Investment in healthcare workforce announced as doctor shortage looms

The Obama administration on Wednesday announced its first allocations of funding for workforce education under the healthcare reform law, with a $250 million investment this year. The announcement comes amid growing concern that the nation will not have the number of doctors and nurses — especially primary care physicians — to care for the extra 32 million people who will have insurance by 2020 thanks to the healthcare reform bill.

Health and Human Services Secretary Kathleen Sebelius and Rep. Lois Capps (D-Calif.) together announced the allocation, paid for with money from the healthcare bill's $500 million Prevention and Public Health fund for 2010.

Here's the breakdown: 

• $168 million to expand the number of primary care residency training slots, to produce about 500 additional primary care providers by 2015; 

• $32 million to increase the number of physicians' assistants by 600 by 2015;

• $30 million to encourage nursing student to go to school full-time, thereby increasing the number of nurse practitioners by 600;

• $15 million to add 10 new nurse managed health centers, settings in which nurse practitioners provide primary care services and undergo their clinical training; and

• $5 million in grants to encourage states to expand their primary care workforce by 10 percent to 25 percent.

"With this new infusion of funds, we will be able to increase opportunities and build infrastructure for future generations of healthcare professionals," said Mary Wakefield, a nurse who heads the Health Resources and Services Administration at HHS.

Investments in the healthcare workforce were not a main focus of the healthcare reform debate, even though medical experts have been warning about a looming shortage for years.

A 2006 HRSA report projected a shortage of 55,000 to 150,000 physicians by 2020 — and that was before healthcare reform passed.

The Association of American Medical Colleges estimated a shortage of about 21,000 primary care clinicians in 2015, without congressional action.

Others have calculated that the country will have 100,000 fewer physicians by 2020 than the 1.1 million needed under the healthcare reform law.

A recent study by the agency that oversees Medicare found that the increased demand in health services “could be difficult to meet initially … and could lead to price increases, cost-shifting and/or changes in providers’ willingness to treat patients."

And the Washington Post added fuel to the debate Monday with a story looking at pending retirements among doctors and nurses, who tend to be older than the national average.

But the administration says the healthcare reform law, and investments under last year's recovery act, will support the training and development of more than 16,000 new primary care providers during the next five years.

Wakefield also pointed out that healthcare professionals who benefited from student aid relief and are working in underserved areas are eligible for a refund on their 2009 federal income tax return, as well as a tax cut.

"The Affordable Care Act," Capps said, "is truly a jobs bill."