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Hello Everyone!
Happy New Year! I hope everyone had a chance to celebrate with friends and family. We have a lot of great information in this edition of Rural Route.
Tuesday the 24th Sarah Young (Federal Office of Rural Health Policy), John Gale (Flex Monitoring Team) and I hosted a webinar where the we discussed the most recent Performance Improvement and Management System (PIMS) data submission, the results from the technical assistance assessment as well as some suggestions for using PIMS for performance improvement withing your Flex Program. Please find information below to access the recording and slides from the webinar.
Below you will see an article dedicated to recognizing the success of our second Critical Access Hospital (CAH) Recognition Certificate recipient. Please join me in congratulating Carondelet Holy Cross Hospital in Arizona for their efforts.
The Flex Monitoring Team also released a Data Summary Report on the HCAHPS results for CAHs from 2015 data information. Links to that can be found below.
Feel free to send any pictures you happen to take along your travels.
Until next time,
Caleb Siem, MH
Program Specialist
Technical Assistance and Services Center (TASC)
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Welcome and Farewell
We encourage you to keep your Flex staff contact information current by completing the new
contacts form
as soon as possible whenever there are changes in your office. Please review your contacts as listed in your
State Flex Profile
and complete the form as necessary for any additions or changes.
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| Presentation of recognition to Carondelet Holy Cross Hospital team. Left to right - Diana Rojas-Sanchez, Director of Support Services, Holy Cross Hospital, Mark Valenzuela, Board Chair, Holy Cross Hospital, Debra Knapheide, Chief Executive Officer/CNO/COO, Holy Cross Hospital, Joyce Hospoodar, Senior Advisor, Rural Programs, Center for Rural Health,The University of Arizona Mel and Enid Zuckerman College of Public Health, Les Caid, Fire Chief, Rio Rico Fire, Matt Eckhoff, Program Director, Rio Rico Fire Community Integrated Paramedicine Program. |
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CAH Recognition - Emergency Medical Services Innovation
Congratulations to Carondelet Holy Cross Hospital as a recipient of the National Rural Health Resource Center's Critical Access Hospital (CAH) Recognition Certificate for demonstrating innovation in the area of emergency medical services (EMS). Joyce Hospodar, Senior Advisor to the Arizona Flex Program, nominated Holy Cross Hospital for their efforts and leadership.
"Holy Cross Hospital is a proud partner in the Community Healthcare Integrated Paramedicine Program and continues to find innovative models of care to provde quality health care for all Santa Cruz County communities," said Debra Knapheide, CEO/COO/CNO at Holy Cross Hospital. "We are proud to be recognized for our work in this collaborative effort to deliver health care that is affordable, high-quality and necessary for the good of our community. Holy Cross Hospital is committed to keeping pace with health care transformation, which is key to sustaining access to health services for rural communities."
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n 2014, health care providers serving residents of Santa Cruz County, Arizona, came together to create the Community Healthcare Integrated Paramedicine Project (CHIPP). A major focus of this effort was to address the needs of the frequent utilizers of the 911 system and the hospital Emergency Department (ED) in a more proactive and cost effective manner. Using Community Paramedics to make home visits to assess safety of the home environment, review and assess the patient's ability to take medication as prescribed, and monitor patient's medical condition before a 911 call and transport to the ED if needed, was felt to be an alternative approach worth exploring. One of the key providers involved in this collaboration was Carondelet Holy Cross Hospital (CHCH), Nogales, Arizona.
In 2015, the Rio Rico Medical & Fire District (RRMFD) was successfully awarded a three year Health Resources and Services Administration (HRSA)-funded Rural Health Services Outreach Program grant entitled Community Healthcare Integrated Paramedicine Program (CHIPP). CHCH became an integral member of the RRMFD's coalition supporting this effort. CHCH staff working directly with this coalition include the Chief Medical Officer, the Medical Staff Services Coordinator and the Manager of Care Coordination.
The Arizona Rural Hospital Flexibility Program (AzFlex) supports this effort by providing results to CHCH from the statewide EMS needs assessment and by tracking hospital readmissions at the hospital, one of the core quality measures being tracked and addressed by the AzFlex program. In addition, an AzFlex staff member is coordinating and conducting the CHPP evaluation under a separate contract.
Years 2 and 3 of the program will see expansion of the program throughout the county and continued refinement of the ability of home visits by Community Paramedics to proactively address patient needs and minimize unnecessary 911 calls, ED visits and hospital readmissions. Monitoring activities will identify ongoing areas for improvement in the delivery of community integrated evaluation, where a participatory approach is planned involving all stakeholders.
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Sarah Young, FORHP |
Dear Flex Coordinators,
I hope you have been taking advantage of the great Virtual Knowledge Group (VKG) webinars we have had lately. Thank you for the examples you shared on January 9th: Lara (Oklahoma), Emerson and Stacie (Oregon), Penny (Wisconsin) and Lisa (Georgia). The recordings are available in the
Flex Program Forum
As far as Flex grant operations this month, Federal Financial Reports (FFRs) are due January 30 and carryover requests are due no later than March 1 (30 days after the FFR due date). Flex Programs are welcome to request carryover if you have unobligated funds, but only if it makes sense to do so for your program. You don't need to carry over unobligated funds and it is fine to not request carryover if it doesn't help your Flex Program. We will reject any initial carryover requests submitted in the Electronic Handbook (EHB) after March 1, although Flex Programs may continue working with their project officers to revise existing requests after March 1. Even though there is still time, we encourage you to submit carryover requests as soon as you can so it can be approved and your program can get started on the projects without delay.
In MBQIP news, I shared an email with the listserv on Monday, January 23, about the glitch preventing critical access hospitals (CAHs) from reporting outpatient population and sampling data to the secure online portal in QualityNet. Please continue to contact Rural Quality Improvement Technical Assistance (RQITA) by email at tasc@ruralcenter.org if you have questions about this issue or other problems with quality reporting.
Thank you to everyone who has shared feedback on the Performance Improvement & Measurement System (PIMS). You are helping us iterate and improve Flex Program data collection. Please keep the questions and suggestions coming.
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CAH Regulatory Update
Medicare Advancing Care Coordination through Episode Payment Models (EPMs)
New Medicare Quality Report from Assistant Secretary for Planning and Evaluation (ASPE)
Rural Economic Development Loan and Grant Programs
Rural Transportation Systems Development
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MBQIP Highlights & Resources
As a reminder, please send your MBQIP questions to the
tasc@ruralcenter.org e-mail address. TASC will ensure your question reaches the best person to answer your question.
MBQIP Data Reporting Reminders - UPDATED
The MBQIP data reporting reminders are for use by Flex Programs in helping critical access hospitals (CAHs) with quality data reporting by reminding them of upcoming data submission deadlines, corresponding collection time periods and submission tools. The January 2017 Reporting Reminder Template should be shared with CAHs to help in their efforts.
*Note: FORHP is aware of the issues related to submission of outpatient population and sampling data in the secure online portal for 3rd quarter 2016 data that is due February 1. Please see the e-mail distributed on 1/23/2017 from Sarah Young for additional details.
Interpreting MBQIP Hospital Data Reports for Quality Improvement Guide
NEW
This guide is intended to help CAH staff use Medicare Beneficiary Quality Improvement Project (MBQIP) hospital data reports to support quality improvement efforts and improve patient care.
Quality Improvement Basics Resource List
For use by Flex Programs and CAHs,
this resource provides rural health care quality professionals a summary of helpful introductory QI resources and provides awareness of the more prominent health care quality organizations, programs and terms.
MBQIP Talking Points
This
list of summary statements is intended to equip state Flex Program staff with talking points to address concerns and encourage participation in quality reporting and improvement programs.
Updated State EDTC Submission Templates - Coming soon!!
Flex Programs will be receiving updated State Emergency Department Transfer Communication (EDTC) Submission Templates from their project officer in the next couple weeks. Please keep an eye out for this information, and utilize the updated template for Q4 2016 EDTC submission due February 10, 2017 to FORHP.
MBQIP Monthly is a monthly e-newsletter that provides CAHs with information and support for quality reporting and improvement and highlights current information about MBQIP. State Flex Programs are encouraged to distribute MBQIP Monthly to their CAHs as an additional resource to supplement state level MBQIP support. The most current version always available on the
MBQIP Monthly webpage.
Rural Quality Improvement Technical Assistance (RQITA) and TASC have teamed up to host MBQIP virtual knowledge group (VKG) calls/webinars to give you the opportunity to share MBQIP successes, challenges, barriers and brainstorm strategies to assist hospitals towards reporting, participating, improving and excelling in the four MBQIP quality domains. These calls/webinars are meant for state Flex Program personnel and designated contractors. The next MBQIP VKG call is scheduled for February 16, 2017, 2:00 p.m. - 3:30 p.m. Central Time. More information will be sent to the appropriate email lists prior to the call. Contact
Jodi Winters at Stratis Health with any questions or for access to the recordings of previous VKG webinars.
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MBQIP Resource List
Bookmark this now!
RQITA has compiled the best-of-the-best overview and key resources for MBQIP into one Resource List for your quick and easy access.
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HCAHPS Results for CAHs, 2015
The Flex Monitoring Team has released reports of (CAH) performance and reporting rates on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, utilizing data from calendar year 2015.
For more information about this study, please contact
Michelle Casey of the Flex Monitoring Team.
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TASC has been busy working on the following items for state Flex Programs, CAHs and other partners:
- Flex Program Fundamentals Guide - will be updated online and mailed to each state Flex Program at the end of January
- State Flex Profiles - 2017 updates will be published online at the end of January
- Virtual Knowledge Group (VKG) webinars - the next webinar will be March 6 on Flex grant and contract management. The most recent VKGs including the January webinar on using rural data and the Critical Access Hospital Measurement & Performance Assessment System (CAHMPAS) can be found in the Flex Program Forum
- The next TASC 90 webinar will be Februrary 15 on Population Health, featuring the recently updated Population Health Portal
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Supporting FORHP in developing a PIMS data collection tool and also a Flex Program data table
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Planning for the April 11-13 Flex Program Workshop in Duluth, MN. If you would like to attend, please email Bridget Hart
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Conducting site visits, updating online resources and planning for the 2017 Flex Program Reverse Site Visit
If you have any questions on any of the above work under development, or an idea for TASC to consider, please let us know by emailing
Tracy Morton.
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Population Health Portal Update
In cooperation with the Federal Office of Rural Health Policy (FORHP), the
Population Health Portal has been updated with new resources to Get Motivated, Get Informed and Get Going to navigate the journey towards improved population health.
The Data Tool focuses on specific scenarios for a hospital or county which allow users to analyze the data in the portal and also extract the data for further analysis in Microsoft Excel. The Data Tool includes three new scenarios and data updates to the six existing scenarios. Scenarios include explanations and instructional videos on how to use and export the data. A new resources provides examples of analyzing claims data.
The new Data Tool scenarios include:
- Socioeconomic Status and Well-being
- Understanding of Care and County Race Demographics
- Uninsured Rates, Behavior and Mental Health
- Using Claims Data
Assess your readiness and receive targeted tools and resources. Where are you in the journey towards population health? Complete the
Critical Access Hospital Population health readiness Assessment, accessed on the portal, to connect with tools and resources targeted towards rural health organizations' unique strengths and needs for transitioning towards population health.
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Community Factors and Outcomes of Home Health Care for High-risk Rural Medicare Beneficiaries
This policy brief demonstrates the outcomes of care varied by region of the
country
for rural Medicare beneficiaries receiving home health services for high-risk conditions, including acute myocardial infarction, heart failure, pneumonia and chronic obstructive pulmonary disease. Rural beneficiaries in the East South Central and West South Central Census Divisions had lower rates of being discharged to the community and higher
rates of hospital readmission and emergency department use. Rural beneficiaries in New England, Middle Atlantic, West North Central and Pacific Census Divisions had higher rates of being discharged to the community and lower rates of hospital readmission and emergency department use. Differences in rural beneficiaries' home health outcomes appear to be related primarily to the region of the country where they live rather than other included community factors such as rurality of beneficiary residence (large, small or isolated small rural areas), country-level economic status and availability of local health resources.
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MIPS Scoring: Quality, Advancing Care Information, and Improvement Activities
In this webinar, Lisa Gall, Clinical Program Manager at Stratis Health, will dig deeper into the Merit-Based Incentive Payment System (MIPS). Participants will learn why small and rural hospitals should consider voluntarily participating in MIPS to prepare for future value-based payments. Value-based care drives organizations to change the way care is provided from an individual patient and episode, to a broader, collaborative health care system. Learn how your hospital/clinic can deliver and engage patients and other health care providers to deliver population-based health care that focuses on patients across the spectrum of care in your community.
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New Flex Virtual Knowledge Group Webinars
We are pleased to announce a series of Virtual Knowledge Group (VKG) webinars for state Flex Program staff for the current Flex program year. VKG webinars are supported by FORHP and coordinated by TASC.
VKG webinars are intended to provide a forum to state Flex Programs for peer learning to share successes, discuss challenges and brainstorm strategies for improvement and Flex Program excellence. A variety of topics focusing on the Flex Program will be discussed on the webinars, focusing on a conversation instead of a presentation. In some instances, subject matter experts and/or state Flex Programs will be identified in advance to share their stories, expertise or experience. An agenda will be distributed prior to each webinar to allow state Flex Program personnel and/or appropriate subcontractors an opportunity to determine whether the topics will align with their needs. The VKG webinars will be recorded with playback made available in the Flex Program Forum. The intended audience for the VKGs include state Flex Program Directors, Coordinators or other Flex personnel, including Flex Program subcontractors working on implementing Flex-related activities.
Please note that the MBQIP VKG calls coordinated by RQITA will also continue to occur. The next scheduled MBQIP VKG is February 16 at 2:00 p.m. Central Time.
Please save the dates for the below VKG webinars. Calendar appointments will also be distributed:
- Monday, January 9, 2017 - Using Rural Data, Including CAHMPAS (Critical Access Hospital Measurement & Performance Assessment System) Recording available on the Flex Program Forum
- Monday, March 6, 2017 - Flex Grant and Contract Management
- Monday, April 3, 2017 - Working with CAHs to Implement Community Health Needs Assessments (CHNAs)
- Monday, May 1, 2017 - Assessing State Emergency Medial Services (EMS) Capacity
- Monday, June 5, 2017 - Mental and Behavioral Health
- Monday, August 7, 2017 - How to Use Crucial Conversations
If you have any questions about the VKGs, please contact Bridget Hart.
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| Photo by Kami Norland, Community Program Manager, The Center |
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New & Updated Resources
The following resources on the TASC website are new or recently updated:
Author: Rural Health Value
This document catalogs and summarizes rural-relevant, value-based programs recently implemented by the Centers for Medicare & Medicaid Services (CMS), including the Center for Medicare & Medicaid Innovation (CMMI). Its purpose is to help rural leaders and communities identify Health and Human Services (HHS) value-based programs appropriate for rural participation.
Author: Minnesota Department of Health & Primary Care
This toolkit contains a series of helpful tools and resources that can be used as an example by a wide variety of stakeholders, but primarily prospective employers interested in hiring and integrating a community paramedic (CP) into their organization. The tools contained in this Toolkit are intended to be both actionable and measurable, and will help streamline an employer's decision-making while adopting a CP program. The toolkit also includes references, resources and examples to help planners get started quickly.
Author: Minnesota Department of Health & Primary Care
This emergency medical services (EMS) toolkit includes resources developed for rural EMS organizations, which are often run by volunteers. The toolkit addresses common issues faced to keep EMS organizations staffed, funded and running smoothly. The toolkit s divided into three main sections: recruitment and retention, funding and finances and leadership and management resources.
Author: Observation Health Data Sciences and Informatics (OHDSI)
Information about Observation Health Data Sciences and Informatics (OHDSI) presented at the American Medical Informatics Association (AMIA) 2015 Annual Symposium.
New/Updated MBQIP Resources - are now in the 'MBQIP Highlights' section above.
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2016 Rural Enrollment in Health Insurance Marketplaces, by State
In
this brief, cumulative county-level enrollment in Health insurance Marketplaces (HIMs) through March 2016 is presented for state HIMs operated as Federally Facilitated Marketplaces (FFMs) and for those operated as Federally Supported State-Based Marketplaces (FS-SBMs). Enrollment rates in metropolitan and non-metropolitan areas of each state, defined as the percentage of "potential market" participants selecting plans, are presented. Results show that estimated enrollment rates varied considerably across the United States. In particular, estimated enrollment rates in non-metropolitan areas were substantially higher than in metropolitan areas in Hawaii, Illinois, Michigan, Montana, Maine, Nebraska, Wisconsin and Wyoming. About half of all states, evenly distributed by Medicaid expansion status, had higher enrollment growth in non-metropolitan areas from 2015 to 2016, and in fact, aggregated non-metropolitan growth was greater than metropolitan growth in both expansion categories.
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MACRA/MIPS Overview and Eligibility
This webinar provides an overview of MACRA's Quality Paymnet Program (QPP), eligibility requirements, and impacts on payment, quality and cost. Small and rural hospitals play a key role in improving patient and community health, avoiding readmissions, and keeping patients healthy. This webinar provides a basis for working with staff and providers affected by the QPP within and outside your organization.
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Connect Peer to Peer in Flex Program Forum
Do you have a question, idea, success or challenge to share with your Flex Program peers? Don't miss the ongoing discussions on the
Flex Program Forum
.
Please note, you will need to login to read recent postings, which include:
If you have questions about the Flex Program Forum, please contact
TASC.
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New Rural Research
Conducting Rural Health Research, Needs Assessment, and Program Evaluation
Rural Communities and health care facilities have limited resources to address many health-related needs. Research and needs assessments can help determine where and how resources may best be targeted, and program evaluations can indicate whether a particular intervention or approach works well in a rural context.
This guide identifies the similarities and differences among rural health research, assessment and evaluation, discusses common methods and provides contacts within the field of rural health research among other things.
Measuring the Impact of Opioid Policies
This overview of the efforts taken by the Centers for Disease Control and prevention (CDC), the Food and Drug Administration (FDA), the U.S. Department of Health and Human Services (HHS) and Congress to address the opioid epidemic. Although some progress has been made, some efforts are too recent to gauge their efficacy, and access to care for rural people still remains an issue.
Animals Help People Health in Rural Areas
Rural programs across the country rely on service or therapy animals to help people with mobility, motor skills, and mood. In
this article you have the opportunity to meet the service dogs of Hawaii, the therapeutic ridding horses of Wyoming and the therapy pig and tortoise who call a skilled nursing facility home in Florida.
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Webinar Playbacks and Event Materials
Are you looking for resources in the topics of: subcontract management, MBQIP data reports, SHIP TA or rural financial strategies? Look no further!
Network
- Allied Health Networks
- Network Development
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National Rural Health Resource Center Blog
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Grow your Career: Save the Dates
Below is a list of upcoming events relevant to rural health:
Technical Assistance and Services Center (TASC)
TASC 90 Webinar - Population Health
February 15, 2017 - 2:00 p.m. - 3:30 p.m. Central Time
MBQIP Virtual Knowledge Group
Thursday, February 16, 2017 - 2:00 p.m. - 3:00 p.m. Central Time
Flex Program Workshop
April 11-13, 2017 Duluth, Minnesota
2017 Reverse Site Visit
July 19-20, 2017 Bethesda, Maryland
View upcoming rural events
by month, s
tate or keyword search.
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Are you interested in receiving quick, up-to-date information from the National Rural Health Resource Center? Like the National Rural Health Resource Center on
Facebook and follow us on
Twitter and
LinkedIn!
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