A Literature Review of How the Widespread Adoption of New Models of Care Will Change US Health Care Workforce Needs

Investigators: Erin Fraher, PhD, MPP; Jacqueline Halladay, MD, MPH

Background: A recent body of research has emerged examining how the widespread adoption of patient centered medical homes, accountable care organizations and integrated delivery systems will affect the numbers and types of health care providers needed in the future (Bodenheimer 2013; Cooper 2013; Auerbach et al 2013; Everett et al 2013; Smith et al 2013). At the same time, numerous on-the-ground evaluations are underway to identify the new roles that health professionals will undertake to increase system efficiency, improve the quality of care and enhance patient satisfaction. The pace of change has been so swift that there has been little time to synthesize what this emerging body of evidence means for health workforce research and policy.

Objective/Aims: The purpose of this project is to synthesize recent research on workforce innovations underway to transform care delivery.  We focus on two primary questions:

  1. What new roles are emerging in the context of redesigning care? Are these new roles are being staffed by existing health professionals (e.g. nurses, social workers, medical assistants) or by new types of health professionals?
  2. What new and different skill mix configurations are being deployed to serve different patient populations in different settings (e.g. acute, ambulatory and community-based settings)?

Policy Relevance: Our findings will suggest the changes needed to education, regulatory and payment systems to ensure that the18 million workers already employed in the health care system are prepared to function in new models of care.  We identify gaps in the literature and suggest a future research agenda about the health workforce development and training needed to support health system transformation.