Cover: Identifying Strategies for Strengthening the Health Care Workforce in the Commonwealth of Virginia

Identifying Strategies for Strengthening the Health Care Workforce in the Commonwealth of Virginia

Published Nov 15, 2023

by Megan Andrew, Brian Briscombe, Raffaele Vardavas, Nazia Wolters, Nabeel Qureshi, Wilson Nham, Mahshid Abir

Download eBook for Free

Full Document

FormatFile SizeNotes
PDF file 1.8 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.


FormatFile SizeNotes
PDF file 2.2 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

Research Questions

  1. What interventions can the Commonwealth of Virginia implement to address workforce shortages in primary care, behavioral health, and nursing?
  2. What should the role of VHWDA be in facilitating these interventions?

Like the United States as a whole, Virginia faces a significant shortage of health care workers in nursing, primary care, and behavioral health. If current trends persist, these shortages will increase across Virginia.

The authors of this report identify interventions that can help the Virginia Health Workforce Development Authority (VHWDA) address these health care workforce shortages. To accomplish this goal, they applied an analytic framework to existing or potential interventions for retaining, recruiting, and improving the structural efficiency of the nursing, primary care, and behavioral health workforces in Virginia. In this report, they highlight which interventions VHWDA should prioritize based on its desired outcomes and policy goals.

Key Findings

  • Medicaid reimbursement for primary care and behavioral health care needs to be increased.
  • Residency slots and funding for primary care fields and psychiatry should be increased.
  • Team-based care needs to be promoted and supported in Virginia through regulatory and reimbursement reform.
  • To help populate teams for team-based care, "health care highways" — ladders (or programs) for upward movement — need to be embraced.
  • Barriers to pursuing health care careers need to be removed, including the number of supervised training hours and related trainee expenses — particularly in behavioral health professions.
  • Tuition support and other incentives need to be expanded — especially for students in the most need — and effectively advertised.
  • Support for faculty and clinical preceptors needs to be enhanced and more flexibility needs to be built into such positions.
  • Loan forgiveness opportunities for specific primary care fields should be instituted — for example, repay loans for those primary care physicians practicing in settings that qualify for the Public Service Loan Forgiveness Program.


  • VHWDA should convene and lead a coalition of key stakeholders to implement the interventions identified in this report to retain and expand the nursing, primary care, and behavioral health workforces in Virginia and to create structural efficiency in health care organizations. These stakeholders include, but are not limited to, the Virginia legislature, state agencies, health care organizations, and educational entities.
  • Implementation of many of the proposed interventions will require cross-sector, including public-private, collaboration. To ensure effective and efficient implementation of these recommendations, VHWDA should serve as the coordinating center for the coalition to help gather the needed collaborations, data, and funds and to leverage other political and social capital in the Commonwealth.

Research conducted by

This research was funded by the Virginia Health Workforce Development Authority (VHWDA) and carried out within the Access and Delivery Program in RAND Health Care.

This report is part of the RAND research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.