VRHA News
>>Children’s Partnership
>>Quality Workshop
>>Congratulations to VCOM Officers!

Virginia Rural Health News
>>Increase in Uninsured Patients
>>Deaton Moves to Danville

National Rural Health News
>>Temporary Extension Act of 2010
>>Rural Roads Goes Online
>>Health Care Begins in Human Bonds
>>EHR Public Comment
>>Part-Time Service Option

Winter Edition now available

Ken Kelly, JD, Director of the Washington DC Office of the Children’s Partnership will be the luncheon speaker for the March 18th Virginia Telehealth Summit. Kelly will discuss how the Children's Partnership provides school-based telehealth throughout the United States.

Kelly is one of the many highlights of the event, which is part of the larger Virginia Rural Health Summit. Click the logo below for daily agendas and additional information.

The 2010 Small Rural Hospital Conference will include the Quality Workshop: Taking Control in an Era of Intolerance.

The average hospital currently spends approximately forty-five cents of every dollar earned on administrative activities.   At least half of this expenditure is driven by quality-related activities and a rapidly growing category of indirect costs associated with soft quality – all those costs that would go away if health care was in control of its environment and just got it right the first time.  Those hospitals that continue to rely on the soft quality practices of the past could easily find these costs breaking fifty percent.  Many have the potential to become casualties along the highway to health care’s future as the industry moves deeper into an Era of Intolerance from the public, regulators and purchasers of health care.

To find more about this session and additional conference information, visit the conference web page. 

The VRHA Student Chapter of the Virginia College of Osteopathic Medicine recently held officer elections for the upcoming academic year. The results are:

• President - Janelle Blair
• VP - Ryan Lusk
• Secretary - Nick Harman
• Treasurer - Anna Sullivan
• Volunteer Coordinator - Scott Graupner

VCOM is the only academic institution with an active VRHA student chapter, 166 students are VRHA members. In addition to volunteering weekly at free clinics in the New River Valley; chapter members serve at RAM clinics and organize community health fairs and vaccination clinics.

Congratulations to Janelle, Ryan, Nick, Anna and Scott and thanks to outgoing officers President Amanda Stevens, VP Elliott Sally, Secretary Leah McKay and Volunteer Coordinator Jacinda Hays.

JournalPress.com

Community Health Centers (CHCs) in Virginia continue to grow to meet the rising need for access to health care services in medically underserved communities. This past year alone saw community health centers experiencing tremendous increases in new patients. Across Virginia, 78,557 new patients have received primary health care from community health centers. More than 54 percent of those new patients are uninsured. Despite the financial strain imposed by trying to meet the demand for services, community health centers continue to provide the services that they can to meet the needs in their communities.

At the same time that community health centers are experiencing such a large increase in new uninsured patients, pending state funding cuts will harm the ability of some community health centers to deliver services to some patients.
State funds help offset the costs of providing primary care to the uninsured, those who are at or below 200 percent of the federal poverty level, as well as those who have lost their jobs during the current economic crisis.

Read the full article.

Deaton Moves to Danville

A message from CMS:

On March 2, 2010, President Obama signed into law the “Temporary Extension Act of 2010.”  Among other things, this law extends through March 31, 2010, the zero percent update to the Medicare Physician Fee Schedule that was in effect for claims with dates of service January 1, 2010, through February 28, 2010.  Consequently, effective immediately, claims with dates of service March 1 and later which were being held by Medicare contractors will be released for processing and payment.  Please keep in mind that the statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims).

In addition, the new law extends through March 31, 2010, the exception process for therapy claims reaching the annual cap, retroactive to January 1, 2010.  Affected providers may submit claims for exceptions to the annual therapy caps, with dates of service January 1 through March 31, 2010, using the KX modifier, following the pre-January 1, 2010, requirements for therapy cap exceptions.

The therapy caps are determined on a calendar year basis, so all patients began a new cap on January 1, 2010.  For physical therapy and speech language pathology services combined, the limit on incurred expenses is $1,860.  For occupational therapy services, the limit is $1,860. Deductible and coinsurance amounts applied to therapy services count toward the amount accrued before a cap is reached.

Some therapy providers have been holding claims for services furnished on or after January 1, 2010, for patients who exceeded the cap but qualified for an exception under previous law.  These providers may submit those claims to Medicare effective immediately.   Therapy providers, who submitted claims which were denied, for services furnished on or after January 1, 2010, for patients who exceeded the cap but whose services now qualify for an exception, should contact their Medicare contractor to request that their claim be adjusted to add the KX modifier and ensure the appropriate exception applies.

Rural Roads, NRHA’s award-winning human interest magazine, is now online at www.RuralRoadsonline.com.
Learn about innovative heart health programs and rural research in recognition of American Heart Month. And check out articles on:

• a unique telemedicine solution,
• H1N1 hospital and clinic preparedness and
• how to introduce teens to mental health.

To be included in an upcoming issue, share your story of helping Haiti with Lindsey at corey@NRHArural.org.

By Robert Bowman M.D. - the Daily Yonder

What people may not realize is that rising health care costs are often due to inappropriate medical responses to patients’ needs -- a direct result of weak or non-existent relationships. When physicians have not followed patients for a period of time, when there’s no continuity of care, doctors are more likely to miss significant health changes and symptoms.

A standard way of looking at health care  systems is via the cost-quality curve: the more investment that that goes in, the better the health care outcome. The concept of managed care was based in large part on the idea of a flattening cost-quality curve: after enough resources are applied, the reasoning went, the quality improvement per unit of resources injected begins to decline. Managed care emphasized compromise, presuming we can get nearly the same quality for less cost. The focus was more on economics than on true quality and relationships.

Read the full article.

As part of the HITECH Act in 2009, CMS administers the Electronic Health Record (EHR) incentive programs under Medicare and Medicaid. CMS prepared a proposed rule on the EHR incentive programs for public comment. This proposed rule includes the definition of meaningful use and other requirements for qualifying for incentive payments.

The comment period for this proposed rule closes on March 15, 2010. CMS welcomes your comments which may be submitted through http://www.regulations.gov.

For additional information on the proposed rule, visit http://www.cms.hhs.gov/Recovery/11_HealthIT.asp on the web. Here you will find fact sheets, presentation materials summarizing the proposed rule, and links to the proposed rule itself.

In March 2010, clinicians working part-time (20 to 39 hours each week, at least 45 weeks each year) at NHSC-approved facilities will be eligible to apply to the National Health Service Corps demonstration program for the Part-time Loan Repayment.

The criteria for the Part-Time Demonstration Program will be comparable to the current NHSC Loan Repayment Program. Below are some specifics about the program:

• Four year service commitment for $50,000
• Potential for additional years of support - 2 year service contract
• Application Period open for 30 days
• 400 awards Anticipated
• Same eligible disciplines as full-time Loan Repayment Program (see Application Information Bulletin: Eligibility

Interested? Sign-up to be notified when the Application Bulletin becomes available.

Mark your calendar

For more information about these and other events, visit http://www.vrha.org/events.html

March 16: Rural Health Workforce Summit - Danville
March 17: Annual Rural Health Summit - Danville
March 18: Telehealth Summit - Danville
April 7-10: Applied Gerontology as Community Engagement - Richmond
April 13 & 14: Virginia Small Rural Hospital Conference - Williamsburg
May 17 & 18: Statewide Summit on Childhood Obesity - Richmond
May 19 - 21: NRHA's Annual Rural Health Conference - Savannah, GA

Resources

County Health Rankings
Includes a collection of 50 reports, one per state, that ranks all counties within each state on their overall health. Each county is ranked within the state on how healthy people are and how long they live. They also are ranked on key factors that affect health such as: smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates and number of children living in poverty.

Health Workforce Information Center
A free online library of health workforce resources funded by the Health Resources and Services Administration (HRSA) has reached their first anniversary. HWIC services can help you to find statistics, funding, program ideas, and other information.

Users of the HWIC website can now access over 10,000 resources on 57 topics, 94 professions, and all states.

New Topics and Professions

• Care Coordination
• Economy
• Military Health and Veterans Health
• Specialty Choice
• Doulas
• General Surgeons
• Genetic Counselors
• Laboratory Professionals

New Features

• Narrow resource lists by state, topic,
  profession, and resource type (such as
  resources related to the diversity of
  physicians in Georgia)
• A-Z list with cross-references make pages easier to find
• RSS feeds allow you to keep up with new additions to specific pages (like funding for Washington state or resources related to national health workforce policy)
• Updated search features allow phrase matching and results narrowing

HWIC's information specialists can provide FREE customized assistance at 1-888-332-4942 or info@healthworkforceinfo.org.

Funding Opportunities

AHRQ Small Grant Program for Conference Support
Application deadline: Applications accepted on an ongoing basis.
Grants to support conferences that help to further its mission to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

Champ A Champion Fur Kids Grants
Application deadline: Applications accepted on an ongoing basis.
Grants for children’s health and wellness.

Small Health Care Provider Quality Improvement Grant Program (SHCPQI)
Application deadline: Mar 15, 2010
Grant program designed to assist rural providers with the implementation of quality improvement strategies, while improving patient care and chronic disease outcomes.

Harold Amos Medical Faculty Development Program
Application deadline: Mar 17, 2010
Program aimed to increase the number of academic medicine faculty from historically disadvantaged backgrounds.

Organizational Davies Award of Excellence
Application deadline: Mar 31, 2010
Awards to recognize exemplary implementations of electronic health records (EHRs).

Nicholas E. Davies Public Health Award of Excellence
Application deadline: Apr 16, 2010
Award stresses excellence in the development of systems that creatively and effectively utilize electronic data on individual patients/clients in the public health arena.

Award for Excellence in Medication-Use Safety
Application deadline: Apr 29, 2010
An award program to honor a pharmacist-led multidisciplinary team for its significant institution-wide system improvements relating to medication use.

Remote Patient Monitoring Diffusion Grants
Letter of Intent (Required): Mar 12, 2010
Application deadline: Apr 30, 2010
Funding to expand the use of remote patient monitoring technologies that help improve the health and safety of older adults.

Rural Development Leadership Network
Application deadline: Applications accepted on an ongoing basis.
The Rural Development Leadership Network assists community leaders to strengthen their practical skills, knowledge and credentials while remaining involved in their community development work.