Why Workforce Development for Value-Based Care is a Vital Issue to Address

Reforming our nation’s health care system is an economic and moral imperative that is long overdue. The COVID-19 pandemic has only further illustrated its deficiencies and made clear the vital importance of a high-value health system capable of responding to the needs of US citizens.

While there have been meaningful improvements in healthcare delivery over the last decade, they have not catalyzed the transformation necessary to advance health value and equity. The promulgation of health policy and the implementation of new alternative payment models have created a landscape for experimentation in value-based care, yet the seismic shift needed to facilitate long-term and sustainable improvements has yet to be seen. We believe the key enabler for the future of our industry is workforce readiness to deliver on the promise of high value, high quality care that delivers equitable outcomes for all.

Value-based care and health equity will not happen by structure alone. Policy efforts to advance APMs that realign the economics of medicine will be ineffective if the current and incoming workforce lacks the skills necessary to deliver care in that new paradigm. Reskilling and upskilling of the workforce is necessary to ensure a high-value system and will require scalable educational solutions.

Health care transformation begins with the competency of the team, and workforce development should be a top priority in value-based care movement. This is a lesson that must be applied by learning from our past. When we look at the days gone by in healthcare, it can be readily observed how we have not always had the right people in the right roles. This misalignment places our system in jeopardy. For example, the continued high rate of medical errors can be attributed to an ongoing lack of training on quality and safety.

Workforce development will not only drive success in value-based care by ensuring industry capability; it will put America back to work by providing the necessary skills for those seeking an opportunity to improve their standing in society. Displaced workers due to the economic recession will be able to successfully re-enter the workforce if they can access programs to support value-based care readiness and quality improvement. Most importantly, patients will benefit from a remobilized and upskilled health care workforce that is focused on population health interventions to improve societal outcomes and reduce inequities.

A significant challenge for any industry transformation, especially one as far-reaching as the shift to value, is workforce sufficiency. The scale and impact of workforce skill and knowledge is either a force multiplier or an impedance for change. It is critically important to understand the new knowledge, skills and abilities needed for each role to make a shift from transaction-focused care delivery to an outcomes focus. Once these skills are aggregated and validated, they become a foundation for organizational strategy to shift care and financial models to accept risk and change the focus staff and providers bring to the system. By developing the specific competencies needed in quality, population health, care coordination, data analytics, governance and care delivery, comprehensive educational approaches can be developed to prepare the team and provide a web of relevance for different ways of thinking. As the coronavirus has illustrated, wholesale transformation is difficult and can only be advanced by imperative (as this pandemic necessitated) or by a commitment to lift the skills of the workforce quickly and at scale. Using an open-source skills strategy as the driver for education is a key way to achieve scale. 

Healthcare policy makers have long focused on who was going to ‘receive’ healthcare and who was going to ‘pay’ for it. Today, we ask these policy makers to focus on who is going to ensure the goals around equity, value and quality are achieved? Hammers don’t build houses, people do. And its people, who will make or break the new paradigm of healthcare.

This coalition believes that emphasis on workforce development in health care will change the lives of individuals and families through education while also improving the value of care through a mobilized workforce oriented towards patient outcomes and cost accountability. The social impact made by scalable workforce development programs centered on value-based care competencies will ultimately lead to improvement in the human condition.

About the authors

Stephanie Mercado, CAE CPHQ, CEO and Executive Director, National Association for Healthcare Quality (NAHQ)

Stephanie Mercado is a leader in healthcare association management and advancing healthcare professions. Since joining NAHQ in December 2013, CPHQ certification candidates have grown by over 95% in the last six years and membership by almost 50%. As NAHQ’s CEO, Stephanie has raised NAHQ’s prominence and value with the introduction of industry-elevating initiatives, such as the award-winning Healthcare Quality Competencies Framework and the National Healthcare Quality Summit. Stephanie has deep knowledge of healthcare issues gained from almost 20 years in association leadership roles, supporting both practitioners and healthcare executives. She has led the development of healthcare competencies and medical curriculum models, certifications, professional development and training programs, and advocacy efforts for societies and professions.

David B. Nash, MD, MBA, Founding Dean Emeritus, Dr. Raymond C. & Doris N. Grandon Professor of Health Policy, Jefferson College of Population Health

David B. Nash, MD, MBA, is the Founding Dean Emeritus and the Dr. Raymond C. and Doris N. Grandon Professor of Health Policy at the Jefferson College of Population Health (JCPH). His tenure as Dean completes nearly 30 years on the University faculty. Nash was recently appointed Special Assistant to Bruce Meyer, MD, MBA, President of Jefferson Health. Dr. Nash is a board-certified internist who is internationally recognized for his work in public accountability for outcomes, physician leadership development and quality-of-care improvement.

Eric Weaver, DHA, MHA, FACHE, FACMPE, Executive Director, Accountable Care Learning Collaborative

Dr. Eric S. Weaver is nationally recognized for his work in primary care transformation and value-based care. Most recently, he was a corporate vice president for Innovista Health Solutions, a population health management services organization, where he oversaw enterprise capital investment strategy and technology adoption. Prior to his work at Innovista, he was the President and CEO of the Austin, Texas-based Integrated ACO – one of the most successful physician-led Accountable Care Organizations in the country. Dr. Weaver is a committed health care executive with Fellow designations from the American College of Healthcare Executives, the Medical Group Management Association and the Health Information and Management Systems Society.

Michael O. Leavitt, former governor of Utah and former secretary of the U.S. Department of Health and Human Services

Michael O. Leavitt was sworn in as the 20th Secretary of the U.S. Department of Health and Human Services on January 26, 2005. As secretary, he leads the Nation’s efforts to protect the health of all Americans and provide essential human services to those in need. He manages one of the largest civilian departments in the federal government, with a budget that accounts for almost one out of every four federal dollars and more than 67,000 employees. During his first year, he led efforts to successfully enroll tens of millions of seniors and disabled persons in the new Medicare prescription drug benefit; mobilized the nation’s pandemic preparedness; accelerated the development of health information standards and oversaw the medical response to Hurricane Katrina. He also presided over changes in Medicaid statutes to give states flexibility to provide targeted insurance coverage to more people, and reauthorization by Congress, after ten extensions, of the Temporary Assistance to Needy Families.

He is intensively focused on making health care more transparent in quality and price and reducing the time and expense of bringing safe and effective drugs to market.

Prior to his current service, Leavitt served as head of the U.S. Environmental Protection Agency and three-term Governor of Utah.

During his eleven years of service, Utah was recognized six times as one of America's best managed states. He was chosen by his peers as Chairman of the National Governors Association, Western Governors Association and Republican Governors.

Prior to his public service, he served as president and chief executive officer of a regional insurance firm, establishing it as one of the top insurance brokers in America. He is married to Jacalyn S. Leavitt; they are the parents of five children.