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

Ted.Wymyslo@odh.ohio.gov

Ohio Primary Care Workforce PlanHeather Reed

Acting Chief, Bureau ofCommunity Health Services

614-752-8935Heather.Reed@odh.ohio.gov

Coleen SchwartzAdministrator,

Primary Care Office614-728-3700

Coleen.Schwartz@odh.ohio.gov