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Texas Gme Salsberg 4 8 08v4

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Information about Texas Gme Salsberg 4 8 08v4

Published on April 15, 2008

Author: stevelevine

Source: slideshare.net

Description

From TMA GME Stakeholder Forum
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Edward Salsberg Senior Associate Vice President Director, Center for Workforce Studies April 8, 2008 The Role of GME in Meeting Physician Workforce Needs presentation to: The Texas Health Care Policy Council and The Texas Medical Association 2008 Stakeholder Forum

Aligning GME Policies with Physician Workforce Needs: Overview Identifying, measuring and monitoring workforce needs Needs are multi-faceted and no agreement on how to measure Aligning GME policies No easy levers Establishing a process and assigning responsibility

Identifying, measuring and monitoring workforce needs

Needs are multi-faceted and no agreement on how to measure

Aligning GME policies

No easy levers

Establishing a process and assigning responsibility

Defining Physician Workforce Needs Overall supply/numbers Geographic distribution Specialty distribution Competencies Diversity

Overall supply/numbers

Geographic distribution

Specialty distribution

Competencies

Diversity

Some possible goals Increasing the total number of GME positions Training in community based settings Training in shortage specialties Interdisciplinary – team training and care Improved training methods and competencies Educational innovations Training in underserved regions Influencing post training practice setting

Increasing the total number of GME positions

Training in community based settings

Training in shortage specialties

Interdisciplinary – team training and care

Improved training methods and competencies

Educational innovations

Training in underserved regions

Influencing post training practice setting

How to Measure and Project Physician Needs in a State No single correct number; needs vary based on wide range of factors such as demographics and disease patterns of population, and extent of poverty Can compare to benchmarks such as national average or similar states but very indirect measure of need Importance of considering current system and needs and desired system For assessing today’s needs can consider from perspective of: providers (hospitals, clinics, health plans: i.e. recruitment difficulties) practitioners (i.e. waiting times, not taking new patients, assessment of shortages) patients (i.e. access problems and waiting time) For forecasting, critical to assess projected population demographics, utilization patterns and health system Recommend a systematic review in the short run and a comprehensive study of needs in the state in the longer run

No single correct number; needs vary based on wide range of factors such as demographics and disease patterns of population, and extent of poverty

Can compare to benchmarks such as national average or similar states but very indirect measure of need

Importance of considering current system and needs and desired system

For assessing today’s needs can consider from perspective of:

providers (hospitals, clinics, health plans: i.e. recruitment difficulties)

practitioners (i.e. waiting times, not taking new patients, assessment of shortages)

patients (i.e. access problems and waiting time)

For forecasting, critical to assess projected population demographics, utilization patterns and health system

Recommend a systematic review in the short run and a comprehensive study of needs in the state in the longer run

Decision Makers and Leverage Points Medical students and residents Medical schools Residency programs Teaching hospitals RRCs Health care delivery system

Medical students and residents

Medical schools

Residency programs

Teaching hospitals

RRCs

Health care delivery system

Methods of Distributing Funds As part of reimbursement system or from a central fund Standard amount per resident or variable amount based on some criteria Grants in response to RFP Distribute to teaching hospitals, medical schools, consortia or other organizations Limit eligibility, such as to specific areas or specialties

As part of reimbursement system or from a central fund

Standard amount per resident or variable amount based on some criteria

Grants in response to RFP

Distribute to teaching hospitals, medical schools, consortia or other organizations

Limit eligibility, such as to specific areas or specialties

The VA Model for GME Expansion The Critical Needs/Emerging Specialties RFP New Affiliations and New Sites of Care RFP Benefits Identify priorities Targeting to high need areas and specialties Encourage innovation Rational process

The Critical Needs/Emerging Specialties RFP

New Affiliations and New Sites of Care RFP

Benefits

Identify priorities

Targeting to high need areas and specialties

Encourage innovation

Rational process

What about encouraging primary care? Needs in both primary care and non-primary care specialties such as those serving the elderly Need to improve reimbursement and delivery system Currently more primary care GME positions than applicants Need to encourage more applicants Reimbursement policies Loan repayment Supportive grants to assist rural sites Education and training with teams of PAs, NPs and others

Needs in both primary care and non-primary care specialties such as those serving the elderly

Need to improve reimbursement and delivery system

Currently more primary care GME positions than applicants

Need to encourage more applicants

Reimbursement policies

Loan repayment

Supportive grants to assist rural sites

Education and training with teams of PAs, NPs and others

Closing Thoughts Establish a systematic process to identify physician needs on an on-going basis Encourage flexibility to support training in the most appropriate setting Support for federal legislation to lift or modify the cap on Medicare GME Set aside some GME funds to be distributed via RFP to encourage new initiatives: Interdisciplinary teams Establishment of programs in specialties with shortages in regions of the state Innovations in education

Establish a systematic process to identify physician needs on an on-going basis

Encourage flexibility to support training in the most appropriate setting

Support for federal legislation to lift or modify the cap on Medicare GME

Set aside some GME funds to be distributed via RFP to encourage new initiatives:

Interdisciplinary teams

Establishment of programs in specialties with shortages in regions of the state

Innovations in education

 

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