Strengthening and expanding the primary care workforce is a pivotal component of recent health reform legislation, and the Department of Health and Human Services (HHS) recently announced a key step toward that goal: the availability of $250 million in new workforce funding. Intended to help meet the growing demand for primary care workers, the funding—part of a new Prevention and Public Health Fund—will help train thousands of new doctors, nurses, physician assistants and other providers.
Increasing access to primary and preventive care to prevent disease, improve outcomes, and shrink health care costs is a tenet of the health reform bill—but cannot be achieved without alleviating the current and growing shortage of primary caregivers. The American Association of Medical Colleges (AAMC) has estimated that if trends continue, the United States will face a deficit of approximately 21,000 primary care physicians in 2015.
Recognizing the need to reverse this trend, the first Prevention and Public Health Fund allocation funds five key initiatives—outlined below—to attract, train, and support 500 new primary care physicians (PCPs) and other providers. HHS dedicates a majority of the funds toward bolstering the ranks of primary care physicians, but also supports training of over 1000 physician extenders. For a complete funding allocation breakdown, see Table 1.
Creating additional primary care residency slots: Training more than 500 new primary care physicians by 2015.
Supporting physician assistant training in primary care: Supporting the development of more than 600 new physician assistants, who practice medicine as members of a team with their supervising physician, and can be trained in a shorter period of time compared to physicians.
Increasing the number of nurse practitioners trained: Train an additional 600 nurse practitioners, including providing incentives for part-time students to become full-time and complete their education sooner.
Establishing new nurse practitioner-led clinics: Supporting the operation of 10 nurse-managed health clinics which assist in the training of nurse practitioners. These clinics are staffed by nurse practitioners, who provide comprehensive primary health care services to populations living in medically underserved communities.
Encouraging states to plan for and address health professional workforce needs: $5 million for states to plan and implement innovative strategies to expand their primary care workforce by 10 to 25 percent over ten years to meet increased demand for primary care services.
“These new investments will strengthen our primary care workforce to ensure that more Americans can get the quality care they need to stay healthy,” said HHS Secretary Kathleen Sebelius. “Primary care providers are on the front line in helping Americans stay healthy by preventing disease, treating illness, and helping to manage chronic conditions.”
While new funding will not directly add to the supply of nephrologists nationwide, it nonetheless offers benefits for patients with or at risk for kidney disease. Many people with kidney disease are unaware they have it, and as more of these individuals are able to access routine care and screenings they may be considerably more capable of preventing the progression of their condition.
“Expanding access to preventive care by growing the primary care workforce is a significant step toward earlier detection and better management of kidney disease,” said ASN Chronic Kidney Disease Advisory Group Chair Thomas DuBose, MD, FASN. “Increasing Americans’ access to routine kidney function tests and timely referrals to a nephrologist through a PCP will translate to better renal health nationwide. However, it will be even more important for us as nephrologists to work closely with the primary care community in educating these new providers about identification and care of chronic kidney disease.”
