Health Workforce Research e-Library

By working with state rural health and health workforce offices, this study determined the current recruitment practices to both build the provider pipeline in a given state and incentivize practice in areas suffering from maldistribution of workers. This report describes state incentives for behavioral health provider recruitment, particularly in rural areas.

The analysis examined characteristics of the child and adolescent psychologist workforce, including psychologists who self-report being child and adolescent psychologists (2015 American Psychological Association Survey of Psychology Health Service Providers and National Plan and Provider Enumeration System (NPPES) Registry) and psychologists who are board certified in clinical child and adolescent psychiatry (American Board of Professional Psychology).

The analysis examined characteristics of the child and adolescent psychologist workforce, including psychologists who self-report being child and adolescent psychologists (2015 American Psychological Association Survey of Psychology Health Service Providers and National Plan and Provider Enumeration System (NPPES) Registry) and psychologists who are board certified in clinical child and adolescent psychiatry (American Board of Professional Psychology).

This brief aims to determine the variation in behavioral health provider reimbursement rates per unit of service under fee-for-service (FFS) and MCO in states with Medicaid waivers for behavioral health, and in non-waiver states, determine if there are fewer behavioral health providers available in Medicaid FFS and MCO programs.

This study aimed to measure the extent to which social workers were able to transition to tele-behavioral health during COVID-19 and the barriers and facilitators they experienced during this rapid change to tele-behavioral health service delivery.

In order for the current health workforce to meet the increasing demand brought about by the pandemic, health care delivery organizations, educators, and government leaders will need to work together to adapt regulations to expand workforce capacity. Strategies such as expanding scopes of practice, developing cross-state licensure programs, and increasing telehealth services are essential. This article provides recommendations for increasing and sustaining a vibrant health workforce during the pandemic and beyond.

Evidence supports that integrated behavioral health care improves patient outcomes. Colocation, where health and behavioral health providers work in the same physical space, is a key element of integration, but national rates of colocation are unknown. This article establishes national colocation rates and analyzes variation by primary care provider (PCP) type, practice size, rural/urban setting, Health and Human Services region, and state.

To describe and compare triennial rates of physicians’ recommendations for physical therapy (PT), lifestyle counseling, and pain medication for knee osteoarthritis (OA) and to identify patient, physician, and practice factors associated with each treatment recommendation.

This research brief assesses which professionals comprise the workforce that provides MAT in primary care, how OBOT teams communicate about patient care, and the behavioral components of MAT provided in primary care settings.

Surge planning for COVID+ patients requires administrators to evaluate capacity and capability in space, skills, and supplies, and then develop and apply structures to move current capacity to maximum capability. This document provides guidelines and resources to prepare organizations for an increase in patient volume in the wake of the COVID-19 pandemic.

This document focuses on providing resources for surging critical care skills, not critical care professionals. This document contains suggestions for focused strategies to maximize skill utilization in defined roles to meet the surge demands of the COVID-19 pandemic. State regulatory and scope of practice restrictions should always be consulted

Surge planning for COVID+ patients requires administrators to evaluate capacity and capability in space, skills, and supplies, and then develop and apply structures to move current capacity to maximum capability. This document provides guidelines and resources to prepare organizations for an increase in patient volume in the wake of the COVID-19 pandemic.

This document focuses on maximizing the skillsets of health care workers on a home care team in order to meet an increased workforce demand. Attention is given to “flexing” the skills of staff already in homebased care as well as incorporating new members into the team and telehealth where appropriate.

This document focuses on providing resources for medical inpatient specialists and ambulatory care providers who will be expanding their scope of care to include acute care and general inpatient medical care. This document contains suggestions for focused strategies to maximize skill utilization in defined roles to meet the surge demands of the COVID-19 pandemic and to ensure patients that are displaced to specialty floors receive appropriate care. State regulatory and scope of practice restrictions should always be consulted.

This document provides suggestions for how to maximize the skillsets of potential health care workers on a LTC team in order to meet an increased workforce demand. Attention is given to “flexing” the skills of staff already in LTC, as well as incorporating new members into the team and alternate workflows where appropriate. State regulatory and scope of practice restrictions should always be consulted.

Among the many trends influencing health and health care delivery over the next decade, 3 are particularly important for North Carolina: 1) the transition to value-based care and increased focus on population health, 2) the shift of care from acute to community-based settings, and 3) addressing the vulnerability of rural health care systems. This report discusses how to best utilize common workforce strategies to develop the future health workforce in North Carolina.

This document focuses on providing resources for healthcare workers who are returning to practice or shifting roles to meet surge needs for ambulatory care. Attention is given to “flexing” the skills of staff already in ambulatory care as well as incorporating new members into the team and telehealth where appropriate.

Community Health Centers (CHCs) are critical to our nation's ability to respond to COVID‐19 in rural and underserved communities. Rural residents are at increased risk of poor outcomes due to age and health status, and there are substantially fewer healthcare resources available in rural areas, meaning that once the virus becomes more widespread in these communities, the results could be disastrous. This commentary examines the real threat COVID-19 poses to CHCs and the current efforts being made to save them.

Increasing aware­ness of the Social Determinants of Health (SDOH) has prompted health systems to im­plement strat­egies to screen for and address pa­tient SDOH. With the increased awareness comes the question of what workforce is needed to implement SDOH screening and re­lated inter­ventions? To answer, this research must be conducted for which healthcare workers screen for SDOH, who actually addresses needs related to patient SDOH, and how to incorporate screening and intervention into the clinic work­flows. This research brief uses Electronic Health Records (EHR) data to describe the mix of profession­als identifying and addressing pa­tient SDOH.

To help inform workforce development policies and strategies to train the future office-based opioid treatment (OBOT) workforce, this study examined: (1) the provider composition of OBOT teams, (2) team members’ respective duties, and (3) communication patterns.

We call for increased attention to and investment in prevention and health promotion in the proposed 5As framework. We contend that effectively addressing SDOH and improving alignment between health and social systems require reconceptualization of the traditional health care workforce and renewed state and national advocacy efforts. A paradigm shift encompassing a broader "workforce for health" that is well trained in prevention, health promotion, and advocacy is critical to addressing SDOH, improving population health outcomes, and achieving health equity. Given their professional mission, training, expertise, and scope of practice, social workers are well positioned to lead this effort.

Despite a growing body of research on the evolving roles of medical assistants, nurses, social workers, pharmacists, nurse practitioners, and physician assistants, there is currently a lack of knowledge regarding different team configurations in primary care practices. This article utilizes data from the American Board of Family Medicine (ABFM) examination application to explore what types of professions are working together in practice.

Medical assistants (MAs) are a flexible and low-cost resource for primary care practices and their roles are swiftly transforming. We surveyed MAs and family physicians in primary care practices in North Carolina to assess concordance in their perspectives about MA roles, training, and confidence in performing activities related to visit planning, direct patient care, documentation, patient education, coaching or counseling, quality improvement, population health and communication.

Medication-assisted treatment (MAT) in office-based opioid treatment (OBOT) is expanding treatment of opioid use to primary care settings. OBOT combines MAT and behavioral health interventions, however, the literature varies on best practices. This review focuses on psychosocial interventions as an OBOT component.

This brief describes the respiratory therapist workforce in the U.S.

Therapy assistants represent approximately half of the therapy workforce in skilled nursing facilities. Employment of therapy assistants enables skilled nursing facilities to provide more therapy services at lower costs. As new payment mechanisms provide incentives for therapy in skilled nursing facilities, employment of therapy assistants may be a cost-effective way to continue to provide services when necessary. This article examines the relationships between organizational characteristics of skilled nursing facilities and employment of therapy assistants.

This study describes the health-related occupations that are able to deliver evidence-based non-pharmacologic pain management, and how education-, policy- and practice-related factors serve as barriers or facilitators to further leverage this workforce to effectively help manage chronic pain.

This study describes the professions that are able to deliver evidence-based non-pharmacologic pain management, and how education-, policy- and practice-related factors serve as barriers or facilitators to further leverage these professions to effectively provide collaborative pain management.

Therapy assistants represent approximately half of the therapy workforce in skilled nursing facilities. Employment of therapy assistants enables skilled nursing facilities to provide more therapy services at lower costs. As new payment mechanisms provide incentives for therapy in skilled nursing facilities, employment of therapy assistants may be a cost-effective way to continue to provide services when necessary. This article examines the relationships between organizational characteristics of skilled nursing facilities and employment of therapy assistants.

In October 2019, the Centers for Medicare & Medicaid Services (CMS) implemented a new payment model for skilled nursing facilities (SNFs) that eliminated financial incentives to provide high-intensity therapy. Yet high-intensity therapy in SNFs has been linked to better quality outcomes, potentially putting patients at risk if clinically indicated therapy is reduced under the new payment model. A metric to help differentiate between financially motivated vs clinically indicated therapy in SNFs is thresholding: the percentage of patients receiving therapy within 10 minutes of reimbursement thresholds. This study examined which SNF characteristics are associated with thresholding and how thresholding relates to quality outcomes.

This study explores commuting patterns among selected health care occupations, including where people live versus work, and how these patterns may inform discussions of health workforce supply.

This study explores commuting patterns among selected health care occupations, including where people live versus work, and how these patterns may inform discussions of health workforce supply.

This brief describes the physical therapist workforce in the U.S.

To date, no single source of information exists that best characterizes the increasingly complex nature of the pharmacist workforce. In this study, we reviewed the literature and conducted interviews with key stakeholders from national pharmacy professional organizations. This study aimed to identify the many different settings where pharmacists work, their current and emerging roles, and the barriers and facilitators to greater involvement of pharmacists in patient care.

This brief describes the pharmacist workforce in the U.S.

This poster focuses on how racial/ethnic composition of associate degree in nursing programs have changed over time between 2012-2018, and compares whether student composition varies by the institutional status of the programs.

Policies that support graduate medical education (GME) have goals of increasing the proportion of program graduates who remain in generalist practice and, for pediatrics, in subspecialties supported through the Children’s Hospital Graduate Medical Education Program. Policy attention has also focused on promoting practice in primary care health professional shortage areas, and in rural and micropolitan counties. Although individual states have spent millions of dollars annually on residency training, it has become apparent that they have little knowledge of what their investment yields in terms of producing a physician workforce that includes sufficient generalists and subspecialists that practice in underserved locations. This policy brief explores outcome metrics that can be used to evaluate pediatric GME investments in producing the workforce that meets state and national health care needs.

The role of the Doctor of Nursing Practice-prepared nurse (DNP) outside of academic settings has not been clearly articulated or widely explored, and therefore the value DNP-prepared nurses bring to their practice settings is largely unknown. This study: (1) surveyed existing DNP programs to identify the nonacademic settings in which their DNP graduates were employed and (2) conducted semistructured interviews with employers to identify the role and value of the DNP-prepared nurse in nonacademic settings.

The opioid epidemic is a national emergency in the United States. To meet the needs of individuals diagnosed with Opioid Use Disorder (OUD) office-based opioid treatment programs (OBOT) are quickly expanding. However, social workers roles in OBOT programs are not clearly described. This paper will emphasize three roles social workers may fulfill in OBOT programs to combat the opioid crisis.

Traditional workforce planning methodologies and interprofessional education (IPE) approaches will not address the significant challenges facing health care systems seeking to integrate services, eliminate waste and meet rising demand within fixed or shrinking budgets. This article describes how New Zealand's workforce planning approach could be used as a model by other countries to move toward needs-based, interprofessional workforce planning.

This study serves as a benchmark of the growth of Integrated Behavioral Healthcare (IBH) and continued monitoring of co-location is needed to ensure social work workforce planning and training are aligned with changing models of care. Further, identifying mechanisms to support social work education, current providers, and health systems to increase IBH implementation is greatly needed.

This article presents findings from a study of 395 social workers who are members of interprofessional teams in integrated health care settings across the country. Discussion includes the characteristics, clinic types, and populations served are explored.

This research brief demonstrates how electronic health records data can be used as a workforce research tool to assess the scope, contributions, and value of social work, a profession still in the process of establishing its return on investment in health care.

While the number of physician assistants (PAs) participating in the primary care workforce continues to rise, the proportion of PAs practicing in primary care rather than other specialties has decreased. The purpose of this study was to identify the characteristics of matriculating PA students planning to enter primary care specialties and compare them with students planning on entering other specialties.

Incentive programs are a common strategy to address health professional shortages, and this study sought to systematically describe allied health incentive programs at the state level (including the District of Columbia)—their goals, policies, practices, and available data on their success in allied health professional recruitment and retention to rural and underserved areas.

State-based programs that provide loans, scholarships, and other incentives for allied health professionals in exchange for service in rural and underserved areas are one approach to alleviating workforce shortages. This study examined the operation of these programs across the U.S., allied health professionals targeted, and efforts to gauge programs’ success in recruitment and retention through a review of publicly available information on state programs and interviews with program leaders in 27 states.

Medical assistants (MAs) are a rapidly growing and increasingly important workforce. High MA turnover, however, is common and employers report applicants frequently do not meet their needs. We collected survey responses from a representative sample of Washington’s MAs with certified status (MA-Cs) to understand their demographic, education and employment backgrounds, job satisfaction, and career plans.

This presentation focuses on state incentive programs that encourage allied health professionals to provide care for underserved populations.

This study examined the early pipeline of physician assistants (PAs) by comparing the characteristics of recently matriculated PA students who, at the beginning of their training, expressed intent to practice in primary care with matriculated PAs planning to enter other specialties

This study identifies key components of registered MA apprenticeship programs in the U.S. and describes implementation approaches. It describes motivations for, as well as barriers and facilitators to implementing apprenticeships. Findings help clarify the development, design, and expansion of MA apprenticeship programs in the U.S. and offer employers and other sponsors alternative ways to adopt this workforce development approach.