Health care workforce: Readiness for health reform

Research Objectives: Prior to implementing the ACA, there was interest in California's readiness to meet expected increased demand for services with existing workforce. We explored implications of health care reform on the workforce in concert with the State's planning effort. We examined the supply and distribution of the current workforce, the student pipeline, and policy options to meet changing demands. Methods: Using data from professional boards and surveys, we analyzed geographic distribution, trends, and ratios of workforce to population. We conducted a literature review and key informant interviews to explore existing conditions and developed a series of policy recommendations. Findings: Geographic maldistribution of the one-million-strong workforce has resulted in shortages in some areas and surpluses in others. Existing workforce and education datasets are not standardized and contain significant gaps, making it difficult to conduct workforce planning. The health professions are overall not reflective of the state's ethnic and racial diversity. Conclusions and Implications: ACA implementation is projected to expand coverage to 4-6 million Californians. Because workforce maldistribution is such a critical issue, adopting and expanding successful policies that address geographic practice choices will be key. Expanding scope of practice and education programs targeting mid-level providers may help meet the demand for new primary care providers. New practice models can better utilize the available workforce to meet increasing demand. Targeting educational resources to capitalize on the state's diversity and implementing strategies to enhance the skills and supply of frontline staff may help address issues of ethnic and linguistic concordance.