Health Care Workforce:

HRSA Action Needed to Publish Timely National Supply and Demand Projections

GAO-13-806: Published: Sep 30, 2013. Publicly Released: Oct 30, 2013.

Additional Materials:

Contact:

Kathleen M. King
(202) 512-7114
KingK@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

What GAO Found

Since 2008, the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services (HHS) has awarded five contracts to research organizations to update national workforce projections, but HRSA has failed to publish any new reports containing projections. As a result, the most recent projections from HRSA available to Congress and others to inform health care workforce policy decisions are from the agency's 2008 report, which is based on data that are more than a decade old. While HRSA created a timeline for publishing new workforce projection reports in 2012, the agency missed its goal to publish a clinician specialty report by December 2012 projecting the supply of and demand for health care professionals through 2025. HRSA officials attributed the delay in publishing this report to data challenges and modeling limitations. HRSA has also revised its timeline to postpone publication of two other health care workforce reports, as shown in the table below. HRSA officials said that the agency does not have standard written procedures for preparing a report for publication after final reports are delivered from contractors, which may impede its ability to accurately predict how long products will take to review and monitor their progress through the review process.

Why GAO Did This Study

For over a decade, government, academic, and health professional organizations have projected national shortages of health care professionals, which could adversely affect patients' access to care. However, there is little consensus about the nature and extent of future shortages, partly because of the complexity of creating projections and uncertainty about future health care system changes. Up-to-date workforce estimates are essential given the significant federal investment in health care training programs. Within HHS, HRSA is responsible for monitoring health care workforce adequacy; to do this, HRSA conducts and contracts for workforce studies.

GAO was asked to provide information about health care workforce projections. This report examines the actions HRSA has taken to project the future supply of and demand for physicians, physician assistants, and advanced practice registered nurses since publishing its 2008 report. GAO reviewed HRSA's contract documentation, select delivered products, and timeline goals for publication. GAO also interviewed HRSA officials, workforce researchers, and provider organizations.

What GAO Recommends

GAO recommends that the Administrator of HRSA expedite the review and publication of HRSA’s report on national projections for the primary care workforce, create standard written procedures for report review, and develop tools to monitor report review to ensure timeline goals for publication are met. HHS agreed with GAO’s recommendations and provided technical comments.

For more information, contact Kathleen M. King at (202) 512-7114 or kingk@gao.gov.

Status Legend:

More Info
  • 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

    Recommendations for Executive Action

    Recommendation: The Administrator of HRSA should expedite the review of the report containing national projections to 2020 for the primary care workforce to ensure it is published in the fall of 2013 in accordance with HRSA's revised timeline.

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

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Administrator of HRSA should create standard written procedures for completing the tasks necessary to review and publish workforce projection reports delivered from contractors; such procedures may include a list of necessary review steps, estimates of how long each step should take to complete, and designated internal and external reviewers.

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

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Recommendation: The Administrator of HRSA should develop tools for monitoring the progress of projection reports through the review process to ensure that HRSA's timeline goals for publication are met.

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

    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

    Aug 13, 2014

    Aug 11, 2014

    Jul 30, 2014

    Jul 29, 2014

    Jul 23, 2014

    Jul 16, 2014

    Jul 15, 2014

    Jul 10, 2014

    Looking for more? Browse all our products here