Health Care Workforce: Federal Investments in Training and the Availability of Data for Workforce Projections

What GAO Found

GAO found that there is substantial federal funding for health care workforce training programs but that obtaining comprehensive information about the scope of such programs is challenging. In GAO's August 2013 report on the federal role in health care workforce training, GAO found that four federal departments—the Department of Health and Human Services (HHS), the Department of Veterans Affairs (VA), the Department of Defense (DOD), and the Department of Education (Education)—administered 91 programs that supported postsecondary training or education specifically for direct care health professionals in fiscal year 2012. All together, the four departments reported obligating about $14.2 billion for health care workforce training programs in fiscal year 2012, with HHS funding the most programs (69) and having the largest percentage of total reported funding (82 percent). The majority of funding for health care workforce training in fiscal year 2012—about $11.1 billion, or 78 percent—was invested in seven programs that supported postgraduate residency training for physicians, dentists, and certain other health professionals, called Graduate Medical Education. The remaining 84 programs administered by HHS, VA, DOD, and Education accounted for obligations of about $3.2 billion and provided varying levels of assistance, ranging from participation in short-term continuing education courses to full support for tuition and books and a stipend for living expenses. Compiling comprehensive information about the scope of federal support for health care workforce training is challenging because multiple federal departments administer such programs, and GAO found that the departments did not always have comparable program information.

Lack of timely, regularly updated data creates challenges for projecting health care workforce supply and demand. The Health Resources and Services Administration (HRSA)—an agency within HHS—is responsible for monitoring the supply of and demand for health care professionals. At the time of its September 2013 report, GAO found that, since publishing a 2008 report on physician supply and demand, HRSA had awarded five contracts to research organizations to update national health care workforce projections. However, HRSA had failed to publish any new workforce projections. While HRSA created a timeline in 2012 for publishing a series of new workforce projection reports, the agency missed its original goals for publishing them and had to revise its publication timeline. HRSA's report on the primary care workforce was published in November 2013, more than 3 years after the contractor originally delivered its report to HRSA for review.

Why GAO Did This Study

A well-trained and diverse health care workforce is essential for providing Americans with access to quality health care services, including primary care services. To help ensure a sufficient supply of physicians, nurses, dentists, and other direct care health professionals for the nation, the federal government has made significant investments in health care workforce training through various efforts. As Congress considers funding existing or additional training programs that would address any potential shortages of health care professionals, timely and up-to-date estimates of future supply and demand for health care professionals are critical.

This statement addresses (1) the scope of the federal government's role in health care workforce training and (2) the availability of data related to projecting health care workforce supply and demand. It is based on findings from two recent GAO reports. The first report identified federal programs that supported postsecondary training and education for direct care health care professionals in fiscal year 2012, including information about program purpose, funding, and targeted health professionals. The second report examined actions HRSA has taken to project the future supply of and demand for physicians, physician assistants, and advanced practice registered nurses (APRN) since publishing its 2008 physician workforce report. These products used a variety of methodologies, which are detailed in each report.

For more information, contact Linda T. Kohn at (202) 512-7114 or kohnl@gao.gov.