Health Professions Network. Vision: HPN is the recognized voice of the collective associations of...
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Health Professions Network
Health Professions Network. Vision: HPN is the recognized voice of the collective associations of allied health professions Mission: HPN is a forum that
Vision: HPN is the recognized voice of the collective
associations of allied health professions Mission: HPN is a forum
that advocates, collaborates, communicates and disseminates
information on behalf of allied health professions to promote
effective care, lower cost, and better health for patients in the
United States.
Slide 3
What can we as the Allied Health community do, in a collective
and collaborative manner, to promote, develop, and strategically
place allied health professionals in more critical roles to deliver
the Triple Aim: Improve the experience of care for individuals
Improve population health Lower per capita costs
Slide 4
The Changing Face of Workplace Systems
Slide 5
Healthcare Providers Disruptive Innovation Continues: 1980s:
DRGs, EMTALA, multis Emergence and growth of for profit structures
and systems. Dynamic tensions arise in education and providers
1990s-2000s: Reengineering and Restructure Models of care show
changes to various delivery processes Demographics of demands vs.
existing programs/new needs 2010s-2020s: Chaos to Creation,
Accelerated Evolution Current chaos has been building for several
years Major shifts will occur and current structures will not come
back Cost and quality pressures are driving the change
Slide 6
Healthcare Providers Redesign of how its delivered, less
emphasis on who Emphasis on primary and preventative care Current
labels and structures: Accountable Care Organizations (ACOs)
Integrated delivery systems Coordinated Care Evidence based
medicine What does it look like?? Where is it going ??
Slide 7
Healthcare Providers Major Shift from Episodic Care to
Population Health Management Volume to value Quantity to quality
Events to outcomes Preserve the core business and stimulate the
transition Volume based model that is still working to see how
money will flow to the new model (business model migration) Larger
scale systems will emerge
Slide 8
Healthcare Providers Major Shift from Episodic Care to
Population Health Management (Quantity to Quality, Events to
Outcomes) Massive data integration, analysis, and management
Transaction oriented to intelligence oriented Analysis of small
percentage that incur largest expense dollars Analysis of
effectiveness of provider programs Development of structure for
new/changing programs Document the value/cost per delivery of
service
Slide 9
Healthcare Providers Major Shift from Episodic Care to
Population Health Management; (Quantity to Quality, Events to
Outcomes) Massive data integration, analysis, and management
Community and public health issues/treatment Disease management
(chronic and selective) Targeted services Eldercare Programs
Patient Centered Medical Home Physician acquisition and engagement;
leadership roles Wellness programs End of life care
Slide 10
The Changing Face of the Workforce
Slide 11
2010-2020: Occupational Volume Growth Occupation Registered
Nurses Physicians Source: Bureau of Labor Statistics; January, 2012
New 712,000 168,000 Vacant 495,000 137,000 Total 1,207,000 305,000
1,512,000
Slide 12
2010-2020: Occupational Volume Growth Occupation Registered
Nurses Physicians Home Health Aides (ST,OJT) Nursing Aides,
Orderlies, Attendants (LT 1) Licensed Practical/Vocational Nurses
(1) Medical Assistants (UT 1) Source: Bureau of Labor Statistics;
January, 2012 New 712,000 168,000 706,000 302,000 169,000 163,000
Vacant 495,000 137,000 132,000 194,000 *227,000 81,000 Total
1,207,000 305,000 1,512,000 838,000 496,000 396,000 244,000
1,974,000
Slide 13
2010-2020: Occupational Volume Growth Occupation Registered
Nurses Physicians Home Health Aides (ST,OJT) Nursing Aides,
Orderlies, Attendants (LT 1) Licensed Practical/Vocational Nurses
(1) Medical Assistants (UT 1) Pharmacy Technicians (2) Pharmacists
(6-8) EMTs/Paramedics (UT 2) Source: Bureau of Labor Statistics:
January, 2012 New 712,000 168,000 706,000 302,000 169,000 163,000
108,000 70,000 75,000 Vacant 495,000 137,000 132,000 194,000
*227,000 81,000 58,000 *70,000 46,000 Total 1,207,000 305,000
1,512,000 838,000 496,000 396,000 244,000 166,000 140,000
121,000
2010-2020: Occupational Volume Growth Occupation Registered
Nurses Physicians Entry Level Positions Technical and Professional
Positions Source: Bureau of Labor Statistics; January, 2012 New
Positions 712,000 168,000 1,340,000 662,000 Vacant Positions
495,000 137,000 634,000 448,000 Total Positions 1,207,000 305,000
1,512,000 1,974,000 1,110,000 4,596,000
Slide 16
2010-2020: Occupational Volume Growth Occupation Registered
Nurses Physicians Practitioners and Technical (w/o Physicians &
RNs) Diagnosing and Treating Practitioners Technologists and
Technicians Other Practitioners/Technical Positions Support
Services Occupations Nursing and Home Health Aides OT and PT
Assistants and Aides Other Support Positions Source: Bureau of
Labor Statistics; January 2012 New 712,000 168,000 1,140,000
(396,000) (720,000) (23,000) 1,444,000 (1,019,000) (66,000)
(359,000) Vacant 495,000 137,000 939,000 (311,000) (577,000)
(52,000) 598,000 (334,000) (23,000) (241,000) Total 1207,000
305,000 1,512,000 2,079,000 (707,000) (1,297,000) (75,00 0)
2,042,000 (1,353,000) (89,000) (600,000) 5,633,000
Slide 17
2010-2020: Occupational Volume Growth Occupation Registered
Nurses Physicians Practitioners and Technical (w/o Physicians &
RNs) Diagnosing and Treating Practitioners Technologists and
Technicians Other Practitioners/Technical Positions Support
Services Occupations Nursing and Home Health Aides OT and PT
Assistants and Aides Other Support Positions Source: Bureau of
Labor Statistics; January 2012 New 712,000 168,000 1,140,000
(396,000) (720,000) (23,000) 1,444,000 (1,019,000) (66,000)
(359,000) Vacant 495,000 137,000 939,000 (311,000) (577,000)
(52,000) 598,000 (334,000) (23,000) (241,000) Total 1207,000
305,000 1,512,000 2,079,000 (707,000) (1,297,000) (75,00 0)
2,042,000 (1,353,000) (89,000) (600,000) 5,633,000
Slide 18
Where Do Health Care Workers Work ?? Setting Hospitals
Physician Offices Workers 4,685,300 3,818,200
Slide 19
Where Do Health Care Workers Work ?? Setting Hospitals
Physician Offices Nursing/Residential Care Home Health Care
Services Outpatient Facilities Source: Bureau of Labor Statistics;
January, 2012 Workers (2010) 4,685,300 3,818,200 3,129,000
1,080,600 1,077,000 13,790,100
Slide 20
Where Do Health Care Workers Work ?? Setting Hospitals
Physician Offices Nursing/Residential Care Home Health Care
Services Outpatient Facilities Source: Bureau of Labor Statistics;
January, 2012 Workers (2010) (2020) 4,685,300 5,563,600 3,818,200
5,209,600 3,129,000 3,951,000 1,080,600 1,952,400 1,077,000
1,471,200 13,790,100 18,147,800
Slide 21
Where Do Health Care Workers Work ?? Setting Hospitals
Physician Offices Nursing/Residential Care Home Health Care
Services Outpatient Facilities Source: Bureau of Labor Statistics;
January, 2012 Workers (2020) (# - %) 5,563,600 878K19% 5,209,600
1,391K-36% 3,951,000 822K-26% 1,952,400 872K-81% 1,471,200 304K-37%
18,471,800 4,358K-32%
Slide 22
Thoughts for Future Changes: There is no way you can have a
substantial change in the work PLACE and delivery systems for
health care without a resulting impact on the work FORCE and skill
sets that deliver the care. Its a call for right skill sets, not
necessarily a job title, to be in the right place at the right time
to provide the right care
Slide 23
A Workforce for Health, Not a Health Workforce Existing workers
shifting to new employment settings Existing workers taking on new
roles in the new models Existing workers moving between needed
specialties and changing services they offer New types of health
professionals performing new functions (CMS Innovation Programs)
Broader implementation of true team-based models of care and
education Source: Erin Fraher, PhD MPP; Director, Program on Health
Workforce Research & Policy; Cecil G. Sheps Center for Health
Services Research, UNC
Slide 24
CMS Innovation Program Grants Engage a broad set of innovation
partners to identify and test new care delivery and payment models
that originate in the field and that produce better care, better
health, and reduced cost through improvement for identified target
populations. Identify new models of workforce development and
deployment and related training and education that support new
models either directly or through new infrastructure activities.
Support innovators who can rapidly deploy care improvement models
(within six months of award) through new ventures or expansion of
existing efforts to new populations of patients, in conjunction
(where possible) with other public and private sector
partners.
Slide 25
CMS Innovation Program Grants Lean Practice Redesign Specialist
Patient Navigator Parent Navigator Community Health Navigators
Patient Advocate Care Team Coordinator Care Transition Specialist
Community Health Advocates Personal Care Advisor/Attendant Living
Skills Specialist Peer Health Workers/Coaches Transition
Guide/Coordinator Grand Aides (Certified) Health Improvement
Specialist Community Health Worker Evaluation Specialist
Interdisciplinary Team Members Enrollment Specialist Qualitative
Interviewers/Specialists Panel Manager Multi-cultural Specialist
Care Transition Team Patient and Family Activators Investigators
Comprehensive Care Giver Community Coordinators Primary Care
intensivists Peer Wellness Coaches Outreach Workers Health Care
Economist
Slide 26
A Few Questions: What is the specific competencies, activities,
and key tasks performed by each of these new roles? How will
competencies be determined? How will effectiveness be measured? How
are the workers going to be educated? Where will the education and
training take place? What is the source and training for the
workers? Regulations: state licensure or private sector
credentials? Are we concerned about consistency across the
board?
Slide 27
What About Management??
Slide 28
General Management Overview Long term Baby Boomer managers and
executives retiring or phasing back / out Good news / bad news
situation: experience isnt there, but neither are values and
relationships CEOs being replaced by physicians and outsiders
Traditional progressive managers being replaced by innovative risk
takers creating new markets. New manager and executive positions
/titles emerging along with the new delivery systems
Slide 29
What About Nurses?? What are the current trends for nurses in
existing systems? Solidifying their positions in existing provider
structures Already in positions to move on up to new/expanded roles
Moving to bigger and more expansive responsibilities Status
somewhat tempered by financial leaders and constraints Reallocation
of resources for existence and new programs in absence of increases
in revenue (revenue vs. expenses) What will be the role of nurses
in the new systems?
Slide 30
IOM Recommendations: Remove scope-of-practice barriers. Expand
opportunities for nurses to lead and diffuse collaborative
improvement efforts. Implement nurse residency programs. Increase
the proportion of nurses with a baccalaureate degree to 80 percent
by 2020. Double the number of nurses with a doctorate by 2020.
Ensure that nurses engage in lifelong learning. Prepare and enable
nurses to lead change to advance health. Build an infrastructure
for the collection and analysis of interprofessional health care
workforce data.
What Can We Do.. Create a same page for all of us to get on for
going forward? What areas can we start with? What barriers can we
work on?
Slide 42
What Can We Do.. Create a same page for all of us to get on for
going forward? What areas can we start with? What barriers can we
work on? Create our version of the education pipeline? What
can/should we standardize and how? How can we take our efforts
across the board? Who can/should be the driver/coordinating body
for all of this?
Slide 43
What can we as the health care community do, in a collective
and collaborative manner, to promote, develop, and strategically
place all health care professionals in more critical roles to
deliver the Triple Aim: Improve the experience of care for
individuals Improve population health Lower per capita costs
Slide 44
Slide 45
Presented by: Lynn Brooks Health Professions Network
[email protected] (406) 273-7028 Charleston, SC January 28,
2015