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NCHN eNews
June 12, 2012
This issue's highlights:
  • NCHN News: The Consulting Group Services Program
  • NCHN News: NCHN's New Website Coming Soon
  • Member News: Baraboo News Republic Guest Article by Tim Size: Medicare changes a real threat
  • Partner News: Emerging doctor seeks to follow role model after graduation from Edward Via College of Osteopathic Medicine
  • National News: One rural doctor decides to close shop: ‘It’s just not sustainable’
  • Funding: Center for Sharing Public Health Services: Shared Services Learning Community

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The Consulting Group Services Program

During the NCHN Quarterly Membership call yesterday (Monday, June 11th), Steve Stoddard, Chair of the RHNR Consulting Group Task Force, introduced the Consulting Services Program. A brief description of the program is below, with more detail provided in the Members Only section of the forum.

Overview of the Consulting Program
Many health networks, both new and established, rely on the services of outside consultants to obtain assistance and guidance. The National Cooperative of Health Networks Association (NCHN) Network Member Executives and Associate Members have an invaluable wealth of network knowledge and expertise. For years, NCHN members have provided their knowledge and assistance informally. Formalizing this process will help connect network leaders to specialists who have the knowledge needed to further their goals, while also facilitating a platform through which networks can be compensated for support that is often too extensive for an informal context.

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.

For more information on becoming a consultant, download the materials for the 2012 Quarterly Membership Call from the NCHN forum.


The word 'FACETIOUSLY' contains the six vowels, A-E-I-O-U and Y, in their alphabetical order. Can you find another English word that does the same?


NCHN's New Website

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 new features you can use with your login are:

  • The ability to add an expanded profile page for your network that includes programs, staff, year founded, number of members… really anything you want to share about your network on the site – there is no limit to the amount of text you enter.
  • You can upload or add a link to a current news article or newsletter
  • The ability to post Members Only and Public documents in the Documents section
  • You will be able to post and on the NCHN-based discussion forum
  • Post blog and news comments
  • Search members by specialization and location
  • A significantly improved search functions
    Your general site search will return results according to categories (Documents, News, Members, etc.)

Each of you will have a profile page where you can list your programs and specializations, edit your contact information, add staff, and add a logo and photos. There’s no limit to the amount of information you can share and you no longer have to send it to Rebecca or Christy to have it posted. When you log in, you will be able to add and edit any of the information you have listed. Additionally, we will have a Member Newsletters page and you can post your newsletter on that page.

The biggest issue with making the site more interactive and user authored  – i.e.., both the biggest risk and also the biggest area of opportunity – is that its end value is directly proportional to how much users actually use it. We all know that Facebook, for example, is a great tool for staying in touch with our friends. However, if your friends never login to update you, it’s not much of a tool for staying up to date. With the NCHN site, the ability to connect is there, but if you don’t log in and add information about your network, add your news, etc., its usefulness is going to be minimal.

Our hope is that when we send you your new login in the next few weeks, that you will log in, play around with the site, have some fun updating your profile page and just generally share information about your network so that when other networks want to find out who is doing a Wellness program or launching a Telemedicine program, or who has been a past HRSA grantee, etc., they will find you and your network.  We’re a small community and networks are relatively new, so we hope that you will use this platform to share and gain as much information as possible. And we are very excited about the new site in its ability to facilitate that.

Upcoming NCHN Calls & Events

2013 Conference Planning Committee Call
Tuesday, June 12 @ 2:00 PM ET

Program Development Committee Call
Tuesday, June 19 @ 12:00 PM ET

Coffee/Tea Chat with Dr. Chess
Wednesday, June 20 @ 12:00 PM ET




Guest Column: Medicare changes a real threat
by Tim Size

We found the following article by Tim Size, Executive Director of RWHC, in the news last week. It appears in the Baraboo News Republic.

(Baraboo News Republic) - One out of every six of us lives in rural America. The Midwest has the highest percentage of people living in rural communities — one out of every four.

Most of us have a job. Most of us have health insurance. Neither is perfect. You may feel you don’t need to worry about what Congress does to Medicare. Guess again. Regardless of your age, it will affect you.

The politicians in Washington continue with their high stakes child’s game of “king of the hill.” As they do so, the fragile payment system supporting rural hospitals and clinics may be trampled.


Pioneer Health Network Case Study: New Intranet Helps Small Hospitals Tackle Big Challenges

Two challenges met Bob Krickbaum at the door when he became CEO of Edwards County Hospital in November 2010 — internal communications and policy and procedure management. Both were so disjointed that staff, clinicians and senior leaders at the hospital, located in Kinsley, Kansas, had to nearly conduct a scavenger hunt to find information, policy templates and procedural outlines.

“It was an absolute mess,” said Krickbaum. “When two directors of nursing left before I came on board, half of our policies disappeared. Every department created their own policies, their own templates and there was no way to share them throughout the organization and ensure that they were being read.” Internal messaging depended on blast emails and word of mouth, which meant some staff were not receiving key information. This also made collecting staff feedback a cumbersome task.




Emerging doctor seeks to follow role model after graduation from Edward Via College of Osteopathic Medicine
by Sarah Bruyn Jones

The following article is about a VCOM graduate. VCOM is a supporter of NCHN and was the receipient of the Friend of NCHN Award in 2011.

June 2, 2012 (The Roanoke Times) - Graduating student Emily Bralley said Dr. Paul Brown in Marion showed her the value of treating people with compassion and a sense of community

As a teenager, Emily Bralley would drive over the mountain from her family's farm in Smyth County to spend her free time shadowing Dr. Paul Brown.

There, in Marion, she witnessed the intersection of compassion, medicine and community. And she found her calling.

She spent her visits watching Brown instruct patients on how to take care of the common chronic conditions of rural Virginia, like hypertension and diabetes. She observed his good nature in treating the young and old with broken bones and nasty colds.




Rural Health Open Door Forum
Centers for Medicare and Medicaid Services

Conference Call: June 12, 2012 @ 2:00 PM ET
Dial: 800.837.1935
Conference ID: 52260523


Assess Needs & Resources, Putting County Health Rankings into Action
County Health Rankings & Roadmaps

Webinar: June 12, 2012 | 2:00 - 3:00 PM CDT

One of the first steps in local health improvement is to take stock of your community's needs, resources, strengths, and assets. You will want to understand what helps as well as what hinders progress toward improving your community’s health. Learn about guidance, tools and resources for understanding your community’s strengths, resources, needs, and gaps.


HRSA's Maternal and Child Health Webcasts

MCH Learning supports communication, education and collaboration between state and federal maternal and child health professionals who serve the nation's mothers, families and children. Join our live webcasts with presenters in real time or access archived webcasts at any time.

June Webcasts

  • Lessons Learned from Innovative Approaches to Promote Healthy Weight in Women
    June 4, 2012 | 2:00 - 3:30 PM ET
  • The National Pediatric Readiness Project
    June 18, 2012 | 1:00 - 2:30 PM ET
  • Kids in Disasters: Facing Our Challenges
    June 20, 2012 | 12:30 - 2:00 PM ET


National Advisory Committee on Rural Health and Human Services

June 18 - 20, 2012
Kansas City, MO

The National Advisory Committee on Rural Health and Human Services provides counsel and recommendations to the Secretary with respect to the delivery, research, development, and administration of health and human services in rural areas.

Persons interested in attending any portion of the meeting should contact Aaron Wingad at the Office of Rural Health Policy (ORHP) via telephone at (301) 443-0835 or by email at The Committee meeting agenda will be posted on ORHP's Web site


Version 5010 – Are You Ready?

Webinar: June 20, 2012 | 12:00 - 1:00 PM ET

Please join CMS staff for an informative webinar for healthcare providers, clearinghouses and vendors on Version 5010. Version 5010 refers to the standards that HIPAA-covered entities (health plans, health care clearinghouses, and certain health care providers) must use when electronically conducting certain health care administrative transactions, such as claims, remittance, eligibility, and claims status requests and responses. All covered entities should have been fully compliant with Version 5010 by January 1, 2012; however, an enforcement delay is in effect until June 30, 2012.

Stay tuned for further information on the details of your region’s session and registration information.

» UPDATES: If you want to subscribe to the provider-only listserv, please email: with “subscribe” as the subject line.

NRHA Rural Quality and Clinical Conference

July 18 - 20, 2012
Seattle, WA

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's March for Rural Hospitals

July 30 - 31, 2012
Wasington, D.C.

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.




Obama Administration Lists Rural Successes
by Jefferson Sinclair

June 7, 2012 (The Daily Yonder) - The Obama Administration recently unveiled a report that, according to the White House Office of Communications, highlights the administration’s “accomplishments supporting rural communities.”


One rural doctor decides to close shop: ‘It’s just not sustainable’
by Sarah Kliff

June 6, 2012 (The Washington Post) - A day in the life of Dr. Marc Shiffman can go something like this: Leave home at 7:45 a.m. Drive 40 miles through rural Colorado to Summit Internal Medicine, the clinic he founded in 2007. Start seeing patients at 8:30 a.m. Stop seeing patients at 5:30 p.m. Do paperwork—forms that need to be sent to insurers, bills that need to be looked over—until 9:15 p.m. Make the 40-mile drive back home. Arrive around 10 p.m. Repeat.

Shiffman is the only internist in Summit County, a rural area of Colorado about 72 miles west of Denver. He founded his own clinic in April 2007, after a long career working in large doctor groups and hospitals. At the end of this month, on June 30, Shiffman will close his clinic.


More from The Wastington Post
Reedville country doctor just wants to have fun (May 27, 2012)

Rural Kansas Hospital Recruits Physicians with a Mission
by John Commins

June 6, 2012 (HealthLeaders Media) - There is no shortage of strategies to recruit physicians to rural America.

With varying degrees of success, enticements have included student loan debt relief, homey pitches touting country living, membership at the local country club, a house, a car, no ED call, great schools for the kids, a cushy job for the spouse, and for foreign docs, a fast-track to U.S. citizenship.


Short-stay general hospitals receive safety scores

June 7, 2012 ( - More than 2,600 U.S. hospitals have received letter grades — formally known as a Hospital Safety Score — based on patient safety through a first-of-its-kind initiative.

A blue-ribbon panel of the nation’s top patient safety experts provided guidance to The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits, to develop the Hospital Safety Score using publicly available data on patient injuries, medical and medication errors and infections.


A CEO Checklist for High-Value Health Care
by Delos Cosgrove, Michael Fisher, Patricia Gabow, Gary Gottlieb, George Halvorson, Brent James, Gary Kaplan, Jonathan Perlin, Robert Petzel, Glenn Steele, and John Toussaint

June 5, 2012 (Institute of Medicine of the National Academies) - Health care in the United States is at a critical point. Excessive costs are no longer tenable and mediocre outcomes are no longer tolerable. For 32 of the past 40 years, health care costs have grown faster than the rest of the U.S. economy. Federal health care costs—expected to reach $950 billion in 2012—will become the largest contributor to the national debt. States, too, are being crippled by health care costs. Medicaid now consumes almost a quarter of state budgets, crowding out investments in education and infrastructure. In the private sector, escalating costs have eroded the bottom line for employers who purchase health care for their employees and have eliminated any appreciable gains in income for American families during the past decade. Purchasers simply cannot afford the status quo.


The Downside Of Health Care Job Growth
by Jenny Gold

June 7, 2012 (Kaiser Health News) - Health care employment has been the bright spot in the otherwise lackluster recent jobs reports. As overall employment decreased by 2 percent from 2000 to 2010, employment in the health care sector actually increased by 25 percent. But that’s not necessarily a good thing, according to an opinion piece published in the most recent edition of the New England Journal of Medicine. “Treating the health care system like a (wildly inefficient) jobs program conflicts directly with the goal of ensuring that all Americans have access to care at an affordable price,” write Katherine Baicker and Amitabh Chandra, two researchers from Harvard.


States join to create tools for implementing Affordable Care Act
by Sarah Kliff

June 8, 2012 (The Washington Post) - For 14 months, a bipartisan group of 17 states has been quietly collaborating with the Obama administration to help build a foundation for the health-care reform law’s success.

The group includes some of the law’s staunchest supporters working alongside a handful of its bigger detractors. They are backed by $3 million in funding from eight nonprofit organizations that hope to see the Affordable Care Act succeed.


USDA releases report on rural community support

June 4, 2012 (Delta Farm Press) - The USDA has released a report highlighting the ways in which infrastructure investments in rural communities help create jobs and boost economic development.

"Quality hospitals, schools and libraries are the building blocks for a vibrant rural America," said Agriculture Secretary Tom Vilsack. "Today's announcement illustrates how the Obama administration is leveraging Rural Development's investments to ensure that rural communities can compete in the global economy."


Consumer Reports Releases First-Ever Doctor Practice Ratings

June 2012 (Robert Wood Johnson Foundation) - Consumer Reports released its first patient experience ratings of primary care physician groups as part of a partnership with Aligning Forces for Quality, the Foundation’s signature effort to lift the quality of care in 16 targeted communities. The ratings cover nearly 500 practices in Massachusetts and were developed by Massachusetts Health Quality Partners (MHQP), a coalition of leading health care stakeholders that operates Greater Boston Aligning Forces for Quality. The report promotes opportunities for patients to become more involved in their care and to build stronger partnerships with their doctors.


Information about CMS' Comprehensive Primary Care Inititative
Center for Medicare & Medicaid Innovation

The Comprehensive Primary Care (CPC) initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. Medicare will work with commercial and State health insurance plans and offer bonus payments to primary care doctors who better coordinate care for their patients. Primary care practices that choose to participate in this initiative will be given resources to better coordinate primary care for their Medicare patients.


House companion to rural hospital bill introduced

June 8, 2012 ( - At the urging of AHA, Reps. Tom Reed (R-NY) and Peter Welch (D-VT) today introduced a House companion to the Rural Hospital Access Act, legislation that would reauthorize the Medicare-Dependent Hospital program and extend the enhanced low-volume Medicare adjustment for prospective payment system hospitals for one year (through September 2013). The House bill also calls for the Government Accountability Office to study the impact of the add-on payments. Rural hospitals are more dependent on Medicare revenue and financially vulnerable to prospective payment because of the high percentage of Medicare beneficiaries who live in rural areas. To reduce this risk, the MDH program pays 211 eligible hospitals for inpatient services the sum of their prospective payment system rate plus three-quarters of the amount by which their cost per discharge exceeds the PPS rate. The AHA expressed support for the legislation in a letter today to Reed and Welch. (link to orginial article)

Young, Uninsured, and in Debt: Why Young Adults Lack Health Insurance and How the Affordable Care Act Is Helping
by Sara R. Collins, Ph.D., Ruth Robertson, M.Sc., Tracy Garber, M.P.H., and Michelle M. Doty, Ph.D.

June 8, 2012 (The Commonewealth Fund) - The Commonwealth Fund Health Insurance Tracking Survey of Young Adults finds that between November 2010 and November 2011, an estimated 13.7 million young adults ages 19–25 stayed on or joined their parents' health plans, including 6.6 million who likely would not have been able to do so prior to the passage of the Affordable Care Act. The findings of the survey underscore the need for policymakers to implement the remaining coverage expansions in the law. Nearly two of five young adults ages 19–29 were without health insurance for all or part of 2011, with young adults in low- and moderate-income households the most at risk. The lack of insurance had significant health and financial implications for young adults: 60 percent said they did not get needed health care because of cost and half reported problems paying medical bills or said they were paying off medical debt over time.


An Estimated 6.6 Million Young Adults Stayed on or Joined Their Parents' Health Plans in 2011 Who Would Not Have Been Eligible Prior to Passage of the Affordable Care Act (The Commonwealth Fund, June 8, 2012)



Center for Sharing Public Health Services: Shared Services Learning Community
Robert Wood Johnson Foundation

2012 Call for Proposals

Deadline: August 29, 2012 @ 3:00 PM EDT

Purpose: lth Purpose: Public health agencies play a critical role in our nation’s health system. The dramatic increases in the length and quality of life for so many Americans over the past century are attributed, in large part, to the efforts of public health and the work of public health agencies to keep people healthy and safe. As communities face new challenges, like the increasing burden of chronic disease and lean fiscal environments, and new opportunities like advances in technology, many public health officials and policy-makers are exploring new ways to organize and structure the management and delivery of public health services. One such strategy is the sharing of services, resources and functions across multiple public health agencies and jurisdictions. Referred to as cross-jurisdictional sharing (CJS), these arrangements range from informal agreements around sharing discrete services or programs, to regionalization including the formal merger or consolidation of multiple public health agencies. In order to better understand the opportunity and impact of cross-jurisdictional sharing among public health agencies, the Robert Wood Johnson Foundation (RWJF) will fund up to 18 teams across the country that are exploring, implementing or improving cross-jurisdictional sharing arrangements to participate in the Shared Services Learning Community.

RWJF will provide two-year grants of up to $125,000 to up to 18 teams of public health officials, policymakers, and other stakeholders that are exploring, implementing and/or improving CJS arrangements between two or more public health agencies. The Shared Services Learning Community will foster a peer learning environment among teams that are taking a systematic approach to CJS arrangements to achieve the dual goals of greater efficiency and enhanced public health capacity.



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