Health Care:

Health Professions Education Programs

GAO-06-55: Published: Feb 28, 2006. Publicly Released: Mar 30, 2006.

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For fiscal years 1999 through 2005, the Health Resources and Services Administration (HRSA), an agency within the Department of Health and Human Services (HHS), spent about $2.7 billion to fund the more than 40 health professions education programs authorized under title VII and title VIII of the Public Health Service Act. These programs include those providing grants to institutions, direct assistance to students, and funding for health workforce analyses. Title VII includes programs related to the education of providers, such as primary care physicians. Title VIII includes programs related to nursing education. Most of these programs were last reauthorized in 1998. GAO reviewed changes in funding and in the number of these programs since 1998, HRSA's goals and assessment of the programs, and HRSA's national health professions workforce projections. GAO reviewed relevant laws and agency documents and data, and interviewed HRSA officials and representatives of health professions education associations.

Funding for title VII and title VIII programs increased from about $300 million in fiscal year 1999 to more than $450 million in fiscal year 2005, and the overall number of these programs also increased since reauthorization in 1998. From fiscal years 1999 through 2005, funding for title VII programs rose by about one-fourth, while that for title VIII programs more than doubled. The overall numbers of title VII and title VIII programs administered by HRSA increased from 46 in fiscal year 1998 to 50 in fiscal year 2004. The number of title VII programs remained the same, while the number of title VIII programs increased. HRSA has published performance goals for title VII and title VIII health professions education programs but cannot fully assess the programs' effectiveness because the goals do not apply to all the health professions education programs, and the data for tracking progress are problematic. Recognizing the need for a better means of measuring the results of title VII and title VIII programs, HRSA is developing new performance goals and measures for them. The effectiveness of these efforts will depend upon the agency's ability to collect complete and timely data to assess progress toward these new goals. HRSA has published few recent national workforce projections. In the past decade, the agency has published national supply and demand projections for the nurse and pharmacist workforces but no national projections for the physician and dentist workforces. Yet regular reassessment of future health workforce supply and demand is key to setting policies as the nation's health care needs change.

Status Legend:

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  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendation for Executive Action

    Recommendation: The Administrator of HRSA should develop a strategy and establish time frames to more regularly update and publish national workforce projections for the health professions.

    Agency Affected: Department of Health and Human Services: Public Health Service: Health Resources and Services Administration

    Status: Closed - Implemented

    Comments: HRSA agreed with GAO's conclusion that updated workforce supply and demand projections are vital for informed decision making about health professions programs. In 2012, HRSA established timeframes for producing detailed workforce supply and demand projections for key health professions, including physicians, nurses, nurse practitioners, and physician assistants, during the period 2013 through 2016.

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