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TMA Border Health Caucus

TMA Border Health Caucus . Gilbert A. Handal, MD Professor, Pediatric Infectious Diseases Marta Cuellar Chair for Child Advocacy Department of Pediatrics Director of Global Health Texas Tech University H.S.C. at El Paso August 23, 2013.

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TMA Border Health Caucus

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  1. TMA Border Health Caucus Gilbert A. Handal, MD Professor, Pediatric Infectious Diseases Marta Cuellar Chair for Child Advocacy Department of Pediatrics Director of Global Health Texas Tech University H.S.C. at El Paso August 23, 2013 Graduate Medical Education: Implications for the Border Laredo, Texas

  2. Other Healthcare Professionals

  3. Practicing Physicians in Texas

  4. Medical School enrollment

  5. 1343 graduates in 2007 recommended increase projected to be 1700 by 2012 • Enrollment in 2007: 1493 • Projected to meet the AAMC of increased the enrollment by 30% by 2015 • 11.3% growth between 2004-05 (150 students) • 12% between 2007 to 2010-11 (173 students) Medical Schools in Texas

  6. GME US/Texas

  7. Producing our own physicians • Physicians tend to stay where they do their residencies • Physicians tend to return to their places of origin • Physicians and other health care professionals will respond to appropriate incentives before, during and after training Proposed solutions Increase work force

  8. Develop a comprehensive state health care workforce plan • Develop a dynamic strategy and methodology to project future need for workforce development • Population growth and composition, aging and LTS, migration etc. • Changing physician service demands • Technological and new model approaches to care • Requirements by Federal or State Programs • Prioritize statewide needs by specialty • Increase rural and alternate training • Enhance data collection Solutions to address the health care workforce problem

  9. Innovations programs funding • New sites for training • Changes and increase in formula funding • Changes in the allocation of DME and IME funding: from Hospital to alternate sites • Develop a system of extended contribution in the payments for training: Private Insurance or MCO’s contribution Solutions to enhance Residency program development

  10. Importing them from other States: Tort reform and incentives • Facilitating IMG practicing in Texas HPSA • J-1 Waiver facilitation • Consider H1-B visas • Conrad expansion Need to align the incentives with the workforce needs in Texas; Consider supply and demand Need to develop a culturally diverse workforce Improving health care Workforce

  11. Loan repayment programs • Premiums for Medicare and Medicaid reimbursement • Appropriate coverage to allow time for respite, CME and vacations (locums) • Consider State service obligation • Develop a “State NHSC”: education loan and repayment system” • Telemedicine • Increase Academic Health Centers involvement with Border and Rural Medicine • Consider critically the workforce needs and investment needs New medical schools?? Special considerations for border and rural areas

  12. Need to improve efficiencies and effectiveness • Protection of Tort Reform • Innovations projects in Texas favoring rural and border areas • Support Primary care and areas where there is a need with post graduation commitment • Increasing level of IMG • Funding for Primary Care preceptorship program • Facilitate Primary care settlement in HPSA areas Special considerations for border and rural areas – Cont.

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