HEALTH
PROFESSIONS
Programs
included in this section are:
HEALTH
PROFESSIONS AND NURSING EDUCATION AND TRAINING PROGRAMS
# |
Key
Outcomes |
FY
2004 Actual |
FY
2005 Actual |
FY
2006 |
FY
2007 |
FY
2008 Target |
FY
2009 Target |
Out-Year
Target |
Target |
Actual |
Target |
Actual |
Long-Term
Objective : Promote the development of
a diverse and culturally representative
health care workforce |
6.I.B.1 |
Increase
the proportion of graduates and program completers
of Titles VII and VIII supported programs who
are underrepresented minorities and/or from
disadvantaged backgrounds.
(Baseline - 2001: 42%) |
48% |
47% |
44% |
39% |
40% |
57% |
50%a |
50%a |
2010:50% |
6.1 |
Increase
the proportion of persons who have a specific
source of ongoing care.
(Baseline – 2001: 88%) |
|
|
|
|
|
|
|
|
2010:96% |
6.I.C.1 |
Increase
the proportion of trainees in Titles VII and
VIII supported programs training in medically
underserved communities.
(Baseline - 2001: 52%) |
60% |
53% |
54% |
40% |
41%b |
43% |
43% |
NAc |
|
6.I.C.2 |
Increase
the percentage of health professionals supported
by the program who enter practice in underserved
areas.
(Baseline - 2001: 19%d) |
24% |
16% |
21% |
39%e |
21% |
35% |
35% |
NAc |
2010:40% |
# |
Key
Outputs |
FY
2004 Actual |
FY
2005 Actual |
FY
2006 |
FY
2007 |
FY
2008 Target/ Est. |
FY
2009 Target/ Est. |
Out-Year
Target/ Est. |
Target/
Est. |
Actual |
Target/
Est. |
Actual |
Efficiency
Measure |
6. E |
Maintain the average cost per graduate or
program completer to the program of providing
pipeline and formative education and training. |
$456 |
$460 |
$456 |
Mar-08 |
$456 |
Mar-09 |
$456 |
$456 |
|
|
Appropriated
Amount
($ Million) |
$409.5 |
$419.1 |
|
$263.7 |
|
$303.4 |
$319.5 |
$66.1 |
|
Notes:
a Targets for FY 08 thru FY 09 are lower
than the FY 07 result because past performance result
levels suggest that the FY 07 result may be an aberration
and may be difficult to sustain.
b The FY 07 target in the FY 08 CJ was
changed to reflect full-year continuing resolution
funding for FY 07.
c Targets for these measures were not set
for FY 09 because Title VII programs that contribute
data to this measure are not proposed for funding.
d The baseline was calculated as the average of FY
99 through FY 01 data.
e Service location data are collected on
students who have been out of the HRSA program for
1 year. The results listed in 2006 are from programs
that have the ability to produce clinicians 1-year
post program graduation. In years 2001 - 2005,
reported data inadvertently contained students (such
as junior and high school students) who were in early
education pipeline programs (such as HCOP) who were
many years away from graduating from a health professions
school and could not be clinicians in 1 year.
NA = Not Applicable.
INTRODUCTION
The
Health Professions program performance measures and
activities build upon HRSA's long-range goal
to "Improve Access to Health Care" and
are keyed to the following HRSA Objectives:
B. Promote the development of a diverse and culturally
representative health care workforce
C. Improve the distribution of health professions
in underserved areas, including rural and border areas
Performance
measure information is used by the program to highlight
success in the program design and implementation and
to identify areas that may require improvement. A
strategy for improving performance is to identify
grantees that are better meeting program goals and
the best practices of such programs. These best practices
may be encouraged through additional funding preferences
and priorities during the grant-making process. Also,
performance information is used to provide technical
assistance to grantees to help them gather better
data.
DISCUSSION
OF RESULTS AND TARGETS
Long-Term
Objective: Promote the development of a diverse and
culturally representative health care workplace.
6.I.B.1.
Increase the proportion of graduates and program completers
of Titles VII and VIII supported programs who are
underrepresented minorities and/or from disadvantaged
backgrounds.
(Baseline - 2001: 42%)
In
2007, the proportion of graduates and program completers
of Titles VII and VIII supported programs who were
underrepresented minorities and/or from disadvantaged
backgrounds was 57 percent. This was an 18% increase
over FY 06 and exceeded the FY 07 target by 17 percentage
points. (See Section below on "Targets Substantially
Exceeded or Not Met.") The target for FY 09
is 50 percent. The targets for FY 08 through FY 09
are lower than the FY 07 result because past performance
result levels suggest that the FY 07 result may be
an aberration and may be difficult to sustain.
6.1.
Increase the proportion of persons who have a specific
source of ongoing care.
Access
to a source of ongoing care does not directly reflect
all of the specific activities of the Health Professions
program. However, over time, HRSA expected this program
to contribute to increasing the proportion of persons
with a specific source of ongoing care, through its
support of training health professions in all settings.
6.I.C.1. Increase the proportion of trainees
in Titles VII and VIII supported programs training
in medically underserved communities.
The
proportion of trainees in Titles VII and VIII supported
programs training in medically underserved communities
was 43 percent in 2007 which slightly exceeded the
target of 41 percent. While this represents a is a
slight increase over the FY 06 result of 40 percent,
it is lower than FY 04 and FY 05 results of 60 and
53 percent, respectively. A target for this measure
was not set for FY 09 because Title VII programs that
contribute data to this measure are not proposed for
funding.
6.I.C.2.
Increase the percentage of health professionals supported
by the program who enter practice in underserved areas.
The
percentage of health professionals supported by the
program entering practice in underserved areas was
35 percent in 2007, which exceeded the target by 14
percentage points.
(See Section below on "Targets Substantially
Exceeded or Not Met.") In FY 04, FY 05, and
FY 06 the actual percentages were 24, 16, and 39 percent,
respectively. A target for this measure was not set
for FY 09 because Title VII programs that contribute
data to this measure are not proposed for funding.
6.E.
Maintain the average cost per graduate or program
completer to the program of providing pipeline and
formative education and training.
The
efficiency measure for the Health Professions program
is to maintain the average cost per graduate and program
completer at $456.
Per
capita costs vary tremendously among these different
types of programs, depending on the level of effort,
and the length of the commitment required to complete
them. The baseline for FY 04 ($456) represents the
average cost per graduate or program completer to
Title VII and Title VIII of providing pipeline formative
education and training. For FY 05, the average cost
per graduate or program completer was $460. The number
of programs in each category will change significantly
in response to funding changes for Title VII and Title
VIII and per capita costs will change accordingly.
Changes in tuition costs will also be an important
factor.
TARGETS
SUBSTANTIALLY EXCEEDED OR NOT MET
Measure:
Increase the proportion of graduates and program completers
of Titles VII and VIII supported programs who are
underrepresented minorities and/or from disadvantaged
backgrounds.
FY 07 Target: 40 percent
FY 07 Result: 57 percent
The
programs target is ambitious because the baseline
for this measure of 42 percent is a partial one, because
grantees in some States cannot by law collect race/ethnicity
data. Past program results of 48 percent (FY 04),
47 percent (FY 05) and 39 percent (FY 06) indicate
a declining
trend in the number of graduates who were underrepresented
minorities and/or from disadvantaged backgrounds.
One reason the target was exceeded is that funded
programs were more focused in their efforts to collect
the race/ethnicity of program participants.
The
targets for FY 08 thru FY 09 were not increased in
response to the FY 07 result, because past performances
result levels suggest that the FY 07 result may be
an aberration and may be difficult to sustain. Reaching
future targets is highly dependent upon future funding
levels. The impact of this result is that a more diverse
and culturally representative health care workforce
is available to provide access to health care.
Measure: Increase the percentage of health
professionals supported by the program who enter practice
in underserved areas.
FY 07 Target: 21 percent
FY 07 Result: 35 percent
Since
service location data are collected on students who
have been out of a HRSA-funded program for 1 year,
data are reported only for programs that could produce
clinicians one-year post program graduation. That
is, programs such as the Health Careers Opportunity
Program (HCOP) where many of the students were early
in the education pipeline (like high school) are no
longer included in the calculation of the performance
data for FY 06 and FY 07. Prior years' denominator
data included students earlier in the education pipeline
who could not be clinicians in 1 year, artificially
lowering results, resulting in a relatively low FY
07 target.
The
program will adjust future year's targets to
be more inline with FY 06 and FY 07 performance. Reaching
future targets is highly dependent upon future funding
levels. The impact of this result is that more health
care professionals are entering practice in underserved
areas, thus increasing access to health care.
CHILDREN'S
HOSPITALS GRADUATE MEDICAL EDUCATION PAYMENT PROGRAM
# |
Key
Outputs |
FY
2004 Actual |
FY
2005 Actual |
FY
2006 |
FY
2007 |
FY
2008 Target |
FY
2009 Target |
Out-Year
Target |
Target |
Actual |
Target |
Actual |
Long-Term
Objective 1: Expand the capacity of the
healthcare safety net |
7.
I.
A.1 |
Maintain the number of FTE residents in
training in eligible children’s teaching
hospitals. |
4,693a 199b |
4,911a
192b
|
4,450a
378b |
5,051a
192b |
4,450a
378b |
Jul-08 |
5,051a
192b |
NA |
|
7.
VII.
C.1 |
Percent of hospitals with verified FTE residents
counts and caps. |
100% |
100% |
100% |
100% |
100% |
100% |
100% |
NA |
|
# |
Key
Outputs |
FY
2004 Actual |
FY
2005
Actual |
FY
2006 |
FY
2007 |
FY
2008
Target/ Est. |
FY
2009
Target/ Est. |
Out-Year
Target/ Est. |
Target/
Est. |
Actual |
Target/
Est. |
Actual |
Efficiency
Measure |
7.E |
Percent of payments made on time. |
100% |
100% |
100% |
100% |
100% |
100% |
100% |
NA |
|
|
Appropriated
Amount($ Million) |
$303.2 |
$300.7 |
|
$296.8 |
|
$297.0 |
$301.6 |
|
|
Notes:
a Total trained on-site.
b Total trained off-site.
NA = Not applicable because no funding is requested.
INTRODUCTION
The
Children's Hospital's Graduate Medical
Education Payment Program's (CHGME PP) performance
measures and activities build upon HRSA's long-range
goal to "Improve Access to Health Care"
and Achieve Excellence in Management. They are keyed
to the following HRSA Objectives:
A. Expand the capacity of the health care safety net.
C. Preserve the financial integrity of HRSA's
programs and activities.
This
program provides payments to freestanding children's
teaching hospitals to enhance their financial viability
and to help them maintain graduate medical education
(GME) training programs which expands the capacity
of the health care safety net and improves access
to health care.
Performance
measure information is used by the program to assess
the success of the CHGME PP in helping maintain graduate
medical education programs and FTE resident counts
in children's hospitals nationwide.
DISCUSSION OF RESULTS AND TARGETS
Long-Term
Objective: Expand the capacity of the health care
safety net.
7.I.A.1.
Maintain the number of FTE residents in training in
eligible children's teaching hospitals.
The
program exceeded its target for this program measure,
by 601 residents. In FY 07, the target was 4,828 residents
and the actual count was 5,051. The target for FY
08 is 5,051 residents. This measure does not have
a FY 09 target because no budget is proposed.
7.VII.C.1.
Percent of hospitals with verified FTE residents counts
and caps.
In
FY 07 as in previous years, the program met the target
of 100% of hospitals with verified FTE resident counts
and caps. The measure does not have a FY 09 target
because no budget is proposed.
7.E.
Percent of payments made on time.
The
efficiency measure for CHGME Payment Program is to
make 100 percent of DME and IME Payments to children's
hospitals on time. For FY 07, HRSA made 100 percent
of all payments on time.
NATIONAL
PRACTITIONER DATA BANK
# |
Key
Outcomes |
FY
2004 Actual |
FY
2005 Actual |
FY
2006 |
FY
2007 |
FY
2008 Target |
FY
2009 Target |
Out-Year
Target |
Target |
Actual |
Target |
Actual |
Long-Term
Objective : Promote patient safety and improve
patient protections |
8.
III.
B.
1. |
Increase annually the use of the NPDB for
licensing and credentialing decision-making,
operationalized as the number of licensing
and credentialing decisions which limit
practitioner’s ability to practice because
of information contained in NPDB reports.(Baseline
– 2005: 44,500 Decisions) |
43,800
Decisions |
44,500
Decisions |
45,025
Decisions |
46,450 Decisions |
45,550 Decisions |
47,200 Decisions |
46,075 Decisions |
46,600 Decisions |
2013:
48,700 Decisions |
8.
III.
B.
2. |
Increase annually the number of times information
provided by NPDB is considered useful by
the querying entity which received it.(Baseline
2005 – 451,400) |
444,200 |
451,400 |
456,100 |
475,300 |
456,300 |
479,500 |
475,300 |
475,300 |
2013:
489,000 |
# |
Key
Outputs |
FY
2004 Actual |
FY
2005
Actual |
FY
2006 |
FY
2007 |
FY
2008 Target/ Est. |
FY
2009 Target/ Est. |
Out-Year
Target/ Est. |
Efficiency
Measure |
8.E |
Increase
annually the number of queries for which NPDB
and HIPDB responded within 240 minutes. |
4,329,000 |
4,414,000 |
4,611,000 |
4,549,800 |
4,701,00 |
4,710,600 |
4,792,000 |
4,883,000 |
|
|
Appropriated
Amount
($
Million - user fees collected) |
($15.0) |
($15.2) |
|
($15.7) |
|
($16.2) |
($18.6) |
($18.9) |
|
INTRODUCTION
The
National Practitioner Data Bank (NPDB) program's
performance measures and activities build upon HRSA's
long-range goal to "Improve the Quality of Health
Care" and are keyed to the following HRSA Objective:
B. Promote patient safety and improve patient protections
This
program maintains a data base that identifies physicians
and dentists who have malpractice judgments against
them, sanctions from medical boards, or who have lost
memberships in professional medical societies. This
database restricts the ability of physicians and dentists
with poor practice records or who have exhibited unprofessional
behavior from moving State-to-State without disclosing
previous damaging or incompetent performance. Potential
employers will be able to make better hiring decisions
that will provide for a better quality health workforce.
Performance
measure information, some of which is updated monthly,
is used by the program to assess the success of the
Data Banks in meeting goals for querying and use of
the information by queriers for decision making in
individual licensing and credentialing cases. Overall
the information, which is assessed annually, is used
to help determine the degree to which the program
is meeting the needs of the queriers. A strategy the
Program uses is to regularly conduct surveys to assess
the utility of its information to customers, customer
satisfaction, and areas on which improvement efforts
should be focused.
DISCUSSION
OF RESULTS AND TARGETS
Long-Term
Objective: Promote patient safety and improve patient
protections.
8.III.B.1.
Increase annually the use of the NPDB for licensing
and credentialing decision-making, operationalized
as the number of licensing and credentialing decisions
which limit practitioner's ability to practice
because of information contained in NPDB reports.
In
FY 07, 47,200 licensing or credentialing decisions
were impacted by information supplied by the NPDB.
This was an increase over FY 06 and exceeded the target
by more than 3 percent. Implementation of Section
1921, regulations, which will place most reports currently
in the HIPDB into the NPDB, is now projected for FY
08. This is expected to substantially increase use
of NPDB over what is shown in the previous table.
Targets will be adjusted as needed after Section 1921
regulations are adopted. A target of 46,600 decisions
has been set for FY 09.
8.III.B.2.
Increase annually the number of times information
provided by NPDB is considered useful by the querying
entity which received it.
In
479,500 cases in FY 07, the querying entity considered
the information provided by NPDB to be useful. This
was an increase over FY 06 and exceeded the target
by about 5 percent.
8.E. Increase annually the number of queries for which
NPDB and HIPDB responded within 240 minutes.
The
length of time it takes the NPDB-HIPDB to process
a query and return results to the querier has been
reduced while both the number of queries and the number
of reports in the system have continually increased.
When the NPDB opened in 1990, it took days to process
queries. The system has changed from paper documents
to an internet-based system containing electronic
documents. Queries are now responded to within 240
minutes. The volume of queries has increased greatly
over the years, to over 4.7 million queries in FY
07 that were responded to within 240 minutes. The
target for FY 09 is 4.9 million queries.
HEALTHCARE
INTEGRITY AND PROTECTION DATA BANK
# |
Key
Outcomes |
FY
2004 Actual |
FY
2005 Actual |
FY
2006 |
FY
2007 |
FY
2008Target |
FY
2009Target |
Out-Year
Target |
Target |
Actual |
Target |
Actual |
Long-Term
Objective: Promote patient safety and improve
patient protections |
8.III.B.3 |
Increase annually the use of the HIPDB for
licensing and credentialing decision-making,
operationalized as the number of licensing
and credentialing decisions which limit
practitioner’s ability to practice because
of information contained in NPDB reports.
(Baseline – 2005: 1,120 Decisions) |
1,000 Deci-sions |
1,120 Deci-sions |
1,155 Deci-sions |
1,150 Deci-sions |
1,190 Deci-sions |
1,300 Deci-sions |
1,225 Deci-sions |
NA |
|
8.III.B.4 |
Increase annually the number of times information
provided by HIPDB is considered useful by
the querying entity which received it.
(Baseline 2005 – 11,400) |
10,200 |
11,400 |
11,750 |
11,650 |
12,100 |
13,150 |
12,450 |
NA |
|
# |
Key
Outputs |
FY
2004 Actual |
FY
2005Actual |
FY
2006 |
FY
2007 |
FY
2008 Target/ Est. |
FY
2009 Target/ Est. |
Out-Year
Target/ Est. |
Target/
Est. |
Actual |
Target/
Est. |
Actual |
Efficiency
Measure |
8.E |
Increase annually the number of queries
for which NPDB and HIPDB responded within
240 minutes. |
4,329,000 |
4,414,000 |
4,611,000 |
4,549,800 |
4,701,000 |
4,710,600 |
4,792,000 |
NA |
|
|
Appropriated Amount($ Million –includes
user fees and supplemental funds from the
OIG as necessary) |
($4.2) |
($4.3) |
|
($4) |
|
($3.8) |
($3.8) |
NA |
|
Notes:
NA = Not applicable because no separate funding is
proposed. With the implementation of Section 1921
in FY 08 there will be little unique information available
from the HIPDB. The FY 09 legislative proposal would
sunset HIPDB and move the unique HIPDB reports not
covered by Section 1921 into the NPDB by amending
Section 1921. This will effectively move HIPDB revenue
and associated costs into the NPDB.
INTRODUCTION
The
Healthcare Integrity and Protection Data Bank (HIPDB)
program's performance measures and activities
build upon HRSA's long-range goal to "Improve
the Quality of Health Care" and are keyed to
the following HRSA Objective:
B. Promote patient safety and improve patient protections
This
program maintains a data base that provides critical
information to State and Federal agencies, law enforcement
officials, and health plans concerning adverse licensure
and contract actions; health care related judgments;
and criminal convictions against health care practitioners,
providers and suppliers. This information is to combat
fraud and abuse in health insurance and health care
delivery to protect patients and provide for a better
health care system.
Performance
measure information, some of which is updated monthly,
is used by the program to assess the success of the
Data Banks in meeting goals for querying and use of
the information by queriers for decision making in
individual licensing and credentialing cases. Overall
the information, which is assessed annually, is used
to help determine the degree to which the program
is meeting the needs of the queriers.
DISCUSSION
OF RESULTS AND TARGETS
Long-Term
Objective: Promote patient safety and improve patient
protections.
8.III.B.3.
Increase annually the use of the HIPDB for licensing
and credentialing decision-making, operationalized
as the number of licensing and credentialing decisions
which limit practitioner's ability to practice
because of information contained in NPDB reports.
(Baseline -- 2005: 1,120 Decisions)
In
FY 07, 1,300 licensing or credentialing decisions
were impacted by information supplied by the HIPDB.
This was an increase over FY 06 and about 9 percent
above the target. Implementation of Section 1921 regulations,
which will place most reports currently in the HIPDB
into the NPDB, is now projected for FY 08. This is
expected to substantially decrease querying of the
HIPDB. The FY 09 target is 1, 260 decisions. The targets
will be adjusted as needed after Section 1921 regulations
are adopted. Note that the program expects that adoption
of Section 1921 will result in an overall increase
in the use of the information for decision-making
since more users will access it through the NPDB.
8.III.B.4.
Increase annually the number of times information
provided by HIPDB is considered useful by the querying
entity which received it.
In
13,150 cases in FY 07 the querying entity considered
the information provided by HIPDB to be useful. This
represents an increase over FY 06 and is about 8 percent
above the target level.
8.E.
Increase annually the number of queries for which
NPDB and HIPDB responded within 240 minutes.
The
length of time it takes the NPDB-HIPDB to process
a query and return results to the querier has been
reduced while both the number of queries and the number
of reports in the system have continually increased.
When the NPDB opened in 1990, it took days to process
queries. The system has changed from paper documents
to an internet-based system containing electronic
documents. Queries are now responded to within 240
minutes. The volume of queries has increased greatly
over the years, to over 4.7 million queries in FY
07 that were responded to within 240 minutes. The
target for FY 09 is 4.9 million queries.
|