A Collaboration to Increase Family Medicine GME Medical College of - PowerPoint PPT Presentation

A Collaboration to Increase Family Medicine GME Medical College of Georgia at Augusta University, Augusta University Health System and University Health Care System Joseph Hobbs, M.D., FAAFP Anna Ramanathan Professor and Chair, and the Department Administrator GAFP J.W. Tollison, M.D., Distinguished University Chair Department of Family Medicine Department of Family Medicine Medical College of Georgia Senior Associate Dean for Faculty Affairs Medical College of Georgia 2/23/17 – ADFM Presentation

Augusta University Health System Strategic Investment in Primary Care Growth • Increase primary care access for projected covered lives • Market primary care services to enterprise employees • PCMH transformation of primary care resident faculty practice sites based on FM model • Expand AUHealth System’s primary care remote site(s) • Develop primary care community partnerships • Increase UME and GME learning sites • Increase FM GME and faculty CFTE

Augusta University • Comprehensive research institution • ~9,000 students • 1,000 full time faculty • 7,000 staff • 125 educational programs

Augusta University Summerville Health Science AUHealth Campus Campus System (5 Colleges) * (4 Colleges) ** Medical College of Georgia 21 6 16 FM Center and Department of AU Medical Centers and Basic Science Other Clinical FM Inpatient Family Medicine Associates Institutes Departments Departments Service * Health Science Campus: Medical College of Georgia, College of Allied Health Sciences, Dental College of Georgia, College of Nursing ** Summerville Campus: Hull College of Business, College of Education, The Graduate School, College of Science and Mathematics, Pamplin College of Arts, Humanities, and Social Sciences

Medical College of Georgia • Faculty size – 615 full time faculty – 217 part time faculty – 2,081 volunteer faculty • Medical school enrollment (230 students) – Main campus (190 students per class) • 3 Clinical Campus – Augusta University/University of Georgia Medical Partnership 4 year campus (40 students per class) – 534 residents/fellows and 45 programs

Augusta University Health System • 154-bed children’s and 478-bed adult hospitals • Level I adult and pediatric trauma center • Ambulatory care services – Practice sites for 80 specialties, including Family Medicine Center – Digestive Health Center – Georgia Radiation Therapy Center – Sports Medicine Center – Georgia Cancer Center – Remote primary care and specialty practice sites • Georgia War Veterans Nursing Home • Roosevelt Warm Springs Rehabilitation and Specialty Hospitals

MCG Department of Family Medicine Chair Executive Council Department Administrator Graduate Undergraduate Research and Inpatient Clinical Outpatient Clinical Medical Education Medical Education Discovery Programs Programs Program Program Programs MCG FM FM Clerkship Health Family Medicine FMIS Residency Program 1 Disparities Unit Resident/Faculty FM Required and Practice Site Geriatric Programs Practice-Based Elective Preclinical Osteopathic Electronic Program Component and Clinical Courses Research Network, Health Record HamesNet GWVNH FM General Maintenance Rural Tract FM Training and Student Advising Residency Program 2 Rural Health Research Grant AUMA Practice Site Education and Management FM Interest Group GME Hospital Liaison Service Initiatives Affiliates IPPH Coordination UME Community AU Medical Center GME Community Faculty Network CQI Liaison Faculty Network AUMA CQI Liaison 1 24 total ACGME position 2 6 ACGME rural track positions

MCG Family Medicine Residency Program Funding • Funding Support – AUHealth System via DME and IME – State FM capitation through Georgia Board for Physician Workforce – AU Medical Associates – Training grants – Faculty and resident clinical coverage contracts (e.g., Georgia War Veterans Nursing Home) and FM departmental reserves

Current Family Medicine GME Positions and Faculty CFTE • Faculty FTE 18.65 • Faculty CFTE 8.49 • 42 approved GME positions • 30 funded GME positions • MCG (24) • Rural 1+2 (6) • 11 Community Clinical Faculty

MCG Department of Family Medicine • Personnel – 37 Faculty • 19 MD/DO on campus clinician educators • 5 PA on campus joint appointment clinician educators • 1 EdD nurse administration • 2 PhD scientists • 3 MD regional campus • Dean’s staff – 1 PhD on campus psychologist – 2 MD regional campus – 1 PhD – 2 MSW/MPA – 22 academic staff – 32 clinic staff – 241 community clinical faculty – 30 residents

MCG Department of Family Medicine • Family Medicine Center – 15,000 sq ft – Largest single site of primary care in region – NCQA recognized Level 3 PCMH – ~37,000 patient visits per year – Family Medicine EHR in enterprise EHR environment

MCG Department of Family Medicine Service and GME Growth Initiative Goals Challenges • Increase on campus and • Financial and space constraints community primary care access for additional residents and faculty • Increase primary care GME in • Most clinical rotations occurring in response to increased Georgia AUHealth System UME • Recruitment competitiveness of • Increase GME and UME access to large community health systems campus and community clinical • Insufficient exposure to sites community based contemporary FM models • Disproportionate resident exposure to complex primary care • Historic service and teaching relationships with community health system

MCG Department of Family Medicine Service and GME Growth Initiative • Opportunities – 36 ACGME approved positions • 24 AUHealth System funded positions • 12 approved positions obtained in response to CMS national redistribution of unused positions – AUHealth System clinical growth initiative • Planned hospital in adjacent county • Expansion of primary care services • Functional integration and “right-sizing” of faculty practices • Changing healthcare environment – Educationally willing external partners

MCG Department of Family Medicine Service and GME Growth Initiative • Opportunities – Governor’s statewide GME growth initiative • Board of Regents “GME Regents Evaluation and Assessment Team” (GREAT) – Increase primary care GME positions – Increase GME positions in identified specialty deficits (e.g., psychiatry, general surgery, etc.) – Target 400 new GME positions in GME naïve hospitals – Incentivize GME position development and startup – Georgia Board for Physician Workforce • State capitation for community hospital based primary care GME • Federal match component

Strategic Initiative Increase Family Medicine GME and Faculty CFTE • Faculty FTE 18.65 • Faculty CFTE 8.49 • 42 approved GME positions Current • 30 funded GME positions • MCG (24) • Rural 1+2 (6) • 11 Community Clinical Faculty • 24.65 Faculty FTE • 13.5 faculty CFTE • 42 approved GME positions Initial • 42 funded GME positions Proposal • MCG (36) • Rural 1+2 (6) • 18 Community Clinical Faculty

Statewide Strategy Expanding GME in GME Naïve Hospitals • Governor’s initiative committing $20 million over 5 years for start up support • Funding to establish 400 residency positions at new teaching hospitals to reach SE region resident per capita rate – Hospitals required to match incentives dollar for dollar – New program focus predominantly on primary care and specialties with significant deficits in GA (e.g., general surgery) – Existing GME program expansion purposely excluded • Smaller return on investment • Existing position cap and smaller per resident DME/IME amount • GME expansion managed by GREAT • Advisory committee to GREAT

University Health Care System A Potential Collaborating Partner • 580 bed hospital • Heart & Vascular Institute • W.G. Watson, M.D. Women’s Center • Geographic decentralized primary care and specialty services • Recent area hospital health system acquisition • Emergency department with designated Chest Pain and Primary Stroke centers

Reasons for Collaboration MCG Family Medicine • Increase FM GME using MCG ACGME approved positions and University Health Care System’s unused DME and IME • Increase training capacity to match FM ACGME approved positions • Increase service capacity at AUHealth System • Provides GME training experiences outside the AHC in community settings • Enhanced FM recruitment potential based on AHC and community health system educational interface • Access to extramural capital beyond DME and IME required to support FM GME

Reasons for Collaboration University Health Care System • Protects current IME and DME positions • Provides support of statewide GME initiative • Exposes 36 MCG FM residents to health system • Creates physician recruitment opportunities • Increasing provider satisfaction to those interested in teaching • Marketing AHC affiliation