2011 Rural Health Summit presentation

1. National Center for Health Workforce Analysis Christina Hosenfeld, MPH Public Health Analyst, National Center for Health Workforce Analysis Department of Health and Human Services Health Resources and Services Administration Bureau of Health Professions 2011 Virginia Rural Health Summit April 6, 2011 Wintergreen, VA

2. Overview National Health Employment Trends The Framework for Health Workforce “Planning” Federal/State Partnerships for Planning HRSA-Based Rural Health Resources

3. National Health Employment Trends

5. Hospitals experienced slower employment growth than other healthcare settingsEmployment Growth By Setting, 2000-2008 Source: Center for Workforce Studies, SUNY Albany Analysis of BLS data.

7. Hospitals added 33,600 jobs across the last year; in contrast, physician offices added 26,000Growth in Healthcare Employment by Setting, Jan. 2010 - Jan. 2011 Source: Altarum Institute, Health Market Insights from the BLS January 2011 Employment Data.

9. Increased incidence of chronic diseases3

10. Insurance coverage expansion41U.S. Census Bureau “Projections of the Population and Components of Change for the United States: 2010 to 2050” 2Bureau of Labor Statistics “Career Guide to Industries, 2010-2011: Healthcare” 3CDC “Chronic Diseases and Health Promotion” 4Affordable Care Act

11. Demand for Health Care Occupations Will Continue to Grow Projected Increase, 2008 - 2018 Source: Bureau of Labor Statistics Monthly Labor Review, November 2009.

12. Possible Members of the Health Care Team of the Future Physicians Nurse practitioners Physician assistants Psychologists Optometrists Registered Nurses Pharmacists Case Managers Nutritionists/Dieticians Physical Therapists Community Health Workers …And more

13. 10% of the Population Account for 60% of Costs Percent of Health Care Expenditures Accounted for By Top Spenders, 2005 – 2006 Percentage of total U.S. expenditures Percentage of the Population, by Spending Bracket Source: AAMC Center for Workforce Studies analysis of Cohen, S.B., Rohde, F. (2009)The Concentration in Health Expenditures over a Two Year Time Interval, Estimates for the U.S. Population, 2005–2006. MEPS Statistical Brief #244. Figure One. (U.S. civilian non-institutionalized population).

15. Strong incentives to make better use of existing workforce and to allow health personnel to work at the top of their license

16. Shift to team-based care and inter-professional practice

17. Shift care to lower cost settingsSource: National Center for Health Workforce Analysis

18. The Framework for Health Workforce “Planning”

19. Health Workforce Challenges General shortages health personnel including physicians and nurses; some specific concerns: Primary Care; Chronic and Long Term Care; Behavioral Health Mal-distribution of existing workforce Barriers to health personnel working at the top of their competency Increasing need for workforce diversity Implementing inter-professional education and practice Planning for an uncertain future

20. Key National Health Workforce Questions Will there be enough physicians, nurses and other health workers? If not: What can we do to increase the supply? What can we do to make better use of health professionals? What can we do to get these workers to the highest need areas? What can we do to assure access? What can be done to slow the increase in costs?

22. Widespread dissemination of data, analyses, and information

23. Federal-state partnerships

24. Increasing attention to evaluation and longitudinal tracking

26. National Center for Health Workforce Analysis

27. State Health Care Workforce Development Grantees

29. Strengthen national and state capacity for data collection and analysis including within professional associations and states

30. Develop and promote a national uniform minimum data set

32. Federal/State Partnerships for Planning

33. Federal Workforce Roles National data collection and analysis and development of data collection guidelines Identification of national trends and needs Projections of national supply and demand and needs Support for health workforce research Development of comparative state data Federal programs to fill gaps, i.e., Title VII

34. State Health Workforce Roles State supported education and training Licensure and regulation of practitioners Scholarships and loan repayment State labor department - tracking employment and workforce needs State and local public health services Regulation of service delivery

35. A Federal – State Partnership The National Center for Health Workforce Analysis will provide data, information and guidance on the health workforce States are in the best position to identify their priority needs and understand their local resources The National Center and State Health Workforce Development Grantees can build an effective partnership

36. State Health Care Workforce Development Planning Grants Approved and funded applicants will: Enhance current health care workforce initiatives by fostering relationships and formally convening partnerships. Develop comprehensive and coherent statewide strategies by examining and bringing together key stakeholders. Assess health workforce supply and demand to inform next steps. Use universities and other health workforce data oriented organizations to help with data gathering and analysis. Develop a standard health workforce data set and method for collecting data.

37. Approved and Funded State Health Care Workforce Development Grants WA VT ME MT ND MN NH OR ID WI NY MA SD MI RI WY CT PA IA NJ NE OH NV IL IN DE UT WV MD CO MO VA CA KS KY DC NC TN OK NM AR AZ SC GA AL MS LA TX FL AK HI PR Planning grant Implementation grant

38. Rural Health Workforce and HRSA Resourceshttp://hrsa.gov/ruralhealth Slides and content from A. Fischbach, ORHP

39. Residence by Rural-Urban Status, U.S. Population Practicing Physicians by Rural-Urban Status, U.S. Population Source: WWAMI Rural Health Research Center

40. Fewer Physicians for Rural Populations, U.S Source: WWAMI Rural Health Research Center

41. Federal Office of Rural Health Policy for rural communities Slides and content from A. Fischbach, ORHP

42. “Within the total amount requested for Rural Health, the Budget includes $79 million to continue the President’s initiative to improve rural health. The goal for of this initiative is to improve the access to and quality of health care in rural areas. Slides and content from A. Fischbach, ORHP

44. Rural Health Outreach

45. Rural Network Planning

46. Rural Network DevelopmentNEW! Rural Health Workforce Development Slides and content from A. Fischbach, ORHP

48. Student/resident housing and transportation support

49. Payment of preceptorsORHP awarded 20 grants in 18 states on September 1, 2010. Slides and content from A. Fischbach, ORHP

50. Rural Health Grants 2005-2009 Rural Health Outreach Grants Rural Health Network Planning Grants Rural Health Network Development Grants Small Health Care Provider Quality Improvement Grants Prepared by: HRSA Office of Information Technology from the HRSA Geospatial Data Warehouse, datawarehouse.hrsa.gov Slides and content from A. Fischbach, ORHP

51. Contact Information Christina Hosenfeld, MPH National Center for Health Workforce Analysis 301-443-9257 chosenfeld@hrsa.gov Aaron Fischbach, Public Health Analyst:Office of Rural Health Policy 301-443-5487; afischbach@hrsa.gov