VRHA Weekly Update
In this Issue December 19, 2011- January 3, 2012

VRHA News
Virginia News National News Mark your calendar
Resources
Funding Opportunities
VRHA Site

Newsletter available

 

 

VRHA News

VRHA Office Schedule

The VRHA office will be closed December 22 - January 3. There will be no Update the week of December 26.

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Members in the News

By Katrina Koerting - Lynchburg News and Advance

The newly completed Blue Ridge Medical Center [a VRHA member] will open to the public on Tuesday, Dec. 20.

“We’re just glad to be able to bring this to the community,” said Peggy Whitehead, the executive director of the Blue Ridge Medical Center.

About 20 more patients can be seen a day with the opening of the new two-floor building. The new 28,600-square-feet building a little more than triples the size of the current center. Currently the center treats between 120-140 patients a day, or 9,000 a year. There are 30,000 patient charts in the system, Whitehead said.

Read the full article.

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Virginia News

RN Volunteers Needed

A study to explore rural registered nurses’ perceptions of their role in influencing healthcare in the rural community is looking for Virginia participants.

Two groups of nurses are needed:

  • Group 1:  Two individual one-hour each interviews with RNs, who practice in a rural healthcare facility.
  • Group 2:  One-hour focus group session with 5 RNs who practice in a rural healthcare facility.

Click here for full details.

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Tavenner At CMS Helm

By Mary Agnes Carey and Phil Galewitz - Kaiser Health News

Marilyn Tavenner was tapped by President Barack Obama to succeed Dr. Donald M. Berwick as administrator of the Centers for Medicare and Medicaid Services.

Before coming to CMS, Tavenner served as secretary of Virginia’s Health and Human Services where she oversaw 12 agencies that employed 18,000 people. Her career also included 25 years working for the Hospital Corporation of America where she started as a staff nurse and became president of outpatient services. She has also previously served as acting CMS administrator.

Read the full article.

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National News

ACTION ALERT!

Contact your Representatives and Senators now to support vital rural Medicare "extenders".

Speaker of the House John Boehner announced early Sunday morning that House Republicans would oppose the Senate passed extension of various Medicare provisions, including rural specific provisions. The Senate passed package would extend, for a two-month period, the outpatient hold harmless provision, Medicare Section 508 reclassification, reimbursement increases for ambulance services, rural mental health add-ons, extension of therapy cap exemptions and an update for the sustainable growth rate within the physician fee schedule.

The Senate package modified House legislation that failed to include a number of these provisions and cut payments for bad-debt reimbursement, outpatient hospital visits and DSH facilities.

Speaker Boehner advocated a formal conference between the House and the Senate that would reconcile these differences.  It is imperative that you call your Representatives and Senators now to make sure these vital provisions are included in any conference agreement. 

Please visit the NRHA Congressional Action Kit for more information about these extenders and contact information for your Representatives and Senators.  Time is short and action is critical.

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When CAHs Are Not So Critical

By Jenny Gold - Kaiser Health News

Hood Memorial Hospital is just the kind of health care facility where the federal government hopes to save money. The two-story brick hospital, about an hour north of New Orleans, hasn’t been full in at least two decades, and the yellowing hallways are lined with empty rooms.

CEO Hoppie Jones says that on an average day, fewer than four of the hospital’s 25 beds are occupied. Jones is a slight man in his 60s, and his face is creased with the stresses of his monumental task: keeping the doors of the hospital open despite losing money 11 out of the past 12 years.

One of the only bright spots on Jones' balance sheet is the extra money he receives from the federal government through a program for critical access hospitals —small, rural facilities that receive a higher Medicare reimbursement rate to help keep them afloat. But while Hood is in a small town, it is not geographically isolated: there are at least four other competitor hospitals within a 26 mile radius, including three other critical access facilities.

Read the full article.

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Rural Publications

Project Talent: Nursing Quantifies the role that affinity for community and desired work specialization play in the migration decision of nursing students and reveals whether those raised in rural towns would like to return to rural communities.

Diabetes and stress: an anthropological review for study of modernizing populations in the US-Mexico border region One framework for understanding diabetes in developing nations and Indigenous peoples can be provided by a focus on the impact of stress. Prevention and intervention efforts should consider more than just a biomedical model.

Nature and nurture in the family physician's choice of practice location Nature versus Nurture is the age old question of rural workforce. How do nations address populations suffering a shortage of physicians? Studies should consider both Nature and Nurture, as well as involving multiple institutions.

Identifying Barriers to Treatment for PTSD Among Reserve Component Veterans in Rural Pennsylvania: An Analysis of Five Focus Groups Provides insight into reasons combat veterans were not seeking or receiving the behavioral health treatment they may need after deployment in a combat zone.

Increasing EHR Use for Quality Improvement in Community Health Centers: The Role of Networks Researchers describe how networks helped CHCs to use EHRs to improve chronic and preventive care and the barriers they faced.

Investigation of the Developmental Course of Burnout Among Rural Clinicians Discusses rural mental health clinician burnout - a significant concern for clinicians as well as mental health organizations.

Handling the Handoff: Rural and Race-Based Disparities in Post Hospitalization Follow-up Care Among Medicare Beneficiaries with Diabetes This report uses information regarding Medicare beneficiaries with diabetes to examine the provision of care in rural America.  It provides estimates of hospital admission rates for rural Medicare beneficiaries with diabetes, tracks the proportion of patients who receive adequate outpatient care post discharge, and assesses subsequent readmissions to the hospital.  It also explores the potential for race-based disparities in care for diabetes.

ORH Fact Sheet: Information About the Office of Rural Health and Rural Veterans Lists data and statistics related to rural veterans and the work of the VHA Office of Rural Health.

Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients (Policy Brief & Final Report)
This policy brief and report (1) assess the financial and quality challenges—and potential unintended consequences for rural providers and patients—of implementing bundled payments for acute and post-acute care episodes; (2) explore the possible impact on quality of care delivered under a facility-physician bundled payment system; and (3) describe potential modifications to current bundling proposals and additional steps CMS could take that will help address rural-specific issues.

Rural America at a Glance, 2011 Highlights the most recent indicators of social and economic conditions in rural areas for use in developing policies and programs to assist rural areas. The 2011 edition focuses on the U.S. rural economy, including employment trends, poverty, education, and population trends.

The High Performance Rural Health Care System of the Future The RUPRI Rural health panel has written a description of a future rural system that would be built on foundations of affordability, accessibility, community focus, high quality, and patient centeredness, The paper develops the Panel’s vision of rural health care that is affordable and accessible for rural residents through a sustainable health system that delivers high quality, high value services.

Patient-Centered Medical Home Services in 29 Rural Primary Care Practices: A Work in Progress
This new Policy Brief discusses survey responses from 29 rural physician practices from around the country. When asked about their use of specific policies and procedures that are included as criteria to certify patient-centered medical homes, fewer of them would qualify in each of five domains, including access to care, population-based, quality, care management, and clinical information management.

Weight status and health characteristics of rural Saskatchewan children There are few studies that examine the health of rural children. In an attempt to address this gap, the authors of this cross-sectional study used a health questionaire with rural children in Saskatchewan, Canada. Their data reveals much about participating childrens' food intake, activity levels and weight status.

Rural Medicare Advantage 2011: Enrollment Trends and Plan Characteristics
This paper report findings from analysis of the Centers for Medicare and Medicaid Services data to examine the trends and geographic variations in Medicare Advantage (MA) plan enrollment, premiums and market concentration by firm.   MA enrollment in rural areas remains strong and continues to grow in 2011, despite the recent shift in enrollment from private fee-for-service plans to preferred provider organization plans. The data presented in this policy brief provide an overview of the Medicare Advantage program in rural America and highlight key rural/urban differences within the program.

Depression literacy: rates and relation to perceived need and mental health service utilization in a rural American sample Depressed or not depressed? Do rural men and women identify depression and what do they do about it? What is the relationship of education and gender regarding depression literacy? How do mental health care professionals and churches fit into the picture? Many questions are raised when exploring depression literacy in rural Arkansas.

Health Care Access and Use Among the Rural Uninsured (Policy Brief) Using data from the 2002-2007 Medical Expenditure Panel Survey (MEPS), this study examined access to care and service use among non-elderly, uninsured rural and urban residents. 

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Mark Your Calendar

For more information about these and other events, visit the VRHA Calendar.

December 21: Privacy and Security Under HIPAA & HITECH - webinar
January 6: Virginia Dental Home Initiative - Richmond
January 24-26: Rural Coding Bootcamp - Abingdon
January 30 - February 1: National Rural Health Association Policy Institute - Washington, DC
February 7-9: Rural Coding Bootcamp - Staunton
March 6-8: Rural Coding Bootcamp -Danville
March 15-18: Mid-Atlantic Telehealth Resource Center Summit - Charlottesville

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Resources

Medicare Advantage
The RUPRI Center website has been updated with the “new” June 2011 Medicare Advantage maps and tables.

From the Medicare Learning Network:

The revised “The Medicare DMEPOS Competitive Bidding Program Repairs and Replacements” fact sheet (ICN 905283) is designed to provide education on repairs and replacements under the DMEPOS competitive bidding program.  It includes information on which items and services can be provided by contract versus non-contract suppliers.

The revised “Medicare Disproportionate Share Hospital” fact sheet (ICN 006741) includes the following information: background; methods to qualify for the Medicare disproportionate share hospital (DSH) adjustment; Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and Deficit Reduction Act of 2005 provisions that impact Medicare DSHs; number of beds in hospital determination; and Medicare DSH payment adjustment formulas.

The new MLN Matters® Special Edition Article “2012 Electronic Prescribing (eRx) Payment Adjustment: Assessment and Application” (#SE1141) is designed to provide education on how the 2012 eRx payment adjustment was calculated and applied for individual eligible professionals, and group practices participating in eRx Group Practice Reporting Option (GPRO).   It includes guidance on how eligible providers should assess and apply the 2012 eRx payment adjustment.

The MLN has released the next in a series of podcasts designed to provide education on how to avoid common billing errors and comply with requirements of the Medicare Program.  The new “Medicare Overpayment Collection Process” podcast (ICN 907563), posted Thu Dec 8, is designed to provide education on the Medicare Overpayment Collection Process.  It includes information from the MLN fact sheet titled "The Medicare Overpayment Collection Process," which describes the collection of Medicare physician and supplier overpayments. Please visit the MLN Multimedia webpage to download this and other podcasts from the MLN.  We also encourage you to visit the MLN Provider Compliance webpage for the latest educational products designed to help Medicare FFS providers understand–and avoid–common billing errors and other improper activities identified through claim review programs.  Stay tuned for future podcasts from the MLN!

 

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Funding Opportunities

National Health Service Corps Critical Access Hospital Pilot Program
The Health Resources and Services Administration has released its 2012 guidance for the National Health Service Corps (NHSC) Loan Repayment Program (LRP), which includes a pilot program that expands eligibility to Critical Access Hospitals (CAHs) and eligible clinicians working in CAHs:  primary care physicians; psychiatrists; nurse practitioners; certified nurse midwives; and physician assistants.

CAHs and interested clinicians should review the 2012 guidance.  CAHs that want to become service sites have to be in a Health Professional Shortage Area (HPSA) and meet other basic program requirements. Currently, approximately 64 percent of CAHs are located in HPSAs. Of these, 36 percent have HPSA scores of 14 or more. 

Once they are approved as service sites, their clinicians can apply for loan repayment. The NHSC will pay up to $60,000 for an initial 2 years of full‐time clinical practice to clinicians serving at an NHSC‐approved service site with a HPSA score of 14 or higher. Applicants working at NHSC‐approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 2 years of full‐time clinical service.

The NHSC will pay up to $60,000 for an initial 4 years of half‐time clinical practice to clinicians serving at an NHSC‐approved service site with a HPSA score of 14 or higher. Applicants working at NHSC‐approved service sites with HPSA scores of 13 or lower are eligible to receive up to $40,000 for an initial 4 years of half‐time clinical service.

HIVMA Minority Clinical Fellowship Program
HIVMA awards two one-year clinical fellowships annually, with one going to an African American physician and one to a Latino physician interested in providing HIV care to underserved populations  in the U.S.  During the year, fellows manage the ongoing care of patients with HIV disease under the supervision of an HIVMA mentor. The award includes a $60,000 stipend plus funding to support fringe benefits for one year. The deadline has been extended to January 2, 2012.

Center for Dental Informatics at the University of Pittsburgh 
The Center is seeking applicants at the certificate, MS, PhD and postdoctoral levels for this highly multidisciplinary program. Open to individuals with a variety of backgrounds, such as information science/computer science, dentistry, medicine, information technology or related fields. Financial support, in the form of a full scholarship, a stipend, health insurance and more from the National Institutes of Health is available to eligible individuals. Program start is August 2012.

Georgetown University Community Health Center Director Development Fellowship  
Gain administrative and executive experience working with the CEO of Unity Health Care, the largest consortium of community health centers in Washington, D.C. Fellows develop skills in CHC advocacy and public health policy through collaboration with ACU and the National Association of Community Health Centers. Board-certified or board-eligible physicians who have completed family medicine residency and are committed to advocating and caring for the underserved are eligible. Competitive salary and benefits. Deadline: March 31, 2012.

Students to Service
The National Health Service Corps (NHSC) Students to Service Loan Repayment Program (S2S LRP) pilot application cycle is now open. The S2S LRP provides loan repayment assistance to medical students (MD and DO) in their last year of school, in return for a commitment to provide primary health care services in eligible Health Professional Shortage Areas (HPSAs) of greatest need.

HIV Care Grant Program Part B
Application deadline: Jan 3, 2012 Grants to assist States and Territories in developing and/or enhancing access to a comprehensive continuum of high quality, community-based care for low-income individuals and families living with HIV.

Traveling Professorship in Rural Areas
Application deadline: Jan 6, 2012 Grant to provide support for the applicant to provide face-to-face infectious diseases education to practicing physicians in rural areas in the applicant's state of residence or primary practice.

2012 Minority Nurse Scholarship Program
Application deadline: Feb 1, 2012 Annual scholarship program to help outstanding students complete their studies leading to a BSN degree.

American Psychiatric Foundation 2012 Awards for Advancing Minority Mental Health
Application deadline: Feb 3, 2012 The awards recognize psychiatrists, other health professionals, mental health professionals, and mental health programs that have undertaken innovative and supportive efforts to raise awareness of mental illness in underserved minority communities.

Award for Excellence in Medication-Use Safety
Application deadline: Feb 3, 2012 An award program to honor a pharmacist-led multidisciplinary team for its significant institution-wide system improvements relating to medication use.

Nurse I Am Scholarship
Application deadline: Mar 1, 2012 Scholarships to nursing students.

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