Health Workforce Research e-Library

This study examines the demographics, socioeconomic status, and job mobility of workers by long-term care (LTC) sector and occupation. The study identifies the characteristics associated with job mobility and turnover of LTC workers, and their pathways to LTC jobs.

This study examines the demographics, socioeconomic status, and job mobility of workers by LTC sector and occupation. The goal of the study is to identify the characteristics associated with job mobility and turnover of LTC workers, and the pathways to LTC jobs these workers utilize.

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

This presentation discusses the entry and exit of workers in long-term care.

This presentation discusses how long-term care workforce demand will be impacted by changes in demographics and utilization patterns.

This report updates previous studies of the licensed practical nurses (LPN) workforce by presenting the latest national data available on LPN employment patterns with emphasis on employment in long-term care. The report also describes trends in the demographic characteristics and educational attainment of LPNs.

This poster focuses on trends in the licensed practical nurse workforce from 2008-2013.

This study characterizes the personal care assistance role played by family members and non-family in California, which has the nation’s largest consumer-directed Medicaid personal care assistance programs. We describe factors that affect turnover among PCAs, as turnover is associated with lower quality of care and adverse outcomes for recipients.

This study characterizes the personal care assistance role played by both family members and non-family in California, one of the nation’s largest consumer-directed Medicaid personal care assistance program. We describe factors that affect turnover among PCAs, as turnover is associated with lower quality of care and adverse outcomes for recipients.

This poster focuses on personal care aides in rural America.

A looming question for policy makers is how growing diversity of the US elderly population and greater use of home and community-based services will affect demand for long-term care workers. We used national surveys to analyze current use of long-term care and the current long-term care workforce.

A looming question for policy makers is how growing diversity of the US elderly population and greater use of home and community-based services will affect demand for long-term care workers. We used national surveys to analyze current use and staffing of long-term care, project demand for long-term care services and workers through 2030, and assess how projections varied if we changed assumptions about utilization patterns.

This case study explores Arizona’s development and implementation of a peer provider workforce in mental health (MH). Peer providers are individuals hired to provide direct support to those undertaking MH or substance use disorder (SUD) recovery, often referred to in the literature as “consumers.”

This research brief systematically reviews and analyzes care coordinator policies and practices within health plans participating in the US Centers for Medicare and Medicaid Services’ (CMS) demonstration programs for dually-eligible Medicare and Medicaid beneficiaries (referred to as “duals”).

This report summarizes the findings of a landscape analysis on the topic of peer providers in MH and SUD treatment services. Companion reports providing summary information on peer provider practices and a review of practices in four “leader” states providing peer provider services were also conducted (Arizona, Georgia, Pennsylvania, and Texas).

This report examines the demographics, socioeconomic status, and job mobility of workers by Long Term Care (LTC) sector and occupation. It identifies the characteristics associated with job mobility and turnover of LTC workers, and the pathways to LTC jobs these workers utilize.

This report updates previous studies of trends in licensed practical nurses (LPN) education and licensure by presenting the newest available national data. The report describes trends in numbers and types of LPN education programs, numbers of persons completing LPN education and their characteristics, and numbers of persons taking and passing the National Council Licensure Examination-Practical Nurse (NCLEX-PN).

Team‐based care involving physician assistants (PAs) and nurse practitioners (NPs) is one recommended strategy for improving access and quality and reducing cost in the patient‐centered medical home (PCMH). PAs and NPs can, and do, perform a variety of roles on primary care teams. This suggests that there is plasticity within the professions and between PAs, NPs, and physicians. This brief investigates the roles of PAs and NPs in team-based care implemented at PCMHs. Key findings include that a large majority of PAs and NPs in PCMH programs are practicing as primary providers, and often conduct work that meets their level of training.

This study looks at changes in NP and PA specialty distribution in North Carolina (NC) between 1997 and 2013. NP and PA licensure data from the NC Board of Nursing (NCBON) and NC Medical Board (NCMB), maintained in the NC Health Professions Data System at the Sheps Center, were used.

This study used Medicare data to assess changes in the number of outpatient visits made to various specialty groups for atrial fibrillation and for esophageal, gastric and duodenal disorders in rural areas that vary in their local availability of cardiologists and gastroenterologists, respectively.

The local supply of physicians in any community, especially smaller and rural communities, depends on a flow of physicians into those communities from the places where they train or from more populous locations that may have more than enough physicians to meet population needs. This research brief explores whether it is possible to predict that a place will become more or less underserved based on the personal characteristics of physicians, especially primary care physicians, the characteristics of the counties from and to which they move, and their likelihood to move into or out of rural communities.

This brief synthesizes the emerging body of evidence on the workforce implications of new models of care.

Despite this growing interest in team-based care, little is known about how leaders of primary care facilities decide on the types of providers and support staff to hire, and how they organize their roles to best serve patients. To gain insight into the decision-making process, researchers from George Washington University’s Center on Health Policy focused on community health centers (CHCs), the federally funded safety net facilities that provide comprehensive primary care services to 21 million low-income Americans every year.

Numerous areas of the United States have an inadequate supply of primary care physicians and the shortfall is expected to grow and spread. To address these concerns, as well as to improve the quality of the care delivered, health policy experts have recommended that medical practices transform to embrace team-based" care, encouraging a broader range of medical staff working together. This article examines different medical staffing patterns in community health centers across the country, the impact of staffing on productivity, staff roles, and the factors associated with staffing patterns."

Community health centers’ (CHCs) patient panels are expected to increase in the coming years. This brief examines the relationship between the use of electronic health records and productivity in CHCs.

This webinar discusses opportunities and challenges that states face in collecting health workforce data for use in understanding patterns in supply and distribution, informing policy decisions, and engaging in health workforce planning. The presenter also discusses common barriers to developing data systems and different strategies for collecting state data. At the end of the webinar there is a Q&A with the audience.

In the US, the primary responsibility for health professions regulation falls to states. There is concern that this approach is not well-suited to respond to the workforce challenges faced in a health care delivery system that is undergoing rapid transformation. This webinar describes the aspects of health professions regulation that constrain effective and efficient use of the health workforce and offer recommendations to strengthen scope of practice decision-making. Also discusses an innovative approach used in Virginia to address proposed scope of practice expansions.

Much discussion is underway about how to align payment incentives and new models of care to achieve the triple aim of improving population health, lowering cost and enhancing patients’ experience of care. Often overlooked from this discussion is how to align the workforce—particularly the 18 million workers already in the health system—to meet the needs of a transformed health care system. This webinar discusses new and emerging roles for health workers and the challenge to reshape the education and training system to deliver new competencies to the workforce.

This webinar delves into alternative approaches to health workforce supply and demand modeling at the national, state, and local levels. Also discusses data and methods, and tips/best practices to help ensure study success. The presenter shares lessons learned over 20 years of health workforce modeling.

Linda Lacey has been involved in the start-up of two different health workforce centers, one focused exclusively on the nursing workforce in North Carolina and another with a broad focus on all health workforce groups in South Carolina. Through those experiences she has become familiar with the trials, tribulations, and rewards of developing an effective health workforce center. In this webinar, she shares some of the lessons she has learned.

States require community health assessments at a county or at a public health district level to identify population health needs and ultimately develop strategies to address those needs. Under the ACA, hospitals are now required to develop community health assessments to maintain their not-for-profit status. This webinar describes the steps to develop a community health assessment, including identifying data sources, and how to engage stakeholders, prioritize competing demands, and develop strategies during the process.

Timely and reliable data about the health workforce is critical to effective health workforce planning. The Health Workforce Minimum Dataset (MDS), developed by the National Center for Health Workforce Analysis, provides guidance on key variables to include in health workforce surveys, including demographic, educational, and practice characteristics. This presentation provides an overview of the MDS, discusses one state’s efforts to integrate MDS questions into a health workforce monitoring system, and provides examples of analyses based on MDS data.

Although previous research has demonstrated a paucity of standards in most states, a few have engaged in a rational approach to designing personal care aide (PCA) training standards with the goal of better preparing these essential frontline workers to provide care. This research brief highlights seven “leader states” in training standards for Medicaid-funded personal care aides.

Some state Medicaid-funded programs enable older adults and individuals with disabilities to reside safely in their homes and participate in their communities. In the absence of federal standards, there exists wide variation in minimum training requirements between states and between programs within states. Most of the existing state training requirements are relatively undeveloped compared with standards for home health aides and certified nursing assistants. This brief presents research findings on the national landscape of personal care aide (PCA) training requirements across state Medicaid-funded programs.

Although previous research has demonstrated a paucity of standards in most states, a few have engaged in a rational approach to designing personal care aide (PCA) training standards with the goal of better preparing these essential frontline workers to provide care. This report highlights seven “leader states” in training standards for Medicaid-funded personal care aides.

Some state Medicaid-funded programs enable older adults and individuals with disabilities to reside safely in their homes and participate in their communities. In the absence of federal standards, there exists wide variation in minimum training requirements between states and between programs within states. Most of the existing state training requirements are relatively undeveloped compared with standards for home health aides and certified nursing assistants. This report presents research findings on the national landscape of personal care aide (PCA) training requirements across state Medicaid-funded programs.

The focus of health system innovation, however, has largely been on reorganizing care delivery processes, reengineering workflows, and adopting electronic technology to improve outcomes. Little attention has been paid to training workers to adapt to these systems and deliver patient care in ever more coordinated systems, such as integrated health care networks that harmonize primary care with acute inpatient and postacute long-term care. This article highlights how neither regulatory policies nor market forces are keeping up with a rapidly changing delivery system and argues that training and education should be connected more closely to the actual delivery of care.

The overall distribution of physicians in the United States is uneven, with concentrations in urban areas while some rural places have proportionately very few. This report examines the movement of physicians who have completed their training and choose to move from one location to another.

The authors believe that although the pace of health system transformation has accelerated, a shortage of workers trained to function in the new models of care is hampering progress. In this Perspective, they argue that urgent attention must be paid to retraining the 18 million workers already employed in the system who will actually implement system change. Their view is shaped by work they have conducted in helping practices transform care, by extensive consultations with stakeholders attempting to understand the workforce implications of health system redesign, and by a thorough review of the peer-reviewed and gray literature.

Contract tracing is an essential tool in the effort to control COVID-19, particularly when spikes in cases occur. By deploying the workforce effectively to trace infections, localities can determine appropriate mitigation policies. This tool allows users to estimate based on the number of new cases, the size of the local population, and other factors.

This dashboard is the COVID-19 County Workforce Estimator. Users can select a county to view the peak county-level projected COVID-19 hospitalizations and COVID-19 intensive care unit (ICU) bed counts are estimated to occur in the next 30 days, the estimated number of available intensivists (critical care physician specialists) in the county, and how that translates to the number of intensivists available per 12-hour shift. This information is used to estimate the ICU patient to intensivist ratio and the percent COVID-19 hospital occupancy for the county.

This is the Emergency Vaccinator Policies in Response to COVID-19 dashboard. This map displays state policies including executive orders, legislation, and regulations that expand on the types of personnel authorized to provide the COVID-19 vaccine beyond existing vaccination authority.

Promoting racial and ethnic diversity in the health workforce can help meet the healthcare needs of underserved and racially diverse populations. More work needs to be done to provide easily accessible information about how levels of racial representation in the health workforce vary in different areas of the country. This interactive tool allows users to examine the level of racial representation for multiple different health occupations in each state.

This interactive map provides information on personal care aide training requirements.

These data dashboards use publicly available data sources to describe important trends for a selection of healthcare occupations. Each dashboard explores a topic – the supply of workers, aging trends or commuting patterns – that helps policymakers plan for an adequate workforce.