Out of Order, Out of Time: The State of the Nation’s Health Workforce is a report undertaken by the Association of Academic Health Centers (AAHC) to focus attention on the critical need for a new, collaborative, coordinated, national health workforce planning initiative.

2013 Update

Five years after the release of Out of Order, Out of Time: The State of the Nation’s Health Workforce, AAHC has issued an update of the 2008 report.  Much has changed since then, particularly with respect to the health insurance market, and many more changes are to come. Most notably, less than a year from now, the Affordable Care Act’s individual mandate requiring every person to have health insurance will go into effect. That looming deadline highlights an area in which there is still significant work to be done. The health workforce, already strained under the needs of the current population, is faced with millions more people entering the healthcare delivery system in 2014. Much attention has been paid to workforce numbers: are there enough doctors, nurses, pharmacists, etc. in the right places to meet the needs of the population? However, there are many other factors at play in the current environment beyond the numbers, including misaligned incentives, long-standing barriers to interprofessional collaboration, and rapidly evolving technology.

The report draws several broad conclusions from the detailed findings including:

• A broader, more integrated national strategic vision than our historic approach to health workforce policymaking and planning is needed if complex and urgent health workforce issues are to be addressed effectively.
• A new mechanism is needed to serve the currently unfilled integrative role that existing health workforce policymaking and planning processes are not designed, and are ill-equipped, to serve.
• It is critically important to act immediately to develop and implement an integrated, comprehensive national health workforce policy before intensifying health workforce needs outpace available resources, putting the U.S. at risk of losing its status as the global health care leader.