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GAO Report Calls HHS Workforce Management into Question

January 14, 2016
by Rajiv Leventhal
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Despite overseeing 72 healthcare workforce programs, the Department of Health and Human Services (HHS) lacks comprehensive planning and oversight, according to a new report from the Government Accountability Office.

For the report, GAO was asked to review HHS's workforce efforts. In the report, GAO examines (1) HHS's planning efforts for ensuring an adequate supply and distribution of the nation's healthcare workforce and (2) the extent to which individual HHS healthcare workforce programs contribute to meeting national needs. GAO did this by reviewing strategic planning documents, workforce projection reports, and other related documents obtained from HHS agencies; interviewing HHS officials; and analyzing performance measures for the largest healthcare workforce programs operated by HHS.

According to GAO, 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 health centers—to which department officials said the healthcare workforce programs relate. 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 report stated.

More specifically, while 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, the report said. According to GAO, HHS’s “two Medicare GME [Graduate Medical Education] programs accounted for about three-quarters of HHS's fiscal year 2014 obligations for healthcare workforce development. However, HHS cannot target existing Medicare GME program funds to projected workforce shortage areas because the programs were established by statute and funds are disbursed based on a statutory formula that is unrelated to projected workforce needs.”

As such, GAO recommended 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 recommendations, per the report.

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