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​About Us

Established in 2013, the Health Workforce Research Center (HWRC) on Emerging Health Workforce Topics, is part of the Fitzhugh Mullan Institute for Health Workforce Equity. The center’s research portfolio examines how new payment and delivery models, patient centered medical homes, team-based care, telehealth, National Health Service Corps, and other emerging care management strategies impact access and quality of care for rural and underserved populations.

We are committed to advancing the science of workforce analysis by 1) developing cutting edge research methods for documenting how workforce staffing configurations impact patient satisfaction and health outcomes, 2) employing innovative uses of available datasets to identify the workforce caring for patients living in health professional shortage areas, 3) publishing a portfolio of peer-reviewed publications that build off of each other to identify policies for improving care for vulnerable and underserved populations, and 4) training the next generation of health workforce researchers to carry the work forward into the future.

Leadership

Director: Patricia Pittman, PhD
Deputy Director: Clese Erikson, MPAff
PEER-REVIEWED PUBLICATIONS
  1. Erikson C, Park Y, Felida N, Dill M. 2023. Telehealth Use and Access to Care for Underserved Populations Before and During the COVID-19 Pandemic. Journal of Health Care for the Poor and Underserved. doi:10.1353/hpu.2023.0009.
  2. Erikson C, Herring J, Park JH, Luo Q, Burke G. 2022. Association between State Payment Parity Policies and Telehealth Usage at Community Health Centers During COVID-19. Journal of the American Medical Informatics Association. doi: 10.1093/jamia/ocac104.
  3. Chen C, et al. 2021. Coronavirus Disease 2019 Planning and Response: A Tale of 2 Health Workforce Estimator Tools. doi: 10.1097/MLR.0000000000001606.
  4. Han X, Pittman P, Ku L. 2021. The Effect of National Health Service Corps Clinician Staffing on Medical and Behavioral Health Care Costs in Community Health Centers. Medical Care. doi: 10.1097/MLR.0000000000001610.
  5. Markus A, Pillai D. 2021. Mapping the Location of Health Centers in Relation to “Maternity Care Deserts”: Associations With Utilization of Women’s Health Providers and Services. Medical Care. doi: 10.1097/MLR.0000000000001611.
  6. Ziemann M, Erikson C, Krips M. 2021. The Use of Medical Scribes in Primary Care Settings: A Literature Synthesis. Medical Care. doi: 10.1097/MLR.0000000000001605
  7. Park J, Regenstein M, Chong N, Onyilofor C. 2021. The Use of Community Health Workers in Community Health Centers. Medical Care. doi: 10.1097/MLR.0000000000001607.​
  8. Han X, Pittman P, Barnow B. 2021. Alternative Approaches to Ensuring Adequate Nurse Staffing: The Effect of State Legislation on Hospital Nurse Staffing. Medical Care. doi: 10.1097/MLR.0000000000001614.
  9. Richwine C, Erikson C, Salsberg E. 2021. Does Distance Learning Facilitate Diversity and Access to MSW Education in Rural and Underserved Areas? Journal of Social Work Education. doi:10.1080/10437797.2021.1895929.
  10. Pittman P, Westfall N, Ziemann M, Strasser J. (2021, March 9). Who Is Allowed To Administer COVID-19 Vaccines? The List Is Growing. [Blog]. 10.1377/forefront.20210303.890600​.
  11. ​​​Pittman P, Park J, Bass E, Luo Q. 2020. Understanding Why Nurse Practitioner (NP) and Physician Assistant (PA) Productivity Varies Across Community Health Centers (CHCs): A Comparative Analysis. Medical Care Research and Review.
  12. Luo Q, Chong N, Chen C. 2020. Independent Freestanding Emergency Departments and Implications for the Rural Emergency Physician Workforce in Texas. Health Services Research. doi: 10.1111/1475-6773.13587.
  13. Luo Q, Dor A, Pittman P. 2020. Optimal Staffing in Community Health Centers to Improve Quality of Care. Health Services Research. doi: 10.1111/1475-6773.13566.
  14. Delhy R, Dor A, Pittman P. 2020. The Impact of Nursing Staff on Satisfaction Scores for U.S. Hospitals: A Production Function Approach. Medical Care Research and Review. doi: 10.1177/1077558720950572.
  15. Han X, Chen C, Pittman P. 2020. Use of Temporary Providers in Primary Care in Federally Qualified Health Centers. Journal of Rural Health. doi: 10.1111/jrh.12424.
  16. Park J, Dowling N. 2020. Do Nurse Practitioner-Led Medical Homes Differ from Physician-Led Medical Homes? Nursing Outlook, 68(5): 601-610. doi.org/10.1016/j.outlook.2020.05.010.
  17. Han X, Pittman P, Erikson C, Mullan F, Ku L. 2019. The Role of the National Health Service Corps Clinicians in Enhancing Staffing and Patient Care Capacity in Community Health Center. Medical Care, 57(12):1002–1007. doi: 10.1097/MLR.0000000000001209.
  18. Han X, Ku L. 2019. Enhancing Staffing In Rural Community Health Centers Can Help Improve Behavioral Health Care. Health Affairs, 38(12). doi: 10.1377/hlthaff.2019.00823.
  19. Park J, Han X, Pittman P. 2019. Does Expanded State Scope of Practice for Nurse Practitioners and Physician Assistants Increase Primary Care Utilization in Community Health Centers? Journal of the American Association of Nurse Practitioners. doi: 10.1097/JXX.0000000000000263.
  20. Park J, Erikson C, Han X, Iyer P. 2018. Are State Telehealth Policies Associated With the Use of Telehealth Services Among Underserved Populations? Health Affairs, 37(12): 2060-2068.
  21. Park J, Wu X, Frogner B, Pittman P. 2018. Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers? Medical Care. doi: 10.1097/MLR.0000000000000965
  22. Frogner B, Wu X, Park J, Pittman P. 2017. The Association of Electronic Health Record Adoption with Staffing Mix in Community Health Centers. Health Services Research, 52(S1): 407-421.
  23. Frogner B, Wu X, Ku L, Pittman P, Masselink L. 2017. Do Years of Experience With Electronic Health Records Matter for Productivity in Community Health Centers? Journal of Ambulatory Care Management, 40(1): 36–47.
  24. Li S, Pittman P, Han X, Lowe T. 2017. Nurse-Related Clinical Nonlicensed Personnel in U.S. Hospitals and Their Relationship with Nurse Staffing Levels. Health Services Research, 52(S1): 422-436. 
  25. Malcarney M, Pittman P, Quigley L, Horton K, Seiler N. 2017. The Changing Roles of Community Health Workers. Health Services Research, 52(S1): 360-382
  26. ​Pittman P, Li S, Han X, Lowe T. 2017. Clinical Nonlicensed Personnel in U.S. Hospitals: Job Trends from 2010 to 2015. Nursing Outlook, 66(1): 35-45.​
  27. Pittman P, Masselink L, Bade L, Frogner B, Ku L. 2016. Factors Determining Medical Staff Configurations in Community Health Centers: CEO Perspectives. Journal of Healthcare Management, 61(5): 364-377.  
  28. Pittman P, Scully-Russ E. 2016. Workforce Planning and Development in Times of Delivery System Transformation. Human Resources for Health, 14: 56.
  29. Ku L, Frogner B, Steinmetz E, Pittman P. 2015. Community Health Centers Employ Diverse Staffing Patterns, Which can Provide Productivity Lessons for Medical Practices​. Health Affairs, 34(1): 95-103. 

Current Research Studies (2023-2024)

Area Deprivation and Access to Primary Care for Medicaid Beneficiaries
The utilization of geographic-based deprivation indices is growing rapidly to measure social deprivation through composite scores based on demographic variables that policymakers can use to incorporate social risk. However, how these indices relate to healthcare utilization remains unclear, or if they effectively identify underserved areas. This study will examine the extent to which the ADI is associated with access to primary care providers for Medicaid beneficiaries and the role of community health centers (CHCs) in serving residents in areas of “high deprivation”. 

Key Questions:
  • How do Medicaid primary care providers' (FM, IM, Peds, OBGYNs, NPs, and PAs) patient panels vary by levels of ADI?
  • How do beneficiary’s levels of primary care utilization vary by the ADI?
  • To what extent are community health centers (CHCs) the main access point for primary care services among Medicaid beneficiaries living in areas of high deprivation, and how does this vary across rural and urban settings?

For questions about this study, contact Jordan Herring at jordan_herring@gwu.edu. 
Changing Medicaid Participation from 2016 to 2019 and Associated Factors
Medicaid participation is key to addressing inequities in healthcare access for low-income populations. However, one-third of primary care providers (PCP) do not see Medicaid patients. This study will examine the consistencies and fluctuations of Medicaid participation among PCPs. 

Key Questions:
  • What was the consistency for Medicaid participation intensity for primary care providers from 2016 to 2019?
  • What proportion of primary care providers fluctuated in terms of their Medicaid participation from 2016 to 2019?
  • What potential provider-, organizational- and state-, policy-level factors are associated with changes in providers’ Medicaid participation intensity?

For questions about this study, contact Mandar Bodas at mvbodas@gwu.edu​.  
Identifying Strategies to Address Health Worker Well-Being, Recruitment, and Retention in FQHC
Healthcare organizations are beginning to recognize and work to address health worker burnout. Healthcare organizations are beginning to recognize and work to address health worker burnout. This study will focus on strategies to address burnout in health centers. The study will include two parts: 1) a literature review of evidence-based burnout, recruitment, and retention strategies in health centers and 2) a qualitative research exploration of health centers’ views, current practices, and aspiration regarding burnout and retention.
​
For questions about this study, contact Patricia Pittman at ppittman@gwu.edu.  
Telehealth Use for Prenatal Visits Before, During, And After the Covid-19 Pandemic Among Medicaid Populations​
Poor access to prenatal care is a key driver of high maternal mortality and morbidity in the U.S., and telehealth could help enhance prenatal care. This study will examine the uptake of telehealth use for prenatal care among disadvantaged pregnant people during the COVID-19 pandemic and explore its potential for improving access and maternal health outcomes.

Key Questions:
  • How was telehealth used for prenatal care at the start, during, and latter periods of the COVID-19 pandemic for Medicaid beneficiaries?
  • What patient and provider characteristics were associated with telehealth use for prenatal care for Medicaid beneficiaries? What was the uptake among those with high-risk pregnancies?
  • What was telehealth utilization for prenatal care among those seeking care at CHCs?

Related Project:
For questions about this study, contact Mandar Bodas at mvbodas@gwu.edu. 
Trends and Impact of Vertical Integration of CHCs on Workforce
Given the importance of CHCs in providing care for underserved populations, it is critical to understand the trends in vertical integration and its impact on utilization and quality outcomes. We aim to assess the impact of various types of vertical integration on health care utilization and quality outcomes for CHC patients with Medicaid coverage.

Key Questions:
  • What is the difference in health care services utilization between Medicaid patients with vertically integrated CHCs as their primary care providers and those with non-integrated CHCs as their primary care providers?
  • What is the difference in quality outcomes that can be reliably measured using claims data between Medicaid patients with vertically integrated CHCs as their primary care providers and those with non-integrated CHCs as their primary care providers?

Related Project:
​For questions about this study, contact Eric Luo at qluo@gwu.edu​.  
  • Disclaimer
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These projects are supported by the Bureau of Health Workforce (BHW), National Center for Health Workforce Analysis (NCHWA), Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $450,000, with zero percent financed with non-governmental sources. The contents are those of the author[s] and do not necessarily represent the official views of, nor an endorsement by HRSA, HHS, or the U.S. Government.
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