One of the greatest challenges facing California’s health ecosystem is ensuring a robust and diverse workforce to both meet community needs and create sustainable models of care delivery that advance health equity.

At the October 2024 partner meeting of the California Improvement Network (CIN), Libby Abbott, deputy director at the Office of Health Workforce Development at California Department of Health Care Access and Information (HCAI), and Andie Martinez Patterson, chief executive officer at the Alameda Health Consortium (AHC) and Community Health Center Network (CHCN), engaged in future thinking to explore three strategies for addressing these challenges with an emphasis on long-term planning and leaning into Medicaid innovations, such as CalAIM. Highlights from this candid conversation are shared below with the hope of sparking insights for your own future thinking.

Strategy 1: Solving health workforce shortages through nuanced, long-term planning

Abbott outlined how HCAI is focusing on long-term needs with an aim to create a more diverse and available workforce in areas with the most critical gaps, such as the Central Coast, Sierra Nevada, San Joaquin Valley, and Northern regions of California. HCAI has invested in more nuanced supply and demand models to support this orientation, with a particular emphasis on the roles most in demand: behavioral health and nursing.

Abbott emphasized the strategic importance of allied health workers, who are vital for alleviating the burden on licensed professionals and filling critical care gaps; partnerships and collaboration; and recognizing that addressing workforce shortages requires coordinated efforts across regions and sectors.

We’re trying to get ahead of the challenges we’re going to face in 5 to 10 years. Health workers don’t grow on trees. We need to be thinking now about where we’re going to see gaps in the future. — Libby Abbott

Strategy 2: Realizing the potential of CalAIM’s vision by addressing on-the-ground realities

Martinez Patterson highlighted the disconnect between the state’s vision for holistic, population-based care and on-the-ground realities of care delivery, such as technology challenges, workforce retention, and equitable pay. Martinez Patterson shared that while CalAIM is an aspirational vision of person-centered care that most people working in the safety net have long hoped for, the demands of operationalizing this vision impose major requirements and expectations on health and social service organizations with limited capacity.

Additionally, cultural divides between health systems, health plans, federally qualified health centers, and social service and community-based organizations making it challenging to implement. Expectations for data collection and stratification are high, yet patient and client data may be in siloed repositories and can’t be accessed across systems. For CalAIM, and Medicaid, to be successful in California, there is a need to slow down, ensure cross-sector understanding, and set up robust systems and infrastructure.

The gaps of understanding [the needs of CalAIM] between a patient and a provider, between a provider and a plan, between the plans and the state are astronomical, and I just do not think people appreciate that. — Andie Martinez Patterson

Strategy 3: Improving data access and standardization to unlock its power

Both Abbott and Martinez Patterson emphasized the critical role of data and how technology is at the crux of creating a strong health workforce and delivering on the promise of California’s Medicaid program. HCAI is grappling with workforce data gaps in specific roles that make it difficult to anticipate future workforce shortages accurately. Martinez Patterson described the lack of capacity and incentives for health care and community-based organizations to use data effectively, thereby complicating efforts to implement meaningful improvements. Standardization and best practices that address this data divide, instead of allowing organizations to choose their own path for data collection and stratification, will be essential for the future state of California’s health systems.

How is your organization planning for the future?

 

The California Improvement Network (CIN) is a learning and action community that advances equitable health care experiences and outcomes for Californians through cross-sector connections, spreading good ideas, and implementing improvements. Learn more about the California Improvement Network, a project of the California Health Care Foundation that is managed by Healthforce Center at UCSF, and sign up for the CIN newsletter.