Working Together to Strengthen Ohio’s
Safety NetThe HealthPath Foundation of Ohio
April 28, 2011
Ted Wymyslo, M.D., DirectorOhio Department of Health
What efforts are underway to ensure protection of the health care safety net?
Office of Health TransformationPatient-Centered Medical Home initiativeOhio Primary Care Workforce PlanHealth care workforce planning
Agenda:
Public Health Partnerships
Health PathFoundation of Ohio
Hospitals
Dental SafetyNet Clinics
Community Action Agencies
FQHCs
Office of Health Transformation
Ohio Department of Health
Local Health Departments
Medicaid
Ohio Patient-Centered Medical Home Education Pilot Project
44 total practices, 4 medical schools & 5 nursing schoolsCharge from HB 198
o Implement curriculum reform• Inter-professional, collaborative education for physicians and APNs• Focus on Primary Care• Use existing national standards
o Design primary care scholarship
House Bill 198
For Medicaid, this model of care is called the Health Home and its core principles are from Section 2703 of the Affordable Care Act (ACA). Comprehensive care management;
Care coordination and health promotion;
Comprehensive transitional care, including appropriate follow-up, from inpatient to other settings;
Patient and family support (including authorized representatives);
Referral to community and social support services, if relevant; and
Use of health information technology to link services, as feasible and appropriate.
Medicaid Health Home
Recent workforce trends:◦ Decrease in availability of primary care providers◦ Maldistribution of providers
Factors driving need for primary care:◦ Aging population◦ Rising prevalence of chronic conditions◦ Coverage expansion (ACA)
↓ supply + ↑ demand = not enough primary care providers to sustain an adequate workforce
Primary Care Workforce
What we think we know…34,000 active physicians (MD & DO)◦ 12,000 report a primary care specialty
9,000 APNs and 2,000 PAs◦ Unsure how many are primary care providers
What we do know…There is no available data set to provide a complete
picture of Ohio’s primary care workforce.
Ohio’s Primary Care Workforce
Geographic HPSA
Special Population HPSA
Correctional Facility HPSA Facility HPSA
C
Source: March 2011, Primary Care Office, Ohio Department of Health
*Includes “Proposed for Withdrawal” and “No New Data”*Satellite sites of Comprehensive Health Centers are not listed as separate Facility HPSAs
Ohio Primary CareOhio Primary Care Health Professional Shortage AreasHealth Professional Shortage Areas**
Geographic HPSA
Special Population HPSA
Correctional Facility HPSA Facility HPSA
C
Source: March 2011, Primary Care Office, Ohio Department of Health
*Includes “Proposed for Withdrawal” and “No New Data”*Satellite sites of Comprehensive Health Centers are not listed as separate Facility HPSAs
Federal designations of underservice
Development programso Student/Resident Experiences and Rotations in Community
Health (SEARCH)
Recruitment & Retention programs
Health care workforce planning efforts
ODH Initiatives that Address theHealth Care Provider Shortage
Goal: To create a strategic primary care workforce plan that builds upon existing efforts and identifies further actions that can be taken to address Ohio’s primary care workforce needs.
Plan development process: Public input process that included a one-day statewide meeting, 4 half-day Regional Forums, and open public comment period
Final Product: Ohio Primary Care Workforce Plan
Ohio Primary Care Workforce Plan
Reimbursement barriers for primary care
Increased demand on current supply of primary care providers
Declining interest in and increased discouragement in primary care careers
Poor recruitment of and preparation for ideal or “target” students more likely to pursue primary care
Lack of exposure to primary care and underserved settings in training programs
Lack of integration/coordination of all aspects of the workforce pipeline: education, training and practice
Conversation highlights from Plan Contributors
Grouped recommendations into 3 main categories:
I. Develop a Statewide Primary Health Care Workforce Data System
II. Ensure Adequate Supply, Distribution and Diversity of Ohio’s Primary Care Workforce
III. Promote Widespread Adoption of Patient-Centered Medical Home Practice Model in Ohio
Recommendations:
I. Develop a Statewide Primary Health Care Workforce Data System
Establish a centralized health care workforce data repository.
Establish a common core data set for health professional licensure.
Establish a system to track health professions students into practice.
Recommendations:
II. Ensure Adequate Supply, Distribution and Diversity of Ohio’s Primary Care Workforce
School-age children Identify and expand existing programs for school-age children
to prepare for and provide exposure to health care careers.
Undergraduate college education Identify and expand existing programs for undergraduate
students to provide exposure to health care careers and, specifically, primary care.
Recommendations:
Recommendations:II. Ensure Adequate Supply, Distribution and Diversity of Ohio’s
Primary Care Workforce (continued)
Health care professionals in training Institute additional strategies to recruit and retain health
professional students in primary care careers. Increase training experiences in community-based primary care
settings. Simplify training advancement within and between health care
professions.
Recommendations:II. Ensure Adequate Supply, Distribution and Diversity of Ohio’s
Primary Care Workforce (continued)
Practicing health care professionals Create incentives that encourage primary care providers,
especially Ohio-trained providers, to choose to practice in Ohio.
III.Promote Widespread Adoption of Patient-Centered Medical Home Practice Model in Ohio
Increase funding support for implementation of House Bill 198.
Create financial incentives for practitioners and facilities to adopt the PCMH model.
Promote interdisciplinary training and practice within all primary health care related professions.
Recommendations:
Include a broader array of health care professions into health workforce planning
Initiative currently underway:
State Health Care Workforce Development Grant
o Planning Grant: 150K of ACA dollars funded by HRSA to Primary Care Office
o Potential to gain additional funding from the ACA for implementation grant
A broader scope:Health Workforce Development
The strength of Ohio’s safety net is in your hands…
Integrate recommendations provided in the Ohio Primary Care Workforce Plan into the Foundation’s safety net mission.
Build on to current state programs, like state loan repayment programs and the SEARCH program.
A Call to Action
Contact Information Ted Wymyslo, M.D.
Director, Ohio Department of Health614-466-2253
Ohio Primary Care Workforce PlanHeather Reed
Acting Chief, Bureau ofCommunity Health Services
Coleen SchwartzAdministrator,
Primary Care Office614-728-3700