![Page 1: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/1.jpg)
NASHP STATE HEALTH POLICY CONFERENCE
OCTOBER 5, 2010
![Page 2: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/2.jpg)
Health Reform Matrix
OPCA’s tool for tracking health reform:http://www.orpca.org/advocate-for-health-centers/federal-policy
Key areas that impact CHCs
$$ to support CHC growth National Health Service Corps expansion Medicaid expansion to 133% of federal poverty
level Insurance exchange and CHCs Heightened focus on cost and quality
2
Hostetler
![Page 3: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/3.jpg)
A new study indicates that upcoming shortages of primary care physicians may be worse than projected, as will patients' access to primary care.
--American Academy of Family Physicians
Workforce Issues3
Hostetler
![Page 4: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/4.jpg)
Costs of hiring and training
Lack of recruitment staff
Physician shortage
CHC challengesLocation, population complexity, pay
The CHC Recruitment Climb:Getting Steeper
4
Hostetler
![Page 5: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/5.jpg)
And Yikes!
CHC patients expected to double by 2014
5
Hostetler
![Page 6: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/6.jpg)
CHC Residency Program
Health reform act opportunity
Difficult for CHCs Best candidates:
Larger CHCs Other CHCs will
partner with residency programs
6
Hostetler
![Page 7: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/7.jpg)
Offers exposure to CHCs 70% of students continue working with populations in
need
Boosts job satisfaction for CHC providers
Strengthens partnerships with academic institutions
OPCA’s SEARCH program7
Hostetler
![Page 8: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/8.jpg)
Historically used at CHCs
Utilizing Mid-Level Providers
Oregon’s ratio of physician to mid-level Currently 1:1 May evolve to 1:3 or more
8
Hostetler
![Page 9: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/9.jpg)
Training curriculum needs to improve To “hit the ground running” Example: Pacific University PA program
Primary care home model = more patients per provider team
Utilizing Mid-Levels (cont’d)9
Hostetler
![Page 10: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/10.jpg)
Physicians in “medical home” demonstration projects report job satisfaction rates going up tremendously.
--Patient-Centered Primary Care Collaborative
Primary Care Home Model
10
Hostetler
![Page 11: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/11.jpg)
Issues with current primary care model Pressures of the 10 – 15
minute visit Negatively impacts
patient outcomes
Provider satisfaction: More than money
How the Primary Care HomeCan Help
11
Hostetler
![Page 12: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/12.jpg)
What is a Primary Care Home?
Flexible, based on population need Patient-centered experience Quality & safety Team-based care Enhanced access Coordination of care Behavioral health integration
12
Hostetler
![Page 13: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/13.jpg)
Environment: Payment focused on old model Workforce not trained for model Current economic environment
& need to focus on access Payers don’t want to wait for
transformation
Challenges, Barriersand Competing Priorities
13
Hostetler
![Page 14: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/14.jpg)
Clinic level: Capturing data Spreading
leadership and buy-in throughout the clinic
Finding resources Allowing providers
time to lead
Challenges, Barriersand Competing Priorities (cont’d)
14
Hostetler
![Page 15: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/15.jpg)
Account for social factors Support model for entire patient population Minimize clinics’ administrative burden and cost Tailor payment to reward movement on indicators Pay for work that improves care Allow time for care Fund learning collaboratives
Key Issues for Payment Reform
15
Hostetler
![Page 16: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/16.jpg)
Policy alignment and opportunity
Oregon’s initiative is improving: Provider satisfaction Basic patient satisfaction Some clinical quality indicators
Exciting Developments16
Hostetler
![Page 17: NASHP State Health Policy conference October 5, 2010](https://reader035.vdocuments.site/reader035/viewer/2022062803/568146d2550346895db4093e/html5/thumbnails/17.jpg)
Contact InformationCraig Hostetler
Executive DirectorOregon Primary Care Association
Phone: 503-228-8852Email: [email protected]
Thank You!17
Hostetler