Current Projects

Learn more about our ongoing projects here:

 

The Changing Hospital Workforce

Principal Investigator: Erin Fraher, PhD, MPP

This project will examine staffing data from the American Hospital Association’s Annual Survey to understand whether, and how, hospital staffing composition has changed between 2005 and 2021. There is speculation that the number and skill mix of the hospital workforce has, and will continue, to change in response to the pandemic; this project provides the historical data needed to evaluate whether changes occur and, if they do, what hospital characteristics are associated with these changes.

 

The Increase in Numbers of Community Health Workers Billing for Services

Principal Investigator: Brianna Lombardi, PhD, MSW

Community Health Workers (CHWs) are an important workforce for health systems to achieve health equity and reduce health disparities in vulnerable communities.61 This study will use the CMS National Plan and Provider Enumeration System (NPPES) to understand the growth of CHWs with a National Provider Identifier (NPI) over the past ten years and examine characteristics of CHWs with NPIs including geographic location, setting type, and if the CHWs have additional taxonomy accreditations.

 

The Workforce Providing Social Risk Screenings in Community Health Centers

Principal Investigator: Brianna Lombardi, PhD, MSW

Community Health Centers (CHCs) are mandated to address the physical, behavioral, and social needs of the vulnerable communities they serve and the composition of staff in CHCs likely is associated with their ability to conduct social risk screenings. Using the Uniform Data System (UDS) for HRSA-supported CHCs, this study will examine if employment of social workers or enabling providers (i.e., community health workers, case managers, health educators) is associated with an increased documentation of social risk screening at CHCs.

 

Understanding the Contributions of Undergraduate Historically Black Colleges and Universities to Increasing the Diversity of the Physician Workforce: Supplement Funded

Principal Investigator: Jasmine Weiss, MD, MHS

Increasing the diversity of the physician workforce is critical to addressing health disparities in the United States, particularly for Black Americans. This study will examine the role of undergraduate Historically Black Colleges and Universities (HBCUs) in increasing the representation of Black physicians in medical schools and ultimately the physician workforce.

 

Toward a Better Understanding of the Career Trajectories of Physicians from Underrepresented Groups in Medicine.

Investigator: Erin Fraher, PhD, MPP, and William F. Owen, Jr., MD, FACP

The purpose of this study is to use life course theory as a conceptual and methodological framework to investigate how race/ethnicity, age, and gender influence the practice patterns of North Carolina’s primary care physician workforce in different time periods, including whether the physician provides prenatal care, if s/he performs obstetric deliveries, the number of hours worked per week, the type of employment setting in which s/he practices (hospital, group clinic, solo practitioner, medical school etc.) and whether s/he practices in an underserved community. Using data collected on physicians between 2005 and 2019, we will test the following hypotheses:

    1. Between cohort effects: Primary care physicians from URM groups who graduated medical school in different periods will exhibit different practice patterns than their white colleagues.
    2. Intracohort gender effects: Different practice patterns will be observed for male and female primary care physicians of different race/ethnicities within the same medical school cohort.
    3. Age effects: Male and female primary care physicians from URM groups will exhibit different practice patterns at the same age, depending on when they graduated medical school.

 

Interrupted Integrated Health Care: How Primary Care Practices Utilized Tele-Health and Coordinated Team-Based Care in Response to COVID-19

Investigators: Brianna Lombardi, PhD, MSW; Lisa de Saxe Zerden, PhD, MSW; Erica L. Richman, PhD, MSW

This study will investigate how integrated health care (IHC) teams adapted during COVID-19 with a specific focus on their use of tele-health and how they adapted components of IHC such as warm hand-offs between providers and patients, referral linkages, and communication during the pandemic. This study also aims to identify innovative ways IHC practices delivered primary care that addressed patient physical, social, and behavioral health needs during a pandemic and understand areas in which innovation can continue or be reinforced in the post-pandemic period. Read the Policy Brief.

 

Developing a GME Policy Toolkit that States Can Use to Evaluate Return on Investment for Public Funds Invested in Training

        Investigators: Erin Fraher, PhD, MPP; Tom Ricketts, PhD, MPH; Ryan Kandrack, PhD

This study will develop and refine a methodology that states can use to evaluate the return on investment for public funds spent on Graduate Medical Education (GME). Armed with data about the outcomes of GME funds invested—in terms of yield of physicians in needed specialties and geographies–states can make more informed decisions about where to target future GME funds to produce the physician workforce needed to meet population health needs and ensure value for their investment.

Manuscript in Health Services Research: A Methodology for Using Workforce Data to Decide Which Specialties and States to Target for Graduate Medical Education Expansion

 

The Impact of COVID-19 on Primary Care Practice

Investigator: Valerie Lewis, PhD

COVID19 has caused dramatic changes to primary care access and delivery that present significant issues to the primary care workforce. First, primary care practices have cancelled large swaths of in person visits while working to rapidly implement telehealth. This is coupled with dramatic declines in revenue that present organizations with difficult financial choices.  The intensity of care under COVID19 likely may be increasing burnout among clinicians. Currently, information on these changes is largely anecdotal. We propose to conduct qualitative interviews with approximately 40 primary care practices in several states, purposively sampled across key dimensions (e.g. size, rurality, ownership).

 

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Cooperative Agreement for a Regional Center for Health Workforce Studies #U81HP26495. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.