Health System Capacity
and Health Care Reform
The Importance of State
Policy and Programs

The Issue
\"We're looking at a deficit of approximately 200,000

physicians by 2020... we will still not catch up [to the
demand] in the lifetime of anyone in this room or that of
our children.“
Health Economist Richard Cooper of the University of

Pennsylvania at the 14th annual Princeton Conference
sponsored by the Robert Wood Johnson Foundation
(Health Matters, Congress Daily, July 8, 2007)

How Health Care Reform
Complicates the Issue
Article: Doc shortage looms in Mass.

BOSTON, July 27, 2007 (UPI) -- The Massachusetts health reform

plan is in full swing, but so is an acute doctor shortage that may
curtail the state's goal of providing care to hundreds of thousands of
new patients who will want it, according to a new study.
Today, new patients wait an average of 52 days to see an

internist or family doctor for a routine visit, according to the
physician workforce study by the Massachusetts Medical
Society.
Add to this the 500,000 new patients expected to enroll in the

state's new health plan this year, and Massachusetts may have a
crisis of healthcare access on its hands
Many people will have insurance and access to basic healthcare

for the first time in their lives. Some will bring with them problems
that have never been treated and will require extra attention from
their physicians

Nature of the Issue
Health professional shortages cover many disciplines –

medicine, oral health, nursing, behavioral health…
Similar shortages exist for skilled non-provider health staff –

managers, billing staff, receptionists, medical assistants, lab
assistants…
The problem results, in part, from a gap in public policy – both

Federal and State.
The problem also stems from mistakes made in health workforce

planning.
Rural and underserved areas will be inordinately affected by the

problem. The impact will be very severe on primary care centers
and other parts of the health safety net.

Public Policy
and Program Interventions
Supply improvements – increase capacity to educate the number

increasing the number of trained health professionals. Build
education and training infrastructure.
Placement incentives – provide financial and other incentives to

health professionals willing to locate in underserved areas.
Retention incentives – provide financial and other incentives to

health professionals willing to remain in underserved areas.
Scope of Work/Licensing modifications – change the permitted

scope of practice of regulated health professionals.
Participation incentives – provide financial and other incentives for

health professional participation in Medicaid and other public
programs.
Health Professional Mandates – require participation of licensed

health professionals in public programs.