National Academy of Medicine

Workforce for 21st-Century Health and Health Care: A Vital Direction for Health and Health Care

By Steven H. Lipstein, Arthur L. Kellermann, Bobbie Berkowitz, Robert Phillips, David Sklar, Glenn D. Steele, and George E. Thibault
September 19, 2016 | Discussion Paper

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.

About the Vital Directions for Health and Health Care Series

Vital DirectionsThis publication is part of the National Academy of Medicine’s Vital Directions for Health and Health Care Initiative, which called on more than 100 leading researchers, scientists, and policy makers from across the United States to provide expert guidance in 19 priority focus areas for U.S. health policy. The views presented in this publication and others in the series are those of the authors and do not represent formal consensus positions of the NAM, the National Academies of Sciences, Engineering, and Medicine, or the authors’ organizations.
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Suggested Citation

Lipstein, S. H., A. L. Kellermann, B. Berkowitz, R. Phillips, D. Sklar, G. D. Steele, and G. E. Thibault. 2016. Workforce for 21st-Century Health and Health Care: A Vital Direction for Health and Health Care. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi: 10.31478/201609m


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.