October 6, 2010

less providers + more patients = system breakdown

The Patient Protection and Affordable Care Act (PPCA) of 2010 – aka healthcare reform – included a provision to create a National Healthcare Workforce Commission (NHWC). The purpose is to create a body of expert representatives who are “who are nationally recognized in health care labor market analysis including workforce, health financing and economics, health facility management, heath plans and integrated delivery systems, workforce education and training, health care philanthropy, and providers of health care services” [http://phinational.org/]. Their job is to “serve as a national resource for the purpose of assessing if the demand for health care workers is being met, identify barriers to coordination between federal, state and local levels, and encourage innovations” [Summary of the Health Workforce Provisions in the Patient Protection and Affordable Act: H.R. 3590, March 2010, Rachel Morgan, Senior Health Policy Specialist.]

The challenges facing healthcare reform are well documented including on this blog site. Along with funding and creating a “public option” in the to-be-organized health exchange, a strategy must be created to fill the gap in primary care providers (PCPs) to the newly insured; ~15M in 2014 and twice number soon after. Of course, this gap cannot be filled happen right away; it is is too large and the training programs that turn out PCPs are too few and too small.

Commission member characteristics are prescribed in the law. There will be at least one member from (i) health care workforce and health professionals, (ii) employers, (iii) third-party payers, (iv) individuals skilled in interpretation of health care services and economics research, (v) representatives of consumers, (vi) labor unions, (vii) state or local workforce investment boards, and (viii) educational institutions. The other seven spots were filled by the Comptroller General at his discretion. The 15 appointed commissioners were announced September 30. Here is a link to that list.

In order to assess the nation’s specific healthcare workforce needs, the PPCA also established the National Center for Health Workforce Analysis to do the work required by the NHWC. Because there is too much work for a National Center there will also be State and Regional Centers for Health Workforce Analysis. The principle tasks of the National and State Centers include (i) develop information describing and analyzing the health care workforce and workforce related issues, (ii) carry out those activities, (iii) evaluate programs, and (iv) establish and publicize a national internet registry of grant awards along with a database to collect data from evaluations on performance measures.

Here is how the work will get done.
• Collect and analyze workforce data;
• Project the demand for workers;
• Determine education and training capacity and infrastructure and project the demand;
• Review the implications of new and existing federal policies that affect the health care workforce (including those supported through the Workforce Investment Act); and
• Determine the workforce needs of special populations.

Will the funding be enough? The National Center for fiscal years 2010 through 2014 is $7.5 million. The State and Regional Centers budgets for fiscal years 2010 through 2014 is $4.5 million aggregate. This is just the tip of the investigative iceberg.

one of the gospels

There is a lot of work in this legislation for researchers, evaluators, academic medical centers and primary care training programs. Funding to support expansion of allied health training programs in community colleges is there. Support for increasing the numbers of providers from under-represented populations is there.

There is no mention of how Complementary and Alternative Medicine providers might fit in. Perhaps that will be left up to the individual states and training programs, such as family medicine or nursing. No matter…there is plenty of work to do to meet the tsunami of newly insured and to put a nation back to work in a noble and worthwhile profession that has been decaying over the past several decades.

Evaluators, academics and public health policy wonks…start your engines.

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