Making Sense of the System: How States Can Use Health Workforce Policies to Increase Access and Improve Quality of Care

Milbank State Leadership Network


State officials have been innovators in two areas of policy for the health workforce for more than half a century. The two areas are resolving shortages in particular health professions and providing opportunities for persons of all ages, especially young people, to receive higher education leading to careers in health.

This report offers evidence about why colleagues in state government should address shortages of health workers despite the difficulties of the current fiscal situation. The author, Edward Salsberg, assesses the best available data about current and projected demand for health workers. He then summarizes practical suggestions for policy to reduce shortages of health workers that are likely to threaten access to health services of appropriate quality.

The Milbank Memorial Fund commissioned this report at the request of the Reforming States Group (RSG). The RSG, organized in 1992, is a voluntary association of leaders in health policy in the legislative and executive branches of government from most of the states. Fourteen members of the RSG attended meetings to discuss this report or reviewed it extensively in draft. Other members commented on a summary of its findings and recommendations.

The Milbank Memorial Fund is an endowed national foundation that has contributed to innovation in health and social policy since 1905. Staff of the Fund helped RSG leaders to plan meetings to discuss the report and compose its recommendations, offered editorial advice, and guided its production.

Edward Salsberg is Director of the Center for Health Workforce Studies at the School of Public Health of the State University of New York, Albany. He is widely recognized for expertise on issues of health workforce policy that is grounded in first-hand experience in state government.

Eileen L. Cody
Chair, Health Care Committee
Washington House of Representatives
Member, Reforming States Group

Raymond D. Rawson
Assistant Majority Floor Leader
Nevada Senate
Chair, Reforming States Group

Daniel M. Fox
Milbank Memorial Fund