In our last post, we demonstrated the overall decline in primary care physician productivity from 2002 to 2016. The decline has yet to rebound for Family Medicine, Pediatrics and Urgent Care while Internal Medicine and OB/Gyn have seen sharp upticks in productivity in the last several years. This week’s focus is on the medical sub-specialties.
Historically, hospitals and health systems completed Provider Development Plans in three year cycles and utilized these plans for regulatory purposes without updating them in the intervening years. However, with the implementation of Stark III, we have found that most legal counsel with whom we work are more comfortable with either a “real time” or more frequent approach. It also seems reasonable to assume that the utility of the plan would decrease in direct proportion to the length of time that has passed since its completion.
As we continue to work with our clients’ legal counsel across the country, we are finding that the “shelf life” of the Community Needs Assessment has continued to evolve. At this point, the majority of our clients are re-defining their CMS service area (the hospital Stark service area or "geographic area served by the hospital") and updating the community needs analysis on an annual basis. That said, it does vary by organization and legal counsel.
It seems reasonable to assume that the utility of the Community Needs Assessment would decrease in direct proportion to the length of time that has passed since its completion. From 3d Health’s perspective, the assessment is as accurate as possible on the day it is issued. Our clients and their legal counsel ultimately make the determination regarding how long they can rely on the report and still be in compliance.
In order to best serve the needs of our hospital and health system clients, 3d Health offers two approaches to Community Needs Assessments:
1) We work with clients to complete a comprehensive assessment on an annual basis across 45 different physician specialties. This approach, often done in concert with a Medical Staff Development Plan, offers the most comprehensive coverage for hospitals with significant recruitment activity.
2) We issue Single Specialty Studies on a per recruit basis during the course of the year. This approach ensures a determination of community need on a per recruit basis at the time of recruitment. It also allows for a Community Needs Assessment that reflects the many market changes that take place throughout the year: medical staff retirements, community physician retirements, your hospital’s recruiting activities, and the recruiting activities of competitors within the market.