This visualization tool, Entry-Level Health Care Workforce: Information and Programs, is designed to accompany the RAND report titled Strengthening the Entry-Level Health Care Workforce: Finding a Path, by Shira H. Fischer, Ryan K. McBain, Laura J. Faherty, Jessica L. Sousa, Vishnupriya Kareddy, Allyson D. Gittens, and Grant R. Martsolf. This report provides potential approaches to expand and strengthen the entry-level health care workforce in the United States. Attention has been directed to programs in the domains of behavioral health care, long-term care, and primary health care. This research was funded by the Office of the Assistant Secretary for Planning and Evaluation (Task Order Number: HHSP23337008T, under contract HHSP233201500038I) and carried out within the Payment, Cost, and Coverage Program in RAND Health Care.
There is a recognizable shortage and maldistribution of health providers in the United States. Strengthening the scope and scale of the entry-level health care workforce (EHCW) is one strategic response to this. Through a search of academic and gray literature, discussions with key informants, and a close look at 10 selected innovative programs, we identified and reviewed the evidence base for and examples of innovative programs and policies at local, state, and federal levels. We use this information to provide a menu of policy and program options in the public and private sectors. This tool serves as an interactive inventory of existing policies and programs as well as of the literature on the topic, with information current as of April, 2019.
While more data are needed, and evidence on the impact of existing efforts is weak, there are a number of approaches that policymakers and health care leaders may consider adopting to advance the career potential for those in the entry-level healthcare workforce, improve coordination around this workforce, promote use of technology to train and organize workforce members, and address key research gaps.
We surveyed academic and gray literature identified through Google Search and Google Scholar based on keywords under three domains: job categories or occupations of interest, terminology indicative of gaps in labor supply and quality, and terminology connoting solutions to these gaps. With respect to occupations of interest, we restricted our search to those health workforce to positions that require training below the baccalaureate level (pre-baccalaureate) and offer some form of direct patient care or services or care coordination, as noted in the introduction. In conjunction with the systematic Google Scholar search, research team members also conducted a formal academic literature search of four databases—PubMed, Embase, PsycInfo, and Business Search Complete—from 2009 to 2019, using the same Boolean search procedure. We also inspected bibliographies of relevant articles identified from this process for additional search content. More details are included in the report.
Programs and Policies
These are innovative programs and policies that support the EHCW in a training, recruitment, retention, and other general policies. The user can filter by occupation, content area, program level, objective, and whether there was an evaluation. Links to the program and the evaluation are provided, where available.
This is a collection of peer-reviewed literature on the topic. The user can filter by year, author, relevant occupation, content area, relevance, and funder, where available.
This is a collection of reports on the topic. The user can filter by year, institution, relevant occupation, content area, and funder, where available.
Highlighted innovative programs were identified by researchers as those using novel approaches to addressing this problem that weren’t found in other programs gathered in the database. This is a subjective assessment.
* Asterisks indicate programs that don’t focus on those without a baccalaureate degree but with features that could be expanded or applied to the entry-level workforce.
- Some job categories have been combined to minimize the number of categories and use of the tool.
- Nurses = Licensed Practical Nurses, Licensed Vocational Nurses
- Dental Health = Dental Assistants or Dental Hygienists
- Health Aides = Nursing Aide, Health Aide, Nursing Assistant, Home Health Aide, Personal Care Aide, Home Care Worker, Psychiatric Aide
- Community Health Worker = Community Health Worker, Community Health Representative, Health Outreach Worker, Health Educator
- Peer Support = Peer Counselor, Peer Navigator, Peer Educator
EHCW Program and Policies
- User Guide (PDF)
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About this Project
Entry-Level Health Care Workforce: Information and Programs was developed by Shira H. Fischer, Ryan K. McBain, and Emily Cantin, and accompanies the RAND report Strengthening the Entry-Level Health Care Workforce: Finding a Path, by Shira H. Fischer, Ryan K. McBain, Laura J. Faherty, Jessica L. Sousa, Vishnupriya Kareddy, Allyson D. Gittens, and Grant R. Martsolf, PR-A712-1, 2020. This work was commissioned by the Office of the Assistant Secretary for Planning and Evaluation, and the research was conducted in RAND Health Care, a division of the RAND Corporation.