Debra Lochner Doyle MS LCGC State Genetics Coordinator Services Utilization 20042017 Clinical Genetics Service Utilization Ages 019 All Clinics CORNMDS Age data on 84258 clinical service ID: 933501
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Slide1
Genetic Counseling Capacity, wait times, & SERVICE utilization trends in WASHINGTON STATE
Debra
Lochner
Doyle, MS, LCGC,
State Genetics Coordinator
Slide2Slide3Services Utilization 2004-2017
Slide4Clinical Genetics Service Utilization Ages 0-19 (All Clinics)
CORN-MDS
Age data
on
84258 clinical service
visits
Ages 0-19 comprise 47% of all visits between 2004 and 2017
Slide5Clinical Genetics Service Utilization Women (All Clinics)
CORN-MDS
Gender
data on 84258 clinical service visits
Women comprise 63% of
all visits between 2004 and 2017
Slide6Capacity of Genetic Counselors in WA
Supply of GC in Direct Patient Care
Slide7WA Service Delivery Capacity GC
Location of GC
Number of GC
Number of Direct Patient Care GC
% GC in Direct Patient Care
Ratio of GC to General Population
Population in 2017
United
States
4242*
2476*
58.37%
1:131,260
~325 million **
Washington
State
213
8841.31%1:82,954~7.3 million ***
*Data from Hoskovec et al. paper and Census.gov** US population (https://www.census.gov/quickfacts/fact/table/US#viewtop)***Office of Financial Management population data (https://ofm.wa.gov/sites/default/files/public/dataresearch/pop/april1/ofm_april1_poptrends.pdf)
2017 Direct Patient Care Genetic Counselor (GC) to General Population Ratio
Two Options for Optimal Direct Patient Care GC Capacity Estimate vs. Current WA GC Capacity
1: 83,000WA Current Direct Patient Care GC Capacity
Slide8WA Supply Estimates
2017
US Direct
Patient Care
GC to
General Population Ratio
Location of GC
Number of
GC (Total)
Number of
GC (Direct Patient Care)
% GC in Direct Patient Care
Ratio of GC to General Population
Population in 2017
United
States
4242*
2476*
58.37%1:131,260~325 million **WA2138841.31%1:82,954~7.3 million *** * Data from Hoskovec et al. paper and Census.gov
** US population (https://www.census.gov/quickfacts/fact/table/US#viewtop)***Office of Financial Management population data (https://ofm.wa.gov/sites/default/files/public/dataresearch/pop/april1/ofm_april1_poptrends.pdf
Slide9Wait Times – the Demand Model
WA Wait Times for Access to Genetic Services
Understand the impact of the Affordable Care Act (ACA) implementation
Understand the impact of Medicaid Expansion
Hypothesize increase in demand for genetic services statewide
Primary Study Fall 2013 prior to implementation of ACA
Follow-up Study Summer 2017 post-implementation
Slide102017 Study Methods
Called the same clinics as 2013
Identified ourselves as WA Department of Health (DOH)
Asked the scheduler for Third Next Available non-urgent/routine appointment times for a new patient
Appointment times asked for both Medical Geneticists and Genetic Counselors
Repeated the call 2 more times – total of 3 calls in ~10 days
Used Call 1 to fine tune our script - omitted call 1 data for the averages calculated
Slide11Wait Times for Access to Genetic Services
Provider Type and Location
2013 Wait Times (Calendar Days)
2017 Wait Times (Calendar Days)
% Increase over 2013
MD + GC (All Clinics)
32.2
73.4 + *
128%
MD + GC (East Clinics)
18.5
37 +
100%
MD + GC (West Clinics)
49.3
119 +
142%
GC (All Clinics)
1234.2 +185%
GC (East Clinics)830.8 +285%
GC (West Clinics)
18.7
42.3 +
126%
MD (All Clinics)
63.3
105.3+
66.4%
MD (East Clinics)
44
60.8+
38.2%
MD (West Clinics)
82.7
138.8+
67.9%
*+ sign indicates wait times beyond what scheduler can see on calendar for wait times to service
Slide12Self-Pay (Patient-Reported | All Clinics |Prenatal + Clinical)
Slide13WA GC Capacity vs. Wait Times
Two Options for Optimal Direct Patient Care GC Capacity Estimate vs. 2017 WA GC Capacity
1: 83,000
WA Current Direct Patient Care GC Capacity
Wait Times in Calendar Days for Access to Medical Geneticists (MD) & Genetic Counselors (GC)
Provider Type and Location
2013 Wait Times
2017 Wait Times
% Increase over 2013
MD + GC (All Clinics)
32.2
73.4 +
128%
GC (All Clinics)
12
34.2 +
185%
*+ sign indicates wait times beyond what scheduler can see on calendar for wait times to service
Slide14Summary
WA GC capacity is robust and appears to meet optimal capacity model posited by
Hoskovec
,
e
t al
However, wait times for access to genetic services have on average doubled between 2013 and 2017
Service utilization data demonstrate increasing
demand
Self pay rates have dropped suggesting ACA and expanded Medicaid insurance coverage has helped families
A ratio of 1:100,000 does not meet population demands in WA, and possibly ratio of 1:75,000 will not either
Slide15Debra
Lochner
Doyle, MS, LCGC
253-395-6742
Debra.lochnerdoyle@doh.wa.gov