Health care employers have been critical workforce development partners over the past fifteen years.  Through the ups and downs of economic cycles, the health care industry has been steadily hiring, with many good jobs that do not require a bachelor’s degree. The industry is now undergoing a transformation and workforce professionals need to understand how it’s changing in order to continue to serve the industry, counsel job seekers, and prepare the next generation of health care employees effectively. The health care industry played a key role in new job creation and generating employment stability in the face of the Great Recession across all regions in Massachusetts. Between 2001 and 2012, Massachusetts saw employment fall by 32,000 jobs, but the health care industry added 132,000 jobs over the same period. The health care industry accounted for about one in every six jobs in the Commonwealth in 2012. In western Massachusetts the sector accounted for about one in every five jobs. In the eastern part of the state, health care’s share of employment was approximately 15 to 16 percent. Undeniably, changes in the health care industry have a meaningful impact on workers in every corner of the state. In 2012, Massachusetts passed health care quality and cost containment legislation, known as Chapter 224. This Act made Massachusetts the first state in the country to enact legislation to curb the rising cost of health care. Ch. 224 provides incentives and alternative payment structures to encourage health care providers to increase quality of care and reduce costs. Additionally, the legislature acknowledged the needs of employers to train their workers to adjust to the changing modes of health care service delivery by creating the Health Care Workforce Transformation Fund. The Fund allocated $16M to fund planning and training activities to support workforce challenges directly connected to business changes resulting from Ch. 224. While the focus of the Fund is on addressing skills gaps resulting from the effects of Ch. 224 on the workforce, we learned through our interviews with health care industry leaders that business changes are taking place within a larger context than just Ch. 224. National health care reform and other federal and state health care finance developments, as well as legislation that changes staffing ratios, licensing requirements, and health occupation scope of practice are all influencing change in the health care industry. In April 2014, working with the Executive Office of Labor and Workforce Development, Commonwealth Corporation awarded 51 planning grants through this Fund to employers, workforce boards, education and training providers, and professional associations seeking to organize workforce training for the health care workforce. We found that there were several areas of focus in workforce training across the state including primary care practice transformation, community health workers, residencies and fellowships for clinicians/advanced practitioners, behavioral/mental health integration, and certified nursing assistants. Over the past year, Commonwealth Corporation and the Blue Cross Blue Shield Foundation held forums across the state educating various stakeholders about health care payment reform and listening to what employers are expecting will affect the workforce. One of the interesting adjustments expected is an intentional shift to a more integrated team approach to care delivery than the siloed approach currently used. Having medical professionals of all skill levels work in tandem to help achieve better patient outcomes is an increasing priority. Many of the planning grantees included care coordination, team building, and communication training in their plans. The most recent Ch. 224 presentation was held during the summer at Salem State University. This presentation was recorded and the video can be viewed on YouTube. We recently awarded 53 training implementation grants totaling $12.2M to organizations across the Commonwealth representing every subsector of the health care industry including community health centers and physician practices, acute care hospitals, long-term and rehabilitative care, home care, and behavioral health organizations. These training activities will take place over the next two years and we are excited to share what is learned through these grants with the field. Health care employers will continue to play a vital role in our state’s economy and we are committed to understanding how Ch. 224 and national health care reform affects the industry, particularly the demand for skilled health care workers. Commonwealth Corporation plans on continuing to share what we learn through the Health Care Workforce Transformation Fund grants with our workforce development community and we invite you to visit our website and follow us on twitter to stay updated on future events and publications.