NCHN e-News

FEATURED PARTNER

Medical Recovery Services

Medical Recovery Services, a Revenue Cycle Operations firm is dedicated to the financial viability of small hospitals. Medical Recovery Services’ outsource solutions are designed to minimize the investment dollar while maximizing returns. Significant flexibility in payment terms is also featured to further facilitate placing these vital services within reach of all hospital providers.

Services:
Chargemaster / Pricing – The Chargemaster is a hospital’s lifeblood. If services can’t be charged, they can’t be reimbursed, so it is imperative that the chargemaster be compliant, clean and structurally sound. Pricing-only service explores pricing strategies in combination with market position. This is a great first-year service for facilities short on cash. In year two, a complete chargemaster review should be performed.

Business Intelligence – Every hospital should understand its position regarding financial performance of contracts; however Business Intelligence goes beyond that. Powerful analysis of hospital data facilitates detailed examination of service lines, diagnostics, charging, reimbursement and costs.

Managed Care Support – This service can range from simply acting as a knowledge-base resource to predictive contract modeling to full contract negotiation, depending upon the amount of input desired by the client. Negotiating contracts and articulating positions are acquired skills and require strong data, excellent analysis and confidence in understanding the other side. For outstanding managed care contracts without the hassle involved in dealing with insurance companies, Medical Recovery Services will handle the heavy lifting.

Process Improvement – Today’s environment of continued declining reimbursement and subsequent margins requires learning to accomplish more, possibly even with fewer resources. Process Improvement is truly a partnership in exploring opportunities to operate a lean and efficient Business Office by implementing appropriate redundancies and loss prevention strategies. Incorporating the concepts of the “upside-down” revenue cycle, Process Improvement increases financial viability from the inside.

Medical Claim Audit/Recovery – This is one diagnostic tool that may actually increase your net revenues. Designed to monitor payor performance, it can also identify un-/under- paid claims and could lead to revenue that is rightly yours but currently unrealized. Also identifies in-house issues related to billing, coding or payor contracts.

Donald Tapella Contact:
Donald J. Tapella
805 A Main Street
Blue Springs, MO 64015
Phone: 816-229-4887
Email: dtapella@mrsa1.net
Website: www.MedicalRecoveryServices.net

MEMBER BLURBS

Coastal Carolinas Health Alliance Brings Specialized Mobile Simulation Training to Area Hospitals

June 27, 2011 (Wilmington, NC) - A woman is delivering her baby and a complication develops. The baby’s shoulder is caught on the rim of the mother’s pelvic bone, and there is a delay in the delivery. With the clock ticking, nurses must quickly perform specific actions to assist the patient and physician with the birth. Patient assessment, clinical reasoning and skills need to be sharp and fluent. Hands-on training is important for clinicians to learn fluency to provide care. Thanks to the Mobile Simulation Lab real life scenarios can be practiced on life-like human simulator models without real life consequences. Denise Garee, Clinical Coordinator of the Mobile Simulation Lab, commented “Benefits from simulated education for health care providers are increased competence and confidence in dealing with emergent situations and improved patient care and safety, which can lead to decreased health care costs. I am very proud of the service we provide to improve the delivery of health care throughout our region.”

After securing grant funding, Coastal Carolinas Health Alliance (CCHA) was able to build the Mobile Simulation Lab which is available to staff at 12 hospitals in the region. Yvonne Hughes, CCHA’s new Executive Director, has been one of the driving forces behind the mobile simulation lab program. “CCHA’s Mobile Simulation Lab is one example of how we have worked with the hospitals in the region to provide training that can prepare nurses for a wide variety of situations,” says Yvonne. “As Executive Director, I am committed to providing these high quality education programs, cost savings initiatives, grant writing services and collaborative initiatives like the Mobile Simulation Lab and the Coastal Connect Health Information Exchange to all of our member hospitals.”

VCOM Faculty Recognized

June 23, 2011 (Blacksburg, VA) - Congratulations to Dean Sutphin, Ph.D., Associate Vice-President for International and Appalachia Outreach, for being selected to present at the World Congress on Disaster and Emergency Medicine held in Beijing China in early June. While there, he gave a presentation, titled, “Honduras Dengue Outbreak Emergency Response Case Study”, which was authored by Dr. Sutphin, Dean Rawlins, Dean Willcox and Jessica Muller. Also, he presented three posters: “Assessment of Dominican Republic Medical System Preparedness for Emergency and Disaster Response,” authors Dr. Sutphin, Dean Rawlins, Dr. Powers “Multilateral Haiti Earthquake Disaster Response Case Study,” authors Dean Rawlins, Dr. Sutphin, Dr. D’Amato, Dr. Powers, Dr. Frasca “Design for Medical School Emergency Response and Disaster Preparedness,” authors Dr. Sutphin, Dean Rawlins, Dean Willcox, Dr. Powers, Jessica Muller.

VCOM continues to be nationally and internationally recognized for its mission.

» VISIT VCOM ONLINE

UPCOMING EVENTS

Health IT and Quality Webinar: Mobile Health Clinics - Opportunities and Challenges

July 8, 2011 @ 2:00 PM

The Health Resource Services and Administration’s (HRSA) Health Information Technology (IT) and Quality Webinars are technical assistance webcasts for HRSA grantees and the safety net community. These webinars are intended for safety net providers either using or planning to use health IT as a tool to improve quality in their delivery of patient care. Each webinar features leading experts with hands-on experience from within the safety net community, as well as speakers with various grantee experiences and federal expertise. Below is a listing of upcoming webinar topics and dates.

15th Annual 340B Coalition Conference

July 11 - 13, 2011
Washington, DC

Time is running out to register for the 15th Annual Conference on Improving Access to Pharmaceutical Care and Ensuring Compliance with Federal and State Laws, which takes place July 11th-13th in Washington, DC. [SNHPA] also urges you to stay for SNHPA’s Annual Legislative Day on July 14th.

Over a year has passed since health care reform legislation was enacted, but many questions remain about the law’s impact on the 340B program as the government continues to implement many 340B-related provisions. At the same time, the Health Resources and Services Administration (HRSA) will soon publish new guidelines that will redefine what patients and sites are eligible for the 340B program. These guidelines will impact every 340B stakeholder, from the smallest health centers and hospitals in the country to the world’s largest drug manufacturers.

On-site registration fees are $100 more. Register now at ww.340Bcoalition.org and save.

CMS Rural Health Open Door Forum

July 12, 2011
2:00 - 3:00 PM ET

Rural Health Open Door Forum Overview

The Rural Health ODF addresses Rural Health Clinic (RHC), Critical Access Hospital (CAH) and Federally Qualified Health Center (FQHC) issues, as well as some inclusion of other questions and concerns that occur in clinical practice pertaining to other CMS payment systems that also extend into these settings. Topics that frequently arise on this forum often deal with payment & billing for services subject to Health Professional Shortage Area (HPSA) and/or Physician Shortage Area (PSA) status, cost report clarifications, classifications for & qualifications of rural provider types, and the many special provisions being implemented for improving rural health in the Medicare Modernization Act of 2003. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the Forums.

The next Rural Health Open Door Forum is scheduled for Tuesday, July12, 2011 from 2:00pm-3:00pmET. If you wish to participate, dial 1-800-837-1935 Conference ID 59683815. This call will be Conference Call Only. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.

Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals - The Core Course

July 11 - 13, 2011
Omaha, NE

This course is offered by UNMC College of Public Health and is intended for physicians, nurse practitioners, physician assistants, nurses, veterinarians, health educators, migrant health clinicians, physical therapists, undergraduate and graduate students, and others with an interest in rural and agricultural health care.

Grant Writing Workshop

July 18 - 19, 2011
Seabrook Island, SC

The South Carolina Office of Rural Health is once again hosting a grant writing workshop just for rural providers! This special, “retreat-like” event will be held July 18-19, 2011 at the St. Christopher Camp and Conference Center on Seabrook Island, SC. Featured topics this year include how to find funders, grant writing basics, how to write Federal grants, working with your Congressional delegation, and more! The total cost of the event is $105, which includes one night’s lodging, all meals and snacks, and all materials. Space is limited, so register soon to guarantee your spot. For questions, please call Ashley Hoffman at 803.454.3850.

Webinar: How to Recruit and Retain Physicians in a Rural Market

July 21, 2011
1:00 - 3:00 PM CST

This webinar will address physician recruitment and retention activities which represents the difference between just “surviving” and “thriving” of any hospital. It will also address how the new federal health care reform law has just raised the recruitment stakes for available physicians, especially primary care. Experts predict that there will not be enough physicians to treat the millions of people who are newly insured under the law. According to the Association of Medical Colleges, the physician shortage will be 150,000 physicians in the next 15 years. The greatest demand will be for primary care physicians who will have an increasing role in coordinating care for each patient. This predicted shortage will mean more limited access to health care and longer wait times for patients.

Offered by Illinois Hospital Research and Educational Foundation
Cost: $260 for Non-IHA Members

» MORE INFORMATION (pdf)

NRHA: Quality and Clinical Conference

July 20 - 22, 2011
Rapid City, SD

The Quality and Clinical Conference is an interactive conference for quality improvement coordinators, performance improvement coordinators, rural clinicians, quality improvement organizations, and nurses practicing on the front lines of rural health care.

Webinar Recording Available: Roadmap for Success in ICD-10 Readiness

In case you missed it, HospitalPortal.net is offering free access to this webinar, which took place on Tuesday, June 221, 2011.

The upcoming transition from ICD-9 to ICD-10 is the subject of great conversation and stress across the healthcare industry. In this free webinar, experts from Elsevier and HospitalPortal will educate you about some of the innovative and customized e-learning tools that can ensure your staff is ready.

Learn how the right e-learning tools maximize efficiency by utilizing focused, prescriptive training, and monitoring of staff progress. The take-aways from this informative session will include how and when to start the preparation of your staff and how to do so with the least possible disruption of operations.

» VIEW THE WEBINAR

If you are interested in a similar webinar focusing on health networks, contact Regan Sonnabend at rsonnabend@hospitalportal.net

NATIONAL NEWS

Federal Register: Rural Health Care Support Mechanism

June 27, 2011 (Federal Register) - In this document, the Federal Communications Commission (Commission) adopts an interim rule permitting health care providers that are located in a “rural area” under the definition used by the Commission prior to July 1, 2005, and that have received a funding commitment from the rural health care program prior to July 1, 2005, to continue to be treated as if they are located in “rural” areas for purposes of determining eligibility for all universal service rural health care programs. The Commission takes these actions to ensure that health care providers located in rural areas can continue to benefit from connecting with grandfathered providers, and thereby provide health care to patients in rural areas.

Introduction
In this Order, we adopt an interim rule permitting health care providers that are located in a “rural area” under the definition used by the Commission prior to July 1, 2005, and that have received a funding commitment from the rural health care program prior to July 1, 2005, to continue to be treated as if they are located in “rural” areas for purposes of determining eligibility for all universal service rural health care programs. In the accompanying Notice of Proposed Rulemaking (NPRM) published elsewhere in this issue of the Federal Register, we seek comment on whether to make these “grandfathered” providers permanently eligible for discounted services under the rural health care program. Grandfathered providers do not currently qualify as “rural,” but play a key role in delivering health care services to surrounding regions that do qualify as “rural” today. Thus, we take these actions to ensure that health care providers located in rural areas can continue to benefit from connecting with grandfathered providers, and thereby provide health care to patients in rural areas.

AHRQ: Papers from the Collaborative Care Research Network Research Development Conference

This collection of three research papers represents the fruits of the AHRQ-funded Collaborative Care Research Network Research Development Conference in Denver in October 2009. At the meeting, participants took steps toward establishing a research agenda for collaborative care among primary care and mental health clinicians.

Collaborative care emphasizes the recognition and care of mental health problems in primary care settings and the effective collaboration of primary care and mental health clinicians. Collaborative care is regarded as an important function of the patient-centered medical home (PCMH), and one avenue toward achieving PCMH goals for health, patient experience, and affordability.

The three papers are:

Establishing a Research Agenda for Collaborative Care (Miller, Kessler, and Peek).
A Framework for Collaborative Care Metrics (Kessler and Miller).
A Collaborative Care Lexicon for Asking Practice and Research Development Questions (Peek).

» DOWNLOAD (pdf)

More people with Medicare receiving free preventive care

New CMS campaign to educate seniors about new free preventive care provided by Affordable Care Act

June 20, 2011 (CMS News Release) - The Centers for Medicare and Medicaid Services (CMS) released a new report showing that more than 5 million Americans with traditional Medicare – or nearly one in six people with Medicare – took advantage of one or more of the recommended preventive benefits now available for free thanks to the Affordable Care Act. Also today, Medicare launched a nationwide public outreach campaign, including a letter to doctors and a new Public Service Announcement that will raise awareness about all of the important preventive benefits now covered at no charge to patients, including the new Annual Wellness Visit benefit created by the Affordable Care Act.

“The Obama Administration is committed to helping increase the number of Americans who are healthy at every stage of life,” said CMS Administrator Donald Berwick, M.D. “Even in your 70s, 80s, or beyond you can reduce your risk of disability and chronic illness if you take care of yourself. With the new free Annual Wellness Visits and free preventive care, people with Medicare have the tools to take common-sense steps to take control of their health.”

» CONTINUE READING & COMMENT

$10 Million in Affordable Care Act funds to help create workplace health programs

June 23, 2011 (HHS News Release) - The U.S. Department of Health and Human Services announced [on June 23, 2011] the availability of $10 million to establish and evaluate comprehensive workplace health promotion programs across the nation to improve the health of American workers and their families. The initiative, with funds from the Affordable Care Act’s Prevention and Public Health Fund, is aimed at improving workplace environments so that they support healthy lifestyles and reduce risk factors for chronic diseases like heart disease, cancer, stroke, and diabetes.

“Spiraling health care costs and declines in worker productivity due to poor health are eroding the bottom line of American businesses,” said HHS Secretary Kathleen Sebelius. “This new initiative will help companies of all sizes implement strategies to improve employee health and contain health costs driven largely by chronic diseases.”

The 12 Elements of a Successful Health IT Project
by Kim Lamb, Executive Director, Oregon Health Network

June 23, 2011 (Government Technology) - America’s health-care landscape is more complex and multidimensional than ever. Over the past five years, acronyms, federal mandates and funding streams have bombarded decision-makers in a number of health care-related industries. From core operational infrastructure systems to billing, scheduling, electronic medical records and administration, health care has transitioned from being a delivery system that's designed and managed within a silo to one that needs to communicate in real time to the rest of the policymaking continuum.

Health-care executives, providers and administrators, along with local and federal politicians, are tasked with addressing the pressing health-care, economic and work force needs of their constituents. But these issues are increasingly difficult to deal with, particularly because decision-makers aren’t given the broader context of health IT to help them prioritize solutions. The new emphasis on patient-centered care requires collaboration and coordination at the federal, state and regional levels — and full interoperability of hardware, software, payer systems and patient care.

At the federal level, the government is working to remodel the country’s core health-care delivery system. Through the Rural Health Care Pilot Program (RHCPP), the FCC is building the next-generation broadband infrastructure for health-care delivery.

Oregon Health Network (OHN), a participant in the RHCPP, is building a statewide broadband telehealth network — the first in Oregon and one of the first in the country. OHN supports the “Triple Aim,” a revolutionary philosophy adopted by several key organizations, including the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services. The goals of the Triple Aim are to improve the population's health, enhance the patient's experience of care (including quality, access and reliability) and reduce — or at least control — per capita costs.

FUNDING

Cooperative Development Foundation Funding Available

The Cooperative Development Foundation (CDF) is pleased to announce the availability of grant funds from its MSC Fund. The focus of this Fund is to support cooperative development initiatives that will meet the needs of senior citizens in rural communities. In 2011, proposals will only be accepted for innovative work in two specific areas: cooperative home care and senior cooperative housing, both in rural settings. The deadline for submitting proposals is August 1st, 2011. It’s recommended that any NCHN member who is interested should look first visit the Senior Resource Center on the CDF website to review the body of work in this area that’s available at the CDF website. Then contact Liz Bailey at CDF (Lbailey@cdf.coop or 703.302.8093) to talk about what they would propose to do. Even if they decide not make application to the MSC Fund, that conversation could help CDF identify any NCHN members who might want to be part of CDF’s companion piece of feasibility work on the multi-stakeholder home care cooperative.

» For more information on the MSC Fund, grant guidelines and the application form, visit the CDF website

Federally Qualified Health Center Advanced Primary Care Practice (FQHC APCP) Demonstration

Applications accepted from June 6, 2011 - August 12, 2011

The Federally Qualified Health Center Advanced Primary Care Practice (FQHC APCP) demonstration project is a new Affordable Care Act initiative that will pay an estimated $42 million over three years to up to 500 FQHCs to coordinate care for Medicare patients. This demonstration project, operated by the Centers for Medicare and Medicaid Services (CMS) in partnership with the Health Resources Services Administration (HRSA), will test the effectiveness of doctors and other health professionals working in teams to improve care for up to 195,000 Medicare patients. This initiative is part of a broader effort by the Obama Administration, made possible by the Affordable Care Act, to improve care and lower costs.

The FQHC Advanced Primary Care Practice demonstration will show how the patient-centered medical home model can improve quality of care, promote better health, and lower costs. Participating FQHCs must implement electronic health records, help patients manage chronic conditions, as well as actively coordinate care for patients. To help participating FQHCs make these investments in patient care and infrastructure, they will be paid a monthly care management fee for each eligible Medicare beneficiary receiving primary care services. In return, FQHCs agree to adopt care coordination practices that are recognized by the National Committee for Quality Assurance (NCQA). CMS and HRSA will provide technical assistance to help FQHCs achieve these goals.

» ELIGIBILITY APPLICATION