America’s health and health-care workforce is made up of people in many occupations, generally categorized as clinicians and people in technical and supporting occupations. Health care accounts for one-fifth of jobs in America; according to the Bureau of Labor Statistics, health-care occupations will constitute the fastest growing occupational segment in the next decade, accounting for one-fourth of new jobs. In this perspective, we do not attempt a quantitative assessment of the size or distribution of the American health and health-care workforce or of the numerous studies and projections of workforce supply and demand. Rather, we examine the roles, relationships, and capabilities of today’s health and health-care workforce and how they must evolve to serve the needs of the American people better throughout the 21st century.
Today, our health care system is in the midst of a transition from the traditional fee-for-service approach toward value-based models of care delivery. This reformation of care delivery and management is intended to make care more patient-centric and person-centric while reining in health-care costs by keeping people healthy, reducing unnecessary treatment and duplication of services, emphasizing smooth continuity of care within and among sites, and improving the alignment between clinical need and delivery site.
In value-based models, health care providers are paid on the basis of keeping healthy patients healthy while caring for and improving the health of those suffering from acute and chronic illness with cost-effective and evidence-based treatments. Successfully executing those models and achieving the high level of efficiency intended requires not only seamless coordination among care providers but integrated approaches to care centered on the specific needs of individual patients and segments of the patient population that have similar health conditions and characteristics. Health-care organizations, assuming the risk for both health outcomes and costs, are increasingly using patient-targeting models (in which the patient population is stratified according to health risk and care use) to deliver efficient and effective care.