oklahoma state university center for rural health
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Oklahoma State University Center for Rural Health. Where does Oklahoma rank nationally for its health status (1 st is best and 50 th is worst)?. 33 rd 43 rd 46 th 49th. 1 United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”. - PowerPoint PPT PresentationTRANSCRIPT
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Oklahoma State UniversityCenter for Rural Health
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Where does Oklahoma rank Where does Oklahoma rank nationally for its health status nationally for its health status (1(1stst is best and 50 is best and 50thth is worst)? is worst)?
0% 0% 0% 0%
1. 33rd
2. 43rd 3. 46th 4. 49th
1United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”
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Where does Oklahoma rank Where does Oklahoma rank nationally for its ratio of primary nationally for its ratio of primary
care physicians to total care physicians to total population?population?11
0% 0% 0% 0%
1. 5th 2. 23rd 3. 39th 4. 49th
1United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”
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© 2009 Oklahoma State University
The Health Status of OklahomansThe Health Status of Oklahomans11
• 25% of the state’s population smokes (improving)
• 32% of the state’s population is considered obese (increasing)
• 16% of Oklahomans do not have health insurance (was improving)
• Dead last for the percent of the population that has had a recent dental visit
• Dead last for the percent of the population that meets its recommended intake of fruits and vegetables
1United Health Foundation. 2010. “America’s Health Rankings: 2010 Edition.”
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What About Rural Oklahoma?What About Rural Oklahoma?
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How many more people are there How many more people are there per primary care physician in rural per primary care physician in rural
Oklahoma compared to urban Oklahoma compared to urban Oklahoma?Oklahoma?
0% 0% 0% 0%
1. 25% more2. 50% more3. 75% more4. 100% more
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© 2009 Oklahoma State University
MissionMission
Our mission is to support the Oklahoma State University Center for Health Sciences and its College of Osteopathic Medicine by seeking to improve healthcare in rural Oklahoma through:
Student education, Residency training, Research, Program applications, Advocacy, and Alliances with others who share our goals.
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© 2009 Oklahoma State University
Presentation OverviewPresentation Overview
Center for Rural Health Departments and Program Areas
Medical Education Clinical Services Grants and Research Advocacy
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Rural Medical EducationRural Medical Education
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On average, approximately what % On average, approximately what % of all graduates from OSU-COM of all graduates from OSU-COM
have entered primary care have entered primary care following graduation?following graduation?
0% 0% 0% 0%
1. 45%2. 55%3. 65%4. 75%
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Approximately what % of Approximately what % of graduates from OSU-COM have graduates from OSU-COM have entered primary care following entered primary care following
graduation since 2006?graduation since 2006?
0% 0% 0% 0%
1. 40%2. 50%3. 60%4. 70%
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79%
58%
71%
65%
59%
72%
65%
61%
61%
63%
71%
53%
57%
53%
64%64%
71%
65%
64% 63%
69%
64%
73%
56%
69%
57%
70%66%
43%
53%
51%
55%
54%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1977
1978
1979
1980
1981
1982
1983
1984*
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Perc
ent o
f Cla
ssEn
terin
g a
Prim
ary
Care
Res
iden
cy
Graduating Class (Year)
OSU College of Osteopathic Medicine Graduates Entering Primary Care ResidenciesGraduating Classes 1977 to 2010
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© 2009 Oklahoma State University
Community Clinic Rotation SitesCommunity Clinic Rotation Sites20102010
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© 2009 Oklahoma State University
Rural Clinic Rotation SitesRural Clinic Rotation Sites20102010
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© 2009 Oklahoma State University
Community Hospital Rotation SitesCommunity Hospital Rotation Sites20102010
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© 2009 Oklahoma State University
E.R. Rotation SitesE.R. Rotation Sites20102010
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© 2009 Oklahoma State University
Medical EducationMedical Education
Pre-Doctoral Training in Primary Care Grant Medical School
Earlier exposure to rural practice Expanded rural rotations Expanded rural didactics Increased experiences with simulators
Residency Rural residency programs
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Clinical ServicesClinical Services
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© 2009 Oklahoma State University
Clinical ServicesClinical Services
Enid Clinic Primarily Medicare, Medicaid, and
SoonerCare
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Grants and ResearchGrants and Research
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© 2009 Oklahoma State University
Grant Funded ActivitiesGrant Funded Activities
Annual Grants State Office of Rural Health Area Health Education Center
Project GrantsHealth Information Technology
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© 2009 Oklahoma State University
Grant Funded Activities - AnnualGrant Funded Activities - Annual
State Office of Rural Health State Office of Rural Health (SORH) Small Hospital Improvement Program
(SHIP) Medicare Rural Hospital Flexibility
Program (FLEX)
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Grant Funded Activities - AnnualGrant Funded Activities - Annual
Small Hospital Improvement Program (SHIP)
Eligibility Small (49 beds or less) Rural (outside of an MSA)
Authorized Expenditures Prospective payment systems (PPS); Value-based purchasing programs (VBP); Accountable care organizations (ACO); and Payment Bundling.
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© 2009 Oklahoma State University
Grant Funded Activities - AnnualGrant Funded Activities - Annual
Flex Program Conversion to Critical Access Hospital (CAH)
status Support for Quality Improvement Support for Operational and Financial
Improvement Support for Health System Development and
Community Engagement
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At most, how many beds may a At most, how many beds may a Critical Access Hospital have?Critical Access Hospital have?
0% 0% 0% 0%
1. 102. 253. 504. 100
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May a Critical Access Hospital May a Critical Access Hospital have an average length of stay have an average length of stay
of more than 96 hours?of more than 96 hours?
0% 0%
1. Yes2. No
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How much more money annually How much more money annually does a typical Oklahoma hospital does a typical Oklahoma hospital
make by converting to critical make by converting to critical access status?access status?
$42,071.00 $186,106.00 $227,449.00 $291,470.00
0% 0% 0% 0%
1. $ 42,071.002. $ 186,106.003. $ 227,449.004. $ 291,470.00
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© 2009 Oklahoma State University
Impact of CAH ConversionImpact of CAH Conversion
RN Lawler, GA Doeksen, and V Schott. Impact of Conversion to Critical Access Hospital Status for Oklahoma’s Rural Hospitals. The Journal of Rural Health. 2003.
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© 2009 Oklahoma State University
Critical Access HospitalsCritical Access Hospitals
Flex Monitoring Team. Statewide Financial Performance of CAHs – Oklahoma, www.flexmonitoringteam.org/documents/BriefingPaper7_FinancialIndicators.pdf
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© 2009 Oklahoma State University
Critical Access HospitalsCritical Access Hospitals
Flex Monitoring Team. Statewide Financial Performance of CAHs – Oklahoma, www.flexmonitoringteam.org/documents/BriefingPaper7_FinancialIndicators.pdf
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© 2009 Oklahoma State University
Critical Access HospitalsCritical Access Hospitals
Flex Monitoring Team. Statewide Financial Performance of CAHs – Oklahoma, www.flexmonitoringteam.org/documents/BriefingPaper7_FinancialIndicators.pdf
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© 2009 Oklahoma State University
Grant Funded Activities - AnnualGrant Funded Activities - Annual
Area Health Education Center (AHEC) Model AHEC Program State Matching Funds??????? Geriatric Education Center Program
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© 2009 Oklahoma State University
OSU Center for Rural Health’s Services and OSU Center for Rural Health’s Services and ActivitiesActivities
February 2010February 2010
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© 2009 Oklahoma State University
Grant Funded Activities - ProjectGrant Funded Activities - Project
Health Information Technology USDA Distance Learning and
Telemedicine Grant Tobacco Tax Funding for
Telemedicine
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ResearchResearch
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© 2009 Oklahoma State University
ResearchResearch
State Effectiveness of rural medical training programs at
OSU State of the State’s Rural Health
National Gender and generational issues related to physician
recruitment and retention The efficacy of telemedicine in the provision of
mental health in rural areas
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AdvocacyAdvocacy
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© 2009 Oklahoma State University
Advocacy EffortsAdvocacy Efforts
Collaborative Response State
OOA National
AOA NRHA
Propose legislation React to proposed legislation Connect legislators and rural providers
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© 2009 Oklahoma State University
Advocacy AgendaAdvocacy Agenda
State Medicaid reimbursement for telemedicine Reinstate funding for OkAHEC
National Retain increased reimbursement for primary
care physicians Interest-free loans for starting residency
programs in rural, underserved areas
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© 2009 Oklahoma State University
Why should you consider a rural
practice?
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After adjusting for cost of living, After adjusting for cost of living, who earns a higher income?who earns a higher income?
0% 0%
1. Rural Physicians
2. Urban Physicians
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© 2009 Oklahoma State University
Physician Incomes in Urban and Physician Incomes in Urban and Rural AreasRural Areas
Reschovsky JD, Staiti A. Physician Incomes in Rural and Urban America. Center for Studying Health System Change. 2005.
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Who is more likely to be Who is more likely to be satisfied with being a primary satisfied with being a primary
care physician?care physician?
0% 0%
1. Urban Physician2. Rural Physician
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© 2009 Oklahoma State University
Physician Satisfaction in Urban and Physician Satisfaction in Urban and Rural AreasRural Areas
Urban Rural
Pressure to see more patients 74% 60%
Pressure to limit referrals 44% 32%
Pressure to limit treatment options 30% 15%
Satisfied with being a physician 79% 91%
The overall practice climate in my community is excellent/good
32% 47%
Luman K, Zweifler J, and Grumbach K. Physician Perceptions of Practice Environment and Professional Satisfaction in California: From Urban to Rural. The Journal of Rural Health. Summer 2007.