Transcript Automatic Facility HPSAs and IHP Sites

Shortage Designation Update
State Office of Rural Health Orientation Meeting
Rockville, Maryland
September 10, 2014
1
Objectives
• Become familiar Shortage
Designation Branch
• Gain an understanding of
Shortage Designation
Types
• Gain an understanding of
Shortage Partners and
Stakeholders
• Shortage Designation
Management System 2.0
2
Division of Policy and Shortage Designation
• Improve access to health
care services for individuals
and communities that are
underserved by designating
and addressing health
professional shortages areas
(HPSAs) and Medically
Underserved Areas and
Populations (MUA/Ps)
• State Primary Care Offices
• Public Health Service Act,
Title III, Sections 330 and
333
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HPSA Designations:
Health Discipline Shortages
•
Health Professional Shortage Area (HPSA) designations are used to identify areas and
population groups within the United States that are experiencing a shortage of health
professionals
•
There are three categories of HPSAs based on health discipline:
1.
2.
3.
•
primary medical care
dental
mental health
For each discipline category, there are three types of HPSAs
1.
2.
3.
geographic area
population group
facility
•
The primary factor used to determine a HPSA designation is the number of health
professionals relative to the population with consideration of high need.
•
These HPSA Designations are required to be updated on a regular basis
4
Automatic Health Professional Shortage
Area (HPSA) Statute • Legislation in 2002 created
a separate type of HPSA
designation, not based on
geographic or population
data but based on status as
a certain type of facility
• This legislation created
“Automatic Facility (Auto)
HPSAs”
• Auto HPSAs are
automatically designated by
statute
• Auto HPSAs are manually
scored by the BCRS
Shortage Designation
Branch
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Entities Covered under Auto HPSA Statute
 Certified Rural Health
Clinics (RHCs) meeting
NHSC-Site Requirement
 Federally Qualified
Health
Centers/Community
Health Centers
 FQHC Look-A-Likes
(LALs)
• Federal Indian Health
Service Clinics
• Tribally-run Health
Clinics
• Urban Indian Health
Clinics
• Dual-funded
Community Health
Centers/Tribal Health
Clinics
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What is as HPSA
Score?
 HPSA Scores are developed
for use by the National Health
Service Corps in determining
priorities for assignment of
clinicians.
 Scores range from 1 to 25 for
primary care and mental
health, 1 to 26 for dental.
 The higher the score, the
greater the chance of
obtaining a provider.
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Auto HPSA Scores
• A score of “0” can
mean two different
things:
– Data was provided and
calculated score is “0”
– Or, the site has not been
scored, that is no data
has been presented and
thus not scored
– “0” means “null” in the
latter case
 Auto HPSA Scores are
not required to be
updated and only
updated on request
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MUAs/Ps
Health Services Shortages
•
MUAs may be a whole county or a group of contiguous counties, a group of county or civil
divisions or a group of urban census tracts in which residents have a shortage of personal health
services
•
MUPs may include groups of persons who face economic, cultural or linguistic barriers leading
to a shortage of personal health services
•
MUA/Ps use an Index of Medical Underservice (IMU) with a scale of 0 to 100
•
The IMU involves four variables which are summed and weighted to obtain an area’s score:
–
–
–
–
ratio of primary medical care physicians per 1,000 population
infant mortality rate
percentage of the population with incomes below the poverty level
percentage of the population age 65 or over
•
An IMU of 62.0 or less qualifies for designation as an MUA/P
•
Governor’s Exceptional MUP/Designation
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MUAs/Ps
Health Services Shortages
•
MUAs may be a whole county , group of contiguous counties, civil divisions or
urban census tracts in which residents have a shortage of personal health
services
•
MUPs may include groups of persons who face economic, cultural or linguistic
barriers leading to a shortage of personal health services
•
MUA/Ps use an Index of Medical Underservice (IMU) with a scale of 0 to 100
•
The IMU involves four variables which are summed and weighted to obtain an
area’s score:
–
–
–
–
•
ratio of primary medical care physicians per 1,000 population
infant mortality rate
percentage of the population with incomes below the poverty level
percentage of the population age 65 or over
An IMU of 62.0 or less qualifies for designation as an MUA/P
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Shortage Designations and Medicare
Certification as a Rural Health Clinic
• Primary Care Medical
Geographic HPSA
• Primary Care Medical
Population-Group HPSA
• Medically Underserved
Area
• Governor-designated and
Secretary-certified
shortage area
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State Primary Care Offices: PCOs
•
HRSA-PCO Cooperative Agreement addresses the needs of
underserved areas and populations
•
Coordinate and oversee HPSA and MUA/P needs assessment and
application process
•
Retain its historic focus to support states and territories in:
1.
2.
3.
their statewide primary care needs assessments
shortage designation coordination
technical assistance and collaborations that seek expand access to primary care
•
FOA will strongly encourage needs assessments be based on pre-defined Rational Service Area
plans or Primary Care Service Areas (PCSAs) and serve as the basis for shortage designation
applications
•
Discussion of past and/or future plans to coordinate the collection of provider data with all licensing
boards for health professionals in the state or other appropriate organizations
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HPSA Find Website
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HPSA Find Website
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How Shortage Designations are used
National Health
Shortage Designation Option
Service Corps
Federally
Qualified Health
Center Program
CMS
Medicare
Incentive
Payment
CMS Rural
Health Clinic
Program
J-1 Visa
Waiver
X
X
X
Primary Care HPSA
X
Dental Care HPSA
X
Mental Health HPSA
X
X
Geographic HPSA
X
X
Population HPSA
X
Facility HPSA
X
X
X
X
X
X
X
Exceptional MUP
X
Medically Underserved Area
X
Medically Underserved
Population
State Governor's Certified
Shortage Area
X
X
X
X
X
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X
History of Shortage Designation
-The National Health
Service Corps (NHSC)
enacted
- Health Professional
Shortage Area (HPSA)
methodology developed
HRSA Proposed New
Rules for Designation, No
Modifications to
Methodology Implemented
HRSA Proposed New
Rules for Designation, No
Modifications to
Methodology Implemented
Paper Processing
1970 - 1975
1990
2001
1998
2008
2014
ASAPS & Paper Processing
The National Health
Service Corps
Revitalization Act to
Prioritized on HPSAs
ASAPS Built on Manual
Business Process &
HPSA Methodology
Defined in 1970s
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Shortage
Designation 2.0
New Shortage Designation Transformation
•
Shortage Designation 2.0 bridges people, process, and data.
Annual
Updates
Single,
Automated
System for all
Processing &
Scoring
New Business
Process &
Functions
Automated
Recalculations of
Scores via
Standard Data
Shortage
Designation
2.0
Defined Roles &
Responsibilities
Impact
Analysis &
Trending
Use of
Predefined
Rational
Service Areas
Standard Data
Sets
Auditable &
Traceable
Projections
Based on
Standard Data
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Shortage Designation 2.0: Phased Implementation
•
Shortage Designation 2.0 will have releases in 2014 and 2015; leading
to a decision for recalculation of scores.
September 2014 Release
•
•
•
•
ASAPS archival / decommission in August, data migrated as-is and no changes to scores
Designations will not be submitted from September to December
Current process for auto-HPSA manual request and processing will continue to May 2015
PCOs provide additional data attributes for provider data to National Provider Identifier (NPI) file starting in
September
December 2014 Release
•
•
•
•
•
HPSA & MUA/P designations can be submitted and processed; interface to data warehouse restarts
PCOs / stakeholders can use automated data submission for non-standard data
Ability for PCOs and SDB analysts to communicate via system (inquiries)
Current process for auto-HPSA manual request and processing will continue to May 2015
Initial impact analysis of scoring recalculation begins
May 2015 Release
•
•
•
•
PCSA integrated in the system as a support tool
Facility, including Auto HPSA, designations can be requested and processed
Continued impact analysis of score recalculations
PCOs continue to complete provider data to NPI file
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Division of Policy
and Shortage
Designation
Dr. Kae Brickerd, Branch Chief
[email protected]
CAPT Phil Budashewitz, Director
[email protected]
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Q&A
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