where treatment requires significant resources. PHC’s current high-impact specialty type is: Oncology/Hematology Monitors geographic availability for additional specialty defined by DHCS as “Core Specialists.” DHCS ADULT AND PEDIATRIC CORE SPECIALISTS Cardiology/Interventional Gastroenterology Nephrology Orthopedic Surgery* Cardiology* Physical Medicine Dermatology* General Surgery* Neurology and Rehabilitation Endocrinology Psychiatry Oncology/ Hematology ** HIV/AIDS Specialists/Infectious ENT/Otolaryngology Ophthalmology* Pulmonology Diseases *High-volume specialty type; **High-impact specialty type Establishes the following measureable standards for the number of each type of high-volume specialist. (Note: PHC does not establish ratio standards for high-impact specialists, or DHCS Core specialty types not identified as high volume.) NUMBER OF PRACTITIONERS, HIGH-VOLUME SPECIALISTS Practitioner Type Measure: Ratio Standard/Performance Goal of specialists to members) Obstetrics/Gynecology OB-GYN to Member 1: 2,000 ≤ Cardiology Cardiologist to Member 1: 2,000 ≤ Orthopedics Orthopedic Surgeon to Member 1: 3,000 ≤ General Surgery General Surgery to Member 1: 2,000 ≤ Ophthalmology Ophthalmology to Member 1: 3,000 ≤ Dermatology Dermatology to Member 1: 5,000 ≤ Establishes measureable standards for the geographic distribution of each type of specialist (high-volume, high-impact, and DHCS Core). GEOGRAPHIC DISTRIBUTION OF PRACTITIONERS, SPECIALTY CARE Practitioner Type Standard: Geographic Distribution Performance Goal Cardiology*+ Urban/Medium: 90% One within 30 miles ≥ Dermatology*+ or 60 minutes from member’s Endocrinology+ residence ENT/Otolaryngology+ Suburban/Small: One within 45 miles Gastroenterology+ or 75 minutes from member’s General Surgery*+ residence HIV/AIDS Rural: One within 60 miles or 90 Specialists/Infectious minutes from member’s residence Diseases+ Nephrology+ (DHCS Standard) Neurology+
where treatment requires significant resources. PHC’s current high-impact specialty type is: Oncology/Hematology Monitors geographic availability for additional specialty defined by DHCS as “Core Specialists.” DHCS ADULT AND PEDIATRIC CORE SPECIALISTS Cardiology/Interventional Cardiology* Gastroenterology Nephrology Orthopedic Surgery* Dermatology* General Surgery* Neurology Physical Medicine and Rehabilitation Endocrinology Oncology/ Hematology ** Psychiatry ENT/Otolaryngology HIV/AIDS Specialists/Infectious Diseases Ophthalmology* Pulmonology *High-volume specialty type; **High-impact specialty type Establishes the following measureable standards for the number of each type of high-volume specialist. (Note: PHC does not establish ratio standards for high-impact specialists, or DHCS Core specialty types not identified as high volume.) NUMBER OF PRACTITIONERS, HIGH-VOLUME SPECIALISTS Practitioner Type Measure: Ratio Standard/Performance Goal of specialists to members) Obstetrics/Gynecology OB-GYN to Member 1: ≤ 2,000 Cardiology Cardiologist to Member 1: ≤ 2,000 Orthopedics Orthopedic Surgeon to Member 1: ≤ 3,000 General Surgery General Surgery to Member 1: ≤ 2,000 Ophthalmology Ophthalmology to Member 1: ≤ 3,000 Dermatology Dermatology to Member 1: ≤ 5,000 Establishes measureable standards for the geographic distribution of each type of specialist (high-volume, high-impact, and DHCS Core). GEOGRAPHIC DISTRIBUTION OF PRACTITIONERS, SPECIALTY CARE Practitioner Type Standard: Geographic Distribution Performance Goal Cardiology*+ Dermatology*+ Endocrinology+ ENT/Otolaryngology+ Gastroenterology+ General Surgery*+ HIV/AIDS Specialists/Infectious Diseases+ Nephrology+ Neurology+ Urban/Medium: One within 30 miles or 60 minutes from member’s residence Suburban/Small: One within 45 miles or 75 minutes from member’s residence Rural: One within 60 miles or 90 minutes from member’s residence (DHCS Standard) ≥ 90%
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