Authors: Warren Newton, MD MPH; Ann Lefebvre, MSW, CPHQ Background/Policy Relevance Primary care transformation is necessary for health system redesign, but how to support this on a large scale remains unclear. The tasks of contemporary primary care are substantial, and include closing the quality gap and addressing disparities, while lowering total cost of care and… Read more »
Determining the Value and Outcomes of the Doctor of Nursing Practice (DNP) (2015-16)
Investigators: Anna Beeber PhD RN and Cheryl Jones PhD RN Background: As of 2014, 243 DNP programs were enrolling students and an additional 59 DNP programs were in the planning stages. From 2012 to 2013, the number of students enrolled in DNP programs increased from 11,575 to 14,688. During that same period, the number of… Read more »
Predicting Role Transitions for the LPN-to-RN Workforce in North Carolina (2015-16)
Investigators: Cheryl Jones PhD RN, Mark Toles PhD RN and George Knafl PhD Background: Using the dataset developed in our Year 2 project, we will extend our descriptive work to model the key predictors of nurses who transition from LPN to RN roles. Study aims: We will study the likelihood of transitioning (e.g. the dependent… Read more »
Toward a Better Understanding of Social Workers on Integrated Care Delivery Teams (part 1) (2015-16)
Investigators: Mark Fraser PhD; Erica Richman, PhD, MSW; Erin Fraher, PhD, MPP Background: Given the growing number of social workers employed in the healthcare system and the diversity of roles they fill, it is critical to understand the responsibilities and capacity of social workers as healthcare shifts to team-based models of care, value-based payments, and… Read more »
The Future of Medicaid-Funded Graduate Medical Education as the Health Care System Shifts (2015-16)
Investigators: Erin P. Fraher PhD MPP and Julie Spero MSPH Background: While Medicare is the dominant funding source for Graduate Medical Education (GME) in the United States, Medicaid investments in GME totaled nearly $4 billion in 2012. Medicaid GME dollars are attractive to states because they can be matched by federal dollars, thereby increasing the… Read more »
Comparison of Specialty Distribution of Nurse Practitioners and Physician Assistants in North Carolina, 1997-2013
June 15, 2015 Anna Johnson, PhD, MSPH; Erin Fraher, PhD, MPP; Perri Morgan, PhD, PA-C Presentation at the 2015 AcademyHealth Annual Research Meeting Overview Nurse practitioners (NPs) and physician assistants (PAs) fill workforce needs in many specialties. Specialty distributions of NPs and PAs have changed over time, with the proportion of NPs and PAs… Read more »
Building a Value-Based Workforce
June 15, 2015 Erin Fraher, PhD, MPP; Rachel Machta, BS; Jacqueline Halladay, MD, MPH Presentation at the 2015 AcademyHealth Annual Research Meeting Overview What will the shift to value-based payment models mean for the workforce? Literature review of 57 studies focused on staff roles in new models of care that: are new or have… Read more »
Comparison of Specialty Distribution of Nurse Practitioners and Physician Assistants in North Carolina, 1997-2013
May 1, 2015 Perri Morgan, PhD, PA-C; Anna Johnson, PhD, MSPH; Erin Fraher, PhD, MPP Presentation at the 2015 AAMC Health Workforce Research Conference Overview Expected increase in demand for healthcare services in the US Physician supply may not be adequate to meet demand under traditional models of care NPs and PAs might help… Read more »
Pathways in Nursing Careers: Transitions from the Role of Licensed Practical Nurse to Registered Nurse in North Carolina (2014-15)
Investigators: Cheryl Jones, PhD, RN, FAAN; George Knafl, PhD; Mark Toles, PhD, RN; Anna Beeber, PhD, RN Background: In a reforming health care system, nursing personnel, including licensed practical nurses (LPNs) and registered nurses (RNs), are viewed as flexible health care workers because they are readily deployed in diverse health care settings, reduce workforce shortages,… Read more »
Physician Assistant and Nurse Practitioner Roles in Patient-Centered Medical Homes (2014-15)
Investigators: Christine Everett, PhD, MPH, PA-C; Perri Morgan, PhD, PA-C Background: Team-based care involving physician assistants (PAs) and nurse practitioners (NPs) is one recommended strategy for improving access, quality, and cost of care in the patient-centered medical home (PCMH). The fact that PA/NPs can, and do, perform a variety of roles on primary care teams,… Read more »
The Role of Physical and Occupational Therapists in the Acute to Post-Acute Care Transition (2014-15)
Investigators: Janet Freburger, PT, PhD (now at the University of Pittsburgh); Anna Johnson, PhD; Dongmei Li, MS. Background: Medicare spending for post-acute care has increased considerably in the past decade with evidence of significant geographic variation in the use of these services. Acute care hospitals and each post-acute setting also have their own separate… Read more »
Diffusion of Physicians and Access to Primary Care: The Role of Person, Program, and Place (2014-15)
Author: Thomas C. Ricketts, PhD, MPH Background: Federal and state policies try to influence physician location choices using a combination of programmatic or extrinsic factors (e.g. bonus payments, subsidized loans) and personal or intrinsic factors (e.g. promoting volunteerism, orienting trainees to underserved populations and selecting motivated students) to encourage physicians to practice in communities where the… Read more »
Understanding How the Diffusion of Physicians Creates Areas of Underservice (2014-15)
Investigators: Thomas Ricketts, PhD; Erin Fraher, PhD, MPP; Andy Knapton, MSc Background: States and the federal government devote substantial resources to influence physicians to practice in underserved areas. Like the general population, the physician workforce is mobile. About 20% of the active employed physician workforce will relocate to another county within a five-year period. Federal… Read more »
Making Use of Workforce Projections to Inform the Graduate Medical Education Policy Debate in the United States (2014-15)
Investigators: Erin P. Fraher PhD MPP, Andy Knapton MSc Background: There is intense policy debate over whether the nation should expand graduate medical education (GME) or redistribute existing slots to high-need specialties and geographies. The recently released Institute of Medicine (IOM) report recommends creating a GME Policy Council to use data and workforce projections to… Read more »
Comparison of Specialty Distribution of Nurse Practitioners and Physician Assistants in North Carolina, 1997-2013 (2013-14)
Authors:Perri Morgan, PhD, PA-C; Anna Johnson, PhD, MSPH; Erin Fraher, PhD, MPP Background:As healthcare demand in the United States is expected to grow, increased use of nurse practitioners (NPs) and physician assistants (PAs) is seen as a partial solution to potential physician shortages. NPs and PAs can change specialties throughout their careers and may constitute… Read more »