The National Governors Association Center for Best Practices is working with States in a new learning collaborative on strategies to grow and retain the next generation of the healthcare workforce.

Concerns about healthcare workforce supply and preparing the next generation of the healthcare workforce have been building for several years for a variety of reasons. The retirement and aging of an entire generation is front and center of the healthcare workforce shortage, particularly impacting rural communities. Like in other sectors, the healthcare workforce is rapidly aging: over a quarter of all physicians are over 60 years old, the average age of a nurse is over 50, and the average age of the mental/behavioral health workforce is over 50 years old. The onset of the COVID-19 pandemic has exacerbated these issues to an extreme, and accelerated flight from the healthcare delivery field dramatically. Nearly 20% of the healthcare workforce have left positions since the beginning of the pandemic, with an additional 20% contemplating leaving positions as of February 2020. This confluence of circumstances lays bare the need to examine the options Governors’ offices have available to strengthen and grow the healthcare workforce.
In response to this alarming scenario, the National Governors Association Center for Best Practices (NGA Center) has launched a learning collaborative to support Governors’ offices and other senior state officials in implementing strategies to strengthen and grow the next generation of the healthcare workforce. An NGA learning collaborative is a six to nine month learning opportunity for states to assess their current operating environment, share successes and best practices, learn from national, state, and local experts, exchange ideas with other states, and develop and execute an action plan to achieve program and policy change based on state-identified goals. By learning directly from other states and national experts, participating states will gain an understanding of innovative and evidence-based policies, programs, and practices to create a positive environment for an enduring healthcare workforce.
Other interested states will be participating in the Next Gen Knowledge Exchange Network with the Learning Collaborative states. States in this group will be able to attend the project kick-off meeting, access our healthcare workforce toolkit, convene 1-2 times during the project with the full network group to share best practices, receive invitations to any project webinars, and have the opportunity to contribute their state’s best practices to the final project report.
Learning Collaborative Timeline
Tuesday, February 8 , 2022 | Proposal Period Opens |
Monday, February 14 | Applicant Informational Session (Attendance optional) |
Monday, February 28 | Applications Due |
By Thursday, March 10 | State Selection Announced |
Mid-April | Pre-Work Due |
Wednesday, April 27 – Thursday, April 28 | Kick-Off Meeting (two half days) |
April – September 2022 | In-State Site Visits (can be virtual), Ongoing Technical Assistance |
September-October 2022 | Learning Collaborative Wrap-Up Meeting (In-Person or Virtual, TBD) |
October 2022 | Publication on Outcomes of Learning Collaborative |

Learning Collaborative Resources
The healthcare workforce shortage
- British Medical Journal: Healthcare workers 7 times as likely to have severe COVID-19 as other workers
- Brookings: Essential but undervalued: Millions of healthcare workers aren’t getting the pay or respect they deserve in the COVID-19 pandemic
- Kaiser Family Foundation: Primary Care Health Professionals Shortage Areas
- National Library of Medicine: Racial Disparities in COVID-19 Mortality among Essential Workers in the United States
- Nursing Solutions: 2022 NSI National Healthcare Retention & RN Staffing Report.
- Pew Research Center: Health Worker Shortage Forces States to Scramble
- University of St. Augustine: Nursing Data Blog
- University of St. Augustine: 60 Key Nursing Statistics and Trends for 2021
Payment reform
Planning and redesign
- Milbank: Direct Care Workforce Policy and Action Guide
- Niskanen Institute: Unmatched: Repairing the U.S Residency Pipeline
Diversity of the healthcare workforce
- George Washington University Institute of Public Health: Estimation and Comparison of Current and Future Racial/Ethnic Representation in the US Health Care Workforce
- National Medical Association research paper – Fatima Cody Stanford: The Importance of Diversity and Inclusion in the Healthcare Workforce
- National Library of Medicine: Racial Disparities in COVID-19 Mortality among Essential Workers in the United States
- Research paper – Kirsten Wilbur Developing Workforce Diversity in the Health Professions: A Social Justice Perspective
- University of St. Augustine: Diversity in Healthcare and the Importance of Representation
Top of license
- Association of American Medical Colleges: Letter to Washington Leadership
- George Mason University – Robert Graboyes: For Greater Healthcare Access, License Physicians Like Pilots
- Pacific Research Institute: Trimming Red Tape Isn’t Just For Health Emergencies
Aligning education with workforce needs
- Hunt institute: Human Capital for the 21st Century: Aligning Education with Future Workforce Needs
- National Library of Medicine research paper – Sharon Mickan: Exploring Future Health Workforce Educational Needs
- Texas Public Policy Foundation: Supplementing the Success Sequence
Potential Learning Collaborative Outcomes
- Assembling or reengaging existing healthcare workforce bodies to provide recommendations and reports on healthcare workforce supply and quality
- Creating an implementation guide to improve healthcare workforce wellbeing
- Forming the regulatory, legislative, or executive language needed to enhance the career growth pipeline of entry-level healthcare workers
- Organizing a pathway to share relevant data between key departments to monitor healthcare supply and demand
- Other activities that support the growth and retention of the healthcare workforce
For additional information about this learning collaborative, please reach out to:
- Anna Heard – AHeard@NGA.org
- Shelby Hockenberry – SHockenberry@NGA.org
- Jack Porter – JPorter@NGA.org
- Amanda Winters – AWinters@NGA.org
This work is funded by generous support and partnership from the Health Resources and Services Administration (HRSA).