Provider Shortage Leads to Workforce Model Research

PRINCETON, N.J. — The current shortage of primary care providers threatens accessibility and the quality of health care, according to the Robert Wood Johnson Foundation.

To combat the threat, the Foundation is teaming up with the Group Health Research Institute on a new national program designed to make primary care more efficient and effective.

The Primary Care Team: Learning from Effective Ambulatory Practices (LEAP) project aims to identify primary care practices that use health professionals and other staff in ways that optimize services.

The team will identify and study 30 high-functioning primary care practices to learn about innovative staffing arrangements that maximize health and staff contributions.

The LEAP project will identify changes in policy, workforce, culture, education and training related to primary care that can improve the way practices function.

The goal for the workforce models is to be replicated and adopted more widely.

The partnership comes at a time when millions of Americans may enter the health system if the Affordable Care Act is implemented.

“The Foundation’s mission is to improve health and health care, and we cannot succeed unless we address the shortage of primary care services,” said John Lumpkin, MD, MPH, RWJF senior vice president and director of the Health Care Group. “The nation will not be able to train new primary care providers quickly enough to meet the need, so part of the solution must be to use the workforce we have more effectively.”

The primary care team is headed by Ed Wagner, M.D., Ph.D., and Margaret Flinter, Ph.D., APRN. The MacColl Center for Health Care Innovation at Group Health Research Institute in Seattle will serve as the national program office.

“Improving the quality of primary care is a key objective of health care reform. Central to the improvement of primary care is the development of effective primary care teams,” Wagner said. "We are delighted that this project will allow us to study some of the nation’s finest primary care practices and spread their staffing innovations to others.”

The criteria for selecting the exemplary primary care practices — which will represent a variety of settings, practice configurations and locations — will be developed by a national advisory committee chaired by Thomas S. Bodenheimer, MD, MPH, adjunct professor at the University of California, San Francisco, School of Medicine.

After site visits conducted by the research team, the project will bring the sites together as a “learning community” to share best practices and to help distill innovations into a toolkit that can be used by others.

With initial RWJF funding to support the team through June 2014, the LEAP project is designed to identify those that improve patient and practice outcomes, and share information so they can be replicated.

Currently, little information exists on how existing creative workforce models have impacted health care access, quality, value and patient or provider experience — resulting in low implementation levels.

“This project is particularly important because it recognizes that there is tremendous diversity in primary care settings across the country, from small private practices to large health systems to community health centers,” Flinter said. “We need all of these practices to perform at the highest level.”

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