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Mitigating the Coming Provider Shortage

Health care isn’t immune to the laws of supply and demand, and that could pose a problem for patients, provider organizations and payers alike. However, the increased focus on collaborative team-based care — a hallmark of value-based care — may offer at least a partial solution, with the potential to increase retention of health care workers, create a more nimble workforce and improve the quality of care patients receive.

Supply and Demand

First, demand. America is getting older. The number of Americans over the age of 65 is predicted to double by 2060, making up 23% of the total population. Unfortunately, these patients are more frequent users of health care — 3 in 4 Americans older than 65 have multiple chronic conditions.

On the supply side, the current physician shortage is only projected to worsen. As demand continues to outpace supply, the U.S. will see a shortfall of up to 121,300 physicians by 2032, according to the Association of American Medical Colleges. Physicians ages 65 and older account for 15% of the active workforce, while those between ages 55 and 64 make up 27%.

As for nurses, and registered nurses (RNs) in particular, the situation is almost as dire. The American Association of Colleges of Nursing is bracing for a shortage of RNs. However, the circumstances surrounding a possible nurse shortage is a little more nuanced. Some states may see a glut of nurses, while others will experience shortages. Based on government data, California, Texas, New Jersey and South Carolina will be among the hardest hit. Really, this isn’t a country-wide shortage. Rather, it’s more of a distribution problem, with only certain areas facing critical shortages. Rural areas and primary care settings may also feel the impact.

A Value-Based Solution

Clearly, this situation presents a challenge. Such shortages could limit access to care for people who need it, including your employees. Fortunately, other trends — ones largely associated with value-based care — may help mitigate the problem.

Care coordination, for example, is a common theme in any discussion of value-based care. It’s well-established that coordinated care improves outcomes, lowers costs and enhances patient satisfaction. Innovative technology facilitates coordination: For example, electronic health record systems flag redundant and unneeded tests, cutting costs, increasing efficiency and removing some of the burden from both providers and patients in the process.

But as important as technology is, the team-based approach of coordinated care will be ultimately responsible for easing provider shortages and improving the industry’s retention of health care workers.

An Expanded Team

As care teams become more efficient, your employees may see less of their physician and RN and more of other providers. Health care organizations are “upskilling” [link to article already submitted] their workforce — encouraging health care employees to work at the top of their license or skill level. This allows doctors and RNs to focus on the tasks only they can perform and leave the rest to others. Case managers, medical assistants, coaches, social workers, diabetes educators and other providers may all be on the team, depending on the needs of a patient population.

NPs and PAs: Young and Growing

The number of physicians relative to patients may be shrinking, but the number of nurse practitioners and physician assistants is growing — and on average they are considerably younger than physicians.

Nurse practitioners and physician assistants often take on many tasks typically assigned to physicians, allowing doctors to focus on the most complex aspects of care. And research suggests that the care these practitioners deliver is as good as that of physicians.

In many cases, pharmacists are also joining the care team. Clinical pharmacists have shown themselves to be valuable collaborative partners in caring for patients and reducing the burden on primary care providers. Medication management, especially for patients with multiple chronic conditions, is complex and time-consuming. Leaving it to the clinical pharmacist frees primary care providers to focus on other clinical areas in their practice.

Collaboration and Satisfaction

Encouraging everyone to work at the top of their license is a push for efficiency, and it goes a long way toward improving the quality of health care. It may have gained traction as a necessity, but one of the consequences is that each member of the team will do more challenging, meaningful work. That can not only improve health outcomes — it can also boost recruitment and retention efforts. In this period of low unemployment and physician shortages, retention of health care workers is critical. We’re already feeling the effects of the physician shortage. This is the time to develop strategies to remove obstacles and improve health care overall.