Family medicine residency training programs have a new tool to demonstrate their value to sponsoring hospitals, their communities and their states, thanks to HealthLandscape.org.
HealthLandscape Provides Powerful Tool to Residency Programs
By Leslie Champlin
• Kansas City, Mo.
4/11/2007
Now officially launched, the Web site allows users to combine several types of demographic, economic and other data to document and illustrate family medicine's contributions to improving community health, easing health care disparities, enhancing access to care and reducing primary care shortages, according to Andrew Bazemore, M.D., assistant director of the AAFP's Robert Graham Center in Washington, D.C.
Bazemore described the online service April 2 during the Residency Program Solutions Workshop here. It is available to the general public, with additional features specifically for and limited to residency training program directors and constituent chapter executives. The initiative is the result of collaboration among the Graham Center, the AAFP, the University of Cincinnati and the Health Foundation of Greater Cincinnati.
By illustrating the impact of residency programs and their relationships to underserved areas, residency training programs and constituent chapters can create visually compelling and powerful advocacy documents, according to Bazemore.
Research into factors contributing to residency program closures show that "politics and economics, rather than the absence of need, are the two main reasons why programs close," he told residency program directors. "We need ways to demonstrate to legislators and others the impact of our residency programs. With HealthLandscape, you can show the impact of your program -- which counties it affects most and which (counties) become primary care Health Professional Shortage Areas (or HPSAs) without your graduates."
The program will prove invaluable to residency program directors, according to Perry Pugno, M.D., M.P.H., director of the AAFP Division of Medical Education.
"Hospitals are asking the question, 'This residency program is a significant investment. What am I getting for it?'" he said. "HealthLandscape shows real-time benefits in terms of giving people health care access, including preventive care, without relying on the emergency room. Too many communities find out how much the residency program is doing for the community only after the program closes and that resource is lost.
"HealthLandscape allows programs to develop reports themselves, with local information, to remind their sponsoring institutions why they were brought there in the first place, to remind them that they need primary care physicians in the community and that growing their own makes the most sense," said Pugno.
Moreover, he added, the tool allows residency programs to illustrate that they "support the local medical community with referrals, limit the impact on community private practice physicians from uninsured and underinsured patients, and raise the standard of care in the sponsoring institution."
In addition, residency programs can use the information to support grant applications and to improve their Medicare payment by determining whether they are in a HPSA, according to Bazemore.
Programs with providers working in a geographic HPSA are eligible for a 10-percent Medicare bonus payment on all claims; those in a Physician Scarcity Area are eligible for a 5-percent bonus payment on claims. Because the Health Resources and Services Administration, or HRSA, updates HPSA designations regularly and some providers eligible for bonus payments do not receive them, Bazemore advised residency programs to check their clinics' HPSA status to determine if they should be receiving the bonus.
"In a single year, some $4 million in bonus payments due to providers serving in HPSAs nationwide was not dispensed, according to a 2004 study," said Bazemore. "This is failed policy, and primary care providers who deliver care in areas of greatest need are not receiving money intended for them."
HealthLandscape soon will enable programs to map their patient data, which will allow them to better understand whom they serve, whom in the community they might better serve and where they should plan to implement community-oriented primary care, or COPC, he added.
"Billing data is typically used just to pay the bills and keep the lights on," said Bazemore. "HealthLandscape will help you use this dormant data to tell stories about your patients and community and to teach residents COPC."
Bazemore described the online service April 2 during the Residency Program Solutions Workshop here. It is available to the general public, with additional features specifically for and limited to residency training program directors and constituent chapter executives. The initiative is the result of collaboration among the Graham Center, the AAFP, the University of Cincinnati and the Health Foundation of Greater Cincinnati.
By illustrating the impact of residency programs and their relationships to underserved areas, residency training programs and constituent chapters can create visually compelling and powerful advocacy documents, according to Bazemore.
Research into factors contributing to residency program closures show that "politics and economics, rather than the absence of need, are the two main reasons why programs close," he told residency program directors. "We need ways to demonstrate to legislators and others the impact of our residency programs. With HealthLandscape, you can show the impact of your program -- which counties it affects most and which (counties) become primary care Health Professional Shortage Areas (or HPSAs) without your graduates."
The program will prove invaluable to residency program directors, according to Perry Pugno, M.D., M.P.H., director of the AAFP Division of Medical Education.
"Hospitals are asking the question, 'This residency program is a significant investment. What am I getting for it?'" he said. "HealthLandscape shows real-time benefits in terms of giving people health care access, including preventive care, without relying on the emergency room. Too many communities find out how much the residency program is doing for the community only after the program closes and that resource is lost.
"HealthLandscape allows programs to develop reports themselves, with local information, to remind their sponsoring institutions why they were brought there in the first place, to remind them that they need primary care physicians in the community and that growing their own makes the most sense," said Pugno.
Moreover, he added, the tool allows residency programs to illustrate that they "support the local medical community with referrals, limit the impact on community private practice physicians from uninsured and underinsured patients, and raise the standard of care in the sponsoring institution."
In addition, residency programs can use the information to support grant applications and to improve their Medicare payment by determining whether they are in a HPSA, according to Bazemore.
Programs with providers working in a geographic HPSA are eligible for a 10-percent Medicare bonus payment on all claims; those in a Physician Scarcity Area are eligible for a 5-percent bonus payment on claims. Because the Health Resources and Services Administration, or HRSA, updates HPSA designations regularly and some providers eligible for bonus payments do not receive them, Bazemore advised residency programs to check their clinics' HPSA status to determine if they should be receiving the bonus.
"In a single year, some $4 million in bonus payments due to providers serving in HPSAs nationwide was not dispensed, according to a 2004 study," said Bazemore. "This is failed policy, and primary care providers who deliver care in areas of greatest need are not receiving money intended for them."
HealthLandscape soon will enable programs to map their patient data, which will allow them to better understand whom they serve, whom in the community they might better serve and where they should plan to implement community-oriented primary care, or COPC, he added.
"Billing data is typically used just to pay the bills and keep the lights on," said Bazemore. "HealthLandscape will help you use this dormant data to tell stories about your patients and community and to teach residents COPC."
Resident & Student Focus