5 takeaways from the Future Health Workforce Commission Report

California is projected to face a shortage of 4,100 primary care providers, 600,000 home health workers, and up to 40 percent of behavioral health providers in 10 years. The California Future Health Workforce Commission released its new report this month analyzing California’s current and future health care workforce shortage trends and recommending policies to address the problem.  Here are five takeaways from the report and its recommendations:


1. California does not have the internal capacity to meet its own workforce needs. 

According to the report, though California has the largest population in the country, it has the one of the lowest per capita rates of medical school enrollment. That has meant that over 60% of medical school attendees have done so in other states. As the cost of living continues to rise, California cannot depend on these students returning to meet its professional needs. Capacity limitations also exist with regard to medical residency training slots, higher level health professional degrees, as well as other health care related fields like nursing and skills-based health professionals.

To build supply, California must start by addressing capacity.

2. Addressing the shortages means not only building a supply of workers, it also means getting them to the right places.

Rural and low-income communities have already been hit hard by provider shortages. A recent CHCF and Kaiser Family Foundation poll found that one third of Californians perceived that their community does not have enough providers, but that number jumps to around 40% in low-income communities and close to 50% in some rural parts of the state.

Investments in training should both target students from those communities for recruitment in hope they will return, and look towards attracting new professionals to areas they may not have previously considered.

3. System reform is essential to the success of the proposed workforce initiative objectives.

The Commission identified six conditions deemed “essential conditions” to achieving the objectives of their policy recommendations. All touch on large-scale system reforms that impact efficiently and effectiveness of the delivery network.

As ideal climate characteristics for success includes: higher Medi-Cal payment rates, practice transformation initiatives, increased use of value-based payments, greater focus on prevention/social determinants of health, and better academic preparedness to influence success in higher level health care education.

4. Impacting workforce shortages will take coordination and shared ownership.

California is a big state with diverse economic and social interests. Not all interests align or will continue to align and not all conditions in the health care system will remain static. Government, health plans, foundations, employers, health care organizations, hospitals and systems, educational institutions, associations, and advocacy organizations will all play a role in the state’s success or failure to address the looming crisis.

To impact anticipated shortages leaders will need to engage and coordinate a wide array of stakeholders and community interests. Implementation of strategies will be more successful if approached as an ongoing process incorporating feedback and revisions rather than a fixed event.

5. $6 billion over 10 years is a lot, but not nearly as much as the impact of shortages on health outcomes and over all system stability.

Health care accounts for 12.6 percent of California’s GDP and provides 1.4 million jobs. If the state and partners don’t invest to meet ongoing workforce needs, the effects will likely be felt throughout the economy – not solely in relation to health care.

The Commission’s full report presents 10 priority and 17 secondary specific recommendations for action which you can find here. The estimated costs of all 27 recommendations tops $6 billion, but would be predicted to produced 60,000 more health professionals and 47,000 additional health workers in 10 years and lay the infrastructure to meet continually expanding needs in the future.