Medical Staff Development Plan - PowerPoint Presentation

Slide1

Medical Staff Development PlanMAPRA Educational ConferenceOctober 9, 2015

Allison McCarthy

PrincipalSlide2

Each entity and combined

Defined markets

Entity

Primary, secondary, tertiary

Regulatory

System

Organizational shifts

Acquisitions

Departures

Health reform transitions

Risk contracts

Population health

Clinical programsSlide3

Community Need AnalysisDemand versus SupplySlide4

Hospital Defined Markets

Regulatory Defined MarketSlide5

Determining SupplySlide6

Population size in each market region Current and 5 year projected census estimates

Physician-to-population ratios determine full-time equivalent (FTE) needs by specialty – blended approach

Population estimates ineffective for hospital-based specialties

Some specialties lack unique ratios

Vascular surgery included with general surgery

Radiation oncology

Occupational medicine

Podiatry

Oral Surgery

Demand EstimatesSlide7

Physician-to-population ratios to determine community needBy specialty

Population by service area

Ratio providers

GMENAC (Graduate Medical Education National Advisory Committee)

Committee of healthcare experts convened by Congress to assess U.S. healthcare manpower needs in 1980 – still considered a valid standard today

Managed Care

Jonathon Weiner et al. in 1994 and updated in 2004 developed

estimates

based on a number of closed-panel HMOs (included more than 350 clinic sites, 33 hospitals and more than 8 million consumers)

Solucient – regionally based

2003 estimates based on National Ambulatory Health Care Administration, Medical Group Management Association and private/public claims

data

Demand Parameters Slide8

Nationally

recognized

sources

Population/100,000

x Ratio

Medical staff roster, physician directories, licensure boards, etc.

Supply

- Demand

How the Math Works…..Slide9

Note: Average age excludes physicians 65+ years.

Community Need - GASHSlide10

Other factorsSlide11

Need for:

_________________

_________________

_________________

_________________

Medical Staff Development Plan Input

Community Health IssuesSlide12

Panel Size

Degree of Risk

Medicare

ACO/Multiple payers

System Employees

Single Payer

Medicaid

Health Reform EngagementSlide13

Specialty careAddress chronic diseaseIncrease use of ACPs

Carefully managed transitions

Clear agreement on roles

Other points of care

Sub-Acute/Long term care

Home/Palliative care

Behavioral health facilities

Primary care

Diverse venues

Range of provider types

Larger panel sizes

Diverse settings

Population based

Offices and facilities

Manage care differently

Replace those who can’t

The Right MixSlide14

NPs/PAsGetting harder to recruitPharmacists157k shortfall by 2020

Others

Mental health providers

Care coordinators

Educators/health coaches

Group Health, Seattle, WA

10, 000 patient panel

Change in “Who” is Needed Slide15

To ensure medical staff breadth and depth over time Balance between new practitioners, mid-career professionals and mature physicians Ensuring equilibrium within each clinical specialty

Age 65 is a traditional point of retirement consideration

Succession Planning Slide16

Medical staff specificIndustry average age = 49 yearsHigh risk - specialties 50%+ is 60+ years Pending risk – specialties 25-49% is 60+ years

Physician Profile – Age AnalysisSlide17

Interview Findings

Physician InputSlide18

Out-of-area referral patternsSlide19

Employed

Group

Competitor

#1

Competitor

#2

Community Health Center

Unknown/Unaffiliated

Competitive Considerations

Adult PCPs by Affiliation (FTEs)Slide20

Increasing or decreasingWill new physicians helpIf so, which onesRecruit, acquire or affiliate

Cardiology

Oncology

Surgery

Ortho

Neurosurgery

Other Competitive DynamicsSlide21

Strategic growth plansMarket positionMedical staff perspectivesPotential physician transitions

Population projections

Current physician supply

Projected physician demand

Community health needs

Community Need

Organizational Need

Physician Recruitment Priorities

Physician Recruitment Priorities

Synthesize FindingsSlide22

Financially supporting private practice recruitment requires two key components Defined community need in the specialty area

Supported private practices are located within the GASH

If not present, can still recruit but through models other than private practice income guarantees i.e. employment

To recruit in specialty areas which are strategically important but for which there is not community need

To place physicians in markets other than GASH identified communities

Recruitment Parameters Slide23

Weighted PrioritiesSlide24

Your Expertise

Converting to Recruitment Plan Slide25

Degree of priority – strategy, access, availability, etc..

Employment or income guarantee

Budgeted dollars

Prior experience – management, billing, staffing

Practice location identified

Space - existing vs. new

Colleagues and staff – “fit” needs

Management capacity and expertise

Support requirements

Marketing

Hospital services – operating room, beds, ancillaries

Development potential

Pent-up demand

Referral base

Competitive edge

Recruitment factors

In-house capacity

Experience

Budget

Time to recruit

Recruitment Planning CriteriaSlide26

Recruitment Roadmap

Specialty

Practice

Location

Reason

Start

Date

Recruiter

Approved

Team Members

Family Medicine

ABC Group

Ostrow

Replace

July

2016

A. McCarthy

Yes

Dr. A

Dr. B

Pedi NPXYZ GroupMinnie

AddNowK. BarlowYes

Dr. MSally M.Slide27

MSDP more than community needCapture all influencing factorsTeam involvementRegular updatesBenefits to recruitmentBring in your expertise

Understand the “why” behind the recruit

Proactive vs. reactive approach

Longer range perspective

ConclusionSlide28

Thanks!Allison McCarthy

508.394.8098

amccarthy@barlowmccarthy.com