Health Workforce Research e-Library

Medicaid claims data are increasingly used in shortage designation analyses. The panelists discuss their experiences in acquiring Medicaid claims data, cleaning the data, identifying provider specialty, and defining visits. The webinar includes a discussion with PCO participants on their experiences using Medicaid claims data.

The purpose of this analysis was to understand the impact of Medicaid dental benefits and the availability of dental providers on the utilization of dental services among Medicaid-eligible adults in Oklahoma.

Between February and July 2015 researchers at the Oral Health Workforce Research Center (OHWRC) completed case studies at 8 FQHCs headquartered or operating satellite clinics in 9 states. This brief explores the barriers and facilitators to integration of oral health services with primary health care delivery in federally qualified health centers (FQHCs) across the United States. It also discusses employment by FQHCs of a variety of novel oral health workforce to enable better access to oral health services in their delivery systems.

This project examined statutes and regulations governing the practice of dental hygiene effective in 2014 by state and rescored each of the descriptive variables in the 2001 DHPPI to update the scale. One goal of the study was to describe progression in permissions for dental hygienists to practice in expanded settings and to provide services under appropriate levels of required supervision. Rescoring the 2001 variables based on law and regulation in 2014 permitted comparisons of progressions in dental hygiene practice environments over the recent decade.

The objective of this research was to understand the impact of the quality of Medicaid dental benefits and the availability of dental providers for Medicaid enrollees on utilization of dental services. The following provides a comparative analysis between dental services to adult Medicaid enrollees in Oklahoma and New York, states which provide very different dental benefits for adults.

The objective of this research was to understand the impact of the quality of Medicaid dental benefits and the availability of dental providers for Medicaid enrollees on utilization of dental services. The following provides a comparative analysis between dental services to adult Medicaid enrollees in Oklahoma and New York, states which provide very different dental benefits for adults.

This brief examines trends in demand for advanced training by dental students and how this aligns with current policy supporting this training and practice. The brief also explores the impact of residencies in ambulatory care settings, particularly for federally qualified health centers (FQHCs), on service capacity and access for patients.

This report examines trends in demand for advanced training by dental students and how this aligns with current policy supporting this training and practice. The report also explores the impact of residencies in ambulatory care settings, particularly for federally qualified health centers (FQHCs), on service capacity and access for patients.

The Oral Health Workforce Research Center (OHWRC), in cooperation with the American Academy of Physician Assistants (AAPA) fielded a survey to a sample of physician assistants (PAs) to describe their current clinical practices related to oral health service delivery. This brief discusses PA practice characteristics, the extent and source of PA education in oral health, and facilitators and barriers to the integration of oral health service in practice.

The Oral Health Workforce Research Center (OHWRC), in cooperation with the American Academy of Physician Assistants (AAPA) fielded a survey to a sample of physician assistants (PAs) to describe their current clinical practices related to oral health service delivery. This report discusses PA practice characteristics, the extent and source of PA education in oral health, and facilitators and barriers to the integration of oral health service in practice.

In 2016, the Oral Health Workforce Research Center at the Center for Health Workforce Studies, under its cooperative agreement with HRSA, conducted a study to describe FQHCs’ participation with dental education and dental residency programs as clinical rotation sites for dental student externs and/or residents. Of special interest to the research was whether health centers subsequently employed any dental students and/or dental residents who had completed clinical rotations in the FQHC.

In 2016, the Oral Health Workforce Research Center at the Center for Health Workforce Studies, under its cooperative agreement with HRSA, conducted a study to describe FQHCs’ participation with dental education and dental residency programs as clinical rotation sites for dental student externs and/or residents. Of special interest to the research was whether health centers subsequently employed any dental students and/or dental residents who had completed clinical rotations in the FQHC.

Concerns about limited access to oral health services for underserved populations are prompting providers to adopt innovative service delivery models to meet the needs of those with access barriers. The use of teledentistry as a means to improve access to oral health services in areas with inadequate availability of general and specialty dental care is emerging as a practical solution, especially for treatment planning and specialty consultations. This brief helps provide a better understanding of teledentistry program applications, workforce strategies, impacts on access to care, the organizational structure in which services are provided, and the barriers and facilitators of teledentistry services.

Concerns about limited access to oral health services for underserved populations are prompting providers to adopt innovative service delivery models to meet the needs of those with access barriers. The use of teledentistry as a means to improve access to oral health services in areas with inadequate availability of general and specialty dental care is emerging as a practical solution, especially for treatment planning and specialty consultations. This report helps provide a better understanding of teledentistry program applications, workforce strategies, impacts on access to care, the organizational structure in which services are provided, and the barriers and facilitators of teledentistry services.

The underrepresentation of Blacks, Hispanics or Latinos, and American Indians or Alaska Natives among dentists raises concerns about the diversity of the dental workforce, disparities in access to dental care and in oral health status, and social justice. We quantified the shortage of underrepresented minority dentists and examined these dentists’ practice patterns in relation to the characteristics of the communities they serve.

The purpose of this paper is to describe the Black dentist workforce, the practice patterns of providers, and their contributions to oral health care for minority and underserved patients.

In 2001 we developed the Dental Hygiene Professional Practice Index, a numerical tool to measure the state-level professional practice environment for dental hygienists. We used the index to score state-level scopes of practice in all fifty states and the District of Columbia in 2001 and 2014.

This mixed method study examines the models of delivery of dental care in LTC facilities under varying policy conditions in four U.S. states – California, Florida, Minnesota, and North Carolina.

This project examined statutes and regulations governing the practice of dental hygiene effective in 2014 by state and rescored each of the descriptive variables in the 2001 DHPPI to update the scale. One goal of the study was to describe progression in permissions for dental hygienists to practice in expanded settings and to provide services under appropriate levels of required supervision. Rescoring the 2001 variables based on law and regulation in 2014 permitted comparisons of progressions in dental hygiene practice environments over the recent decade.

In 2014, CHWS was awarded a Cooperative Agreement from HRSA to establish an Oral Health Workforce Research Center (OHWRC). One of the first projects conducted under the agreement was to update the 2001 DHPPI to reflect legal conditions for dental hygiene practice in states in 2014. Comparison of scores by state between 2001 and 2014 revealed that scope of practice for the dental hygiene profession had evolved in the decade since the DHPPI was originally constructed, and the variables selected no longer reflected the full scope of dental hygiene practice. To ensure the currency of the DHPPI, the OHWRC sought and received approval from HRSA to construct a “new” DHPPI scale in 2016.

The Center for Health Workforce Studies (CHWS) developed a numerical scope of practice index for the dental hygiene profession called the Dental Hygiene Professional Practice Index (DHPPI) under a contract with the National Center for Health Workforce Analysis at the Health Resources and Services Administration (HRSA). Because the variables in the original DHPPI, which was constructed in 2001 and rescored in 2014, no longer reflected the full scope of dental hygiene practice in states, a new DHPPI was developed to better reflect current practice for the profession. This report describes the process of redesigning the DHPPI and provides the scores for each state on the new index.

The purpose of this study was to examine URM dentists’ contributions to health equity by examining URM dentists’ size, distribution, and practice patterns in relation to community characteristics and patient mix.

The purpose of this article is to describe the American Indian/Alaska Native (AI/AN) dentist workforce, the general practice patterns of these providers, and their contributions to oral health care for AI/AN and underserved patients.

As the aging population increases, the need for palliative care to address serious and chronic illnesses has also increased. However, there is little research on whether palliative care programs meet national staffing guidelines. This article describes an analysis of self-reported operational data on hospital-based palliative care programs from the 2012–13 annual voluntary surveys of the National Palliative Care Registry to examine whether staffing differences were impacted by program characteristics, hospital characteristics, or region.

Many nursing homes have adopted health information technology (HIT) to help improve quality of care and staff productivity. However, it has been unclear as to whether HIT systems have had the intended effect on staff productivity and patient outcomes. This report describes a study utilizing a literature review as well as interviews and focus groups with key informants in nursing homes to examine processes of implementation for HIT systems in nursing homes as well as their impact on patients and staff.

As the aging population and the demand for long-term care services increases, more information will be needed about what factors contribute to stress, burnout, and retention of long-term care (LTC) workers. This report describes a study that utilized data from the American Time Use Survey from 2003-2014 to compare how LTC workers and other health professionals spend their time to identify factors that may contribute to the decreased health and well-being of LTC workers.

This report summarizes the findings of a landscape analysis on mobile integrated healthcare – community paramedicine (MIH-CP) programs that serve persons who currently need or who are at risk for receiving LTC and presents 4 examples of MIH-CP programs that serve these persons.

This study explores the history and configurations of the care workforce in four health systems. Understanding the care coordination role and requirements will assist workforce planning for this growing role.

As the aging population increases, the need for palliative care to address serious and chronic illnesses has also increased. However, there is little research on whether palliative care programs meet national staffing guidelines. This brief describes an analysis of self-reported operational data on hospital-based palliative care programs from the 2012–13 annual voluntary surveys of the National Palliative Care Registry to examine whether staffing differences were impacted by program characteristics, hospital characteristics, or region.

Several health professions have developed a discipline-specific Minimum Data Set (MDS) to facilitate the establishment of databases which collect common elements that can address questions related to worker supply, practice setting, and care provision. These elements were codified into an MDS by SAMHSA about 15 years ago. Building from all of these elements, including those developed for Licensed Professional Counselors, Psychologists, and Substance Use/Addition Counselors, the Behavioral Health Workforce Research Center (BHWRC) developed an updated MDS to inform workforce planning efforts for the broader behavioral health workforce.

As demand for greater and more diverse behavioral health care services increases, expansion of occupational scopes of practice (SOPs) has been suggested as one mechanism for enhancing workforce capacity. SOPs that are uniform for a given occupation across states, and complementary across behavioral health occupations, may help ensure that a full range of mental health and substance use disorder services are authorized and easily accessible for patients. This policy brief explores SOPs for 9 behavioral health occupations, comparing similarities, variations, and gaps in provider authority.

The purpose of the current study is to obtain, analyze and disseminate information about social work SOPs from all fifty states and the District of Columbia, with an emphasis on determining the range of allowable services and professional training requirement of social workers.

In this brief, researchers investigate the use of current procedural terminology (CPT) codes used in behavioral health practice, identify restrictions and limitations around each commonly used CPT, and interview behavioral health providers about CPT code restrictions that may limit scopes of practice.

A behavioral health workforce Minimum Data Set (MDS) was developed through a collaborative process with the Behavioral Health Workforce Research Center (BHWRC) research team and partner Consortium. An MDS instrument with 5 main themes was constructed to include numerous data elements to describe workforce size, composition, and characteristics of the behavioral health workforce, which was broadly defined to include any worker responsible for prevention and/or treatment of mental health or substance use disorders. This report discusses the behavioral health workforce MDS instrument that was developed, exploring demographics, licensure and certification, education and training background, occupation and area of practice, and practice characteristics and practice settings. The MDS instrument was refined based on feedback from subject-matter experts and focus group participants.

Paraprofessionals and other behavioral health technicians have been increasingly recognized for their key role in mitigating provider shortages and increasing behavioral health care access to underserved youth and minority populations. Therefore, it is important to understand the procedures, processes, and services these providers are authorized to provide, as outlined by a scope of practice (SOP). This article examines the scopes of practice for 4 common behavioral health paraprofessions and addiction counselor occupations and investigates the alignment, or lack thereof, between scopes of practice and actual practice for each profession.

The provision of care for rural and geographically isolated vulnerable populations presents substantial challenges for the behavioral health workforce related to its supply and retention of clinicians. This issue is a barrier to providing accessible services to those most in need. This policy brief assesses behavioral health workforce supply and need, barriers to recruiting and retaining care providers, and the extent to which care coordination occurs within care providers serving underserved rural populations in Michigan.

In this report, researchers investigate the use of current procedural terminology (CPT) codes used in behavioral health practice, identify restrictions and limitations around each commonly used CPT, and interview behavioral health providers about CPT code restrictions that may limit scopes of practice.

The behavioral health workforce faces considerable challenges, including demand for behavioral health services, changes to the health system under the Affordable Care Act, the return of war veterans with behavioral health needs, and a shift from incarceration to treatment-oriented behavioral health care in the criminal justice system. These changes place additional strain on the existing workforce and exacerbate behavioral health workforce recruitment and retention challenges such as high turnover, high workload, lack of resources, and stigma. This policy brief assesses work environment factors that may impact recruitment, retention, job satisfaction, and diversity of the behavioral health workforce.

In this issue brief we suggest that, to make the workforce more effective, we need to broaden our definition of who is in the health workforce, focus on retooling and retraining the existing workforce, shift from training workers in acute settings to training them in community-based settings, and increase accountability in the system so that public funds spent on the health professions produce the workforce needed to meet the state's health care needs. North Carolina has arguably the best health workforce data system in the country; it has historically provided the data needed to inform policy change, but adequate and ongoing financial support for that system needs to be assured.

The number of actively practicing physicians in the United States is not precisely known, nor do we know the total number of physicians required to meet population needs. The possible gap between these two numbers is a controversial issue, especially for primary care physicians.

Proposed legislation has suggested that the Workforce Commission (which was never funded), HRSA, and GAO provide input on how new GME positions would be distributed among specialties and states. Currently, these entities do not have a methodology to translate data from workforce projection models into actionable information that could be used to determine how new GME positions should be allocated by state and by specialty. The purpose of this project was to outline such a methodology and use a case example to illustrate how the methodology could be applied.

Stroke survivors who are given early contact with a physical and/or occupational therapist following their stroke improves their outcomes for recovery. The majority of stroke survivors are discharged home following an acute care admission. Understanding the care pathway from the acute to community setting and continuity of therapy across settings is extremely important to the survivors’ recovery. This brief assesses the use of physical and occupational therapists in acute and community settings for discharged stroke patients and identifies contextual factors that impact therapist use.

The purpose of this study was to: 1. survey existing DNP programs to identify the non-academic settings into which their DNP graduates are employed, 2. conduct semi-structured interviews with employers to identify: the roles into which DNP-prepared nurses are hired, including DNP-specific roles, APRN roles, and administration roles, the ways in which DNP-prepared nurses differ from nurses with other preparation (e.g. MSN) when employed in APRN or nursing administration roles, and the flexibility (i.e., their general availability and having the time in their day and skills to fill in for others) that DNP-prepared nurses bring to organizations, including their impact on organizational capabilities consistent with the aims of the DNP curriculum (i.e., evidence-based practice, quality improvement, and systems leadership) as well as other areas identified by the employers.

In conjunction with other legislation, the Patient Protection and Affordable Care Act (ACA) is transforming medical care in the United States. The ACA is seeking to improve patient and population health outcomes while lowering costs. One mechanism is to incentivize the use of interprofessional health teams in primary and specialty care settings. These changes require reconfiguring and strengthening the capabilities of the healthcare workforce. This includes building the capacity of the workforce to focus on both the physical and social determinants of health. This policy brief aims to better define the functions of social workers in integrated care delivery models.

In this project, we examined the professional trajectories of LPNs and described predictors of their transitions to the RN role, including demographic characteristics (e.g., age, gender and self-reported race), professional characteristics (e.g., setting of LPN employment, specialty as a LPN, years since licensed as a LPN, full time versus part time employment and Area Health Education Centers (AHEC) in North Carolina, educational degrees (e.g. highest degree in nursing in last year as an LPN, country of LPN education), geographic location (e.g., rural versus urban address and others), and, as available, socio-economic factors (e.g., unemployment status).

This presentation discusses low skilled low wage workers in health care.

This study provides information that can be used by policymakers, practitioners, educators and other health workforce planning stakeholders to develop health workforce plans and policies to increase access to behavioral health care services through primary care settings.

This descriptive study provides information that can be used by policymakers, practitioners, educators and other health workforce planning stakeholders to develop plans and policies to increase access to behavioral health care services through primary care settings.

This presentation focuses on immigrants in health care jobs.

This study investigates socioeconomic well-being, including occupation-skill match, financial situation, and reliance on state/federal assistance programs, among individuals working in healthcare.