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OGME Development Initiative Consultant Training Seminar June 21, 2011 (updated) OGME Development Initiative Marshalls the Resources of the AOA & the Osteopathic Profession to Help Hospitals Interested in Starting New Osteopathic GME Programs 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. 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. Consultants’ Role Knowledgeable Consultants Initiative Corps of Consultants includes Seasoned Teaching Hospital CEOs & Senior Administrative Staff Directors of Medical Education Deans Program Directors Other Medical Educators 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 Consultants’ Role Help Identify the Keys to Success Local Champions Physician Leadership Medical Staff Hospital & System Administration Hospital & System Boards The Community OPTIs 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 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 The AOA Consultants are working on behalf of the American Osteopathic Association Where to find Resources? Resources “New” OGME Development Initiative web page http://www.osteopathic.org/ogmedevelopment Resources 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 Contact American Osteopathic Association 142 E. Ontario St. Chicago, IL 60611-2864 Phone: (800) 621-1773, ext. 8010 E-mail: [email protected] Flow of Consulting Initial Contact Initial Contact from Hospital Initiative Sends Pre-visit Information Form Information Received (Moveon) No information Received (Done) Teleconference Schedule for Video/Teleconference or Web-cast Yes – Hospital Ready to Move Forward No – Schedule Periodic Contact Site Visit Site Visit Scheduled Yes – Hospital Has Selected OPTI and Moves Forward OPTI Contacted No – Schedule Periodic Contact Site Visit Benefits Benefits of OGME Hospital Benefits Medical Staff Benefits Recruiting Benefits Patient Care Benefits Bottom Line Benefits Hospital Benefits Physician Recruiting Culture of Education In-House Physician Coverage Educational & Technical Expertise Enhanced Service to the Community Competitive Advantage Revenue Stream 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 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 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 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… 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 Strategic Considerations Hospital Goals & Objectives 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 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 Strategic Considerations Community & Customer Needs Community and Customer Needs Helps Determine How an OGME Program Fits within the Hospital Community and Customer Needs Mission: Why Does the Hospital Exist? Patient Care & Physician Services? Service to the Community? Quality & Safety? Education? Research? Community and Customer Needs Vision: What Image does the Hospital Want to Portray as it Works to Accomplish its Mission? 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? SWOT Analysis A Strategic Framework Helps You Analyze How OGME Fits Into the Hospital by Examining – – – – – Internal Strengths Internal Weaknesses External Opportunities External Threats Strategic Considerations Cost & Payment 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) 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 “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 Review Critical Hospital Components Identify the Keys to Success Local Champions Physician Leadership Medical Staff Hospital & System Administration Hospital & System Boards 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 OPTIs 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 Benefits of an OPTI? Formalizes the community-based training network Provides resources to the community-based programs Formalized OPP instruction Choosing an OPTI Location Cost State vs. Private Benefits offered Needs of the training program Autonomy of the program Responsiveness of OPTI personnel Application Process Application Process Applications AOA receives completed application Completed staff AOA found on www.osteopathic.org application is reviewed by AOA forwards completed application to the Specialty College for review Application Process At the discretion of the Specialty College, an on-site review may be scheduled If site reviewed, the report is forwarded to the Specialty College Residency Evaluating Committee (REC) Application Process The Specialty College REC submits recommendations to the Program and Trainee Review Council (PTRC) PTRC discusses recommendations and decides final action Approved new programs receive one year of “Provisional Approval” Dual programs (ACGME) may receive greater number of years of approval Application Process AOA staff schedules a survey review of the program and forwards materials to program Completed program workbook and survey materials are returned to AOA staff Completed survey materials are sent to the Survey Reviewer After site review, Survey Reviewer submits report findings to the AOA Application Process The AOA forwards report to the Specialty College REC or the IEC for review Specialty College REC or IEC reviews and submits recommendations to the PTRC PTRC decides final action, granting one to five years of “Approval” Review OGME Development Initiative Employs A Strategic Approach Expert Consultants Useful Information on Starting and Operating High Quality OGME Programs OGME Development Initiative Answers such Practical Questions as – What are the Benefits of an OGME Program? What Assistance & Information are Available? How to Move Forward from Interest to Program Approval? Where to Call for Complimentary In-Person Assistance from Experienced Consultants? OGME Development Initiative Provides Support to Assist Adding an OGME Program to Hospital’s Strategic Plan Reaping the Benefits of an OGME Program – – – – To the Hospital To Patients To the Community To the Medical Staff