Workforce Transformations Needed to Staff Value-Based Models of Care (2013-14)

QuoteErinsY1ProjectAuthors: Erin Fraher, PhD, MPP, Rachel Machta, BS, Jacqueline Halladay, MD, MPH

Abstract: Secretary Burwell recently announced that by 2018, 50% of Medicare payments will be tied to value through alternative payment and care delivery models. What will this shift to value-based payment models mean for the workforce? This paper synthesizes the existing body of evidence on the workforce implications of new models of care.  We identify: 1. task shifting that is occurring in the delivery of traditional health care services; 2. new staff roles that are emerging to provide enhanced care services; 3. how employers are “putting it all together”; and 4. the implications of these trends for health workforce research and policy.

Key Findings: Health care professionals are taking on new roles with medical assistants having one of the most rapidly evolving roles in new models of care. New roles are emerging that focus on: 1) coordinating and managing patients’ care within the health care system; and 2) “boundary spanning” functions that address the patient’s health care needs across health and community‐based settings. Employers are struggling to rewrite or create new job descriptions, reconfigure workflows, and develop training to support task shifting and new roles. Health workforce researchers and policy makers need to shift focus from “old school” to “new school” approaches. Specifically, they need to shift focus from: 1) workforce shortages to developing a better understanding of how the existing workforce could be redeployed and reconfigured to address the demand‐capacity mismatch; 2) provider type to provider role because different types of health care providers can take on the same roles; and 3) training new professionals to retooling the existing workforce since they will be the ones who will transform care.

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