HEALTH PROFESSIONS

Programs included in this section are:

HEALTH PROFESSIONS AND NURSING EDUCATION AND TRAINING PROGRAMS

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

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

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

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.