Regional Meetings Focus on Work Force Shortages

By the time the California Office of Statewide Health Planning and Development completes a series of regional focus groups, it should have a good handle on creating a robust health care work force. The 10th meeting is scheduled this week in Ontario.

Regional leaders have been charged with offering suggestions on training, recruiting and retaining quality health care workers, while buttressing the impact of reform.

The Patient Protection and Affordable Care Act is bolstering efforts to increase the work force through a variety of provisions addressing the primary care system.

At the same time, reform is paving the way for many more Californians to receive health care, using a bit of a “stick approach,” subjecting 8.2 million uninsured Californians to a tax penalty if they do not acquire coverage. For California’s health care work force, the expected result is common sense economic theory: demand is far outweighing supply. The supply of primary care physicians and allied providers is barely adequate now, but when demand increases as major parts of the reform law take effect, worker shortages are predicted to be widespread and severe.

Angela Minniefield, deputy director  of the statewide planning office Health Workforce Development Division, has her work cut out for her: digesting feedback from focus group participants and later implementing their collective input.

“The model of health care delivery is changing — an emphasis on accountable care organizations and patient-centered medical homes — and making it difficult to estimate the number of primary care physicians needed,” said Minniefield, referring to initial focus group comments.

“There is an emerging need for community health workers — whose definition is not consistent — to educate patients on insurance eligibility and potential options for social services, and to serve as health care advocates and counselors,” she said. “We also have to engage and align educational curricula across the health care workforce.”

Minniefield is optimistic that reform’s expansion of the definition of a “primary care provider” to include all health care providers with direct patient care and support responsibilities will add more able bodies to primary care teams.

“There are no solutions yet, but we are prepared to make administrative and policy recommendations,” she said.

Reform provisions over the next five years should breathe some life into the primary care system. Among them:

• A 10% increase in primary care reimbursement rates in Medicare;
• Increases in Medicaid reimbursement for primary care;
• Medicare and Medicaid patient-centered medical home pilots;
• Scholarships, loan repayment and training demonstration programs to invest in     primary care physicians, midlevel providers and community providers;
• An infusion of funds to recruit primary care providers to serve underserved areas; and
• Reduced penalties for non-compliance with the Primary Care Loan Program.