1. Physician Workforce Issues Alliance for Health Reform Washington DC November 15, 2010 Edward Salsberg Director, National Center for Health Workforce Analysis Department of Health and Human Services (DHHS) Health Resources and Services Administration (HRSA) Bureau of Health Professions

2. Overview (1) An adequate supply and distribution of health workers, including physicians, is essential to assuring access Even before the Affordable Care Act, the nation was facing shortages due to a growing and aging population and increasing array of interventions Programs and policies supported by the Affordable Care Act and American Recovery and Reinvestment Act will increase access and reduce the likelihood of shortages in the future

3. Overview (2) The nation faces both general shortages and distribution problems There are some significant gaps in our data systems; better data is needed to assess current and future workforce needs and better information is needed to guide the workforce marketplace Increasing the supply alone will not be sufficient to assure access. Redesigning the delivery system to make more effective use of our health workforce is critical. The Affordable Care Act includes numerous provisions to encourage innovation and systems redesign

4. Data and Information to Inform Workforce Policies and Investments National Health Care Workforce Commission National Center for Health Workforce Analysis State Health Workforce Development Grants Health Care Workforce Program Assessment

5. National Center for Health Workforce Analysis Develop data, information and projections on health care workforce Widely disseminate the data, information and findings on the health workforce Support research to better understand current and future workforce needs Establish performance measures and evaluate Title VII programs Coordinate with the Commission and assist State Health Workforce Grantees

6. Physician Workforce Issues –Projected general shortages –Projected shortage of primary care practitioners –Mal-distribution –Inadequate diversity

7. 7 American Recovery and Reinvestment Act (ARRA) $200 million for Health Professions $47.6 million for Training in Primary Care Medicine & Dentistry $10.5 million for Public Health $39.5 million for Nursing $52.4 million for Diversity Programs $1.5 million for Licensure Portability $50 million for Equipment

8. Increasing Supply of Primary Care Workforce (ACA) Practitioner InitiativeTotal FundingProgram Expansion (2015 Impact) Primary Care Physicians $167.3M 82 schools, increase of 500 residents Advanced Practice Nurses $31M 26 schools, Increase of 600 NPs and NMWs Physician Assistants $30.1M 28 schools, increase of 600 PAs

9. Other Workforce Provisions National Health Service Corps Expansion $142m in FY2010 – 1,099 new loan repayment awards $300m from Recovery Act – 4,000 new loan repayment awards (FY09-11) Community Health Centers Expansion $11 billion in Affordable Care Act funds authorized through 2015 Oral/Behavioral Health Expansion $23.9 million for oral health workforce development FY2010 ($6.7m Recovery Act) $26.2 million for behavioral health Higher Medicare reimbursement rates for primary care/general surgeons and other bonuses in shortage areas Increase in Medicaid rates for primary care Teaching health centers Support for HIT/HER Insurance billing simplification

10. Closing Comment Assuring an adequate supply and distribution of health workers will be a challenge for the nation The Affordable Care Act provides the nation with new and stronger tools to help assure an adequate supply

11. Contact Information Edward Salsberg Director, National Center for Health Workforce Analysis Bureau of Health Professions Health Resources and Services Administration esalsberg@hrsa.gov 301-443-9355