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NCHN Healthcare News Digest

Issue #15 | Monday, December 13, 2010 |

+ NCHN Upcoming Calls

Upcoming Committee Calls

  • December 14 @ 1:00 - 2:30 PM ET: Program Development Committee Call
  • January 17, 2011 @ 1:00 PM ET: Executive Committee Call

NCHN Orientation Sessions

NCHN will be offering two orientation conference calls on Thursday, January 6, 2011 at 3:00 PM ET and Tuesday, January 11 at 12:30 PM ET. The Orientation Session will provide an overview of the programs and services of NCHN and review the benefits of your membership. This will also give you the opportunity to meet other new NCHN members and/or recently hired network directors. (We are using the term “recently” very liberal --as some of the directors may have been in their positions for several months, but not had the opportunity to attend a NCHN conference and/or an orientation call.)

The following items will be discussed: Mission of NCHN; Strategic Plan and Goals for 2010-2013; Membership Benefits; Business Partners Program

  • January 6, 2011 @ 3:00 PM ET
  • January 11, 2011 @ 12:30 PM ET

Pre-registration is required: To register for one of these sessions, email

Peer-to-Peer Sharing Sessions with HRSA Network Planning Grantees

  • December 15 @ 1:30 PM ET
  • January 19 @ 1:30 PM ET
>> More information on Peer-to-Peer Sharing Sessions...

+ Congratulations to NCHN Staff Member Debbie Comeau

Congratulations to Debbie Comeau, NCHN staff member and Human Resources Administrator/Executive Assistant for Synernet (a member of NCHN) on passing the Professional in Human Resources (PHR) Exam.  Debbie sat for the four-hour test earlier this month and passed.

The process began over two years ago and included going back to school in a continuing education program at the University of Southern Maine and receiving her Certificate in Human Resources Management earlier this year. That led to an intense study process this fall in order to sit for the exam.

>> You can contact Debbie Comeau at

+ NRHA SGR and Appropriations Update

From the National Rural Health Association (emails sent Dec. 8th and 9th)

Dec. 8, 2010 - The Senate has released its plan to address the potential 25 percent Medicare physician payment cut via the sustainable growth rate (SGR) formula.  The Doc-Fix, as it is commonly referred to, will be extended for one year until December 31, 2011 under the plan.  Senate Democrats and Republicans have agreed to use a tax provision in the health reform law to offset, or pay for, its cost, so a unanimous consent agreement is expected on the Senate floor rather than a full vote.  The provision they will use, which requires individuals enrolled in the health insurance exchanges to pay back any overpayments in subsidies they receive, will be altered to allow the federal government to recoup more of those overpayments. 

It was previously believed that the offset would use cuts to the Prevention and Public Health Fund, also created under health reform, but Congress (likely in the face of significant opposition because of the potential funding cut) ultimately opted against that plan and used the tax provision above.

The bill, the Medicare and Medicaid Extenders Act of 2010, also includes the list of rural Medicare extenders included in my last email to the group.  They are:

  1. Extension of MMA section 508 reclassifications.
  2. Extension of Medicare work geographic adjustment floor
  3. Extension of exceptions process for Medicare therapy caps
  4. Extension of payment for technical component of certain physician pathology services
  5. Extension of ambulance add-ons
  6. Extension of physician fee schedule mental health bonus payment
  7. Extension of outpatient hold harmless provision
  8. Extension of Medicare reasonable costs payments for certain clinical diagnostic laboratory tests furnished to hospital patients in certain rural areas

Additionally, the legislation would include a technical correction for children’s hospitals and their ability to utilize the 340B prescription drug discount program for orphan, or rare disease, drugs.  The orphan drug exclusion, however, still applies to the newly eligible 340B entities, such as critical access hospitals (CAHs).  Orphan drugs are used by many rural providers and patients, and while the fix for children’s hospitals represents a positive step, we are still very concerned that without a similar fix for the newly eligible entities, patient access to these important medications will be severely limited or non-existent. Therefore, the NRHA will continue to fight to fix this orphan drug exclusion, and please contact your members of Congress and urge them to do the same. 

Continuing Resolution Plan Released
The House has released a plan to pass a continuing resolution (CR) on current funding levels.  This means that rather than pass a new appropriations bill they will continue current levels of funding for the next year.  Please see the attached document released by the House Committee on Appropriations for more information.  (The HHS section begins on page 7)

The Senate, however, is still working on getting the 60 votes needed to ensure the CR comes to a full vote on the floor.  So, we will wait to see what develops and keep you updated.  

New House Committee Chairmen Announced
Additionally, key House committees have named their new Chairmen.  The House Appropriations Committee has named Rep. Hal Rodgers (R-KY) as its full committee Chair, and will name subcommittee Chairs soon.  The powerful House Energy and Commerce Committee has named Rep. Fred Upton (R-MI) as its Chair, who was quick to announce Rep. Joe Pitts (R-PA) as his Health Subcommittee Chairman.

Though many issues on our plate were not included in this legislation, such as a fix for rural health clinics and their electronic health record incentives, reinstating states’ ability to deem hospitals as “necessary providers,” and a large list of others, we will continue to fight for further issues during this lame duck session and on into upcoming Congress. 

Dec. 9, 2010 - After the Senate passed its fix lat night to the sustainable growth rate (SGR) formula to stave off Medicare physician payment cuts, the House voted 409-2 to confirm the legislation.  So, the SGR fix, or "doc-fix" will be extended for one year until January 1, 2012. 

Also included in the bill was an extension of otherwise expiring Medicare payment programs, known as Medicare "extenders."  Most of these extenders, the full list of which were included in my email yesterday, are very important to rural America and thus completely supported by NRHA. 

Appropriations Update:

While the Senate worked last night on its SGR bill, the House was busy passing its continuing resolution (CR) for the upcoming year's federal appropriations funding.  The legislation would freeze current FY 2010 funding at $1.09 trillion, freezes federal pay, and contains no individual earmarks.  The bill barely passed in the House by a vote of 212-206. 

The legislation then moved to the Senate Appropriations Committee, chaired by Senator Inouye of Hawaii, today, who plans on substituting its own omnibus spending bill, a process which allows Congress to vote on funding for numerous federal agencies all at once.  Previously, it was unclear as to whether or not the Senate would have the votes to pass the omnibus, but sources report that enough Republicans are on board to reach the fillibuster-breaking 60 vote margin.  The current omnibus plan is capped at a higher spending limit than the House's CR at $1.109 trillion. 

So watch for updates on this very important process that will determine funding for current federal programs.  No official timeline has been given by the Senate, but they expect to bring it to a vote very soon.

(Source: NRHA emails sent on Dec. 9 & 10, 2010; SGR and Appropriations Update)

+ NIH to offer new clinical research opportunity

The National Institutes of Health has launched a new program in conjunction with the Albert and Mary Lasker Foundation that will provide medical doctors with funding for patient-focused, clinical research projects. The goal is to bridge the widening gap between cutting-edge research and improved patient care.

The initiative, called the Lasker Clinical Research Scholars Program, enables exceptional clinical researchers in the early stages of their careers to first spend 5 to 7 years at the NIH Clinical Center, the world's largest hospital dedicated to patient-oriented research, in Bethesda, Md.

Upon successful completion of this first stage, the scholars would be offered the opportunity to remain at the NIH as senior clinical research scientists or to apply for up to four years of independent financial support at a university or other external research institution.

>> Continue reading... (Source: NIH News, News Release, Dec. 9, 2010)

+ Beacon Community Highlights and Videos Now Available

The Office of the National Coordinator for Health Information Technology (ONC) has launched new web pages for each of our 17 Beacon Communities. The web pages include case summaries and videos that highlight the goals and programs of each of the 17 communities.
The Beacon Communities are deploying health IT-enabled interventions to help physicians and patients achieve improvements in quality, efficiency, and the overall health of their communities, trading implementation and other insights with other communities along the way.

>> Visit the ONC website today to learn more about how these Beacon Communities are using health IT in new ways to address the most pressing health issues in our country. (Source: ONC Health IT, email sent Dec. 8, 2010; "Beacon Community Highlights and Videos Now Available")

+ Exposure to Tobacco Smoke Causes Immediate Damage, Says New Surgeon General's Report

Exposure to tobacco smoke – even occasional smoking or secondhand smoke – causes immediate damage to your body that can lead to serious illness or death, according to a report released today by U.S. Surgeon General Regina M. Benjamin.  The comprehensive scientific report - Benjamin’s first Surgeon General’s report and the 30th tobacco-related Surgeon General’s report issued since 1964 - describes specific pathways by which tobacco smoke damages the human body and leads to disease and death.

The report, How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease, finds that cellular damage and tissue inflammation from tobacco smoke are immediate, and that repeated exposure weakens the body’s ability to heal the damage.

“The chemicals in tobacco smoke reach your lungs quickly every time you inhale causing damage immediately,” Benjamin said in releasing the report.  “Inhaling even the smallest amount of tobacco smoke can also damage your DNA, which can lead to cancer.” 

>> Continue reading... (Source: | ASPA | Newsroom | News Releases, Dec. 9, 2010)

+ Sebelius outlines how the Affordable Care Act is improving the quality of care

ORLANDO– On Tuesday, December 7th, Health and Human Services Secretary Kathleen Sebelius delivered a keynote address at the Institute for Healthcare Improvement’s 22nd Annual National Forum on Quality Improvement in Health Care in Orlando, Florida. Sebelius outlined how the Affordable Care Act improves health care delivery for doctors, improves care for patients and lowers costs.

“Today, we pay a lot of money for a system that rewards care delivered piece-by-piece, instead of in a seamless, coordinated manner,” said Secretary Sebelius.  “Some Americans get extraordinary care. But quality varies widely, and far too many of our health care dollars go to pay for unnecessary treatments and overhead costs. Thanks to the Affordable Care Act, this is changing.”

>> Continue reading... (Source: | ASPA | Newsroom | News Releases, Dec. 7, 2010)

+ Virginia College of Osteopathic Medicine (a NCHN strategic partner) Recognized for Work in Support of Medical Missions

by Daniel McCann, Staff Editor, TheDO, December 1, 2010)

If you’re interested in establishing a medical clinic in a developing country, having a well-trained staff, adequate medical supplies and boundless goodwill—while necessary—won’t suffice.

That was the message Dixie Tooke-Rawlins, DO, delivered Oct. 25 during the AOA’s 115th Annual Osteopathic Medical Conference and Exposition in San Francisco. Dr. Tooke-Rawlins, the dean and executive vice president of the Edward Via Virginia College of Osteopathic Medicine (VCOM) in Blacksburg, has taken a lead in establishing and coordinating the school’s medical missions in the Honduras, El Salvador and the Dominican Republic.

She told members of the American Osteopathic College of Occupational and Preventive Medicine that successful year-round clinics abroad are built on strong relationships with the host countries’ national and local governments, medical associations, medical schools, and hospitals.

>> Continue reading... (Source: McCann, Daniel. TheDO, | Home | Patient Care | In the Field, Dec. 1, 2010)

+ Health Services Research Theme Issue Explores Payment Reform

The December issue of Health Services Research, published in cooperation with AHRQ, presents research on payment reform, which will play a critical role in efforts to improve the quality and value of health care under the Affordable Care Act.  The goal of this theme issue is to provide new information about how to best design and implement payment reforms, focusing particularly on structuring payment bundles that reduce regional variation without harming quality; selecting performance measures that really do measure performance; fine-tuning pay-for-performance models; and taking into account external market factors. 

The issue’s seven papers address when and under what circumstances   a payment system works to achieve certain objectives.  In brief, the authors found that potentially avoidable hospitalizations for chronic illnesses add 30 percent to employers’ health care spending for certain chronic conditions; more aggressive hospital care costs more but saves lives; composite measures can successfully assess the quality of physician preventive and chronic care services; surveys can  make an effective contribution to risk-adjustment for children with chronic conditions; payment initiatives from one payer affect patients with other payers; and the impact of quality incentives varies with the competitiveness of the market. 

>> Access the Health Services Research: Part II, December 2010 (Source: AHRQ Electronic Newsletter, Issue #301, sent Dec. 10, 2010)

+ Now Available: AHRQ Report on Successes in Health IT

AHRQ released a new report, Using Health IT: Eight Quality Improvement Stories, highlighting the successes of eight projects funded under the Transforming Healthcare Quality through Information Technology program. These projects demonstrate how health IT applications can be used to improve care for vulnerable populations, improve health care delivery, improve the quality of care, and increase access to health care. Select to access the report.

Included in the report is a section entitled, "Network of Rural Hospitals in Iowa Redesign Patient Care Workflow to Use Electronic Health Records".

>> Access the report (pdf)... (Source: AHRQ Electronic Newsletter, Issue #301, sent Dec. 10, 2010)

+ Quality Measures Workgroup Request for Comment

The Quality Measures Workgroup, formed by the Health Information Technology Policy Committee (a federal advisory committee that advises the U.S. Department of Health and Human Services), is developing recommendations on clinical quality measures enabled for use within electronic health record systems.

As part of this work, the Workgroup identified important measure concepts within the domain areas of Patient and Family Engagement, Clinical Appropriateness/Efficiency, Care Coordination, Patient Safety, and Population and Public Health.

The Workgroup currently requests public comment on its list of prioritized measure concepts, specifically seeking detailed examples of measures relevant to each measure concept that are HIT-sensitive, parsimonious, capable of demonstrating preventable burden, capable of assessing health risk status and outcomes, and longitudinal.

Please see the Quality Measures Workgroup Request for Comment, posted on the Office of the National Coordinator for Health Information Technology's FACA blog, for more detail on the Workgroup's request for comment and for the list of the prioritized measure concepts.

Your comments are greatly appreciated as they will contribute to the HIT Policy Committee's work in identifying electronically-specified clinical quality measures.

Comment Deadline: Dec. 23, 2010

>> Submit comments... (Source: ONC Health Information Technology, FACA News Update, sent Dec. 6, 2010)

+ Brain Teaser: Which Bag Contains Counterfeit Coins

Imagine you have 10 bags full of coins, and each bag contains 1000 coins. One of the bags contains counterfeit coins. A real coin weighs 1 gram, while a counterfeit coin weighs 1.1 grams. Using a scale just one time, how can you identify which bag contains the counterfeit coins?

>> View the solution... (and more Brain Teasers)

(Source:, accessed December 13, 2010)

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