Professor Patricia Pittman, co-director of the GW Health Workforce Institute, was a panelist for a briefing hosted by the Wisconsin Evidence Based Health Policy Project on trends and emerging issues in the healthcare workforce nationally and in Wisconsin.
Pittman’s presentation focused on national trends. She presented data compiled by the GW Health Workforce Institute on trends at hospitals and community health centers as a proxy for primary care. The community health center workforce expanded by about 10 percent between 2007 and 2013, she said, and growth was particularly strong for mental health and dental health. The percentage of physicians within the community health center staffs has been shrinking while the numbers of nurse practitioners (NPs) and physician assistants (PAs) has increased significantly.
The Patient Centered Medical Home policy has helped to drive the increase in PAs and NPs in community health centers. The adoption of electronic health records is associated with hiring nurses and medical assistants, Pittman said.
Among hospitals, the employment of PAs and NPs is also rising, Pittman said. For medical assistants, the data shows a drop in the number of high and middle skilled workers and increases in workers with the lowest amount of training and wages.
Pittman shared information about the “production function” approach to determining optimal staffing thresholds for nurses and medical assistants being conducted by the GW Health Workforce Institute. Her talk also touched on Accountable Care Organizations, nurse staffing laws, Medicaid expansion, and reforms to Nurse Practitioner standards of practice.
Research underway by the GW Health Workforce Institute is starting to factor in costs in relation to outcomes, Pittman said. Issues that she and her colleagues are currently investigating include the effects of changes in shifts in the mix of providers, such as nurse burn-out; predictors of NP and PA privileging; and the potential for future shortages of NPs.
While Pittman’s research takes place at the national level, she pointed out that “a lot of the innovative thinking about new models of care and how they relate to outcomes, as well as the thinking about pipelines and incentivizing the workforce to be where we need them is happening at the state level.”
View a video of Pittman’s presentation here