Provider Retention in High Need Areas. Retention Metrics


The definition of retention may be approached in several ways. Retention metrics may be linked to the length of retention and the times at which retention is measured. For example, retention may be measured from the first day of a clinician’s service contract obligation, the day that the clinician concludes his or her initial service obligation, or the day that he or she completes the final service contract if a renewal contract was signed. Additionally, retention may be defined by location—whether the clinician remains in the same specific service site as under the service contract, remains within the same community but at a different practice location, remains within the same county or geographic region, or serving at any practice that prioritizes primary care for underserved communities (Pathman et al., 2012(b)).

NHSC typically assesses retention on the basis of the number of years remaining within either the original service site or within the same HPSA. The point in time from which retention is measured may vary, but it is worth noting that HRSA’s Bureau of Health Workforce (BHW) in its 2012 nationwide retention study of NHSC providers (Pathman et al., 2012(a)) opted to measure retention as the time between completion of the last service contract and the date of departure from either the index site or an alternative underserved site. The outcome of interest was the percentage of NHSC clinicians who were “still working in their NHSC service sites and within the broader set of practices that focus on care for the underserved at specific points in time after they had completed their NHSC service terms.” For clinicians who apply for and are granted renewal of Loan Repayment contracts after completing their initial Scholarship Program or Loan Repayment Program term, retention was calculated from the end of their last renewal contract (Pathman et al., 2012(a)).

Retention metrics used in federal, state, academic, and other types of programs vary widely with respect to length of assessment period, and degree of geographic inclusion in the retention criteria.

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