Health Care Workforce Redesign

Scope of Practice

Scope of practice defines the types of services that a particular health care worker can provide as well as the circumstances under which such services can be provided, including supervision levels and locations where services can be provided. Scope of practice is typically defined by state laws and regulations. States are responsible for ensuring, through licensure and certification, that health care professionals provide high quality services commensurate with their experience.

In some instances, scope-of-practice policies can place inefficient limitations on health professionals that increase health care costs and impede recruitment efforts. The National Governors Association Center for Best Practices (NGA Center) is working with states to explore changes to scope-of-practice laws as a strategy to address potential provider shortages and changing workforce needs while assuring patient safety.

Graduate Medical Education

The NGA Center works closely with states to develop and promote innovative strategies and best practices that improve access to quality health care and services, and assure an adequate supply and effective use of the health care workforce. Using teaching health centers (THCs) is one strategy states using to increase access to primary care. THCs are primary care residency training programs based within communities aimed at improving overall primary care training and addressing primary care shortages in rural and other underserved communities. Early evidence suggests that many more THC residents continue (or intend to continue) providing primary care in underserved communities after completing training as compared to graduates who train in more traditional residency settings, such as hospitals.

Due to limited funding streams, states are considering new sources of funding to grow and sustain the THCs. The NGA Center is working with states and national experts to identify strategies for states to better target Medicaid GME funds to address their workforce needs.

NGA Resources