HPSA Training for Provider Partners: Data Collection & Timeline Anne Dopp, WI DHS Primary Care...

HPSA Training for Provider Partners: Data Collection &

Timeline

Anne Dopp, WI DHS Primary Care OfficeAleks Kladnitsky, WI Primary Health Care Assoc.May 20, 2013

5/20/13Protecting and promoting the health and safety of the people of Wisconsin 2

Increased understanding of Health Professional Shortage Areas (HPSAs) application process:oDefinitions, criteria & benefitsoTimelinesoClinic and physician data collectionoOptions to improve data collection/reporting

Expected Outcomes:

HPSA Definitions & Disciplines

Federally defined threshold indicating a significant shortage of primary care physicians, dentists or psychiatrists for a specific area.

Shortage Disciplines:oPrimary Care PhysicianoDentistoPsychiatrist


HPSA Types

o Geographic – shortage for entire population.

o Low-income population – shortage for population below 200% of federal poverty.

o Facility – shortage for certain facilities (Corrections, State Mental Hospitals).

o Automatic HPSA for safety net facilities (CHCs, RHCs, Tribal Centers).


HPSA Criteria

o Rational Service Area,o Percent of population below poverty,o Population to physician FTE ratio,o Contiguous area resources not

available,o Nearest source of non-designated care,o HPSA score.


HPSA-Linked Benefits

Provider payment incentives:oMedicare 10% bonus payment for physicians,oMedicaid 20% bonus payment for certain primary care services,oFederal RHC certification and cost-based payment.

Provider recruitment & retentionoNational Health Service Corps loan repayment,oWisconsin Health Professions Loan Assistance,oJ-1 visa waiver for foreign medical graduates.


Physician & Clinic Data

o State does not have a database with detailed physician and clinic data required for HPSA applications.

o WI Primary Care Office (PCO) and contracted HPSA staff at WPHCA worked over past three years to establish a HPSA provider database.

o WI HPSA database can now be used to review, update, and add data for new areas.


Frequency for HPSAData Collection

Each HPSA must be reviewed every three yearsoReview is based on date of last update (2010’s due in 2013).oFederal due date for reviews is Sept. 30th of each year.oNeed to do some HPSA reviews early to level out the number due per year (14 due in 2013, 58 due in 2014).oAnnual HPSA reviews are given priority.oRequests for new HPSAs will be reviewed as time allows.oCannot guarantee that a HPSA is eligible for re-designation.


HPSA Provider Surveys

o Conducted by contracted HPSA staff at WPHCA.o Done throughout the year (Oct. – Sept. cycle).o Physician data must be less than two years old.o Must get a 2/3 or higher HPSA survey response

for physicians per area to estimate for entire area.

o Surveys are only done as needed for HPSA reviews.


How to check when a HPSAwas last updated

o Use federal HPSAFind web siteSee handout with screen shots

o See Wisconsin PCO web page for list of HPSA reviews that are due: http://www.dhs.wisconsin.gov/health/primarycare/HPSA-Reviews.htm


Which clinics get HPSA surveys?

o All clinics in the HPSA service area with physicians providing direct, outpatient care.

o Primary care HPSA: family practice, internal medicine, pediatrics, Ob/Gyn, and general practice physicians.

o Mental Health HPSA: general and child psychiatrists.o Sometimes clinics in additional areas, when the HPSA

service area needs to be revised to be “rational.”o All clinics in contiguous areas that are not a HPSA &

are within a “30-minute travel ring” of the HPSA center.


Source of clinic list for surveys

o Wisconsin HPSA provider database.o Clinic contacts in database and physician

recruiters.o Clinics can email updates for clinic

locations and contact people via PCO HPSA web page.

o Network clinic help is especially needed to reach small private clinics to complete HPSA surveys.


HPSA Surveys: Data Needed

o Clinic data: Location, discounted care policy, and contact person information.

o Physician/psychiatrist information:• Work address, license no., year of birth, and

specialty,• Hours per week of outpatient & inpatient care,• Percent patients on Medicaid & discounted care,• Wait time for appointments.

o Do not need to report changes in between surveys.


HPSA Surveys: Privacy

o Data must be shared securely (email or phone).

o Cannot accept faxed or mailed paper surveys (it cannot be imported into HPSA database).

o See separate list of data elements from PCO web http://www.dhs.wisconsin.gov/health/primarycare/HPSA-Reviews.htm


HPSA Surveys: Timeline

o Oct - Nov: PCO releases list of HPSAs due for update via web and email notices.

o Dec - March: HPSA team calls/emails clinic contact to update sites and confirm contact person.

o Dec - June: HPSA team calls clinic contact, gives password, and sends survey by email.

o Dec - July: Clinics review & update survey data *(*more detail on “non-responses” later).


HPSA Surveys:Timeline Continued

o March - Aug: HPSA team analyzes data and prepares HPSA applications for update.

o Sept. 30th: Annual HPSA update applications are due to HRSA (1 year after update list 1st sent out).

o PCO sends out 30-day public notices for review.o Oct - Dec: HRSA reviews & makes decisions on

applications. Approvals added to HPSAFind.o PCO sends out notice of approvals & denials.


HPSA Surveys:Timeline for Withdrawals

o Oct - Nov: HPSAs that no longer qualify are changed to “Proposed for Withdrawal” & immediately lose eligibility for NHSC assistance.

o July of next year: Federal Register list published & “Proposed for withdrawal” become “Withdrawn.”

o January of next year: “Withdrawn” geographic HPSAs lose the Medicare HPSA bonus payment.


HPSA Surveys:Follow-up for “Non-responses”

Surveys are due back two weeks after sent to clinics:oAt 1 week - Reminder to clinic by phone/email.oAt 2 weeks - Late Notice to clinic by phone/email.oAt 3 weeks – At-risk notice is sent to all providers in area, HPSA is set aside, and HPSA will be converted to proposed for withdrawal and lose HPSA-linked benefits.


HPSA Survey: Excel file

Use of the Excel file to review, update and add clinic and physician data:oQuestions?


Other options to improve HPSA data collection?

Can Networks submit data for all sites & all primary care physicians at one time?oCompatible format for importing data.oSubmit data every two years.oIncomplete data needed for HPSAs would need to be followed up.Better ways to keep clinic and contact list updated?


Other options to improve HPSA data collection?

Other options or discussion?

Thank you for your willingness to look for ways to improve the data collection/reporting process.


HPSA Training for Provider Partners: Data Collection & Timeline Anne Dopp, WI DHS Primary Care...

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