American Hospital Association Rural Health Care Leadership Conference February 7, 2018

American Hospital Association Rural Health Care Leadership Conference February 7, 2018

Glen Frick Executive Director and Senior VP UMC Physicians Neal Waters Vice President of Recruiting Jackson Physician Search 2 - NW

UMC PHYSICIANS: FAST FACTS Serving West Texas and Eastern New Mexico: 1996: 17 providers / 11 locations 2016: 125+ providers / 34 locations Recognized by: MGMA for Superior Performance Texas Monthly as Top 100 Best Companies to Work for in Texas US Secretary of Defense as friendly place to work for military personnel Healthgrades, US News Best Regional Hospitals, and Women s Choice UMC Health System: Operated by Lubbock County Hospital District Primary teaching hospital for Texas Tech University Health Sciences Center 3 - GF

JACKSON PHYSICIAN SEARCH: FAST FACTS Serving clients nationwide for 40 years Headquartered in Atlanta Main regional offices in Dallas, Denver and St. Louis 5 satellite offices Modern Healthcare s Best Places to Work: #9 overall in supplier category #4 in best places for Millennials Great Place to Work Certified by independent analysts Fortune s 25 top small workplaces in the U.S. 4 - NW

LEARNING OBJECTIVES Articulate how transparency, autonomy and sustainability translate into actionable practices. Identify best practices for recruitment into rural communities that can be adapted and implemented to address their unique challenges. Please note that the views expressed by the conference speakers do not necessarily reflect the views of the American Hospital Association. 5 - NW

Audience Poll Time! On your phone, tablet or laptop go to www.pollev.com/jacksonphys Log-in NOT required 6 - NW

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AGENDA: RURAL RECRUITMENT PLAYBOOK State of the industry and trends in rural physician recruitment Emerging strategies for recruitment into rural communities Examples of optimized recruitment & retention outcomes Key takeaways for your recruitment & retention playbook 9 - NW

STATE OF THE INDUSTRY Projected physician shortfall between 40,800 and 104,900 by 2030. Physician s retirement decisions are projected to have the greatest impact on supply. Demographic trends continue to be the primary drivers of increasing demand from 2015 to 2030. If underserved populations had standard care utilization patterns, demand for physicians would rise substantially. Source: The Complexities of Physician Supply and Demand 2017 Update. IHS Markit for Association of American Medical Colleges. February 2017 10 - NW

TRENDS IN RURAL RECRUITMENT Medical School Graduates Outnumber Residency Slots Visa Processing Backlog and Foreign Travel Restrictions Limits on Treatment Activity by Advanced Practice Providers Adverse Malpractice Climate 11 - NW

ACUTE SHORTAGE OUTSIDE OF MAJOR CITIES About 20% of Americans live in rural areas where many do not have easy access to primary care or specialist services Less than 8% of physicians practice in rural areas Source: Trend Watch, American Hospital Association; Doximity 12 - NW

RURAL PRIMARY CARE CANDIDATE POOL Active Primary Care Physicians 296,353 Est. Physicians Under 60 177,812 Available due to 7% Turnover 12,447 24% of Residents are International Medical Graduates Source: 2017 AAMC State Physician Workforce Data Book (+) 3Y Residents 40,674 Est. 8% Choose Rural 3,254 15,701 78% of Internal Medicine Residents Pursue Subspecialties 13 - NW

HIGHLY DISPROPORTIONATE ACCESS TO MEDICAL CARE National Rural Health Snapshot Rural Urban Percentage of American population 19.3% 80.7% Population aged 65 and older 18% 12% Physicians per 10,000 people 13.1 31.2 Specialists per 100,000 people 30 263 Source: Health Resources and Services Administration and Rural Health Information Hub. 14 - NW

COMMUNITY IMPACT Adding one physician to a community of 10,000 people is associated with a 5.3% reduction in average mortality. Each physician supports 14 jobs and $2.2 million in economic input for a community. Source: National Center for Rural Health Works, www.ruralhealthworks.org 15 -NW

GEOGRAPHIC COMPENSATION TRENDS Source: Medscape Physician Compensation Report 2017 16 - NW

GEOGRAPHIC COMPENSATION TRENDS Source: Medscape Physician Compensation Report 2017 17 - NW

GEOGRAPHIC COMPENSATION TRENDS Source: Doximity 18 - NW

RURAL RECRUITMENT PLAYBOOK OUTLINE State of the industry and trends in rural physician recruitment Emerging strategies for recruitment into rural communities Examples of optimized recruitment & retention outcomes Key takeaways for your recruitment & retention playbook 19 - NW

CRITICAL TO REACH PASSIVE CANDIDATES 20 - NW

FIND PASSIVE CANDIDATES ONLINE Digital Recruitment is a Trend that is Here to Stay of all physicians use social media 31% for professional networking Source: Maximizing Multi-Screen Engagement Among Clinicians, Epocrates, Inc. 2013; MedTech Media 2015 21 - NW

FIND PASSIVE CANDIDATES ONLINE Digital Recruitment is a Trend that is Here to Stay of U.S. physicians are on Doximity a Top 5 smartphone app used by the American College of 70% Physicians Source: Doximity; American College of Physicians 22 - NW

FIND PASSIVE CANDIDATES ONLINE Digital Recruitment is a Trend that is Here to Stay 95% of all physicians prefer to receive info about job opportunities via email. Source: MMS Job Opportunity Preferences 23 - NW

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EMERGING STRATEGIES Use Digital and Social Media to be Fast AND Strategic 25 - NW

New Medical Schools and Satellite Campuses Home Grown Residencies EMERGING STRATEGIES Discussion Points Housing and Transportation Stipends New Tax Law Impact on Moving Expense Reimbursement Federal/State Loan Forgiveness & Other Incentives Patient, Family and Clinician Acceptance of Telemedicine Residents Advanced Practitioners Other support such as medical scribes, health educators 26 - NW/GF

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CULTURE AND ENGAGEMENT The Interview: Window to Your Culture Tailor the Interview Team to the Candidate Utilize Your Best Facility and Community Advocates Assign Topics & Ensure Consistent Message Explore the Candidate's Priorities and Motivations 28 - NW/GF

CULTURE AND ENGAGEMENT The Interview: Selling the Vision Personalize and Strategize Every Interview Involve the Spouse and Family Community and Culture Should Match Physician s Values Share Your Vision and Community Impact 29 - NW/GF

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MORE IMPORTANT THAN MONEY Two elements have the strongest relationship to satisfaction: Trust in the hospital / health system s leadership team Quality of communication across the hospital or health system Source: The Engagement Gap, Jackson Healthcare, 2016 31 - NW/GF

RURAL RECRUITMENT PLAYBOOK OUTLINE State of the industry and trends in rural physician recruitment Emerging strategies for recruitment into rural communities Examples of optimized recruitment & retention outcomes Key takeaways for your recruitment & retention playbook 32 - GF

OPTIMIZED RECRUITMENT AND RETENTION OUTCOMES Serving communities as large as Lubbock (population 225,000) to as small as Post and Earth (populations 1,000 or less) 33 - GF

TRANSPARENCY Visits/Procedures Expenses Practice Overhead Profit/(Loss) Charges Work RVUs: RVUs & Expense (Cost) per Visit Expenses as % of Collections Patient Collections Gross Collection % Accounts Receivable Staffing Payer Mix based on Encounters 34 - GF

AUTONOMY Nationwide: Physicians Do Not Have Enough Control Over Their Time Not Enough Time with Each Patient Too Many Hours Per Week on Paperwork Source: Medscape Physician Compensation Report 2017 35 - GF

SUSTAINABILITY Focus: Ties to Community and First Year Engagement 36 - GF

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CONTINUOUS IMPROVEMENT Provider Satisfaction Patient Satisfaction Employee Satisfaction 38 - GF

DEFINING BENCHMARKS End Result Placements per Year Efficiency Interviews-to-Hire Time-to-Fill Etc. Process Recruitment Spend-per-Hire Retention Etc. 39 - NW

DEFINING BENCHMARKS Typical Recruitment Benchmarks 1 Total Placements 4 Acceptance Rate 2 Time-to-Fill 5 Recruitment Spend-per-Hire 3 Interviews-to-Hire 6 Retention 40 -NW

EFFECTIVE RECRUITMENT Success Factors for Small, Remote Communities Ob/Gyn Glendive Medical Center Glendive, MT Family Medicine Friend Community Healthcare System Friend, NE Primary Care South Big Horn County Hospital Basin, WY Family Medicine and NP Peak Vista Community Health Centers Limon, CO Forensic Psychiatry Oklahoma Forensic Center Vinita, OK Multiple Canton-Potsdam Hospital Canton, NY 41 - NW

AGENDA: RURAL RECRUITMENT PLAYBOOK State of the industry and trends in rural physician recruitment Emerging strategies for recruitment into rural communities Examples of optimized recruitment & retention outcomes Key takeaways for your recruitment & retention playbook 42 - NW

KEY TAKEAWAYS: PLAYBOOK RECAP Adopt modern recruiting technologies and techniques that provide a competitive edge Identify candidates with community ties or create them Tailor recruitment and retention team to match candidate and spouse Follow best practices that support transparency and autonomy Create benchmark metrics for sustainable performance and return on investment 43 NW/GF

ADDITIONAL RESOURCES Physician Salary Calculator White Paper: Physician Workforce Through 2030 Guide to Developing a Strategic Physician Recruitment Plan Infographic Guides: Physician Trends, Engagement and Networking Case Studies 44 - NW