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Virginia’s Healthcare Workforce Healthcare Workforce Data Center Dianne Reynolds-Cane, MD Director Virginia Department o

Virginia’s Healthcare Workforce Healthcare Workforce Data Center Dianne Reynolds-Cane, MD Director Virginia Department of Health Professions VHWDA Stakeholder Meeting Richmond, Virginia December 4, 2013. New DHP Licensees 2010-2013. Healthcare Workforce Data Center.

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Virginia’s Healthcare Workforce Healthcare Workforce Data Center Dianne Reynolds-Cane, MD Director Virginia Department o

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  1. Virginia’s Healthcare Workforce Healthcare Workforce Data Center Dianne Reynolds-Cane, MD Director Virginia Department of Health Professions VHWDA Stakeholder Meeting Richmond, Virginia December 4, 2013

  2. New DHP Licensees 2010-2013

  3. Healthcare Workforce Data Center • A Program of the Virginia Department of Health Professions • Survey regulated health professionals during renewal period • http://www.dhp.virginia.gov/hwdc/default.htm

  4. Agenda • 2012-2013 Survey Report Findings • Medicaid Workforce Mapping Packet • AHEC Regional Reports • Work In Progress • Take Away

  5. SURVEY REPORT FINDINGS 2012-2013

  6. Practitioner Distribution • Supply • HWDC periodic survey reports • Metro areas, towns, rural areas • NP and PA surveys for 2012 have been released • Demand • Geospatial Innovations • VHHA Healthcare Workforce Strategic Planning Task Force • HRSA National Model

  7. NP and PA Healthcare Practitioners Nurse Practitioners 6,056 in Workforce 6,435 FTEs Half became NPs after Y2000 Physician Assistants 1,891 in Workforce 1,775 FTEs Median Age: 37

  8. NP Scope of Practice Introduced by Virginia Council of Nurse Practitioners and Medical Society of Virginia, HB346 includes: • Elimination of supervisory language– NP’s practice in collaboration and consultation • Collaboration and consultation within Patient Care Teams - 54.1-2900(3) • “Patient Care Team” means a multidisciplinary team of health care providers actively functioning as a unit with the management and leadership of one or more patient care team physicians for the purpose of providing and delivering health care to a patient or group of patients • Patient Care Team Physician who actively provides “leadership and management” NO requirement for MD to regularly practice at the same location • Collaboration and consultation may be via telemedicine • Ratios increased from 4:1 to 6:1 • Periodic review of patient records, no requirements for site visits

  9. PHYSICIANS

  10. Snapshot of Virginia’s Physician WorkforceCouncil on Virginia’s Future Regions Note: Regional estimates do not include physicians whose primary work location is outside of Virginia, or who worked in several localities/locum tenens or whose location could not be determined. Virginia totals do include these physicians.

  11. Southside Virginia has a high proportion of uninsured adults and a low number of physician FTEs per resident.

  12. Projected Virginia Physician Shortages to 2030 Source: Virginia Healthcare Workforce Data Center Analysis. Forecasts performed by the Lewin Group

  13. PHYSICIAN EDUCATION AND TRAINING

  14. 2012 Physician Survey Results • Medical Education and Residencies • Graduated from Virginia medical schools: 20% (23%) • Completed residencies in Virginia: 27% (30%) • Virginia Retains (unchanged): • 35% of its Medical School Graduates • 39% of its Residents • Workforce Demographics • Work full-time : 83% (85%) • Work primarily in patient care: 86% • Work in primary care specialties: 42% (39%) ( )2010 Survey Results

  15. Education and Training The AAMC has committed to increasing the number of Medical School slots by 30% over 2002 numbers by 2017. 528 US Medical Students did not have a residency by the end of match week this year.* Regional: Virginia Washington DC New York Pennsylvania Maryland North Carolina *Rebecca Greenberg, AAMC Reporter, April 2013.

  16. Geriatrics-Virginia Physicians Physician Workforce ABMS-Certified Subspecialtists in Virginia: Family Medicine Internal Medicine Psychiatry Total: 221 Self-Designated Geriatric Specialists: 894 (2010) Virginia Geriatric Training Programs University of Virginia Virginia Commonwealth University Eastern Virginia Medical School Carilion Clinic .

  17. Specialties

  18. MEDICAID WORKFORCE MAPPING

  19. Open for Business

  20. Medicaid Distribution NP and PA

  21. AHEC Regional Reports

  22. Blue Ridge AHEC Region

  23. Northern Virginia AHEC Region

  24. WORK IN PROGRESS

  25. Telemedicine • Mandated for reimbursement in state regulated private market (SB675-Wampler 2010) • Virginia Medicaid has reimbused telemedicine since 2003 • Certified telemedicine technologist training is being developed at New College Institute • Begins 2014 • Partially funded by the VHWDA

  26. Military Credentialing and Licensing • House Bill 1535 (2011) • Physicians and other officer-level professions can be licensed through endorsement from other states. • Enlisted-level occupations require extensive, professional-level cross-walking and gap analyses in comparison with civilian health professional licensure. • In response to Delegate Stolle’s request and upon request to participate in the DoD multi-agency Task force on Military Credentialing, DHP has been contributing to this analysis since March 2012.

  27. National Governors Association • NGA-supported participation in the Veterans Licensing and Certification Policy Academy • NGA-supported Statewide Plan to reduce prescription drug abuse in Virginia

  28. Take Home Demographics • Women represent more than half of the healthcare workforce in several professions and in the younger physician age cohorts • Nearly 25% of several healthcare professionals expect to retire in 10 years Education and Training • Retention of medical school grads and residents is essentially unchanged from 2010 • While Virginia medical school slots are increasing, residency slots are essentially unchanged

  29. Take Home • About half of Virginia’s physicians are educated and trained in bordering or nearby states Workforce Mal-distribution • Many practitioner to population ratios are highest in some urban areas and near employers such as hospitals and long term care facilities. • Legislation such as HB346 and HB1501 enable efficiencies through patient care teams, collaborative care, and healthcare related IT to ease the burden of care carried by too few physicians.

  30. Take Home Practice Related • Group, solo, and hospital practice sites are most common • Most physicians who accept Medicaid and Medicare are accepting new patients. Top Priorities • Enabling civilian licensing of veterans and spouses • DHP continues to collaborate with legislators and stakeholders to provide data to help determine supply and demand of Virginia’s healthcare workforce in Virginia

  31. Perimeter Center Office 9960 MaylandDrive Suite 300 Henrico, Virginia 23233 Thank You!

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