Rural Route
 
June, 2019
In this Issue
TASC Updates
MBQIP Updates
Webinars & Events
Resources
FMT Resources
Quick Links

TASC Home

Events

Resource Library

Staff

State Flex Profiles

FMT

NOSORH

Grants.gov

RHIhub

Rural Health Value

CMS

Hello Everyone!

I hope your summer is off to a good start! June has definitely passed us by quick up here in Duluth.

We are getting excited for the 2019 Reverse Site Visit (RSV).  It will be a great chance for everyone to catch up and to get updated on the new resources and projects. 

I'm looking forward to meeting so many of you in person for the first time in just a few weeks! I hope you enjoy this month's edition of Rural Route. We appreciate you taking the time to read it.

Thank s,                              
Andy Naslund
Program Coordinator
Technical Assistance and Services Center (TASC)
             

Welcome to Britton Hubert, Program Manager in South Carolina.  We are happy to have you as part of Flex!

We bid a fond farewell Melinda Merrell of South Carolina and Abigail Garcia of Indiana. We with them both well!

Please keep your Flex staff contact information current by completing the  State Flex Program Contact Information Form  whenever there are staffing changes in your office. 

FORHP Updates                                 

Hi Flex Coordinators, 

Welcome to summer! In addition to fireflies in the grass, water lotus blooming at Kenilworth Aquatic Gardens, and long sunsets on the National Mall, summer brings the Flex Reverse Site Visit and a chance for us all to share information about the Flex Program. I know I speak for all of us at FORHP-we are very much looking forward to seeing you in July. As always, a huge thank you to the TASC team-Andrew, Nicole, Caleb, Tracy, Terry, and Sally-for organizing and hosting the meeting.

Your peers on the planning committee developed the theme and selected sessions to meet your interests and needs. As you attend the meeting in two weeks, please think about how it goes and let us know what we can change to make the Flex Reverse Site Visit even better in the future. We want to practice continuous improvement in this meeting and in all areas of the Flex program. 

Do you have any questions about Flex issues that you would like us to address at the meeting? Let me know or post them in the Flex Program Forum

Finally I'd like to remind everyone that the Flex Monitoring Team CAH list is our go-to reference for the number and distribution of CAHs nationally. Please let FMT know anytime you have a new CAH in your state so that they can include it in the next update of the CAH list.

See you soon!

Sarah Young

Flex Program Coordinator


CAH Regulatory Update

Updates include: 
  • The Center for Medicare and Medicaid Services (CMS) Request for Information for reducing administrative and regulatory burden
  • CMS Emergency Triage, Treat, and Transport (ET3) Model Request for Applications Preview
  • Health Resources and Services Administration's (HRSA) Teaching Health Center Graduate Medical Education Program
  • CMS Listening Session on Co-Location Guidance
Continue reading CAH Regulatory Updates (Flex Forum login required - contact  TASC for details)

2019 Flex Program Reverse Site Visit
As a reminder, the 2019 Flex Program Reverse Site Visit (RSV) will be held July 10-11, 2019 at the Washington Marriot Wardman Park in Washington, DC. This in-person Flex meeting is supported by the Federal Office of Rural Health Policy (FORHP).
 
The purpose of the Flex Program RSV is to highlight the latest information and issues in the Medicare Rural Hospital Flexibility (Flex) Program, as well as offer states an opportunity to share experiences, lessons learned and successes in a collaborative learning environment.

An online version of the RSV Agenda can be found here .
CAH Recognition: Six CAHs in Washington
Six critical access hospitals (CAHs) in Washington are recognized for an innovative, multi-state, rural palliative care initiative that includes telehealth case consultation with an interdisciplinary team. The initiative also includes one rural prospective payment system hospital.

The six CAHs receiving recognition are: 
  • Columbia Basin Hospital, Ephrata
  • Columbia County Health System, Dayton
  • Jefferson Healthcare, Townsend
  • Newport Hospital and Health Services, Newport
  • Pullman Regional Hospital, Pullman
  • Whitman Hospital and Medical Center, Colfax.

Positive Outcomes
In addition to the participating hospitals, the Washington Rural Palliative Care Initiative includes partners in each community. They partner with quality improvement and evaluation experts to choose, define, and outline measures to satisfy one or more of the following purposes:
  • Quality improvement
  • Program evaluation
  • Knowledge contributions
  • Business case
Top Accomplishments
  • Increased access to palliative care in rural communities to improve patient experience and quality of life.
  • Reduced emergency department and inpatient bed use resulting in decreased total cost of care.
  • Built skills for existing CAH staff that address a potential workforce issue while having a favorable effect on health care teams.
HRSA MBQIP Performance Standards: Public Comment

Dear Flex Program personnel and subcontractors,
 
Since MBQIP was started in 2011, we have seen reporting rates increase in all four MBQIP domains. While reporting rates remain an important indicator of engagement, the Federal Office of Rural Health Policy (FORHP) is seeking opportunities to focus more on measure quality performance and improvement.

Over the past year, the FORHP and the Rural Quality Improvement Technical Assistance team (RQITA) developed a means to evaluate and set goals for MBQIP quality performance and improvement at measure, domain, programmatic, state, and national levels. We gathered input from state Flex programs through Virtual Knowledge Group and focus group calls and refined the methodology. The result is the proposed
MBQIP Performance Standards
 
The purpose of the MBQIP Performance Standards is first and foremost to set national goals for MBQIP and evaluate performance and improvement from a national level down to a specific measure.
 
We are reaching out to you now to get your input! As state Flex Coordinators and MBQIP subcontractors, we want to ensure that you have the opportunity to provide us feedback on the methodology and how you envision FORHP and/or states could utilize these MBQIP performance standards.
 
The public comment period will be from Tuesday, June 25 - Monday, August 12, 2019. Please submit your public comments in our fillable form here:  http://www.cvent.com/d/vyqlqx
 
We will be reviewing the MBQIP Performance Standards on Thursday's MBQIP June VKG (3-4:30pm EST) ( Pre-register here.). Please take the time to review the materials prior to the call.
 
We encourage you to send us your questions ahead of time so that we can answer them on the VKG. Please submit your questions with the subject line "MBQIP Performance Standards" to [email protected].
 
Thank you,
 
Yvonne Chow (Yiu)
MBQIP Coordinator

TASC Updates:

The COPD/Pulmonary Scope of Services Assessment
Flex Coordinators, thank you to everyone who sent out the COPD/Pulmonary Scope of Services Assessment over the past month! The assessment recently closed, but we received so many great responses for the assessment, and we truly appreciate all of you for sending it out to your hospital contacts. The results of the assessment will be used to inform the COPD manual available later this summer.

Rural Chronic Obstructive Pulmonary Disease (COPD) Podcast Series: Episode #4 Out Now!

The National Rural Health Resource Center (The Center) has partnered with Dr. Bill Auxier of  Rural Health Leadership Radio   to produce a six-part podcast series about Rural COPD and its prevalence in rural America. This series from The Center provides information about COPD, how rural  providers are meeting the needs of their communities, and the importance of billing and coding appropriately while ensuring quality of care is being addressed. Each podcast features a guest with expert knowledge in COPD and rural health.
 
Available now: E pisode 4   featuring Michelle Collins
Listen here: http://ruralcenter.libsyn.com/-the-rural-copd-podcast-episode-4
  • Michelle Collins is a registered respiratory therapist at Lincoln Health, Franklin Memorial Hospital, and Central Maine Medical Center in Maine. Working in a rural, critical access, and tertiary hospital, Michelle has wide range of hospital experiences, a passion for cardio pulmonary medicine, and a strong concern for her patients and making sure they have access to the care that they need and the knowledge to utilize the tools at their disposal. 
  • Michelle discusses her definition of leadership, the history of respiratory therapy, the gaps in COPD health care, reimbursement issues related to COPD treatment and pulmonary rehab program closures, COPD Patient obstacles, respiratory treatment and medication, respiratory and medical training, and the hope going forward with COPD care
Coming very soon: E pisode 5  featuring Lindsay Corcoran and Laurie Daigle, Stroudwater Associates
  • Lindsay Corcoran is an accomplished senior consultant and practice management professional with over ten years of healthcare and medical office experience. At Stroudwater Associates, Lindsay focuses on supporting and sustaining health care access for rural communities through hospital operational improvement and affiliation strategies, and has assisted rural and community hospitals and clinics across the country to improve operational and financial performance. Results-oriented and highly organized, Lindsay is a skilled and effective communicator with medical providers, patients, and administration.
  • Laurie Daigle, a senior consultant at Stroudwater Revenue Cycle Solution, is a certified professional coder with over 18 years of experience in medical insurance claim processing, medical billing software training, auditing, and health care financial management. She has years of experience as a manager for a national commercial payor, and extensive experience in health care management, from physician group practices to large academic institutions. She has been instrumental in the creation of Revenue Integrity resources to unify coding, billing, and compliance concerns for total and inclusive revenue cycle oversight. She has led successful initiatives to increase physician and departmental productivity, to improve business office efficiency and accuracy, and to develop policies and procedures for all areas within the revenue cycle.

Catch up on older episodes here!

 

In case you missed it:  COPD Finance Webinar
TASC hosted a COPD Finance Webinar in June that helped participants discover the financial importance of providing COPD/Pulmonary Rehab Care and examine the reimbursement aspects of COPD-related care. The speaker for this webinar was Lindsay Corcoran of Stroudwater Associates.
The 2018 FY EMS Supplemental Project

The goal of the EMS Supplemental Project is to better position state-wide and community-level EMS agencies to move toward value-based care. The EMS Supplemental Project will result in the creation of three manuals and an online assessment for EMS providers to determine their readiness for value-based payment systems in rural communities. A small group meeting was held in March with rural EMS experts from around the country to develop key strategies to support the transition of rural EMS services to value models and a summary will be disseminated in May. In addition, there will be an RSV pre-event learning session held in Washington, D.C. on July 9, 2019 for Flex Programs to share progress, challenges, successes, and lessons learned. Please contact Nicole Clement at  [email protected] with any questions. 

Health Industry Cyber Preparedness (HICP) 

The Health Industry Cyber Preparedness (HICP) is an excellent resource for small and rural providers to improve cyber-preparedness. It is cookbook style and helps organizations focus on what's most important.

In addition to the HICP, the Cyber Security Act 405d task force is launching the bi-monthly 405(d) Newsletter this September. The scope of this newsletter aims to discussion and encourage a broader discussion of cybersecurity issues and how to align practices. Parts of this newsletter will be written by task force members.

The task force will also be launching the bi-monthly 405(d) Spotlight Webinars this October. These webinars again will focus on the broader discussion of cybersecurity issues.
 
Nick Rodriquez is the outreach coordinator for the CSA 405d workgroup. If there are organizations or groups who serve rural providers and who need someone to speak about cyber-preparedness, please contact Nick at [email protected].
Please send your MBQIP questions to the [email protected]. TASC will ensure your question reaches the appropriate person.
Webinars, Recordings & Events

Save the Dates
New and Updated Resources 

A full list of resources is available in the  TASC resource library
Many more resou rces can be found on the  TASC website  by searching for key words in the search field. 
New Flex Monitoring Team Research
A full list of research can be found on the Flex Monitoring Team website.

 

Financial Policy Brief

The Flex Monitoring Team has published a  new brief comparing the characteristics of communities served by critical access hospitals (CAHs) predicted to be at high risk of financial distress to communities served by all other CAHs. Using data from 2017, the Financial Distress Index (FDI) model assigns CAHs to high, mid-high, mid-low, or low predicted risk levels for 2019 using Medicare cost reports and Neilsen-Claritas data summed to market areas.

CAHs predicted to be at high risk of financial distress were found to serve communities with significantly higher percentages of non-White individuals (Black individuals in particular), lower high school graduation rates, higher unemployment rates, and worse health status.

Rural Interview with CDC

The Centers for Disease Control and Prevention (CDC) is focusing on rural health. Take some time to read the RHIhub interview with CDC on their work with rural, and the need for storytelling and data collection.
 
Rural Health Leadership Radio  was launched to support rural health leaders to share stories and information about what is working and what is not. Check out their latest podcasts now! 

The most recent interviews are on the topics of agriculture and mental health, various aspects of rural health, PAs and NPs in CAHs, and HIV, immunization, and billing.



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