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Foster a 21st Century Health Workforce

A growing demand for health care and public health services is being fueled by the aging of the population, with corresponding higher burdens of chronic disease and anticipated retirements from the current work force.  At the same time, implementation of the Affordable Care Act and the Mental Health Parity and Addiction Equity Act also will contribute to an increased demand for services.  Because of disparities in the distribution of providers, some communities (e.g., inner city or rural areas) may experience shortages even when the national supply of providers appears to be adequate. There are tremendous opportunities in the coming years for health care and public health to collaborate further to improve population health.  A critical question is how HHS can encourage well-deployed health care, behavioral health, and public health workforces that address distribution problems, deliver high quality care, improve the health of the population, and maximize limited resources.

Strengthen the Primary Care Workforce

HHS promotes a range of strategies through its payment, grant, and other program policies to expand and strengthen the primary care workforce, including encouraging physicians and other providers to enter and continue practice in primary care; making full use of all primary care providers, panel managers, and patient navigators in the delivery of primary care; incorporating community health workers into care delivery; building effective teams of health care professionals and other practitioners; encouraging use of health information technology at the practice level; encouraging clinical use of community data and measures; enhancing competencies of health professionals; building a culture of accountability and quality improvement; and better integrating the delivery of primary care and behavioral health services.  While much work is underway, ongoing assessment of HHS policies will help spur improvements.

Strengthen the Public Health Workforce

An effective public health system is critical for building a healthy society and reducing the burden of health care costs in the future.  The cornerstone of an effective public health system is a workforce that is trained and empowered to use all available sources of data to target health improvement efforts, to collaborate with partners in health care and other sectors, and to respond when there are urgent threats to the public’s health.  HHS can strengthen the public health workforce by enhancing e-learning for the delivery of training to the busy current workforce, incorporating public health informatics into more training programs, and offering practical tools to support the ability of the workforce to work together to improve the health of their community.

Focus on Effective Models of Care Delivery

The Innovation Center within CMS is testing new models of care delivery and payment, through its Pioneer ACO model, the Comprehensive Primary Care Initiative, and the Community-Based Care Transitions Program.  The Health Care Innovation Awards engage a broad set of innovation partners to identify and test new care delivery and payment models that originate in the field.  The Awards identify new models of workforce development and deployment and related training and education that support new models, either directly or through new infrastructure activities.  

Target Workforce Resources to Areas of High Need

Health care personnel are not evenly distributed across the U.S. and there are pockets of high need in both inner cities and remote rural areas.  HHS will use its policy levers to target programs such as the National Health Service Corps to areas in particular need of providers and explore other means of encouraging practice in currently underserved areas.   Also, HHS will encourage employing technology, such as telemedicine and eHealth tools, to expand resources available in remote areas and address any barriers identified to its expanded use.

Strengthen the Direct Care Workforce

HHS is working to improve the training and competency of professional direct care workers, promote their integration into care teams in and across settings, and is encouraging the development of career pathways for existing workers to become caregiving professionals.  Training has been shown to reduce turnover, improve quality of care, increase job satisfaction, and increase opportunities for advancement.

Support Caregivers

HHS has assembled information on available resources and benefits for caregivers in their efforts to support their loved ones living in the community.  Family caregivers provide the majority of long-term services and supports in the nation’s care delivery system, often coordinate care for their loved ones, and are increasingly assisting with and performing medical tasks associated with care following discharge from acute care settings.  HHS will support and encourage caregiver support interventions, including respite options, through efforts such as the National Family Caregiver Support Program, Lifespan Respite Care Program, and Alzheimer’s Disease Supportive Services Program Site exit disclaimer.  HHS also will work with the Veterans Administration to foster supports and training for family caregivers of veterans.