In addition to extending health care coverage to millions, the
Patient Protection and Affordable Care Act (PPACA) is also focused
on improving the national health care workforce. The Health
Resources and Services Administration (HRSA) estimates that by 2020
there will be shortages in a number of physician specialties and a
need for 67,000 primary care physicians. Currently there is a 6%
shortage of nurses which is expected to grow to 20% by 2020.
Furthermore, 65 million Americans live in communities where they
cannot access a primary health care provider and an additional
16,500 practitioners are required to meet their needs.
To address these issues, the PPACA reaffirms and expands on many
programs already established by the Public Health Service Act
(PHSA), but also creates new programs and activities through
grants, education, training, scholarships, and loan repayment
programs. Larkin Hoffman is providing a four-part series on how the
PPACA intends to innovate and make changes in the workforces of
physicians, nurses, dentists, geriatrics, long term care, allied,
and mental and behavioral health.
See July 2010 Alert for the first article in the series
regarding how the PPACA will be funded.
"Innovations"
National Health Care Workforce Commission
In an effort to create a cohesive approach to the national health
care workforce, the PPACA establishes the National Health Care
Workforce Commission. The Commission will be comprised of 15
members including individuals from across the health care industry
such as researchers, employers, and health care
professionals.
The Commission will review the current workforce supply and demand,
and make recommendations to Congress and the Administration on
priorities, goals, and policies. The Commission will focus its
efforts on recruiting, training, retaining, and educating a health
care workforce to meet the current and future needs of the
country.
State Health Care Workforce Development Grant
Program
A competitive health care workforce development grant program is
established by the PPACA to enable state partnerships to plan and
develop the health care workforce at the state and local
level.
Assessment of the Health Care Workforce
The Secretary of Health and Human Services (HHS) will create a
National Center for Health Workforce Analysis to collect workforce
statistical information and analyze and assess the nation's
health care workforce. Prior to the Center, there was no advisory
board that examined the health care workforce as a whole to
determine distribution and needs. The National Center for Health
Workforce Analysis will work closely with the National Health Care
Workforce Commission.
National Health Services Corp.
The National Health Service Corp. (NHSC) provides scholarships and
student loan repayment for medical students, nurse practitioners,
physicians' assistants, and others who agree to serve for a
period of time as a full-time primary care provider in an area that
has been designated as underserved. The scholarships and loan
repayment program help pay for tuition, fees, and a stipend to
students enrolled in qualifying medical programs.
In an effort to expand the health care workforce, the PPACA
reauthorizes the NHSC and increases the funding available for
scholarships and loan repayment. Money received under the NHSC loan
repayment program or under a state loan repayment or forgiveness
program is excluded for income tax purposes.
Additionally, the PPACA permits health care providers to work
part-time to fulfill their service requirement to encourage more
providers to participate in the program. Teaching time will also
now count towards fulfillment of the NHSC service requirement.
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