Health Planning Solutions: Medical Staff Planning

Health Planning Solutions: Medical Staff Planning

A Presentation for ICAHN and IHA

Medical Staff Planning-Product and Process

Establish goals to meet real community needs.

Assure availability of physicians.

Drive market share for both existing and new services.

Identify issues important to physicians.

Suggest ways to address key issues.

Involve physicians in a collaborative effort.

Medical Staff Planning:A Component of Strategic

Planning

Integral part of strategic planning and competitive analysis.

A complete understanding of the market informs physician needs.

Detailed clinical service line approach.

Detailed market share scenarios.

Physician office visit share.

Medical Staff Planning:Typical CAH Scenario

30-75% of inpatient volume leaves area

PCP needs unmet

Lack of referral base

Greater lack of specialists

Outpatient surgery opportunities foregone

Niche service opportunities neglected

Medical Staff Planning:What Does the Market Require?

Clinical Service Line Planning

Inpatient Discharges

Outpatient Volumes (Visits and Procedures)

Physician Visits

Current and Projected

Population Growth

Demographic Composition

Financial Access

Medical Staff Planning:What Does the Market Require?

Market Share Goals and Scenarios

Existing Clinical Service Base

Success in physician recruitment

Low-Hanging Fruit

The 20-80 rule

Geographic Imperative

Competition

Profit potential

Medical Staff Planning:Demand for Services

Market Share Driven by Physicians

Determining the Number and Type of Physicians Needed

Standard Methodologies

Medical Professional Society-Generated Norms

Efficiency Benchmarks

Population to Physician Ratios

Empirical Models

Age Distribution

Gender Distribution

Specialty Specific

Medical Staff Planning:Demand for Services

HPS Adjustments to Demand Model

Financial Access

Health Status

Projected non-population based change in Use Rates

Competing provider types

Nurse Practitioners/Physician Assistants

Retail Clinics

Urgent Care Clinics

Chiropractors/Alternative Providers

Medical Staff Planning:Provider Supply

Supply of Providers

Determining current and future FTEs

Standard Methodologies

AMA Socioeconomic data

Productivity

By Age

By Region

Specialty-Specific

Medical Staff Planning: Provider Supply

HPS Supply Methodology

Face to Face Survey

Actual current productivity

Actual type of practice

Estimated future provider productivity

Projected retention and recruitment

Physician Survey:Additional Benefits

Identifies referral patterns

Can involve physicians in other issues

Sends positive message

Increases probability of buy-in

Can start or re-start regular communications

Demographics

Population Counts, Estimates and Projections for the Primary Service Area and Secondary Service Area: 2005-2010

64,084 65,143

27870 28208

91954 93351

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

2005 2011

Year

Po

pu

atio

n

PSA SSA

Total

Sources: U.S. Census Bureau; Claritas

Chart 1

1.7% growth

1.2% growth

1.5% growth

Demographics

Age Distribution of Population: Total Area: Primary Service Area; Year 2006

Under 1520.7%

15 to 2416.7%

25 to 4425.8%

45 to 6423.3%

65-747.0%

75+6.5%

Age Distribution of Population: Primary Service Area Year 2010

Under 1520.0%

15 to 2415.8%

25 to 4425.0%

45 to 6424.9%

65-747.5%

75+6.9%

Sources: U.S. Census Bureau; Claritas

Chart 2

Demand for Inpatient Services

Inpatient Discharges: Drew County (PSA)Estimated 2005 and Projected 2010

647

112

278

173211

80 74 90

181210

74

252

150

386

66 58

1176369

417

157

272

80

208189

987484

228

300

187

738

0

100

200

300

400

500

600

700

800

CARDIOLOGY

ENDOCRINE

GASTROENTEROLOGY

GENERAL MEDIC

INE

GENERAL SURGERY

GYNECOLOGY

NEONATOLOGY

NEPHROLOGY

NEUROLOGY

OB/DELIV

ERY

ONCOLOGY MEDIC

AL

ORTHOPEDICS

PSYCH/DRUG A

BUSE

PULMONARY

UROLOGY

VASCULAR SURGERY

Clinical Service Line

Nu

mb

er o

f D

isch

arg

es

2005

2010

Chart 8

14% growth

8% growth8%

growth

Demand for Inpatient Services

Inpatient Discharges: Drew County and Estimated DMH Discharges from Drew County 2005

647

112

278

173211

80 74 90

181210

74

252

150

386

66 5878

122

266

272818

148

7357

331936

218

114

224

0

100

200

300

400

500

600

700

CARDIOLO

GY

ENDOCRINE

GASTROENTERO

LOGY

GENERAL M

EDICIN

E

GENERAL S

URGERY

GYNECO

LOG

Y

NEONATO

LOG

Y

NEPHROLO

GY

NEUROLO

GY

OB/D

ELIVERY

ONCO

LOG

Y MEDIC

AL

ORTHOPEDIC

S

PSYCH/DRUG

ABUSE

PULMONARY

UROLOGY

VASCULAR SURG

ERY

Clinical Service Line

Nu

mb

er o

f D

isch

arg

es

PSA

DMH

Chart 11

Demand for Inpatient Services

Inpatient Market Share By Clinical Service LineDrew County (PSA )

30%

67%72%

61%

16%

23%

45%

59%

39%

71%

23%

10%

17%

64%

33%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CARDIOLO

GY

ENDOCRINE

GASTROENTERO

LOGY

GENERAL M

EDICIN

E

GENERAL S

URGERY

GYNECO

LOG

Y

NEONATO

LOG

Y

NEPHROLO

GY

NEUROLO

GY

OB/D

ELIVERY

ONCO

LOG

Y MEDIC

AL

ORTHOPEDIC

S

PSYCH/DRUG

ABUSE

PULMONARY

UROLOGY

Clinical Service Line

Nu

mb

er o

f D

isch

arg

es

Current Market Share

Projected Market Share

Chart 13

Demand for Inpatient Services

33%28%23%Oncology Medical

40%35%30%Cardiology

74%69%64%Pulmonary

77%72%67%Endocrine

10%10%10%Orthopedics

82%77%72%Gastroenterology

26%21%16%General Surgery

17%

61%

71%

23%

59%

Current

Market Share-PSA

22%

66%

76%

28%

64%

2010 Likely

PSA

27%Psych/Drug Abuse

81%OB/Delivery

71%General Medicine

33%

69%

2010 Best

PSA

Gynecology

Nephrology

Chart 18

Required PSA Market Share: Expected and Best Scenarios

Demand for Outpatient Surgery Services Surgical Outpatient Procedure Volumes: Drew, Ashley, Lincoln, and Desha

CountiesEstimated 2005 and Market Share

2407

716

2048

6,317

11,488

368 167 58 263856

3% 4% 8%23%15%0

2000

4000

6000

8000

10000

12000

14000

Surgery-Digestive Surgery-Ophthalmology

Surgery-Orthopedics

Surgery-All Other Surgery-Total

Num

ber

of P

roce

dure

s

Market

DMH

Market Share

Physician Needs Based on Market Share Scenario

.5

.3

10.0

.25

.1

.2

.2

1

0

1

.25

.75

.5

Likely Model

4 days a month currently/same.1.1Podiatry

2 days a month currently/ Assumes new CTh program

.5.1Oncology

Cardiology clinic 6 days a month/need ½ to full time

1.2Cardiology

ENT surgery 1 day a week/need 1.5-2 days week

.4.2ENT

Need 3-4.5 FTEs11.57.0Family Practice

3 days a month currently/need 6 days a month

.2.1Gynecology

3 days a month currently/need 6 to 9 days a month

.3.1Ophthalmology

5 days a month currently/need full time

1.1Orthopedics

(Developmental clinic 1 day/mth)00Pediatrics

Assumes new inpatient rehab program

10Physiatry

2 days/month. 5.05Pulmonary

Tues 1/2 block; Th. Full block1.0.20General Surgery

1 day a week currently..67.25Urology

Comments Best Model2006 FTEsSpecialty

Expected Need for PhysiciansVisits Required Current FTEs Staffing

Expected FTEs MD Retire/Relocate Additons RequiredFP/IM 116,098 14.74 13.20 3.80 6-10 -.66 to -.4.66General Surgery 6,785 3.53 4.00 0.00 1.00 -1.47Orthopedic Surgery 13,946 3.43 1.00 0.00 2.00 0.43Pediatrics 25,831 5.71 4.00 0.00 3.00 -1.29Ob/Gyn 15,309 3.93 4.40 0.50 0.00 0.03Otolaryngology 6,722 1.63 1.00 0.00 0.00 0.63Ophthalmology 16,188 3.52 3.00 0.00 0.00 0.52Urology 5,496 2.05 0.00 0.00 1.00 1.05Cardiology 6,855 3.01 3.00 0.00 0.00 0.01Neurology 3,930 1.19 0.70 0.00 0.00 0.49Dermatology 11,174 1.51 1.00 0.00 0.00 0.51Podiatry 17,835 2.32 1.00 0.00 0.00 1.32Nephrology N/A 1.00 1.00 0.00 0.00 0.00Hospitalists N/A 3.00 2.00 1.00 2.00 1.00Physiatry N/A 1.00 1.00 0.00 0.00 0.00Vascular Surgery 2,499 0.56 1.00 1.00 0.00 0.56Gastroenterology 2,598 1.18 1.00 1.00 0.00 1.18Pulmonology 4,605 1.32 1.00 1.00 0.00 1.32Psychiatry 10,017 6.96 0.00 0.00 1.00 5.96Endocrinology 2,757 0.92 1.00 1.00 0.00 0.92Oncology 2,765 1.54 1.00 1.00 1.00 0.54Pathology N/A 1.00 1.00 0.00 0.00 0.00Radiology N/A 1.00 1.00 0.00 0.00 0.00Emergency Department N/A 6.00 6.00 0.00 0.00 0.00Oral and Maxillofacial Surgery N/A 2.00 2.00 0.00 0.00 0.00Total 271,411 74.06 55.30 10.30 19.00 11.48-15.48

Physician Capacity - Clovis, Roosevelt, Quay, Bailey, Parmer

Questions or Comments-Now or Later

Peter Strauss Health Planning Solutions 8310 Gannon Avenue, Suite 200. St. Louis, MO

63132 314-583-9023 [email protected] www.healthplanningsolutions.com