The availability of high quality health care services is a key factor in producing satisfactory individual and community health status outcomes. A central role in achieving important objectives is played by the health workforce. A problem is that apart from medicine, few professions have data systems that make it possible to enumerate how many students are in the educational pipeline and how many qualified personnel are in practice, which are determinations required to assess if the workforce matches the health care needs of patients.
The Bureau of Health Professions (BHPr) in the Health Resources and Services Administration (HRSA) in the U.S. Public Health Service for many years in the 1980s and 1990s made important contributions to efforts aimed at producing an allied health workforce data system. An entity known as the Forum on Allied Health Data (FAHD) made it possible for data experts from several professions to gather annually to improve the collection and distribution of workforce information. The Association of Schools Advancing Health Professions (known as the Association of Schools of Allied Health Professions in the 1990s) hosted FAHD meetings and was awarded two federal contracts by the BHPr in that decade.
One project was used to identify workforce data sources extant in federal government agencies (e.g., the Veterans Health Administration, Department of Defense, Indian Health Service, Bureau of Labor Statistics); state and city health departments; and professional organizations. A second project was aimed at developing a Minimum Data Set (MDS) that all of these sources could use to produce comparable kinds of information. The idea was to develop a system that reflected common data elements collected at similar periodic intervals. Unfortunately, that result never was achieved. Although the BHPr continues to receive federal appropriations, no funding is intended specifically for allied health workforce data considerations. Apart from a Bureau endeavor that enabled the Institute of Medicine to host an Allied Health Workforce and Services Workshop in 2011, related substantive efforts have lagged.
National Health Care Quality And Disparities Report
On a related note, the Agency for Healthcare Research and Quality (AHRQ) has released its 2022 National Healthcare Quality and Disparities Report (NHQDR). It provides policymakers, health system leaders, and the public with a statistical portrait of how effectively the health care delivery system provides safe, high-quality, and equitable care to all Americans. The report’s “Portrait of American Healthcare” offers numerous important insights, including: life expectancy in the United States falls behind life expectancy in similarly developed countries, and the gap has grown since 1980; a shortage of primary care health professionals compromises access to services in more than 60% of U.S. counties; and social determinants of health may have a stronger influence on health outcomes than clinical services provided by health care delivery systems.
Medicaid Structured Family Caregiving
The National Academy for State Health Policy (NASHP) has released a report, Medicaid Structured Family Caregiving: Enabling Family Members to Make Caregiving Their Primary Focus. This brief is based on research and interviews with state staff and examines how Georgia, Missouri, and South Dakota are using Medicaid-funded structured family caregiving (SFC) services to help older adults stay in their homes. These services consist of a package that supports a patient’s primary caregiver, including payment, training, coaching, respite care and other ingredients. Meanwhile, the QUICK STAT section of this November 2022 issue of TRENDS also has information about caregiver health status.
Medicare Payment Advisory Commission (MedPAC)
MedPAC met virtually on November 3-4, 2022 to discuss a variety of policy issues, including aligning fee-for-service (FFS) payment rates across ambulatory settings, Medicare policy options for increasing payment to primary care providers, and differences in quality measure performance across Medicare populations. Commissioners analyzed quality measure results for different Medicare fee-for-service beneficiaries grouped by two social risk factors: race/ethnicity categories and income level. Moving forward, these officials will review and discuss the analyses and findings, and provide direction for future work.