The federal agency that projects the nation’s healthcare workforce needs has lagged in publishing updated estimates, leaving the government and industry to base their policies and investments on old data, according to a federal auditor’s report.  

The Health Resources and Services Administration, part of the Health and Human Services Department, has contracts with research organizations to update national workforce projections but has failed to publish any new reports since 2008, the Government Accountability Office said.

“Currently, the most recent projections available from HRSA are based on patterns of utilization and care delivery in 2000, predating the Affordable Care Act by a decade,” said Kathleen King in the report, released Oct. 30. King is the director of healthcare at the GAO and report author.

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Up-to-date workforce projections are fundamental for planning for shortages of primary care physicians, nurse practitioners and other healthcare professionals because it can affect patients' access to care and the operations of healthcare organizations.

HRSA was scheduled to publish a report this fall reflecting the primary care workforce, but that has yet to be issued. The agency has also missed goals to publish workforce projections for clinical specialties (due December 2012) and nursing (due September 2013).

HRSA says it is still aiming to release the primary care shortage report this fall and expects to release the clinician specialty report by the summer of 2014 and the nursing report in the fall of 2014. A report on cross-occupations, scheduled for release in 2013, has been rescheduled to sometime in 2014.

The GAO acknowledged in its report that uncertainty about future health system changes under the ACA make creating projections very difficult, along with factoring in technology used by physicians to increase productivity and the use of non-physician providers. Additionally, a number of ACA provisions will also affect the workforce, including expanding health insurance coverage; targeted funding for certain health professional training; and testing new models of payment and care delivery.

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In a written response to the GAO, HHS agreed with GAO recommendations to expedite the review and publication of HRSA's report on national projections for the primary care workforce; create standard written procedures for completing the tasks necessary to review and publish workforce projection reports delivered from contractors; and develop tools for monitoring the progress of projection reports to make sure that timeline goals are met.

HHS is contracting for development and maintenance of projection models instead of awarding new contracts for individual projections, HHS told the GAO in its letter, and has developed electronic tools to keep report development and review on track.