Inspired by the Affordable Care Act and health care payment models that reward value over volume, health care delivery systems are redefining the work of the health professionals they employ. Existing workers are taking on new roles, new types of health professionals are emerging, and the health workforce is shifting from practicing in higher-cost acute settings to lower-cost community settings, including patients’ homes. The authors believe that although the pace of health system transformation has accelerated, a shortage of workers trained to function in the new models of care is hampering progress. In this Perspective, they argue that urgent attention must be paid to retraining the 18 million workers already employed in the system who will actually implement system change.
Their view is shaped by work they have conducted in helping practices transform care, by extensive consultations with stakeholders attempting to understand the workforce implications of health system redesign, and by a thorough review of the peer-reviewed and gray literature. Through this work, the authors have become increasingly convinced that academic health centers (AHCs)—organizations at the forefront of innovations in health care delivery and health workforce training—are uniquely situated to proactively lead efforts to retrain the existing workforce. They recommend a set of specific actions (i.e., discovering and disseminating best practices; developing new partnerships; focusing on systems engineering approaches; planning for sustainability; and revising credentialing, accreditation, and continuing education) that AHC leaders can undertake to develop a more coherent workforce development strategy that supports practice transformation.
Dr. Fraher is director, Program on Health Workforce Research and Policy, Cecil G. Sheps Center, and assistant professor, Department of Family Medicine and Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Dr. Ricketts is professor, Department of Health Policy and Management and Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Ms. Lefebvre is associate director, North Carolina Area Health Education Centers Program, and adjunct assistant professor, Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Dr. Newton is vice dean, North Carolina Area Health Education Centers Program of the School of Medicine, and William B. Aycock Professor and Chair, Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Other disclosures: None.
Ethical approval: Not applicable.
Correspondence should be addressed to Dr. Fraher, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 MLK Blvd., Chapel Hill, NC 27599-7590; telephone: (919) 966-5012; e-mail: firstname.lastname@example.org.