title: Building a Value-Based Workforce in North Carolina.
abstract: Health care in the United States is likely to change more in the next 10 years than in any previous decade. However, changes in the workforce needed to support new care delivery and payment models will likely be slower and less dramatic. In this issue of the NCMJ, experts from education, practice, and policy reflect on the "state of the state" and what the future holds for multiple health professional groups. They write from a broad range of perspectives and disciplines, but all point toward the need for change-change in the way we educate, deploy, and recruit health professionals. The rapid pace of health system change in North Carolina means that the road map is being redrawn as we drive, but some general routes are evident. In this issue brief we suggest that, to make the workforce more effective, we need to broaden our definition of who is in the health workforce; focus on retooling and retraining the existing workforce; shift from training workers in acute settings to training them in community-based settings; and increase accountability in the system so that public funds spent on the health professions produce the workforce needed to meet the state's health care needs. North Carolina has arguably the best health workforce data system in the country; it has historically provided the data needed to inform policy change, but adequate and ongoing financial support for that system needs to be assured.
authors.affiliation: director, Program on Health Workforce Research and Policy, Cecil G. Sheps Center for Health Services Research; assistant professor, Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina erin_fraher@unc.edu.
authors.forename: Erin P
authors.initials: EP
authors.lastname: Fraher
authors.affiliation: senior policy fellow, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Ricketts
mesh_terms: D015276:Health Care Rationing / Q000639:trends*; D006281:Health Occupations / Q000706:statistics & numerical data*; D006280:Health Workforce / Q000191:economics / Q000592:standards / Q000639:trends; D006801:Humans; D020380:Needs Assessment; D009657:North Carolina; D009936:Organizational Innovation; D058996:Quality Improvement / Q000458:organization & administration*