Comprehensive Planning by the Department of Health and Human Services (“HHS”) Needed to Meet National Needs

Published: December 11, 2015. Publicly Released: Jan 11, 2016.

Why GAO Did This Study

An adequate, well-trained, and diverse healthcare workforce is essential for providing access to quality healthcare services. The federal government, largely through HHS, funds programs to help ensure a sufficient supply and distribution of healthcare professionals. Some experts suggest that maintaining access to care requires an increase in the supply of providers, while others believe that access can be maintained through other means, such as greater use of technology.

GAO was asked to review HHS’s workforce efforts. In the report, GAO examines (1) HHS’s planning efforts for ensuring adequate supply and distribution of the nation’s healthcare workforce; and (2) the extent to which individuals in HHS health care workforce programs contribute to meeting national needs. In its analysis, GAO reviewed strategic planning documents, workforce projection reports, and other related documents from HHS agencies. The GAO also interviewed HHS officials and analyzed performance measures for the largest healthcare workforce programs operated by HHS.

What GAO Found

HHS engages in some level of planning for the seventy-two (72) health care workforce programs administered by its agencies, but lacks comprehensive oversight to ensure that these efforts meet national healthcare workforce needs. HHS’s current strategic plan includes broad strategies such as improving access to comprehensive primary and preventive medical services in historically underserved areas and supporting federally funded healthcare centers. However, these strategies do not explicitly reference workforce issues or specify how these programs contribute towards HHS’s current strategic goals and performance targets. The healthcare workforce performance measures tracked by HHS and its agencies are specific to individual workforce programs and do not fully assess the overall adequacy of the department’s workforce efforts. The Office of the Secretary leads workforce planning efforts, but does not have an ongoing formal effort to ensure that the workforce programs distributed across its different agencies are aligned with national needs. 

HHS’s workforce programs support education and training for multiple health professions, its largest programs do not specifically target areas of workforce need, such as for primary care and rural providers. External stakeholders have also recommended additional reforms that would allow these programs to better target areas of need. Without a comprehensive and coordinated planning approach, HHS cannot fully identify gaps and actions to address those gaps, including determining whether additional legislative proposals are needed.

What GAO Recommends

GAO recommends that HHS develop a comprehensive and coordinated planning approach that includes performance measures, identifies any gaps between its workforce programs and national needs, and identifies actions to close these gaps. HHS concurred with GAO’s recommendation and provided technical comments, which GAO incorporated as appropriate.

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