hawaii’s physician workforce: update
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Hawaii’s Physician Workforce: Update
Kelley Withy, MD, PhD David Sakamoto, MD, MBAwithy@hawaii.edu dts@hawaii.edu
Healthcare Association of HawaiiMay 20, 2011
Primary Care Estimates forAPRN, PA, MD & DOs
•PA: Supply estimate: 35 FTE• Demand Estimate: 59 FTE
•Physicians: Supply estimate: 892 FTE• Demand estimate: 1,228 FTE
•APRN: Supply estimate: 209 FTE • Demand estimate: 268 FTE
Primary Care Estimates forAPRN, PA, MD & DOs
• Current Total Supply, using .75 productivity conversion factor for PAs & APRNs = 1,075• Current Total Demand = 1,473
2010 Shortage of Primary Care Providers is 27%
New systems of care,Administrative simplification,Reimbursement changes
Loan repayment, Sin tax, Tort reform
Tort reform, loan repayment
Pipeline,Appreciation,Social Integration
Office space,Business Services
Pipeline Programs, Targeted Training, Implement EHR, Group Formation, Increase non-Physician Clinicians, Medical Home Model
Solutions Priorities, Designated at June, 2010 Summit
Change Model of Care
• Care teams, Care Coordination, Increase Non-physician clinicians• Patient centered medical home• Kaiser, HMSA, HPCA, HPH• Should we have a conference for education and
consensus building?• Accountable Care Organizations
Revenue Support
• Medicare reimbursement to physicians (#8)• US Bureau of Labor has Hawaii in bottom
quartile (except peds)• MGMA not assess HI, but current hiring at
MGMA average?• Fairhealth doing a claims database study of
reimbursement rates (previously Ingenix)Rural payment differential (UHA and AlohaCare)• Business assistance• Loan repayment
Administrative Simplification
• Central web portal with current enrollment data • Eligibility, plan benefits/restrictions, co-
payment• Drug formularies, rules, forms (standard
preauthorization forms would save staff time)• Single credentialing service
• Standard contract (provider : insurer)• Standardized claims processing, CPT conventions
and ability to track claims• Uniform Health ID card
Tort Reform
• Workgroup:• Pretrial Hearing Process Review/New Ideas
• Enterprise Medical Liability• Broadens the prospects for holding healthcare
organizations, such as hospitals and health plans, directly responsible for medical injuries, in addition to or instead of holding the individual providers liable• Payors demand reduced utilization; legal system says, do
everything
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