Abstract
Shortages in the nursing, primary-care, and behavioral health workforces are an ongoing and widespread issue in the United States. This report assesses shortages in these health care workforces in the Commonwealth of Virginia and identifies potential interventions to address these shortages. The report is the culmination of the second and third phases of a larger study. In the first phase of the study, the Virginia Health Workforce Development Authority and its partners focused on initial data collection and analysis related to challenges faced by Virginia’s health care workforce. This report extends the first phase to identify specific interventions for (1) retaining existing health care workers, (2) recruiting first-time future health care workers, and (3) maximizing the ability of the Virginia health care workforce to meet the Commonwealth’s needs via structural efficiencies—for example, better geographic distribution of the Commonwealth’s workforce via economic and social policy interventions or telehealth practice. We identified interventions to improve retention, recruitment, and structural efficiency based on an environmental scan of peer-reviewed and grey literature; primary multi-stakeholder conference, interview, focus group, and survey data; and statistical analysis and simulation based on data from the Commonwealth and other relevant sources. Importantly, a wide variety of Virginia health care workforce stakeholders participated in and supported the research by attending the study conference, participating in interviews, focus groups, and serving on the study’s advisory board. The participation of these Virginia stakeholders was critical to identifying solutions that better fit Virginia’s specific health care workforce landscape and population needs. Appendixes A–H to this report, which provide details on the methods and analysis used for this research, are contained a separate annex, available at www.rand.org/t/RRA2093-1. This research was funded by the Virginia Health Workforce Development Authority (VHWDA) and carried out within the Access and Delivery Program in RAND Health Care. The Virginia General Assembly established VHWDA in 2010 in order to identify and address health workforce issues in the Commonwealth. As a public entity, VHWDA exercises public and essential governmental functions to secure the health, welfare, convenience, knowledge, benefit, and prosperity of Virginians. VHWDA’s mission is to “facilitate the development of a statewide health professions pipeline that identifies, educates, recruits, and retains a diverse, geographically distributed and culturally competent quality workforce” (VHWDA, undated-a). VHWDA accomplishes this through core functions outlined in the Code of Virginia (Virginia’s Legislative Information System, undated-c). RAND Health Care, a division of the RAND Corporation, promotes healthier societies by improving health care systems in the United States and other countries. We do this by providing health care decisionmakers, practitioners, and consumers with actionable, rigorous, objective evidence to support their most complex decisions.
