Health Workforce Research e-Library

The focus of this paper is to review current programs/trends that could be useful in increasing the number of providers that can effectively serve individuals with co-occurring disorders (COD) using evidence-based practices. Specific policy recommendations to develop the workforce and more effectively track trends over time are provided.

This cross-sectional study examines the relationship between reimbursement and behavioral health provider geographic distribution and seeks to understand how Medicare and Medicaid reimbursement for behavioral health providers may limit service delivery.

This cross-sectional study examines the relationship between reimbursement and behavioral health provider geographic distribution and seeks to understand how Medicare and Medicaid reimbursement for behavioral health providers may limit service delivery.

This brief documents a sample of existing behavioral health care models, the required workforce, and current financing. A resource use model explores existing and proposed fee-bundled, value-based, and capitated payment models. This study helps to inform managers and policymakers at the local, state, and federal levels of viable financing arrangements to promote these and future novel approaches to delivering high-quality, accessible, and sustained behavioral health care to communities and vulnerable populations.

This report documents a sample of existing behavioral health care models, the required workforce, and current financing. A resource use model explores existing and proposed fee-bundled, value-based, and capitated payment models. This study helps to inform managers and policymakers at the local, state, and federal levels of viable financing arrangements to promote these and future novel approaches to delivering high-quality, accessible, and sustained behavioral health care to communities and vulnerable populations.

This study surveyed addiction medicine physicians to describe barriers and facilitators to implementing MAT via telemedicine, estimated nationwide access to specific OUD treatment services, and explored how telemedicine could potentially improve access to care

This study builds upon the existing MAT prescriber surveys conducted by the Behavioral Health Workforce Research Center by surveying addiction medicine physicians to further describe the barriers and facilitators to implementing MAT via telemedicine. This study also aimed to identify if these barriers and facilitators differed based on provider characteristics or patient locations. Lastly, the study estimated nationwide access to specific OUD treatment services, and explored how access could potentially be improved via telemedicine.

In this study we investigate the overall and relative impacts of registered nurses (RNs) and licensed practical nurses (LPNs), on the one hand, and nursing assistive personnel (AP) on the other, on six different measures of patient satisfaction outcomes. In addition to contributing to the nurse staffing literature, the purpose of the study was to develop a methodological approach that could be further adapted for use with different types of workers, different outcomes in different organizational settings.

Federal programs such as the National Health Survey Corps (NHSC) are important for ensuring an adequate supply of primary care professionals in underserved areas. However, we know little about how much NHSC clinicians expand patient capacity at the organizations in which they serve. This article describes a study that examined longitudinal administrative data at more than one thousand qualified health centers in 2013-2016 to determine whether NHSC clinicians increase clinical capacity at these health centers or merely substitute for non-NHSC clinicians.

Using four years of data from a nationally representative consumer survey that spans all payer types, this study fills an important gap by examining trends in telehealth usage over time across the US population and subgroups, as well as examining the role that state telehealth policies play in telehealth usage.

The Next Generation Model targets organizations with a long history of care coordination and population health. The objective of this study is to explore how leaders of Next Gen ACOs are thinking about alternative workforce models, and in particular, emerging roles that may be critical to this latest evolution of value-based care. We also specifically explore the use of the Next Gen waivers that aim to increase use of telehealth, home visits, and reduce hospital stays prior to admission to a SNF, and ask whether leaders believe that the waivers are facilitating the use of new types of health workers. These exploratory questions are intended to lay the groundwork for subsequent survey research that could quantify workforce change occurring in ACOs and relate them to outcomes.

Few studies have examined practice redesign to understand how staffing changed with the adoption of patient-centered medical homes (PCMH), and whether these staffing changes impacted utilization. This article examines the workforce transformation occurring in community health centers that have achieved PCMH status and assesses the relationship of those changes to utilization, as measured by the number of visits.

The Center for Health Workforce Studies, in conjunction with the New York State Center of Excellence in Wireless and Information Technology (CEWIT), unveils New York’s new online Health Workforce Planning Data Guide. The data guide provides information on population demographics, health behaviors and outcomes, as well as the health care system and workforce through data visualization. The interactivity of the data guide allows users to tailor the information to their individual interests and to understand the data on multiple levels. This online data guide serves as a model for other states that are interested in developing one of their own. This webinar presents the visualization features of the data guide, and discusses best practices for initial development of the tool and for collecting and integrating data.

Learn about strategies for identifying and engaging workforce stakeholders at the state level, maintaining stakeholder relationships over time, and troubleshooting problems that arise.

This webinar provides an introductory overview of the oral health workforce in America and highlight key themes emerging from the OHWRC’s work, including: strategies that facilitate oral health integration with primary care, particularly among safety net providers in clinics as well as community based settings, oral health service innovation, with an emphasis on interdisciplinary team based approaches to providing oral health services, including the use of dental therapists, advanced practice dental hygienists and community health coordinators.

The Washington Health Workforce Sentinel Network was developed to detect and communicate emerging health workforce demand changes within a statewide network of engaged industry, education and policy stakeholders. Using an online survey tool, employer “sentinels” periodically respond to a short set of questions on recent workforce vacancies, demand, newly assigned roles/occupations and training/education needs. This webinar describes the collaborative process by which the Sentinel Network was developed, presents key findings to-date, describes current dissemination efforts and outlines future plans for Washington’s Health Workforce Sentinel Network.

During this webinar, the presenters discuss some of the considerations necessary for preparing and presenting health workforce demand data using online interactive dashboards, based on their experience with the Washington State Health Workforce Sentinel Network. Topics covered include: how to create dashboards based on data that are updated periodically, data privacy concerns, software and hardware needs, and a brief overview of Tableau software.

As part of the Health Resources and Services Administration’s (HRSA) Shortage Designation Modernization Project, HRSA is asking PCOs to update state correctional facility and state/county mental hospital designations by July 2nd. This webinar reviews the criteria for these types of designations and includes an interactive panel discussion on things to consider/best practices. Time is also be allotted for PCO participants to ask questions at the conclusion.

HWTAC is conducting an ongoing survey of states to learn more about their health workforce data collection and analysis efforts. This report describes findings to date from the 2018 survey, and includes information about data collection on health workforce supply and demand, and the educational pipeline in specific US states.

The Behavioral Health Workforce Research Center at the University of Michigan's School of Public Health collected scope of practice and credential requirements for 10 behavioral health occupations across all 50 states and DC. These data were then transformed into 2 visualization tools and hosted on the Center's website, allowing visitors to parse through the information intuitively and export subsets of their choosing. This 30-minute webinar covers the visualizations' functionality in detail, explaining the range of information captured, how to use the online tools, and what features will be added in the future. To view the tools, click here. If you have questions or feedback on the tools, please email bhworkforce@umich.edu. 

The Oral Health Workforce Research Center studies dental hygienist (DH) scope of practice and finds great variability in what DHs in different states are allowed to do. Researchers at the Center built a scope of practice scale for DHs, the Dental Hygiene Professional Practice Index (DHPPI) and used it to score state-specific DH scope of practice in 2014. Using 2014 DHPPI scores, researchers found that more autonomous DH scope of practice had a positive and statistically significant association with population oral health. Since broader DH scope of practice is correlated with better oral health outcomes, researchers developed an infographic that allows state-to-state comparisons of DH scope of practice. This presentation highlights the research that supported the development of the DH scope of practice infographic.

On October 2, 2018, policy leaders and workforce researchers gathered to discuss key issues influencing the health workforce. Researchers from 6 health workforce research centers presented work related to value-based care, workforce development programs targeting the underserved, and health workforce roles in opioid misuse prevention and treatment. This video highlights the work presented at the event. For more information on the studies, please visit the centers’ websites.

In 2018, Arizona passed legislation requiring data reporting for some licensed health professionals in the state. This webinar features the perspectives of two individuals who were key in the effort to pass the legislation. The topics covered include: the content of the new law, key supporters of the bill, major challenges faced in securing passage of the bill, and what advice they would give to other states contemplating similar legislation.

This report summarizes trends in the direct provision of oral health services by federally qualified health centers (FQHCs) over recent years and factors that predict the likelihood of an FQHC providing direct general and/or specialty oral health services. The analyses use both current and historical data to describe existing oral health service capacity in FQHCs and differences among health centers and across states in direct delivery of oral health services. This report will be useful for policymakers considering strategies to enable access to oral health services for underserved populations, and will provide important contributions to the literature describing oral health services access barriers for the underserved.

Residents of long-term care (LTC) facilities have a significantly higher risk of poor oral health status compared with those living independently, moreover, the provision of oral health services to LTC residents is often limited. This study identifies and classifies state-level policies and funding sources for dental services that are available to LTC residents. The research details variability in coverage levels, payment sources, workforce capacity, and care delivery configuration, finding little coherence between policy and the needs of patients or providers.

Leaders from academic medical centers, large integrated and community health systems, home health and hospice organizations, and the Veterans Administration were recruited to participate in this qualitative study. This article assesses perspectives of US community-based palliative care program leaders on staffing, recruitment, and training.

Using data from the 2015 American Community Survey Public Use Microdata Sample (1-year file) we describe general employment and demographic characteristics of the long-term care (LTC) workforce in the United States.

This study describes the program requirements, workforce competencies, and barriers for dementia capable care coordination within health plans from seven states participating in the Center for Medicare and Medicaid Services demonstration programs for dually-eligible Medicare and Medicaid beneficiaries.

This case study explores Texas’s development and implementation of a peer provider workforce in mental health (MH) and substance use disorders (SUD).

We examined the roles and implementation of DCSs in California and how the Centers for Medicare and Medicaid Services (CMS) requirements for dementia care coordination are being met. We also assessed the workforce attributes of the DCS role: training, licensure requirements, certification, customary duties, and reimbursement for services.

Many nursing homes have adopted health information technology (HIT) to help improve quality of care and staff productivity. However, the success of HIT systems in nursing homes depend on implementation and little is known about how these systems impact nursing home staff. This article describes a study that included a literature review of articles on HIT implementation in nursing homes as well as interviews with and focus groups of nursing home staff to explore how HIT systems are implemented in nursing homes, how these systems impact workflow for staff, and whether they improve quality of care for residents.

Peer providers are a growing workforce who have become increasingly essential for supporting long-term care needs and alleviating behavioral health workforce shortages. These workers often face stigma and low wages with limited opportunities for career growth. This article describes a mixed-methods study that included a national panel of subject matter experts, site visits in four states, document reviews, and interviews with samples of multiple different stakeholders to examine what issues peer providers face as well as factors that contribute to a favorable policy environment for this workforce.

The purpose of this study was to conduct a county-level analysis of these psychiatrists and determine whether supply in rural and metropolitan communities significantly differed.

The purpose of this study was to conduct a county-level analysis of these psychiatrists and determine whether supply in rural and metropolitan communities significantly differed.

Accurate enumeration of behavioral health workforce supply and characteristics is important for workforce planning. Although numerous data sources exist for the behavioral health workforce, all have substantial data limitations and comparability across data sources is low. A behavioral health workforce Minimum Data Set (MDS) was developed in 2016 to improve data quality. This qualitative report helps to determine the barriers and opportunities for implementing the behavioral health workforce MDS nationwide.

Accurate enumeration of behavioral health workforce supply and characteristics is important for workforce planning. Although numerous data sources exist for the behavioral health workforce, all have substantial data limitations and comparability across data sources is low. A behavioral health workforce Minimum Data Set (MDS) was developed in 2016 to improve data quality. This qualitative report helps to determine the barriers and opportunities for implementing the behavioral health workforce MDS nationwide.

Many Nebraskans suffer from behavior health issues, but many in rural areas are not able to get the care they need due to socio-economic status, stigma, and the lack of qualified providers in areas that are geographically isolated. This report describes a study that examined behavioral health workforce data and conducted interviews with providers and administrators across Nebraska to investigate the variation in the use of telehealth across multiple behavioral regions, identify barriers to implementation, and determine current educational needs.

There is broad consensus that the ubiquity of opioid use disorder (OUD) in the United States constitutes an epidemic. Medication assisted treatment (MAT), which utilizes medications alongside psychosocial treatments and services has been shown to be highly effective for treating OUD, but implementation is low. This report describes a study that utilized geospatial analysis to examine the association between the number of MAT providers and deaths due to OUD as well as an online survey of behavioral health providers in ten states and virtual focus groups to investigate provider roles and barriers to MAT implementation.

The Affordable Care Act’s expansion of Medicaid eligibility among participating states has increased the number of per-capita behavioral health providers more significantly than increases seen in states that did not expand Medicaid eligibility. Further examination of the relationship between Medicaid and behavioral health workforce is necessary given the important role that Medicaid plays in financing behavioral health services across our nation.

Co-location, where behavioral and physical health components of care are housed in the same physical space, is one of the key elements of integration. This report examines the rate of co-location between primary care physicians (PCPs) and social workers/psychologists to (1) identify the percent of PCPs co-located with social workers/psychologists in the US, (2) assess if co-location rates vary by state, region, rurality, or practice size, and (3) determine if co-location rates vary by PCP specialty.

Co-location, where behavioral and physical health components of care are housed in the same physical space, is one of the key elements of integration. This report examines the rate of co-location between primary care physicians (PCPs) and social workers/psychologists to (1) identify the percent of PCPs co-located with social workers/psychologists in the US, (2) assess if co-location rates vary by state, region, rurality, or practice size, and (3) determine if co-location rates vary by PCP specialty.

The field of behavioral health is experiencing a shortfall of licensed providers. Community health workers (CHWs) and peer recovery specialists (PRSs) function as critical components of the workforce that can mitigate access and treatment gaps. Increasing demand for behavioral health services, exacerbated by the ongoing opioid epidemic, has intensified the need for addiction counselors (ACs), who can become credentialed with less formal education than clinical mental health counselors. This brief explores credential requirements, scope of practice (SOP) elements, and Medicaid reimbursement rates for ACs, CHWs, and PRSs across the country to better understand how these workers can contribute to behavioral health service delivery.

The objective of this study is to determine whether receipt of therapy and number and timing of therapy visits decreased hospital readmission risk in stroke survivors discharged home.

A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking. To characterize the occurrence of LPN-to-RN professional transitions, compare key characteristics of LPNs who do and do not make such a transition, and compare key characteristics of LPNs who do transition in the years prior to and following their transition.

To promote patient care and population health, integrating social workers onto interprofessional teams requires educating all members of the healthcare team on the roles and functions of social workers. A case vignette is included to demonstrate how interprofessional teams can use the skills of social workers to offer brief, evidence-supported interventions and inform team-based care. Suggestions are offered for moving forward to increase the participation of social work in IPE and practice settings.

Behavioral and physical health services are increasingly being integrated, with care provided by interprofessional teams of physicians, nurses, social workers, and other professionals. The objective of this study was to describe the functions of social workers on interprofessional teams in primary care and to assess the impact of interprofessional teams that include social workers in integrated care settings.

We examined temporal trends in PCP referral to PT for musculoskeletal conditions and compared these trends to PCP referral to specialty physicians.

Social workers are increasingly being deployed in integrated medical and behavioral healthcare settings but information about the roles they fill in these settings is not well understood. This study sought to identify the functions that social workers perform in integrated settings and identify where they acquired the necessary skills to perform them.

Evaluating the capacity of the health workforce to adopt team-based health care delivery models, nationally or in North Carolina, requires a nuanced approach that explores educational and clinical environments, payment, health systems, and regulatory levers. This paper discusses workforce challenges to team-based care and how best to train, prepare, and retool an equipped health workforce to meet the needs of team-based care.

This cross-sectional study analyzed the practice outcomes in 2016 of physicians who graduated from medical schools between 2004 and 2010. Physicians whose medical school received Title VII funding during their education were compared to physicians who attended medical schools that did not receive Title VII funding.