Welcome to July! The 2012 summer is in full swing and I've heard from some members about their 100+ temperatures. Things are also heating up in the health care arena. Everyone is awaiting the possible ruling from the Supreme Court that may be released on Thursday, June 28 regarding the constitutionally of the Affordable Care Act (ACA). We are watching for updates and news breaks and will get any info out to you as quickly as we can. Thanks to our partner, the National Rural Health Association, we can depend on the accuracy and timeliness of any news from Washington, DC and its specific impact on rural health, including rural health networks.
One of the programs included in the ACA that I just learned more about last week is PCORI or the Patient-Centered Outcomes Research Institute. PCORI is authorized by Congress to conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions. PCORI is governed by a 21-member Board of Governors, which receives guidance from the 17–members of the Methodology Committee, which are appointed by the U.S. Government Accountability Office (GAO). The Board of Governors approved their “National Priorities for Research and Research Agenda” on May 21, 2012 that includes five priorities. These five priorities were developed in light of PCORI’s statutory requirements, its working definition of patient-centered outcome research, and previous national level research prioritization efforts undertaken by nine different organizations, both federal agencies and non-governmental organizations. I have listed the five priorities below and you can review the full report here.
Assessment of Prevention, Diagnosis, and Treatment Options
Improving Healthcare Systems
Communication and Dissemination Research
Addressing Disparities
Accelerating Patient-Centered Outcome Research and Methodological Research
In their first round of funding, PCORI’s Board of Governors approved 50 Pilot Projects totaling $30 million over two years. They are currently in the process of receiving applications for work in the five priority areas. Letters of Intent were due on June 15 and the applications are due on July 31 with Awards announced by December 31. The next open cycle is September 15, with mandatory Letters of Intent due by October 15. I encourage you to check out the PCORI website to determine if this new program focusing on Patient-Centered Outcomes is something your network may wish to apply and compete for funding. It is not too early to start working toward the October 15 due date for the mandatory Letter of Intent. I spoke with Joe V. Selby, M.D., M.P.H., PCORI Executive Director after his presentation in Bethesda last week and express NCHN’s members’ potential interest in his program. He encouraged us to review their website and look at possible funding opportunities. He also indicated that they love to come out and talk to folks about their programs, either through face-to-face presentations at conferences and meetings or through webinars. I will be exploring this possibility with Dr. Selby and his staff and will keep you informed of when and how NCHN members will have the opportunity to interact with this new organization, Patient-Centered Outcome Research Institute and their programs.
Also last week I had the opportunity to explore Practice-Based Research Networks or PBRNs. These networks are supported by funding from AHRQ (Agency for Healthcare Research and Quality). PBRNs are groups of primary care clinicians and practices working together to answer community-based health care questions and translate research findings into practice. PBRNs engage clinicians in quality improvement activities and an evidence-based culture in primary care practice to improve the health of all Americans. AHRQ provides PBRNs with grant funding and supports through a national resource center, an annual national conference, which I attended last week, peer learning groups, an electronic PBRN search repository, public and private listservs and a dedicated private community portal. Over 130 PBRNs have been funded through four major competitive AHRQ grant programs since 2000. If you would like to learn more about PBRNs, you can do so by visiting pbrn.arhq.com. I will continue to search for linkages between both these programs and NCHN’s members. The focus for health care is patient-centered, community based. What is your network providing to your members to support their efforts in these new initiatives?
In other news this month, we are so happy to welcome our four new members! Information about the new members was included in earlier issues of the Weekly Digest this month, but Christy has also provided a review below. Welcome to Western Kansas Frontier Information Network and Jeanne Moffat; Southeast Texas Health System and Shannon Calhoun; North Idaho Rural Health Consortium and Carol Wilson; and a new Associate member and former NCHN organizational member, Dawn Wichmann. We look forward to working with each one of you and welcome you to NCHN!
Upcoming events in July --- new NCHN website, yes it is going to be launched during July along with the announcement of a new NCHN Gold Level Business Partner! Watch for details and some fun contests in the July Weekly Digests; Launching of the RHNR Consulting Group – details will be going out to members on how to sign up to become a consultant; 2012 Network Leader Salary and Benefit Report – results of the survey will be released by the end of July, remember, you only get a copy of the report, if you participated in the survey. If you haven’t completed the survey, you can still do so this week, as Christy is on vacation and will not be compiling the report! Let me know if you need the link.
Enjoy your start to summer and have a safe and Happy 4th of July!
Facts about Independence Day (Disclaimer: some are not funny)
• The major objection to being ruled by Britain was taxation without representation. The colonists had no say in the decisions of English Parliament
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Before cars ruled the roadway, the Fourth of July was traditionally the most miserable day of the year for horses...
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Both Thomas Jefferson and John Adams died on Independence Day, July 4, 1826.
• The origin of Uncle Sam probably began in 1812, when Samuel Wilson was a meat packer who provided meat to the US Army. The meat shipments were stamped with the initials, U.S. Someone joked that the initials stood for “Uncle Sam”. This joke eventually led to the idea of Uncle Sam symbolizing the United States government.
Please join the Board in welcoming NCHN's newest members: Jeanne Moffat, Network Director of Western Kansas Frontier Information Network, Dawn Wichmann, former director of Lakelands Rural Health Network, and Shannon Calhoun, Executive Director of Southeast Texas Health System (SeTHS).
Western Kansas Frontier Information Network
Founded in 2011, WKFIN is based in Tribune, Kansas and has 11 network members.
Its mission is to "strengthen current relationships and ability to care for patients through the creation and support of a secure and compliant information network." WFKIN received a 3 year HRSA HIT Network Development grant in 2011.
Contact:
Jeanne Moffat, Network Director
Ph: 620-376-4035
Email: jmoffat@mygchs.com
Dawn Wichmann
Many NCHN members are already familiar with Dawn, who served as the Executive Director of Lakelands Rural Health Network.
Dawn has rejoined NCHN as an associate member this year. We are delighted to have her continued involvement with NCHN.
Southeast Texas Health System
Founded in 1994, SeTHS is based in Goliad, Texas and has 9 members. Its mission is "to integrate locally and regionally for purposes of responding to growth in a way the preserves local control and maintains the indepence of the members..." SeTHS Members share the common goals of operating cost-effective, quality, healthcare delivery systems to provide a continuum of healthcare services and products that offer greater efficiency, economy and quality, and availability of such services than the individual providers can offer alone. Programs include Health Information Exchange, Diabetes Self Management, Managed Care Contracting, and Training.
North Idaho Rural Health Consortium was founded in 1991 and is based in Couer d'Alene, Idaho. It is currently comprised of 5 members with the mission of helping hospitals in North Idaho improve the care being delivered to patients. Its programs include networking, education, group contracting, program development, and telehealth.
For more information, contact:
Carol Wilson, Executive Director
Ph: 208-666-3863
Email: wilson@nirhc.org
The Consulting Group Services Program
During the NCHN Quarterly Membership call on Monday, June 11th, Steve Stoddard, Chair of the RHNR Consulting Group Task Force, introduced the Consulting Services Program. Rural Health Network Resources, LLC (RHNR), wholly owned by NCHN, has developed a Consulting Group to provide referral services for health networks. RHNR will develop a database of consultants and specializations and connect networks seeking services to consultants with the requisite expertise.
Within the next few weeks, we will be launching a new website. We have mentioned it a few times in the newsletter and we are very excited about its potential. The new site has been under development for the last 12 months and incorporates a lot of changes that will make it a much better resource for connecting members.
In comparison to the old site, the single biggest improvement in the new site - and the area in which most of the potential lies - is that it is much more interactive and user authored. You will be able to share a lot more about your network, and, by the same venue, get much more information about other networks. In the feedback we received about our newsletter, most people have said that the newsletter is fine, but most of all, they are interested in what’s going on with other networks. The new site will allow you to share all of this information through the site itself using your login.
The Hylant Group provides insurance products, wellness programs and disease management services that can be used by individual network facilities. Employee benefit programs include a life insurance and AD&D insurance program, as well as a pharmacy benefit program for self-insured health plans.
NCHN networks have also looked to Hylant for liability coverage such as D&O, property, general liability, medical malpractice, reinsurance and captive insurance consulting.
Contract Benefits
NCHN and the member organizations receive administrative and marketing fee revenue as a result of marketing, managing and self-billing. The concept behind a national group for insurance is based on the ability to create a sizable market by combining the purchasing power of more than one NCHN network.
Hartford (Long Term Disability)
NCHN offers LTD on a group basis through Hartford. By pooling the NCHN participating members LTD plans, discount arrangements have been established with the Hartford. This has enabled NCHN to leverage their group buying strength with one of the largest LTD providers for hospitals and physicians nationally.
Lafayette Life (Life/AD&D Program)
NCHN offers Life/AD&D on a group basis through Lafayette Life. With over 30 facilities currently participating, the NCHN group life program has been extremely successful. The growth of this program has offered stability and opportunity for the participating groups.
Pharmacy Benefit Management (PBM)
The PBM program works best with self-funded employee benefit programs. Your network, NCHN and the individual network facilities all benefit from group purchasing of prescription drug administration services.
Assess Needs & Resources In-depth
County Health Rankings & Roadmaps
Webinar: June 26, 2012 | 2:00 - 3:00 PM CDT
This webinar is limited to the first 40 registrants and will focus in-depth on the Assess Needs & Resources section of the Take Action Cycle. It will also be interactive so the participants can have a dialogue with the presenters.
EHR Incentive Programs and Certified EHR Technology
CMS
Webinar: June 27, 2012 | 2:00 - 3:00 PM ET
CMS and the Office of the National Coordinator for Health Information Technology provide an overview of the Medicare and Medicaid EHR Incentive Programs, including the use of certified EHR technology to meet meaningful use. Learn about the different types of certification and what certification actually tests. CY 2012 is the last year Medicare eligible professionals can begin to participate to earn the full Medicare Electronic Health Record (EHR) incentive payments.
» MORE INFORMATION (Registration closes at 12 p.m. ET on June 27th or when capacity is reached)
AHA's RACTrac Quarterly Webinar
American Hospital Association
June 27, 2012 | 2:00 - 3:30 PM ET
Join us June 27th to learn the results of the first quarter 2012 nationwide data collection of the American Hospital Association’s (AHA) RACTrac survey. More than 2,000 hospitals have responded to the survey, allowing AHA to identify important trends in RAC activity throughout the country. Join us for this free webinar to learn more about the impact of the permanent RAC program on hospitals, how you can get involved in the RACTrac initiative and how we can work together to ensure RACTrac continues to be a strong advocacy and educational tool for the hospital community.
The webinar is for hospital representatives and state, regional and metro hospital association representatives only. During the webinar, we will provide a RAC program update, review first quarter 2012 RACTrac survey results—including data reflecting an increase in medical necessity denials and continued hospital success in the appeals process—and provide information on how to use RACTrac.
A decision from the Supreme Court is now expected on Thursday. NRHA will have a call at noon EST that day to explain how the Court's decision will impact rural America. You can register for the webinar now: https://www2.gotomeeting.com/register/469573834
Free Educational Webinar Series: Accountable Care Solutions--Learn How To Achieve Triple Aim
Alere
Webinar: June 28, 2012 | 2:00 - 3:00 PM CDT
October 2012 and beyond....are you ready? How will you meet the requirements of the Triple Aim? Connected health capabilities from Alere can serve as the backbone for care coordination, collaboration and care management.
Payment Reform and the Safety Net
National Academy for State Health Policy
June 29, 2012 | 3:00 - 4:00 PM EDT
Medicaid payment reform is needed to drive delivery system change. Moving to value-based purchasing strategies, particularly for patients with complex health needs, makes sense. Historically, however, few Medicaid programs have succeeded in moving safety net providers away from volume-based reimbursement. This Medicaid-only webinar will discuss options and possibilities for safety net providers to participate in value-based payment models. Oregon’s Medicaid Director will discuss how safety net providers fit into the state’s new Coordinated Care Organization program, as well as the development of a new alternative payment methodology (APM) for federally qualified health centers (FQHCs). Senior staff from the Center for Medicaid and CHIP Services, CHIP, and Survey & Certification (CMCS) at the Centers for Medicare & Medicaid Services (CMS) will follow with remarks on state flexibility to pursue new value-based purchasing strategies, especially through State plan amendments and 1115 waivers. The webinar will conclude with time for discussion among states and opportunities to give CMS feedback on this topic.
NRHA’s Rural 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.
NRHA is hosting this free education and advocacy event.
Join experts in D.C. to learn how to save Medicare Dependent Hospitals (MDHs) and the Low-Volume Hospital (LVH) program, and take this important message to Capitol Hill:
If congressional action is not taken by Oct. 1, millions of dollars in reimbursements to these facilities will be lost, hospital services will be reduced, and rural hospital doors will close.
Supreme Court Decision on Health Law Expected on Thursday
June 25, 2012 (NRHArural.org) - Whether you support or oppose the current health care bill, it is important to realize that many of its provisions include benefits for both the rural provider and patient. During the reform debate, NRHA’s message was clear: Improve rural America’s access to health care providers by resolving the rural workforce shortage crisis and eliminate long-standing payment inequities for rural providers. Click here for the rural benefits of the Affordable Care Act.
A decision from the Supreme Court is now expected on Thursday. NRHA will have a call at noon EST that day to explain how the Court's decision will impact rural America. You can register for the webinar now: https://www2.gotomeeting.com/register/469573834
Health care ruling: What to expect
by Joanne Kenen
June 19, 2012 (Politico) - No matter what the Supreme Court finally rules on the health law, tens of millions of Americans are not going to like it. And judging from the wildly contradictory polls and expectations of the past few years — in which people often declare how much they detest the health law and at the same time say how much they like what’s in it — many won’t understand the ruling, either.
Value of Rural Hospitals Linked to ED Utilization
by John Commins
June 20, 2012 (HealthLeaders Media) - Any comparisons of urban and rural healthcare costs come freighted with caveats. For starters, rural hospitals usually cannot provide the array of specialized and expensive care seen in larger urban hospitals, making per-patient cost comparisons difficult. There can also be stark differences in patient populations. And rural hospitals do not enjoy the economy of scale and leverage with vendors and insurance companies that are seen in larger urban hospitals. Critical access hospitals get higher reimbursements from the federal government for care delivery, further muddying comparisons.
The Dashboard currently provides summary information about all ONC HITECH grant programs, and detailed data from the Regional Extension Center, and Community College Consortia to Educate Health IT Professionals programs.
Using ONC's Health IT Dashboard, you can:
Generate maps of health IT adoption statistics for common groups of health care providers & hospitals
Examine the impact of ONC's Recovery Act grant programs implementation at national and local levels
Download and analyze the data for your own research projects.
IRS issues proposed rule on ACA requirements for tax-exempt hospitals
June 22, 2012 (AHANews.com) - As the nation awaits the Supreme Court's decision on the Patient Protection and Affordable Care Act, the Internal Revenue Service today released a proposed rule implementing requirements for tax-exempt hospitals under Section 501(r) of the Act. The 94-page rule, which includes a 54-page preamble, contains proposed regulations that provide guidance regarding the requirements for charitable hospital organizations relating to financial assistance and emergency care policies, charges for certain care provided to individuals eligible for financial assistance, and billing and collections. IRS addresses which tax-exempt hospitals will be covered by the regulations and proposes to extend the requirements to government hospitals.
Speak Your Piece: Farm Bill Blues
by Timothy Collins
June 20, 2012 (The Daily Yonder) - A hundred years ago, T. Roosevelt made the mistake of equating rural with "agricultural." The latest version of the Farm Bill is guided by the same wrong idea.
Count me among the disappointed. Or pessimistic. Or both. Bill Bishop’s recent discussion of President Obama’s “rural term paper” suggests the continued withdrawal of Washington from large segments of rural America. The administration’s support of the Senate version of the 2012 Farm Bill, which, at the moment lacks a rural development title and reduces funding for food programs and conservation, is problematic at best. The apparent support for cuts in food programs is reprehensible.
2010 NIS Available for Health Services Research on Inpatient Hospital Visits
AHRQ
Jun e 20, 2012 (AHRQ e-mail) - The Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) featuring 2010 data is now available. The NIS is the largest all-payer inpatient care database in the United States. The NIS is nationally representative of all short-term, non-Federal hospitals in the U.S. It is drawn from the HCUP State Inpatient Databases (SID) and includes more than 8 million hospital stays. The NIS includes all patients from each sampled hospital, regardless of payer—including persons covered by Medicare, Medicaid, private insurance and the uninsured. The NIS contains data from 45 states and can be weighted to produce nationwide estimates, allowing researchers and policymakers to use the NIS to identify, track, and analyze national trends in health care utilization, access, charges, quality, and outcomes.
Ten Attributes of Health Literate Health Care Organizations
by Cindy Brach, Debra Keller, Lyla M. Hernandez, Cynthia Bauer, Ruth Parker, Benard Dreyer, Paul Schyve, Andrew J. Lemerise, Dean Schillinger
June 19, 2012 (Institute of Medicine of the National Academies) - A wide range of organizations have recognized that having health literate health care organizations benefits not only the 77 million Americans who have limited health literacy, but also the majority of Americans who have difficulty understanding and using currently available health information and health services. This paper presents 10 attributes that exemplify a health literate health care organization. Each attribute includes a brief elaboration of the meaning of and basis for the attribute, followed by a set of implementation strategies that can be used to achieve the attribute.
Change is coming to rural health care, whatever the Supreme Court decides
by Jennifer Vogel
June 25, 2012 (MPRnews) - Whether the U.S. Supreme Court confirms or strikes down portions of the federal Affordable Care Act later this week, change is coming to rural health providers, Bill Finerfrock, executive director of the National Association of Rural Health Clinics, said here this morning. He was speaking to a packed house and kicking off the annual Minnesota Rural Health Conference, which runs through [Tuesday, June 26, 2012].
His advice to rural health care providers: Don't sit back waiting for the system to sort itself out after the high court rules.
University of Washington program tries to give rural Idaho medicine a boost
by Katie Roenigk
June 25, 2012 (Idaho Statesman) - An official wants Idaho to fare better and see its numbers increase in a Northwest program.
There’s a growing need for health care in remote areas. According to the National Center for Biotechnology Information, about 20 percent of the United States population — more than 50 million people — is in rural locations, but only 9 percent of the nation’s physicians practice there.
Physician Adoption of EHRs Accelerates, but Rural Providers Slow to Embrace EHRs
June 25, 2012 (DARKdaily.com) -
Adoption of EHR systems by small practices, small hospitals, and rural health providers lags behind the pace of urban-based hospitals and physician groups
As larger numbers of physicians implement electronic health record (EHR) systems, clinical laboratories are faced with the task of building interfaces that connect their laboratory information systems (LIS) to those EHRs. Recent numbers indicate that hundreds of thousands of physicians are now enrolled in the federal EHR incentive program. This puts medical laboratories and anatomic pathology groups squarely in the midst of the drive to encourage physicians to both implement an EHR in their clinical practice and use that EHR in ways that meet “Meaningful Use” requirements.
GAO reviews HRSA grant program for new health center sites
June 22, 2012 (AHANewsNow) - The Health Resources and Services Administration should evaluate the fiscal year 2011 New Access Point health center grant award process for effectiveness and transparency, identify lessons learned and incorporate any improvements for future funding cycles, the Government Accountability Office concludes in a new report. Republican leaders of the Senate Health, Education, Labor & Pensions Committee asked GAO to review HRSA's awarding of the grants for new health center service delivery sites and possible effects, such as competition, on other providers. According to GAO, health centers in the communities studied collaborate with other providers and generally do not compete with them for patients. However, GAO found greater potential for competition in rural areas, where patients are more likely to be insured and rural health clinics and certain hospitals might seek to serve some of the same patients.
Health and Human Services brings innovative approach to solving health care challenges
June 22, 2012 (HHS News Release) - Health and Human Services Deputy Secretary Bill Corr today announced that the department is exploring new ways of bringing an entrepreneurial spirit to solving the nation’s health and health care challenges. The new HHS Innovation Fellows Program aims to bring fresh, innovative ideas and expertise from outside the agency to help HHS accelerate health and health care innovation.
The Innovation Fellows Program enables agencies to bring on board some of the brightest external experts and entrepreneurs to work with host innovators at HHS in taking on the department’s toughest challenges. Fellows will be highly talented professionals from non-federal backgrounds such as business, industry, and academia who seek to bring successful innovation experiences, models, and business practices to HHS. The application period for external fellows is June 20-July 20, 2012.
MultiPlan to Award $30,000 in Grants to Rural Hospitals
MultiPlan, Inc.
2012 Call for Proposals
June 14, 2012 (PRWeb) - MultiPlan, Inc., the nation’s oldest and largest independent PPO network, is accepting applications for its 2012 Rural Health Outreach Grant. The program, now in its 17th year, awards hospitals serving rural areas financial grants to help them introduce or expand services, education, screenings and other endeavors aimed at improving the health of people in their communities.
National Cooperative of Health Networks