OGME Development Initiative Consultant Training Seminar

1. OGME Development InitiativeConsultant Training Seminar June 21, 2011 (updated)

2. OGME Development Initiative Marshalls the Resources of the AOA & the Osteopathic Profession to Help Hospitals Interested in Starting New Osteopathic GME Programs

3. OGME Development Initiative The purpose of the OGME Development Initiative is to provide effective, timely assistance to nonteaching hospitals that want to start new OGME programs.

4. OGME Development Initiative • Key to the Initiative is a corps of consultants knowledgeable about OGME and ready to work with • Prospective teaching hospitals • Hospitals seeking dual accreditation • Osteopathic programs that are struggling.

5. Consultants’ Role

6. Knowledgeable Consultants Initiative Corps of Consultants includes • Seasoned Teaching Hospital CEOs & Senior Administrative Staff • Directors of Medical Education • Deans • Program Directors • Other Medical Educators

7. Consultants’ Role Provide Peer-to-Peer Assistance, by Conference Call & On Site, to - • Answer Questions • Work One-on-One with Colleagues • Share Expertise & Experience • Advise on Start-Up Costs & Medicare Payment • Guide Hospitals Through the Accreditation Process

8. Consultants’ Role Help Identify the Keys to Success • Local Champions • Physician Leadership • Medical Staff • Hospital & System Administration • Hospital & System Boards • The Community • OPTIs

9. Consultants’ Role Focus on Critical Components - • Faculty Resources • Community Needs • Adequate Medicare Percentage for Reasonable Payment • Sufficient Patient Load • Scope, Variety & Volume of Trainee Experiences

10. The AOA • Professional Association Representing 100,000 Osteopathic Physicians Medical Students • Primary Certifying Body for DOs • Accrediting Agency for Osteopathic GME, Colleges of Osteopathic Medicine, Hospitals & Other Health Care Facilities

11. The AOA • Consultants are working on behalf of the American Osteopathic Association

12. Where to find Resources?

13. Resources • “New” OGME Development Initiative web page • http://www.osteopathic.org/ogmedevelopment

14. Resources

15. Resources Provides Easy Access to Web-Based Resources on: • Medicare Funding • Program Approval & Accreditation • Educational Standards & Policies • Physician, Hospital & Trainee Agreements • Templates, Models & Forms Designed to Help Smooth Your Way to a Quality Program

16. Contact • American Osteopathic Association • 142 E. Ontario St. • Chicago, IL 60611-2864 • Phone: (800) 621-1773, ext. 8010 • E-mail: OGMEdevelopment@osteopathic.org

17. Flow of Consulting

18. Initial Contact

19. Teleconference

20. Site Visit

21. Site Visit

22. Benefits

23. Benefits of OGME • Hospital Benefits • Medical Staff Benefits • Recruiting Benefits • Patient Care Benefits • Bottom Line Benefits

24. Hospital Benefits • Physician Recruiting • Culture of Education • In-House Physician Coverage • Educational & Technical Expertise • Enhanced Service to the Community • Competitive Advantage • Revenue Stream

25. Medical Staff Benefits • Environment of Life-Long Learning • Expanded Referral Network • Prestige in the Community • Tighter Bonds Among Medical Staff & Among Attendings, House Staff & Nursing • Enhanced CME Opportunities • Succession Planning • Mentoring & Molding Future Physicians

26. Recruiting Benefits • Ability to “Grow Your Own” Medical Staff • Reduced Physician Recruiting Expenses • Caliber of Training is a Known Quantity • Trainees are Already Known & At Home in the Community • Interns & Residents Tend to Remain in the Area Where They Train

27. Patient Care Benefits • Access to Care • Enhanced Coverage & Quality • Enhanced Ability to Meet Community Needs • Expanded Scope of Services • Presence of Residents 24/7 • More Patient Contact with Physicians • Increased Comfort Level for Nursing • Opportunity for Clinical Trials & Research

28. Bottom Line Benefits • Medicare Direct & Indirect GME Payments • Reduced Medical Staff Coverage Expenses • Increase in Physician Referral Base • Financial Support also may be available from Medicaid, the Veterans Administration & Other Federal or State Programs • And…

29. Osteopathic GME • Primary Care Focus + Medical & Surgical Specialties • Community-Based Clinical Education • 1 in 5 Medical Students now attends a College of Osteopathic Medicine • Osteopathic Medicine is One of the Fastest Growing Health Professions

30. Strategic ConsiderationsHospital Goals & Objectives

31. Hospital Goals and Objectives • Physician Workforce Shortages • New Colleges of Osteopathic Medicine & Medical Schools • Increasing Number of Medical Graduates • Increased Interest in Starting GME Programs = New Hospital Opportunities

32. What Keeps CEOs Up at Night? • Competition for Well-Reimbursed Patient Services • Increased Cost of Physician Services • Emphasis on Cost Containment • Quality Oversight/Ties to Payment • Shortage of Skilled Healthcare Workers • Shortage of Physicians – Especially Primary Care Physicians

33. Strategic ConsiderationsCommunity & Customer Needs

34. Community and Customer Needs Helps Determine How an OGME Program Fits within the Hospital

35. Community and Customer Needs Mission: Why Does the Hospital Exist? • Patient Care & Physician Services? • Service to the Community? • Quality & Safety? • Education? • Research?

36. Community and Customer Needs Vision: • What Image does the Hospital Want to Portray as it Works to Accomplish its Mission?

37. Community and Customer Needs Values: What Guiding Principles Drive the Hospital? • Moral Values? • Improving Community Health? • Providing Care for Those in Need? • Providing a Resource for Physicians?

38. SWOT Analysis A Strategic Framework Helps You • Analyze How OGME Fits Into the Hospital by Examining – • Internal Strengths • Internal Weaknesses • External Opportunities • External Threats

39. Strategic ConsiderationsCost & Payment

40. A Word about Costs Start-Up Costs Include: • Resident Salaries & Benefits • Faculty Salaries • DME & Program Director(s) • Inpatient & Ambulatory Teaching Faculty • Support Staff • Certain Capital & Equipment Costs (e.g., call rooms, library, computers, resident lounge)

41. A Word about Payment Medicare Pays Teaching Hospitals • Direct Graduate Medical Education (DGME) Payments • Indirect Medical Education (IME) Adjustment Based on Formulas, Statutory Factors & Certain Hospital-Specific Data

42. “New” Teaching Hospital • Hospital that Starts Training Residents for the First Time on or after January 1, 1995 • Resident “Cap” is Set Based on the Number of Residents in All Specialty Programs in the 5th Year After Training Begins • Once Caps are Set, Urban Hospitals Generally Cannot Add Medicare-Funded Positions • Rural Hospitals Can Add New Specialties but Cannot Expand Existing Programs

43. Review

44. Critical Hospital Components Identify the Keys to Success • Local Champions • Physician Leadership • Medical Staff • Hospital & System Administration • Hospital & System Boards

45. Critical Hospital Components Identify the Keys to Success • Hospital & System Resources • Hospital & System Metrics • Types of providers • Volumes (Hospital, ED, Clinic, Procedures) • The Community • OPTIs

46. OPTIs

47. Characteristics of OPTIs • Customer service organization emphasizing medical education • Services will depend on the vision and financing of the OPTI • Services will be compliant with OPTI standards

48. Benefits of an OPTI? • Formalizes the community-based training network • Provides resources to the community-based programs • Formalized OPP instruction

49. Choosing an OPTI • Location • Cost • State vs. Private • Benefits offered • Needs of the training program • Autonomy of the program • Responsiveness of OPTI personnel

50. Application Process