NASHP STATE HEALTH POLICY CONFERENCE OCTOBER 5, 2010
Health Reform Matrix <ul><li>OPCA’s tool for tracking health reform: </li></ul><ul><ul><ul><li>http://www.orpca.org/advoca...
<ul><li>A new study indicates that upcoming shortages of primary care physicians may be worse than projected, as will pati...
<ul><li>Costs of hiring and training </li></ul><ul><li>Lack of recruitment staff </li></ul><ul><li>Physician shortage </li...
And Yikes! <ul><li>CHC patients expected to double by 2014 </li></ul>Hostetler
CHC Residency Program <ul><li>Health reform act opportunity </li></ul><ul><li>Difficult for CHCs </li></ul><ul><ul><li>Bes...
<ul><li>Offers exposure to CHCs </li></ul><ul><ul><li>70% of students continue working with populations in need </li></ul>...
<ul><ul><li>Historically used at CHCs </li></ul></ul>Utilizing Mid-Level Providers <ul><ul><li>Oregon’s ratio of physician...
<ul><li>Training curriculum needs to improve </li></ul><ul><ul><li>To “hit the ground running” </li></ul></ul><ul><ul><li>...
<ul><li>Physicians in “medical home” demonstration projects report job satisfaction rates going up tremendously. </li></ul...
<ul><li>Issues with current primary care model </li></ul><ul><ul><li>Pressures of the 10 – 15 minute visit </li></ul></ul>...
What is a Primary Care Home? <ul><li>Flexible, based on population need  </li></ul><ul><ul><li>Patient-centered experience...
<ul><li>Environment: </li></ul><ul><ul><ul><li>Payment focused on old model </li></ul></ul></ul><ul><ul><ul><li>Workforce ...
<ul><li>Clinic level: </li></ul><ul><ul><ul><li>Capturing data </li></ul></ul></ul><ul><ul><ul><li>Spreading leadership an...
<ul><li>Account for social factors </li></ul><ul><li>Support model for entire patient population </li></ul><ul><li>Minimiz...
<ul><li>Policy alignment and opportunity </li></ul><ul><li>Oregon’s initiative is improving: </li></ul><ul><ul><li>Provide...
<ul><ul><li>Contact Information </li></ul></ul><ul><ul><li>Craig Hostetler </li></ul></ul><ul><ul><li>Executive Director <...
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Tuning Up the Workforce Building Capacity to Meet Demand

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Tuning Up the Workforce Building Capacity to Meet Demand

  1. 1. NASHP STATE HEALTH POLICY CONFERENCE OCTOBER 5, 2010
  2. 2. Health Reform Matrix <ul><li>OPCA’s tool for tracking health reform: </li></ul><ul><ul><ul><li>http://www.orpca.org/advocate-for-health-centers/federal-policy </li></ul></ul></ul><ul><li>Key areas that impact CHCs </li></ul><ul><ul><li>$$ to support CHC growth </li></ul></ul><ul><ul><li>National Health Service Corps expansion </li></ul></ul><ul><ul><li>Medicaid expansion to 133% of federal poverty level </li></ul></ul><ul><ul><li>Insurance exchange and CHCs </li></ul></ul><ul><ul><li>Heightened focus on cost and quality </li></ul></ul>Hostetler
  3. 3. <ul><li>A new study indicates that upcoming shortages of primary care physicians may be worse than projected, as will patients' access to primary care. </li></ul><ul><li>--American Academy of Family Physicians </li></ul>Workforce Issues Hostetler
  4. 4. <ul><li>Costs of hiring and training </li></ul><ul><li>Lack of recruitment staff </li></ul><ul><li>Physician shortage </li></ul><ul><li>CHC challenges </li></ul><ul><ul><ul><li>Location, population complexity, pay </li></ul></ul></ul>The CHC Recruitment Climb: Getting Steeper Hostetler
  5. 5. And Yikes! <ul><li>CHC patients expected to double by 2014 </li></ul>Hostetler
  6. 6. CHC Residency Program <ul><li>Health reform act opportunity </li></ul><ul><li>Difficult for CHCs </li></ul><ul><ul><li>Best candidates: Larger CHCs </li></ul></ul><ul><ul><li>Other CHCs will partner with residency programs </li></ul></ul>Hostetler
  7. 7. <ul><li>Offers exposure to CHCs </li></ul><ul><ul><li>70% of students continue working with populations in need </li></ul></ul><ul><li>Boosts job satisfaction for CHC providers </li></ul><ul><li>Strengthens partnerships with academic institutions </li></ul>OPCA’s SEARCH program Hostetler
  8. 8. <ul><ul><li>Historically used at CHCs </li></ul></ul>Utilizing Mid-Level Providers <ul><ul><li>Oregon’s ratio of physician to mid-level </li></ul></ul><ul><ul><ul><li>Currently 1:1 </li></ul></ul></ul><ul><ul><ul><li>May evolve to 1:3 or more </li></ul></ul></ul>Hostetler
  9. 9. <ul><li>Training curriculum needs to improve </li></ul><ul><ul><li>To “hit the ground running” </li></ul></ul><ul><ul><li>Example: Pacific University PA program </li></ul></ul><ul><li>Primary care home model = more patients per provider team </li></ul>Utilizing Mid-Levels (cont’d) Hostetler
  10. 10. <ul><li>Physicians in “medical home” demonstration projects report job satisfaction rates going up tremendously. </li></ul><ul><li>-- Patient-Centered Primary Care Collaborative </li></ul>Primary Care Home Model Hostetler
  11. 11. <ul><li>Issues with current primary care model </li></ul><ul><ul><li>Pressures of the 10 – 15 minute visit </li></ul></ul><ul><ul><li>Negatively impacts patient outcomes </li></ul></ul><ul><li>Provider satisfaction: More than money </li></ul>How the Primary Care Home Can Help Hostetler
  12. 12. What is a Primary Care Home? <ul><li>Flexible, based on population need </li></ul><ul><ul><li>Patient-centered experience </li></ul></ul><ul><ul><li>Quality & safety </li></ul></ul><ul><ul><li>Team-based care </li></ul></ul><ul><ul><li>Enhanced access </li></ul></ul><ul><ul><li>Coordination of care </li></ul></ul><ul><ul><li>Behavioral health integration </li></ul></ul>Hostetler
  13. 13. <ul><li>Environment: </li></ul><ul><ul><ul><li>Payment focused on old model </li></ul></ul></ul><ul><ul><ul><li>Workforce not trained for model </li></ul></ul></ul><ul><ul><ul><li>Current economic environment & need to focus on access </li></ul></ul></ul><ul><ul><ul><li>Payers don’t want to wait for transformation </li></ul></ul></ul>Challenges, Barriers and Competing Priorities Hostetler
  14. 14. <ul><li>Clinic level: </li></ul><ul><ul><ul><li>Capturing data </li></ul></ul></ul><ul><ul><ul><li>Spreading leadership and buy-in throughout the clinic </li></ul></ul></ul><ul><ul><ul><li>Finding resources </li></ul></ul></ul><ul><ul><ul><li>Allowing providers time to lead </li></ul></ul></ul>Challenges, Barriers and Competing Priorities (cont’d) Hostetler
  15. 15. <ul><li>Account for social factors </li></ul><ul><li>Support model for entire patient population </li></ul><ul><li>Minimize clinics’ administrative burden and cost </li></ul><ul><li>Tailor payment to reward movement on indicators </li></ul><ul><li>Pay for work that improves care </li></ul><ul><li>Allow time for care </li></ul><ul><li>Fund learning collaboratives </li></ul>Key Issues for Payment Reform Hostetler
  16. 16. <ul><li>Policy alignment and opportunity </li></ul><ul><li>Oregon’s initiative is improving: </li></ul><ul><ul><li>Provider satisfaction </li></ul></ul><ul><ul><li>Basic patient satisfaction </li></ul></ul><ul><ul><li>Some clinical quality indicators </li></ul></ul>Exciting Developments Hostetler
  17. 17. <ul><ul><li>Contact Information </li></ul></ul><ul><ul><li>Craig Hostetler </li></ul></ul><ul><ul><li>Executive Director </li></ul></ul><ul><ul><li>Oregon Primary Care Association </li></ul></ul><ul><ul><li>Phone: 503-228-8852 </li></ul></ul><ul><ul><li>Email: [email_address] </li></ul></ul>Thank You! Hostetler
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