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Healthcare Workforce

Quick Facts

  • The Affordable Care Act (ACA) with create additional primary care residency slots for 500 new primary care physicians by 2015.
  • National Health Service Corps (NHSC) provides scholarships and loan repayment for physicians and other health professionals who provide primary care services in underserved areas. The ACA increases funding for NHSC by $1.5 billion over five years.
  • Federally Qualified Health Centers (FQHCs) are clinics that work in underserved areas or for underserved populations. The bill increases funding for FQHCs by $11 billion over the next five years.
  • The law establishes a new Workforce Advisory Committee – a multi-stakeholder committee to develop a national workforce strategy.

Problem

The health system reforms signed into law will cover an estimated 32 million uninsured patients by 2019. But will there be enough primary care physicians, nurses and dentists to care for the newly insured and the baby boomers?

Some reports estimate that the nation likely will see a shortage of about 160,000 physicians by 2025 -- leaving too few to keep up with the flood of newly insured patients seeking care for long-neglected health problems. Approximately 20 percent of Americans—or 64 million people— already live in rural or inner-city locations designated as health professional shortage areas. Moreover, an aging population is projected to drive demand up and supply down: as the Baby Boomers age, they are more likely to develop complex and multiple conditions, requiring more extensive medical care. By 2030, 70 million Americans — 1 of every 5 — will be over age 65. At the same time, more than one in three physicians are currently over 55 and likely to retire within the next two decades.

Fewer medical students than ever are choosing primary care as their profession. Of the 24,000 medical students who entered residency programs this year, according to the New England Journal of Medicine, between 16 and 18 percent are likely to end up practicing primary care (general internal medicine, pediatrics and family medicine).

Opportunity

The Patient Protection and Affordable Care Act (PPACA) contain a number of provisions that will help strengthen the nation’s health care workforce. The Act establishes a National Health Workforce Commission and National and State Centers for Health Care Workforce Analysis. It also establishes Teaching Health Centers, an initiative that supports developing residency programs within qualified community-based ambulatory primary care settings. Community Health Centers and the National Health Service Corps, two enterprises which strongly support primary care and access to care, will receive increased funding. A Primary Care Extension program will be established to support and educate primary care providers about preventive medicine, health promotion and disease management.

Primary care providers will receive a 10% Medicare bonus payment for primary care services provided, and Medicaid reimbursement levels will be increased to match Medicare levels for primary care physicians. The Act also redistributes unused Medicare-funded residency slots to programs that agree to train more primary care providers and prioritizes the slots based on hospitals in states with high physician need.

In June 2010, Secretary Sebelius announced the availability of $250 million in new funding provided by the Affordable Care Act (ACA) to expand the primary workforce. The new funding – part of the Prevention and Public Health Fund – will help prepare the health system to meet the demand for health care workers with a new initiative that will train and support thousands of new doctors, nurses, nurse practitioners, and physician’s assistants.

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