Reforming the Health Care Delivery System: A Team Approach

Reforming the American health care system is a front-burner topic for many policymakers. One main reason is the desire to extend coverage to some if not all of the more than 45 million uninsured in this country. But there is an emerging consensus that reform must also encompass ways to improve quality and value in the system, and one of the prime targets for reform is the way care is delivered. Advocates, analysts, policymakers, consumers and the business and labor communities are all looking for ways to get more value for their health care dollar – delivering better care at lower cost.






Preparing the Nursing Workforce for a Changing Health System: The Role of Graduate Nursing Education

The nursing profession, with nearly 3 million licensed and practicing nurses in the U.S., comprises the largest segment of the nation’s health care workforce. There is consensus among experts that nursing education should be modernized to train a greater percentage of nurses at the graduate level and provide the skills nurses need as today’s health care delivery system continues to evolve towards more team-based, data-driven, and coordinated care. What does the nursing workforce look like now, and how does it need to change to meet current and future health needs in the U.S.? How are nursing education and training currently financed? What is the role of federal policy in training a 21st century nursing workforce? How does the nursing workforce fit into today’s primary care workforce and the evolving health care delivery system?






Preparing The Nursing Workforce For A Changing Health System- The Role Of Graduate Nursing Education

The nursing profession, with approximately 3 million licensed and practicing nurses in the U.S., comprises the largest segment of the nation’s health care workforce. However, efforts are underway to rethink nursing education and training so that it meets the needs of an aging population with increasingly complex chronic diseases. This toolkit is intended to provide policymakers with a primer on today’s nursing workforce, expert views on how nursing education should evolve to meet the needs of a changing health system, and the role of federal policy in advancing nursing education.

Training the Workforce for a Changing Health System

Questions about how to best prepare health professionals to practice in an evolving health care delivery system are receiving increased attention. Graduate medical education (GME)—the training that medical school graduates receive as residents, typically in teaching hospitals—has been an ongoing focal point in the discussion about how health care workforce training is conducted and financed. This issue brief provides an overview of the GME system, highlights core policy issues, identifies new training strategies and provides a synthesis of key resources.

Rural Reality: More Coverage, Enough Care?

Sixty-two million Americans live in rural areas and they have higher rates of mortality, disability and chronic disease than their urban counterparts. With high poverty and unemployment rates, low rates of health insurance coverage and an undersupply of health care providers, the ills of the health care system are especially notable in rural communities. The Patient Protection and Affordable Care Act (ACA) contains provisions relating to access to care, coverage and delivery system reform. But the impact of these provisions is uncertain in rural America, with its unique challenges.






The Health Care Workforce: Prescription for the Future

The Patient Protection and Affordable Care Act (ACA) has the potential to greatly increase the number of insured people and change how health care services are delivered. What the additional coverage will mean regarding access to providers, who those providers will be and what services they will deliver are issues that affect all segments of the health care workforce.






Health Care Workforce: Nurses

It is projected that 260,000 additional nurses will be needed by 2025 to care for the increased population, the increase in insured population and the explosive care needs for chronic diseases in the population and geriatric care in older age groups. This toolkit, written by Deanna Okrent of the Alliance, aims to provide an array of resources and perspectives that describe numerous challenges to assuring an adequate physician workforce and some of the proposed solutions under consideration. Supported by the Robert Wood Johnson Foundation.

Health Care Workforce: Physicians

A shortage of more than 90,000 physicians is predicted to occur within the next 10 years--including 45,000 primary care physicians and 46,000 surgeons and specialists. This toolkit, written by Beeta Rasouli of the Alliance, aims to provide an array of resources and perspectives that describe numerous challenges to assuring an adequate physician workforce and some of the proposed solutions under consideration. Supported by the Robert Wood Johnson Foundation.

Health Care Workforce: HIT Shortage

Health care providers are scrambling to find their way in the fast-paced world of technology, and the federal government is making billions of dollars available to help them do it. But while cost has traditionally been the big hurdle, the lack of a qualified workforce now poses a significant barrier, according to major surveys. This toolkit offers links to many resources. Includes a list of experts and websites. Supported by the Robert Wood Johnson Foundation.

Health Care Workforce: Direct Care

In the move to increase access and coverage while enhancing the value of the health care dollar, the direct care workforce provides an important contribution to coordinated care in a high quality system. This toolkit, co-written by Bill Erwin and Deanna Okrent of the Alliance, aims to provide an array of resources and perspectives that describe numerous challenges to assuring an adequate workforce and some of the proposed solutions by the ACA. Supported by the Robert Wood Johnson Foundation.

The Health Workforce Dream Team: Who Will Provide the Care?

In today’s evolving health care system, many providers and policymakers envision team-based care as an important component of the plan to improve quality, maximize resources, promote wellness, expand preventive care and enhance the value of the health care dollar. The health workforce “dream team” includes physicians, nurses, nutritionists, physical therapists, social workers, nurses’ aides, direct care workers, home health aides and others who contribute to coordinated care in a high quality system.






Physician Workforce: The Next Generation

For years, there have been concerns about whether the supply of physicians can meet the demand of our nation’s population – a population that is growing in size, age and diversity. One consideration: The physician workforce is aging as many physicians approach retirement. And physicians are increasingly looking for opportunities that allow them to balance their professional and family obligations.






Primary Care Innovation: The Patient-Centered Medical Home

It is widely accepted that the U.S. health care system, although touted by some as the “best system in the world,” has room for improvement. Many people have no regular health care provider. Care is often fragmented and lacks coordination, which compromises quality and efficiency. Incentives for providers have not caught up with the demographics of chronic care. Some 75 percent of Medicare spending is on beneficiaries with five or more chronic conditions – and those people see an average of 14 different physicians a year.






Innovations in Patient Care: Lessons from the Field

With the health reform discussion in full swing, improving value for the money we spend on health care is an essential part of the debate. Nurses can play a prominent role in improving quality. A growing body of research points to the positive impact of nurses on coordinating care, reducing hospital readmissions and improving clinical outcomes – all with a potential to reduce costs.






Rewarding Quality Performance: The Multidisciplinary Approach

In today’s health care system it is clear that there needs to be a multidisciplinary approach toward improving quality. Nurses are on the front lines of implementing this quality improvement. By using the highest quality measurements and optimizing the delivery of care, those outside the nursing community would understand the importance of their role in quality performance.