and some allied health professionals, the efforts of other health professionals—including nurses—is invisible in most federal data sets.

As discussed above, the ACA authorizes the NHWC. It also authorizes a National Center for Workforce Analysis, as well as state and regional workforce centers, and provides funding for workforce data collection and studies. A priority for these new structures and resources should be systematic monitoring of health care workforce shortages and surpluses, review of the data and methods needed to predict future workforce needs, and coordination of the collection of data relating to the health care workforce in federal surveys and in the private sector. These three functions must be actively assumed by the federal government to build the necessary capacity for workforce planning in the United States. The NHWC has the potential to build a robust workforce data infrastructure and a high-level analytic capacity.

HRSA’s Bureau of Primary Care and Bureau of Health Professions conduct some monitoring—primarily for nurses, primary care clinicians, mental health professionals, dentists, and pharmacists—for purposes of designating health professional shortage areas/facilities and medically underserved areas/populations and informing funding decisions to support clinician training. Thus, HRSA is well positioned to assume leadership in directing resources needed to build a data infrastructure to support health care workforce research.

One currently available resource for examining the role of providers in primary care is the National Provider Indicator (NPI). While the NPI is a mechanism for tracking billing services, this data source at the Centers for Medicare and Medicaid Services (CMS) could be thought of as an opportunity to collect workforce data and conduct research on those nurses who bill for services, primarily nurse practitioners. The committee believes the NPI presents a unique opportunity to track and measure nurse practitioners with regard to their practice, such as where they are located, how many are billing patients, what kinds of patients they are seeing, and what services they are providing. These data would be a significant contribution to the supply data currently being collected, adding to the knowledge base about practice partnerships, utilization of services, and primary care shortages. The committee encourages CMS to make these data available in a useful way to workforce researchers and others who might contribute to this knowledge base.

The NHWC needs to develop predictions for a range of assumptions about future delivery systems and patterns, including the future workforce supply across the professions (see Figure 6-3 for factors to consider) and the demand for services that can be provided by more than one profession or specialty (see Figure 6-4 for factors to consider). The following example illustrates the complexity of developing workforce projections and the depth of the data needs with respect to a single profession, as well as the innovative solutions the Gulf Coast region of Texas found for meeting its nursing needs. The committee commends this example to the NHWC while encouraging it to extend this innovation by looking at workforce needs across professions.

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