RURAL RECRUITMENT PLAYBOOK OUTLINE

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RURAL RECRUITMENT PLAYBOOK OUTLINE State of the industry and trends in rural physician recruitment Emerging strategies for recruitment into rural communities. Examples of optimized recruitment & retention outcomes 2

STATE OF THE INDUSTRY Projected physician shortfall between 40,800 and 104,900 by 2030. Physician s retirement decisions are projected to have the greatest impact on supply. Demographic trends continue to be the primary drivers of increasing demand from 2015 to 2030. If underserved populations had standard care utilization patterns, demand for physicians would rise substantially. Source: The Complexities of Physician Supply and Demand 2017 Update. IHS Markit for Association of American Medical Colleges. February 2017 3

TRENDS IN RURAL RECRUITMENT Medical School Graduates Outnumber Residency Slots Visa Processing Backlog and Foreign Travel Restrictions Limits on Treatment Activity by Advanced Practice Providers Adverse Malpractice Climate 4

ACUTE SHORTAGE OUTSIDE OF MAJOR CITIES About 20% of Americans live in rural areas where many do not have easy access to primary care or specialist services Less than 8% of physicians practice in rural areas Source: Trend Watch, American Hospital Association; Doximity 5

RURAL PRIMARY CARE CANDIDATE POOL Active Primary Care Physicians 296,353 Est. Physicians Under 60 177,812 Available due to 7% Turnover 12,447 24% of Residents are International Medical Graduates Source: 2017 AAMC State Physician Workforce Data Book (+) 3Y Residents 40,674 Est. 8% Choose Rural 3,254 15,701 78% of Internal Medicine Residents Pursue Subspecialties 6

HIGHLY DISPROPORTIONATE ACCESS TO MEDICAL CARE National Rural Health Snapshot Rural Urban Percentage of American population 19.3% 80.7% Population aged 65 and older 18% 12% Physicians per 10,000 people 13.1 31.2 Specialists per 100,000 people 30 263 Source: Health Resources and Services Administration and Rural Health Information Hub. 7

COMMUNITY IMPACT Adding One Physician to a community of 10,000 people is associated with a 5.3% reduction in average mortality. Each physician supports 14 jobs and $2.2 million in economic input for a community. 8

CRITICAL TO REACH PASSIVE CANDIDATES 9

FIND PASSIVE CANDIDATES ONLINE Digital Recruitment is a Trend that is Here to Stay 31% of all physicians use social media for professional networking Source: Maximizing Multi-Screen Engagement Among Clinicians, Epocrates, Inc. 2013; MedTech Media 2015 10

FIND PASSIVE CANDIDATES ONLINE Digital Recruitment is a Trend that is Here to Stay 70% of U.S. physicians are on Doximity a Top 5 smartphone app used by the American College of Physicians Source: Doximity; American College of Physicians 11

FIND PASSIVE CANDIDATES ONLINE Digital Recruitment is a Trend that is Here to Stay 95% of all physicians prefer to receive info about job opportunities via email. Source: MMS Job Opportunity Preferences 12

RURAL RECRUITMENT PLAYBOOK OUTLINE State of the industry and trends in rural physician recruitment Emerging strategies for recruitment into rural communities. Examples of optimized recruitment & retention outcomes 13

EMERGING STRATEGIES Use Digital and Social Media to be Fast AND Strategic 14

CULTURE AND ENGAGEMENT The Interview: Window to Your Culture Tailor the Interview Team to the Candidate Utilize Your Best Facility and Community Advocates Assign Topics & Ensure Consistent Message Explore the Candidate's Priorities and Motivations 15

CULTURE AND ENGAGEMENT The Interview: Selling the Vision Personalize and Strategize Every Interview Involve the Spouse and Family Match Your Community and Culture to the Physician s Values Share Your Facility Vision and Community Impact 16

MORE IMPORTANT THAN MONEY Two elements have the strongest relationship to satisfaction: Trust in the hospital / health system s leadership team Quality of communication across the hospital or health system Source: The Engagement Gap, Jackson Healthcare, 2016 17

RURAL RECRUITMENT PLAYBOOK OUTLINE State of the industry and trends in rural physician recruitment Emerging strategies for recruitment into rural communities. Examples of optimized recruitment & retention outcomes 18

TRANSPARENCY Visits/Procedures Expenses Practice Overhead Profit/(Loss) Charges Work RVUs: RVUs & Expense (Cost) per Visit Expenses as % of Collections Patient Collections Gross Collection % Accounts Receivable Staffing Payer Mix based on Encounters 19

AUTONOMY Nationwide: Physicians Do Not Have Enough Control Over Their Time Not Enough Time with Each Patient Too Many Hours Per Week on Paperwork Source: Medscape Physician Compensation Report 2017 20

SUSTAINABILITY Focus: Ties to Community and First Year Engagement 21

CONTINUOUS IMPROVEMENT Provider Satisfaction Patient Satisfaction Employee Satisfaction 22

DEFINING BENCHMARKS End Result Placements per Year Efficiency Interviews-to-Hire Time-to-Fill Etc. Process Recruitment Spend-per-Hire Retention Etc. 23

DEFINING BENCHMARKS Typical Recruitment Benchmarks 1 Total Placements 4 Acceptance Rate 2 Time-to-Fill 5 Recruitment Spend-per-Hire 3 Interviews-to-Hire 6 Retention 24

EFFECTIVE RECRUITMENT Success Factors for Small, Remote Communities Ob/Gyn Glendive Medical Center Glendive, MT Family Medicine Friend Community Healthcare System Friend, NE Primary Care South Big Horn County Hospital Basin, WY Family Medicine and NP Peak Vista Community Health Centers Limon, CO Forensic Psychiatry Oklahoma Forensic Center Vinita, OK Multiple Canton-Potsdam Hospital Canton, NY 25

ADDITIONAL RESOURCES Physician Salary Calculator White Paper: Physician Workforce Through 2030 Guide to Developing a Strategic Physician Recruitment Plan Infographic Guides: Physician Trends, Engagement and Networking Case Studies 26