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Retention and the NHSC Ron Yee, MD, MBA, FAAFP Chief Medical Officer United Health Centers Parlier, California NACHC Winter Strategy Meeting Delray Beach, Florida January 24, 2013

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Discussion Points NHSC Definitions Retention Assessment Survey United Health Centers Experience Retention Strategies Challenges to Retention Retention Data NHSC Retention Strategy Summary

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NHSC Definition of Retention The percentage of NHSC clinicians who remain practicing in underserved areas (HPSAs) after successfully completing their service commitment to the Corps Short-term = up to 1 year after completion Long-term = up to 10 years after completion

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NHSC 2012 Retention Assessment Survey 9,908 NHSC Field Strength 26% response rate 94% LRP + 6% SP 82% Short-term retention (10 years) Up 6% vs. 2000 rate

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NHSC 2012 Retention Assessment Survey Most important factors for retention 56% Overall site experience 48% Practice hours/schedule 34% Salary 32% Alignment with personal goals 27% Community involvement 21% Proximity to family

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United Health Centers Experience Retention Strategies Challenges to Retention Retention Data

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Retention Strategies from the Front Lines Run a quality mission-driven organization Help them find their niche Let them focus on quality patient care Maintain a sense of mission Offer opportunities for input & leadership

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Run a quality mission-driven organization Jim Smurr, MD, LRP, Retained 15 years

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Help them find their niche Lance Gault, DO, final year SP

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Let them focus on quality patient care Rogelio Fernandez, MD, LRP, Retained 19 Years

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Maintain a sense of mission Rob Wageneck, DO, SP 1997 Jay Downey, MD, LRP, 1996

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Offer opportunities for input & leadership Lance Gault, DO, final year SP

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Challenges to Retention Distance from home to site in rural areas Productivity/Finances vs. finding niche Trust in site leadership/supervisor Change in life status during commitment Competition from other entities

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Distance from home to site Shani Muhammad, MD, SP 2011

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Challenges to Retention Distance from home to site in rural areas Productivity/Finances vs. finding niche Trust in site leadership/supervisor Change in life status during commitment Competition from other entities

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Retention Data UHC specific (25 total SP+LRP, since 1991) SP: 4/5=80% ST, 1/1=100% LT LRP: 19/20=95% ST, 6/6=100% LT 10 Active: 3SP+7LRP 43% all staff NHSC P/P Ave. Retention all 10Y+ UDS reporting - HRSA Table 5 additions

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NHSC Retention Strategy Summary Customer Service Standardize transactions, including response times Call Center training, scripts, monitoring Communications and Outreach Corps Connection electronic newsletter NHSC Facebook page social media NHSC Ambassadors human capital Corps Community Day national recognition

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NHSC Retention Strategy Summary Business Value to Sites and Providers NHSC Job Center - recruitment tool, cost savings, global outreach Virtual Job Fairs 4-5 planned for 2013 Expansion of PrimaryCareForAll.hrsa.gov Scholars and GPS Program

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NHSC Retention Strategy Summary BCRS Regions Enhanced engagement with sites and providers Scholar placement direct Regional assistance Site Visits Technical assistance, webinars, share best practices around retention BCRS Policy Initiatives Scholar completion non-competitive transition to LRP at HPSA >=14 Allow contemporary clinical practice telemedicine and home health

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Retention and the NHSC Ron Yee, MD, MBA, FAAFP Chief Medical Officer United Health Centers Parlier, California NACHC Winter Strategy Meeting Delray Beach, Florida January 24, 2013