TASC would also like to provide you with some pointers and suggestions for data sources as you compile your needs assessment. If you have any questions or comments on these resources, please start a conversation on the
Flex Program Forum (login required).
First, the needs assessment portion may be lengthy to write - start writing now if you haven't already. Once you've gathered the data, call on other staff in your office, partners or subcontractors that can help review sections and highlight what stands out to them.
Read not just the instructions:
Reading the Review Criteria will provide you insight into what the external reviewers will be looking for in the needs assessment. Though the exact criteria haven't been released yet, it will likely include the following that is similar to previous grant cycles:
- Brief overview of purpose of the proposed project
- Focus of your state Flex program
- Goals for the five-year period of performance. Clearly indicate which, if any, of the Flex program areas you will include in addition to the required program areas 1 and 2
- Critical Access Hospital (CAH) Quality Improvement (required)
- CAH Operational and Financial Improvement (required)
- CAH Population Health Improvement (optional)
- Rural Emergency Medical Services (EMS) Improvement (optional)
- Innovative Model Development (optional)
- CAH Designation (required if requested)
- Vision of the Flex Program as informed by the need and expected outcomes over five years
- Identify the collective needs of CAHs, rural EMS agencies and rural communities in the state. This section outlines the high-level needs for CAHs in your state from a Flex perspective.
- Tips:
- Avoid including broad rural demographics for all issues such as population changes, technology, all health disparities
- Refer to your previous cycle evaluation - what outcomes were not yet achieved
- Describe local, state, national factors contributing to needs and partners (potential or engaged)
- Include information on small, rural hospitals that are eligible for CAH conversion (if you are applying for that activity)
- Include data from CAH-related population health improvement for CAHs and rural EMS agencies, among other stakeholders (as applicable if you are applying for population health, EMS and innovation activities)
- Use relevant data for required Flex CAH activities of quality, operation and finance. Identify and explain current information gaps related to the Flex program.
- Clearly identify data sources and data time frames to show that the needs assessment is based on the most recent information available
- Tip:
- Don't skip the part of listing your data and the data time frame. It demonstrates your knowledge, provides a frame of reference for the reviewer and will likely be data sources you can use in other reports or when telling your program's story.
- Data should tie to outcomes desired and justify the activities and budget proposed
- Describe the assessment techniques used to determine and prioritize the collective needs of CAHs to be addressed with Flex funds
- Tip:
- State if qualitative and primary information is also being used such as focus groups, listening sessions, CAH advisory groups or networks, partner or consultant reports of past activities, CAH sites visits or assessments for Flex needs
Data source ideas:
You have many sources of data at your finger-tips to determine the needs of your CAH
communities, as well as to determine the progress and impact of your past program activities. Below are a few suggestions of data sources by program area. Keep in mind you likely have state-specific data available through state hospital or rural health associations, primary care, networks, universities and departments within your organization (particularly if you are a government-based organization or health department).
Quality
Finance and Operations
- Use Key Financial Indicators from the Flex Monitoring Team (FMT) (state reports or CAHMPAS) or partner data such as hospital association/benchmarking data
- Operational Indicators - CAH workforce, Interoperability (Meaningful Use)
Population Health
EMS
Innovation
- Prevalence or lack of CAHs participating in accountable care organizations (ACOs), Global Budgeting or other alternative payment models (APM) with data from quality innovation networks (QINs), Caravan, state hospital associations
- Participation in Patient-Centered Medical Home(PCMH) using data from the Centers for Medicare and Medicaid Services (CMS) or the Agency for Healthcare Research and Quality (AHRQ)
- Telehealth/Project ECHO participation or lack of connection to telehealth
CAH Conversions
- Number of eligible hospitals not converted
Flex Welcome and Farewell
Welcome:
- Renee Clark, North Carolina Flex personnel
Farewell:
- Amanda Ramirez, Iowa Flex Coordinator
