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The Health Care Workforce Challenge

The Health Care Workforce Challenge. Barbara S. Brown Virginia Hospital & Healthcare Association. Drivers of Demand. Population: Xers 28% fewer; VA 13th Economics: proxy education/covered Technology. PP&ACA Major Provisions. Coverage Delivery System Insurance Market. Key Provisions.

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The Health Care Workforce Challenge

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  1. The Health Care Workforce Challenge Barbara S. Brown Virginia Hospital & Healthcare Association

  2. Drivers of Demand • Population: Xers 28% fewer; VA 13th • Economics: proxy education/covered • Technology

  3. PP&ACAMajor Provisions • Coverage • Delivery System • Insurance Market

  4. Key Provisions • Major coverage expansions • Virginia Medicaid enrollment to increase by 300,000 to 400,000 in 2014 • Exchanges to provide new coverage options • Insurance market – • no pre-existing; • individual mandate; • % premium for patient care

  5. Key Provisions • Delivery sys reforms - numerous pilot tests • Greater focus on care coordination, disease management • Value-based purchasing (readmissions) • ACOs • Bundling

  6. Co-evolution of delivery system & payment reforms

  7. Technologic Advances • Most common reason for being in hospital? • Three most expensive hospitalizations? • Inpatient vs. Ambulatory Surgery • Self test

  8. Better Data • Track supply: BON-48% plan to retire in 10 yrs—2003 • Demand and supply analysis—2004 • Link to econ growth: NoVAHealth Force Coalition--2005 • DHP Workforce Center --2009

  9. 2008 DHP Findings MDs: 29,500 MDs; 70% (20,650) in VA > 23% trained here 33% 55 yrs or older; 33% 45 to 54 yrs RNs: 70% work in VA; > 80% work FT supply & demand matched until health reform 20% indicate they will retire in 3-5 yrs

  10. VA. RN Supply and Demand FTE per 100,000 Population Data Source: National Center for Health Workforce Analysis, BHPr, HRSA

  11. VirginiaRN Demand by Region 2000-2020 Data Source: Virginia NDM projections, CHPRE

  12. Unfilled Demand for RNs in Adjacent States and U.S. Data Source: National Center for Health Workforce Analysis, BHPr, HRSA

  13. 2020 Virginia RN Projections … What they Mean • RN Supply will have to increase by 60% to meet needed demand • Need between 2600 and 3100 newly licensed RNs each year; Double # newly licensed by 2011 • Current drop in vacancies?

  14. Not Just Nurses • Top 5 fastest growing occupations: Med Asst, Phys. Ther. Aides; Medical Records/HI techs, Occup. Ther. Asst; Dental Assist. • Top 5 with most annual openings: • RNs, NAs, LPNs, Med. Asst, Dental Assist.

  15. Realities of Educational System • Paid for enrollment not graduates • Application process • Expansion issue re: courses & facilities • Tuition covers <50% of cost of educating a nurse • Find ways to include military with medical training • Appeal to men and minorities • Age of faculty

  16. Virginia Full Time Faculty Mean Age by Region Data Source: SCHEV Nursing Salary Study 2002

  17. Opportunity and Competition Health workforce jobs are secure; demand continues to grow Need for midlevel practitioners More emphasis on rehabilitation, coordination, data/electronics Need to shorten the timeline-start process in high school Competition for education will remain high

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