State Update on Rural Health Initiatives Deborah B. Munchmeyer Program Manager, Graduate Medical Education, SCDHHS October 11, 2017
Background/History • Physician Workforce/Healthcare Access Shortage o Physician recruitment/retention Ø 2010 SC medical school graduates: 52.6%: in-state (county of origin: 84.8% - urban, 14.3% - rural) 1 Ø In-state correlation – 77% of SC physicians completing both medical school and residency training in-state remained in-state to practice 2 Ø Sustainment of rural practitioners 1 2010 SC Office for Healthcare Workforce Analysis & Planning Study. 2 2013 SC Office for Healthcare Workforce Analysis & Planning. Retaining Physicians Educated in South Carolina Data Brief. 3 2013 AAMC Center for Workforce Studies State Physician Workforce Data Book. 4 2013 SC Office for Healthcare Workforce Analysis & Planning Study. 5 2014 SC GME Advisory Group Report. 2
Background/History • Physician Workforce/Healthcare Access Shortage o Primary care services Ø 77.5 primary care physicians per 100,000 population (ranked 40 th in US; 2012) 3 Ø State data suggests that 50% of internal medicine residents go on to subspecialty practice (does not include hospitalists) 4 o Geographic distribution Ø All 46 SC counties have primary care shortages and/or areas of medically underserved populations 5 1 2010 SC Office for Healthcare Workforce Analysis & Planning Study. 2 2013 SC Office for Healthcare Workforce Analysis & Planning. Retaining Physicians Educated in South Carolina Data Brief. 3 2013 AAMC Center for Workforce Studies State Physician Workforce Data Book. 4 2013 SC Office for Healthcare Workforce Analysis & Planning Study. 5 2014 SC GME Advisory Group Report. 3
Background/History 2012 2013 2014 2015 2016 2017 2018 Medical GME Executive GME Education Advisory Report Order Group Advisory 2015-03 Council 4
Recommendations & Path Forward 11 Recommendations o Priorities Ø Create new graduate medical education (GME) residencies in family medicine and other primary care specialties that are critically needed in the rural and underserved areas of SC. Ø Broaden scope of existing GME funding to promote and expand use of telemedicine, support education of advanced practitioners and enhance programs to recruit and retain physicians, NPs and PAs in medically underserved areas. 5
SC State Provisos - Rural Health Initiatives • ICARED o Provide onsite subspecialty access Ø Dental, pediatric subspecialties, maternal fetal medicine, neurology, orthopedics and adult cardiology Ø Society Hill, Hartsville, Orangeburg, Sumter, Lancaster, Winnsboro, Aiken, Bamberg and Florence Ø Expansion of sites and services ongoing and need- based Ø Onsite echocardiography Ø Physician training on use of handheld ultrasound devices 6
SC State Provisos - Rural Health Initiatives • ICARED o Support rural physician practices Ø Practice Management Ø CME/training/tele-education o Promote collaborations/partnerships Ø FoodShare Fresh Food Box Program and Diabetes Tele-Education Ø USC academic schools and SCORH - studies, teaching and training programs 7
SC State Provisos - Rural Health Initiatives • SC Center for Rural and Primary Healthcare o Support rural/underserved providers Ø Improve access to specialty care Ø Pharmacy extension program Ø Rural practice information hub o Improve rural health workforce Ø Training – students, residents and fellows Ø Practitioner/staff development Ø Statewide scholarship/loan repayment program 8
SC State Provisos - Rural Health Initiatives • SC Center for Rural and Primary Healthcare o Establish research center Ø Public-use data warehouse o Promote collaboration among rural health stakeholders Ø SCORH, SCDHHS, SC AHEC, SC public institutions of higher education 9
SC State Provisos - Rural Health Initiatives • Graduate Medical Education (GME) Expansion o Rural medicine workforce development – up to $500,000 in available funding Ø SFY17 v New rural rotation programs v New medical residency/fellowship programs or expansion of existing programs Ø SFY18 v Continuation of SFY17 program development and implementation v New round of planning grants offered (announcement is imminent) 10
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