CPAs & ADVISORS PHYSICIAN POPULATION RATIOS: THE KEY TO EVALUATING PHYSICIAN NEED, AND CREATING EFFECTIVE RECRUITING, RETENTION PLANS

Transcription

1 CPAs & ADVISORS experience ideas // PHYSICIAN POPULATION RATIOS: THE KEY TO EVALUATING PHYSICIAN NEED, AND CREATING EFFECTIVE RECRUITING, RETENTION PLANS Presented by Scott Bezjak, Partner, BKD, LLP and Tiffany Evans, Director of Physician Recruitment & Relations, Aultman Hospital

2 LEARNING OBJECTIVES Introduce why recruitment and retention of community physicians is a key success factor for hospitals and health systems Review the key components used to calculate physician need using physician population ratios and enhance general understanding of physician population ratios Take away several new ideas to improve the quality of your physician recruitment strategies 2 // experience ideas

3 PHYSICIAN RECRUITMENT AND RETENTION IS KEY SUCCESS FACTOR Potential shortage of physicians through 2020 Aging of the physician workforce (Baby Boomers) Many community physicians have become employees of the hospital Complicated regulations exist for the recruitment and employment of physicians Physicians is often main topic/ focus of Governance Clinical affiliation relationships between hospitals to share physician resources & physician recruitment efforts Clinical Integration vs. Asset Integration 3 // experience ideas

4 BENEFITS OF PHYSICIAN NEED CALCULATIONS Builds an effective recruiting and retention plan with specific goals and targets that can support hospital s strategic plan Provides strategic initiative over competitors Identifies new opportunities and gaps in hospital product and service lines Identifies potential practitioner shortages in the community Avoids improper allocation of resources Assists with Stark and regulatory compliance 4 // experience ideas

5 Physician Population Ratios and Use Rates PHYSICIAN POPULATION RATIOS: THE KEY TO EVALUATING PHYSICIAN NEED, AND CREATING EFFECTIVE RECRUITING, RETENTION PLANS 5 // experience ideas

6 BASIC COMPONENTS OF PHYSICIAN NEED CALCULATION Define primary and secondary service area Determine service area demographics (population) Apply use rates to service area population and evaluate service area demographics Inventory service area physicians Analysis of need 6 // experience ideas

7 DEFINE PRIMARY AND SECONDARY SERVICE AREA Identify Geographic Area ZIP code or County analysis County analysis is easier Prefer zip code analysis Primary vs. Secondary Service area Primary = 75% of volume Secondary = 90% of volume Primary care vs. medical and surgical specialties Volume descending utilization by zip code or County Discharges, outpatient visits or emergency room visits Utilize Mapping software 7 // experience ideas

8 SERVICE AREA EXAMPLE 8 // experience ideas

9 DEFINE PRIMARY AND SECONDARY SERVICE AREA PITFALLS Eliminate far-away zip codes from analysis Plot on a map to ensure zip codes are contiguous Small population zip codes that should be in service area may not rank in volume descending analysis Inpatient vs. outpatient Establish separate service areas for subunits Specialty Hospital Clinics Urgent care centers 9 // experience ideas

10 SERVICE AREA HEAT MAP 10 // experience ideas

11 SERVICE AREA DEMOGRAPHICS Population demographics Estimated vs. Projected Age specific cohorts (Pediatric services) Gender specific cohorts (OB services) Race Mortality and vital statistics Birth rates Infant mortality Causes of death 11 // experience ideas

12 12 // experience ideas

13 APPLY USE RATES TO SERVICE AREA DEMOGRAPHICS (POPULATION) Age adjusted physician population ratios for primary care, medical and surgical specialties GMENAC Goodman Hicks & Glen Solucient Apply use rates to community population for applicable specialties Occurrence per 1,000 Population (100 or 10,000) Based on National Statistics (Advance Data) Based on State Specific Statistics (OHA Data) Ability to adjust for change in demographics 13 // experience ideas

14 PHYSICIANS REQUIRED PER 100,000 POPULATION S PECIALTIES: GMENAC GOODMAN HICKS & GLENN S OLUCIENT Primary Care Family Practice 25.2 N/A Internal M edicine 28.8 N/A Pediatrics 12.8 N/A Medical S pecialties Allergy/immunology N/A 1.7 Cardiology Dermatology Endocrinology 0.8 N/A N/A N/A Gastroenterology N/A 3.5 Hem/Onc N/A 1.1 Infectious Disease 0.9 N/A N/A N/A Nephrology 1.1 N/A N/A 0.7 Neurology Psychiatry Pulmonology N/A 1.3 Rheumatology N/A // experience ideas

15 PHYSICIANS REQUIRED PER 100,000 POPULATION S PECIALTIES: GMENAC GOODMAN HICKS & GLENN S OLUCIENT S urgical S pecialties General surgery Neurosurgery N/A N/A OB/GYN Ophthalmology Orthopedic surgery Plastic surgery Urology // experience ideas

16 PHYSICIAN NEED CALCULATION FRANKLIN COUNTY 2020 Zip or Zip or County County GMENAC Physician Physician Physician Name Population Physician Type Use Rate Demand Inventory Need Franklin 1,237,960 / 100,000 X Orthopedic 6.2 = = // experience ideas

17 PHYSICIAN NEED CALCULATION DO IT YOURSELF 2020 Zip or Zip or County County GMENAC Physician Physician Physician Name Population Physician Type Use Rate Demand Inventory Need Service Area Total / 100,000 X = - = 17 // experience ideas

18 Inventory and Composition of Physicians PHYSICIAN POPULATION RATIOS: THE KEY TO EVALUATING PHYSICIAN NEED, AND CREATING EFFECTIVE RECRUITING, RETENTION PLANS 18 // experience ideas

19 INVENTORY & COMPOSITION OF PHYSICIANS BEST PRACTICES Analysis and profile of admitting practitioners Identify top admitting practitioners Employed vs. non-employed Hospital privileges Insurance alignment Projected retirement dates Utilize adjusted FTE s as opposed to total headcount Incorporate nurse practitioners & other non-physician providers (CRNA s) Utilize projected 2019 population data as opposed to 2010 census data 19 // experience ideas

20 INVENTORY & COMPOSITION OF PHYSICIANS BEST PRACTICES Perform sensitivity analysis summarized by specialty Perform detailed patient origin analysis on a practitioner level Identify practice patterns and opportunities for physician alignment or potential practice mergers/combinations Consider new practice site locations or possible relocation of existing physician practices Evaluate Outmigration patterns and impact on physician need 20 // experience ideas

21 PHYSICIAN INVENTORY ADDITIONAL BEST PRACTICES Augment physician to population need metrics with a utilization based demand analytics to arrive at a blended analysis for overall demand Consider whether non-retirement turnover is a factor that should be considered Consider other quantitative analytics, such as service line profitability studies, to help set strategic recruiting priorities. Physician/Hospital profitability analysis using Hospital cost to charge ratios Forecast longer than a 5 year period Add quality component to analysis (weighted by specialty) Separate each of the EMSA areas into separate analyses. Adjust the population ratios for technology advances and mortality rates Add geographic location to specialties (How many in each County) and map locations 21 // experience ideas

22 PHYSICIAN RECRUITMENT STRATEGIES Work with management team Summarize physician needs identified during previous steps Prioritize physician needs Prepare written strategy and staff development plan Develop Goals, physician target objectives and various succession plans Integrate the Community Physician Needs Assessment results with community initiatives and hospital strategic plan, if requested. 22 // experience ideas

23 Sample Documents PHYSICIAN POPULATION RATIOS: THE KEY TO EVALUATING PHYSICIAN NEED, AND CREATING EFFECTIVE RECRUITING, RETENTION PLANS 23 // experience ideas

24 SAMPLE DETAIL NEED CALCULATION 24 // experience ideas

25 SAMPLE PHYSICIAN DASHBOARD 25 // experience ideas

26 AULTMAN HOSPITAL S 2012 CONCENTRATION OF MEDICARE INPATIENT CASES SOURCE: 2012 MEDICARE HOSPITAL SERVICE AREA FILE 26 // experience clarity

27 DERMATOLOGY (2) PINPOINTS REPRESENT DERMATOLOGY PHYSICIAN LOCATIONS SEE ANALYSIS ON THE FOLLOWING SLIDE SOURCE: MANAGEMENT S PHYSICIAN DATABASE 27 // experience clarity

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