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U.S. Senate Considers Health Care Workforce Challenges

May 22, 2018

A hearing today before the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee considered strains the health care workforce is experiencing as it works to meet the needs of patients, as well as federal programs underway that support the recruitment, training, and retention of medical professionals.

Of particular concern, the hearing provided an opportunity to explore efforts to:

  • Meet the needs of underserved areas, including rural communities
  • Build a more diverse workforce representing racial and ethnic minorities, and promoting cultural and language competency
  • Confront the challenges of an aging population and geriatric care
  • Address the shortage of mental and behavioral health professionals

In his opening remarks, U.S. Senate HELP Committee Chairman Lamar Alexander (R–TN) cited the core dilemma to be explored during the hearing—“the widening of the gap between the number of people who need health care and the number of those who provide it.”

Projections outlined in a recent report by the Association of American Medical Colleges (AAMC), The Complexities of Physician Supply and Demand: Projections from 2016–2030, indicate a national shortage of up to:

  • 20,000 physicians by 2030
  • Between 42,600 and 121,300 physicians by the end of the next decade

Moreover, the AAMC projects that by 2030:

  • The total population will increase by more than 10 percent
  • The percentage of people over 65 will increase by 50 percent compared to today

The HELP Committee hearing—The Health Care Workforce: Addressing Shortages and Improving Care—outlined three avenues by which the federal government is supporting the health care workforce:

  • $10 billion provided through the Medicare Graduate Medical Education (GME) programs to fund resident physician training
  • $1 billion provided to health workforce programs administered by the Health Resources & Services Administration, including the Title VII health professions education and training programs, and the Title VIII nurse education programs
  • $310 million provided to the National Health Service Corps for loan repayment for primary care doctors working in underserved areas

To grow the health care workforce, HAP is advocating for sustained investments in training for doctors and nurses by:

  • Maintaining Medicare GME payments that support the training of resident physicians
  • Increasing the number of federally funded residency positions through federal legislation, H.R. 2267/S. 1301, the Resident Physician Shortage Reduction Act of 2017, which would increase the number of Medicare direct graduate medical education (DGME) and indirect medical education (IME) slots by a total of 15,000 nationwide from 2019 to 2023
  • Funding Federal Title VII and VIII health professions and nursing education programs
  • Supporting nurse workforce training, including hospital-based nurse education and the innovative Graduate Nurse Education demonstration project, which was enormously successful in the Philadelphia region, to increase the supply of advanced practice nurses

Additionally, in an effort to strengthen the health care workforce’s ability to respond to the opioid crisis, HAP has urged Congress to include H.R. 5818/S. 2843, the Opioid Workforce Act of 2018—legislation that incentivizes the training of physicians specialized in the treatment of substance use disorders and pain management—in the opioid package advancing through Congress this summer. 

For information about state advocacy to support the supply of doctors and nurses in Pennsylvania, please contact Scott Bishop, HAP’s senior vice president, legislative advocacy. Questions about federal initiatives in support of health care workforce training may be directed to Laura Stevens Kent, HAP’s vice president, federal advocacy.

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