Promote High Value System Performance

Workforce Stability

OHCA is charged with monitoring the effects of spending targets on health care workforce stability, high-quality jobs, and training needs of health care workers, with the goal that workforce shortages do not undermine health care affordability, access, quality, equity and culturally and linguistically competent care. To achieve workforce stability in the context of spending targets, OHCA adopted its Workforce Stability Standards in June 2024.  

Workforce Stability Standards

The following are the Workforce Stability Standards to advance the stability of the health care workforce. These standards are best practices that health care entities should adopt to ensure workforce stability. 

  1. Monitor a priority set of key performance indicators of health care workforce stability. Relevant indicators to monitor include: 
    • Turnover rates;  
    • Retention rates; 
    • Vacancy rates; 
    • Contract and temporary labor use rates; 
    • Time to fill vacant positions;  
    • Percentage of employees eligible for benefits (e.g., health benefits, paid time off, and retirement); 
    • Employee engagement, including assessing for job satisfaction, burnout, and moral injury; 
    • Investment in continuing education, professional development, and training programs; and  
    • Diversity of workforce and languages spoken in relation to the population served. 
  1. Develop formal processes to adapt to changing workforce conditions. Establish policies and procedures to adjust hiring, training, and other practices based on the key performance indicators and market level influences. Actively engage staff who will be impacted by these policies in the development process. 
  1. Allocate resources for professional development for health care workers to strengthen the current and future workforce. Such training includes developing new skills to adapt to changing health care delivery models that support affordability, access, quality, equity, and culturally and linguistically competent care, sponsoring clinical placements, and supporting advancement of entry-level and non-clinical workers (e.g., housekeeping staff) to other occupations within the organization through career ladders.  
  1. Increase use of interdisciplinary health care teams to support worker engagement and improve affordability, access, quality, and equity. Interdisciplinary teams promote effective use of team members’ diverse skill sets to deliver high-quality, patient-centered care. Examples of interdisciplinary team care include integrated behavioral health in primary care settings and using community health workers to address social needs.  
  1. Prioritize hiring, employee advancement, and care delivery practices that ensure culturally and linguistically competent care. Access to high-quality, equitable care across all communities requires a health care workforce that represents California’s people, speaks their languages, and understands their cultures. Prioritize hiring, employee advancement, and care delivery practices that advance equitable care. Use regional demographic data to align the workforce with the needs of the populations served. 
  1. Monitor and address workplace safety and violence. Continually monitor workplace safety and violence and implement policies and procedures to ensure safe working conditions for all health care workers. A safe workplace supports employee well-being and workforce stability, ultimately improving the quality of patient care. 

Workforce Stability Metrics 

OHCA will use metrics from publicly available datasets to track and analyze workforce stability at the organization and labor market levels. OHCA will establish baseline data on these metrics, monitor the workforce of health care entities as they work to achieve the spending targets, highlight best practices, and discourage practices harmful to workers and patients. 

Over the next several months, OHCA will investigate additional data sources and data collection opportunities and plan for future workforce stability reporting on high-priority Key Performance Indicators (KPIs) from Standard One. In Fall 2024, OHCA will update the Health Care Affordability Advisory Committee and Board on its progress developing new data collection approaches and external data sources. 

For further information, please refer to the OHCA Health Care Workforce Stability Standards.