Strategies to attract and retain talent during the move to VBC
Payment reform stemming from the Centers for Medicare and Medicaid Services (CMS) is transitioning the healthcare industry away from fee-for-service towards a model focused on value-based care. The Affordable Care Act has created a massive influx of newly insured consumers. By 2016, ACA is expected to increase the number of non-elderly insured Americans by 32 million.[i] This increase in insured Americans means an increased need for physicians, specifically in FQHCs.
There are currently about 10,000 primary care physicians employed by FQHCs, but to serve the growing patient population, but some estimate that 15,000 more physicians will be needed in the next 10 years.[ii] Nurse practitioners and PAs will be needed as well, especially in rural areas where the shortage is more severe.
FQHCs must look at creative staffing models and take action to address the physician shortage. While recruiting and retaining talented staff may seem difficult, consider implementing a few key strategies to create a healthy and successful facility.
Explore available programs
FQHCs offer physicians some key benefits and experiences that they cannot find in other practices. Take on aggressive marketing tactics to inform and educate potential staff about the unique opportunities offered to FHQC employees. FQHC physicians can to partner with NHSC on loan payment and scholarships. There is also complimentary malpractice insurance provided under the Federal Tort Claims Act. Additionally, ACA created the Teaching Health Center Graduate for Medical Education (“THCGME”) program, which provides funding to FQHCs to establish or expand new graduate medical education programs focused in primary care. These programs can be effective and attractive recruitment tools for young professionals.[iv]
In addition, residency training programs provide fertile ground for recruitment. Residents can spend time in FQHCs to learn whether they prefer a community health environment, compared to other healthcare delivery environments. Consider establishing programs that encourage emerging young professionals to engage with the community through FQHC partnerships.
Examine current staffing mix
FQHCs should also investigate how the physicians on staff can best serve their local population. A shift towards a population health model means finding the right combination of staff and ensuring your FQHC employs those who are best for supporting the whole patient. Adding behavioral health specialists and nutritionists can bring a high return on investment for delivering effective longitudinal care.[iii] Maintaining an effective ratio of clinical support staff, administrators, counselors, and educators, can also balance revenue with cost in the new VBC model. FQHCs should reevaluate their staffing mix yearly to determine efficiencies, patient needs, and how effectively they are meeting their financial goals.
Retention
Your retention strategy should begin before the hiring process even starts. Once new physicians are hired, FQHCs should establish expectations regarding physician productivity demands and how much time they should spend with each patient. In the new, value-based world physicians are the leaders of patient-centered teams, physicians work with a variety of educators and councilors, in addition to traditional care teams.
The fact that the organization is a nonprofit should not have any affect on the quality or timeliness of the care given; patients should be treated exactly as they would be at any other facility. Leadership must commit to keeping apprised of new incentives and opportunities for physicians as they emerge, allowing them to focus on their patients while knowing they won’t miss out.
Conclusion
FQHCs are poised to lead the industry during payment reform. Ensuring that you have the right staff mix in place can be daunting. The marketplace for physician talent is extremely competitive, with a high demand for talent struggling against a low supply of professionals. Starting with a few simple, clear strategies and staying committed to attracting and retaining quality staff can take you a long way towards success in the changing healthcare market.
[i] “Staffing the Safety Net: Building the Primary Care Workforce at America’s Health Centers.” National
Association of Community Health Centers. Last modified March 2016. http://www.nachc.com/
client//NACHC_Workforce_Report_2016.pdf.
[ii] Abayasekara, Allison. “Addressing Clinician Workforce Shortages in Underserved Areas.” Abstract.
Journal of Health Care for the Poor and Underserved 26, no. 1 (February 2015).
[iii] Medical Doctor Associates. “A Guide to Solving FQHC Staffing Challenges.” N.d. PDF.
[iv] A Guide to Solving FQHC Staffing Challenges.
