Retention and the NHSC

Ron Yee, MD, MBA, FAAFP

Chief Medical Officer

United Health Centers

Parlier, California

NACHC Winter Strategy Meeting

Delray Beach, Florida

January 24, 2013

Discussion Points

• NHSC– Definitions– Retention Assessment Survey

• United Health Centers’ Experience– Retention Strategies– Challenges to Retention– Retention Data– NHSC Retention Strategy Summary

NHSC Definition of Retention• The percentage of NHSC clinicians who

remain practicing in underserved areas (HPSAs) after successfully completing their service commitment to the Corps

• Short-term = up to 1 year after completion• Long-term = up to 10 years after completion

NHSC 2012 Retention Assessment Survey• 9,908 NHSC Field Strength• 26% response rate• 94% LRP + 6% SP• 82% Short-term retention (<=1 year)

– Up 28% vs. 2000 rate

• 55% Long-term retention (>10 years)– Up 6% vs. 2000 rate

NHSC 2012 Retention Assessment Survey• Most important factors for retention

– 56% Overall site experience – 48% Practice hours/schedule– 34% Salary– 32% Alignment with personal goals– 27% Community involvement– 21% Proximity to family

United Health Centers’ Experience

• Retention Strategies• Challenges to Retention• Retention Data

Retention Strategies from the Front Lines

• Run a quality mission-driven organization• Help them find their niche• Let them focus on quality patient care• Maintain a sense of mission• Offer opportunities for input & leadership

Run a quality mission-driven organizationJim Smurr, MD, LRP, Retained 15 years

Run a quality mission-driven organizationJim Smurr, MD, LRP, Retained 15 years

Help them find their nicheLance Gault, DO, final year SP

Help them find their nicheLance Gault, DO, final year SP

Let them focus on quality patient care Rogelio Fernandez, MD, LRP, Retained 19 Years

Let them focus on quality patient care Rogelio Fernandez, MD, LRP, Retained 19 Years

Maintain a sense of mission

Rob Wageneck, DO, SP 1997

Jay Downey, MD, LRP, 1996

Offer opportunities for input & leadershipLance Gault, DO, final year SP

Offer opportunities for input & leadershipLance Gault, DO, final year SP

Challenges to Retention

• Distance from home to site in rural areas• Productivity/Finances vs. finding niche• Trust in site leadership/supervisor• Change in life status during commitment • Competition from other entities

Distance from home to siteShani Muhammad, MD, SP 2011

Distance from home to siteShani Muhammad, MD, SP 2011

Challenges to Retention

• Distance from home to site in rural areas• Productivity/Finances vs. finding niche• Trust in site leadership/supervisor• Change in life status during commitment • Competition from other entities

Retention Data

• UHC specific (25 total SP+LRP, since 1991)– SP: 4/5=80% ST, 1/1=100% LT– LRP: 19/20=95% ST, 6/6=100% LT– 10 Active: 3SP+7LRP– 43% all staff NHSC P/P– Ave. Retention all 10Y+

• UDS reporting - HRSA– Table 5 additions

NHSC Retention Strategy Summary

• Customer Service– Standardize transactions, including response times

– Call Center training, scripts, monitoring

• Communications and Outreach– Corps Connection – electronic newsletter

– NHSC Facebook page – social media

– NHSC Ambassadors – human capital

– Corps Community Day – national recognition

NHSC Retention Strategy Summary

• Business Value to Sites and Providers– NHSC Job Center - recruitment tool, cost

savings, global outreach

– Virtual Job Fairs – 4-5 planned for 2013

– Expansion of PrimaryCareForAll.hrsa.gov

– Scholars and GPS Program

NHSC Retention Strategy Summary

• BCRS Regions – Enhanced engagement with sites and providers– Scholar placement – direct Regional assistance

– Site Visits

– Technical assistance, webinars, share best practices around retention

• BCRS Policy Initiatives– Scholar completion – non-competitive transition to LRP at

HPSA >=14

– Allow contemporary clinical practice – telemedicine and home health

Retention and the NHSC

Ron Yee, MD, MBA, FAAFP

Chief Medical Officer

United Health Centers

Parlier, California

NACHC Winter Strategy Meeting

Delray Beach, Florida

January 24, 2013