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Spring Newsletter

By Sarah Bruyn Jones - Roanoke Times

Diabetes, obesity, mental illness and an aging population were just a few of the health needs considered in designing a new Carilion Clinic hospital in Giles County.

Carilion Giles Community Hospital will open May 22, replacing the rundown Carilion Giles Memorial Hospital. The name change was made to reflect the community's ownership of the new facility.

Meeting the physical health needs of the rural population wasn't the only goal in constructing the hospital. The economic health of the community has also been closely tied to the success of the hospital.

The VRHA office will be closed May 17-24 for the National Rural Health Association annual conference.

Governor Bob McDonnell announced additional appointments to his administration under the Commerce and Trade; Education; and, Health and Human Resources secretariats including Arne W. Owens, Chief Deputy, Department of Health Professionals.

Arne W. Owens is an executive with leadership, management, operations and communications experience spanning a career of military, private sector and public service.  He was most recently a member of the Bush Administration, serving in the U.S. Department of Health and Human Services as acting Deputy Administrator and Senior Advisor to the Administrator, Substance Abuse and Mental Health Services Administration, where he assisted with agency executive management, maintained broad policy oversight of agency programs and served as liaison to key White House offices.  He also served as a Director in the Administration for Children and Families, advancing Administration human services policy priorities related to welfare reform and improving the lives of people in need.

Owens served the Commonwealth of Virginia in the Administration of former Governor James Gilmore, as Deputy Commissioner, Department of Mental Health, Mental Retardation and Substance Abuse Services, where he managed key program areas of the agency, was instrumental in advancing plans for mental health transformation throughout the state and reinvigorated substance abuse prevention and treatment services.  He has also supported Federal government agencies as a contractor, and served in senior positions in non-profit public policy organizations as a national and statewide advocate for building and maintaining strong families.  Until 1997, Owens was a career Army officer, serving in a variety of executive and staff assignments throughout the world, including the Persian Gulf and Iraq during Operation Desert Storm.  He completed his military service in the Office of the Secretary of Defense, at the Pentagon in Washington, D.C., at the rank of lieutenant colonel.

Owens is a graduate of the U. S. Military Academy at West Point, and holds a Masters Degree in Organizational Systems Management from the University of Southern California.  He resides in Richmond, Virginia, with his wife, Arlene, and son Wesley.

Residents Debate Health Care in Danville

The newly named director of the West Virginia Area Health Education Center discusses her training as a social worker and other life experiences that led her to her current position.

Read the article.

By John Moore - Government Health IT

A federal grant program for rural hospitals has been modified to reflect the healthcare reform law.  The Small Rural Hospital Improvement Program (SHIP), managed through the Health Resources and Services Administration (HRSA), offers grants in the $9,000 range to individual facilities.

The program had been geared toward helping hospitals defray costs associated with prospective payment systems and Health Insurance Portability and Accountability Act (HIPAA) compliance.

The revised program continues the focus on prospective payment systems, drops HIPAA support and adds a new category: costs related to delivery system changes in the healthcare reform law.

Read the full article.

By Cheryl Clark - HealthLeaders Media

It's always refreshing to hear about a big, geographically diverse hospital system that tries to find solutions for its smallest facilities, and succeeds. Especially when doing so saves tons of money and prevents medication errors that endanger patients.

Welcome to the world of e-pharmacy, and Bravo Banner Health. The non-profit, Phoenix-based 22-hospital system that stretches across seven states, from Alaska to Nebraska, is doing just that for eight of its small, rural facilities that don't have pharmacy staff to review prescriptions around-the-clock.

Read the full article.

By David Wahlberg - Wisconsin State Journal

When the pharmacy closed in Highland, a small town west of Madison, a machine that dispenses drugs took its place.In Mercer, near the Michigan border, the drugstore was replaced by a video connection to a pharmacist 30 miles away.

But in Elcho, northeast of Wausau, prescriptions can no longer be filled at all. Since the pharmacy shut down in 2006, the town’s 1,300 residents, many of them elderly, have had to drive more than 40 miles round trip for many kinds of medications.

Read the full article.

Congregational Health Assessments
Churches are clearly underutilized as community health partners and lack health expertise and resources. By uniting the best practices of public health with faith-based principles and organizations, we can begin to close the gaps as health inequities are identified and their root causes are addressed at the core of communities. Executive summaries for Congregational Health Assessments for the Virginia counties of Bath, Essex, Page and Shenandoah.

States' Use of Cost-Based Reimbursement for Medicaid Services at Critical Access Hospitals
Critical Access Hospitals (CAH) are reimbursed by Medicare at 101% of allowable cost for both inpatient and outpatient services.  State Medicaid agencies however are not required to reimburse CAHs on a cost-basis and have flexibility in determining how CAHs are paid for providing services to Medicaid enrollees.  This brief documents which states utilize a cost-based reimbursement methodology for Medicaid.

Alternatives to the Outpatient Prospective Payment System: Assessing the Impact on Rural Hospitals
In 2000, CMS implemented a new congressionally mandated hospital outpatient prospective system (OPPS).  The new system changed payments for hospital outpatient services from a retrospective cost basis to a prospective amount based on the median resource cost of groups of services expected to be provided. Because of the magnitude of the potential impact of this payment change on both rural hospitals and rural residents, small rural hospitals were granted protection from payment reductions in the transition to OPPS—referred to as ‘hold harmless’ provisions.  Given changes in rural hospital reimbursement for outpatient services, particularly as the hold-harmless protection is expected to phase out in December 2009, the purpose of this policy brief is to explore alternatives to the OPPS and how these options would affect rural hospitals.

White House economic report focuses on rural America
A new report from the White House Council of Economic Advisors examines the rural economy and lays out steps designed to "ensure the prosperity and vitality of rural America." The report coincides with the president's two-day tour of rural communities in the Midwest.

State Strategies for Achieving Health Equity
ASTHO has developed ten case studies that continue ASTHO’s work in identifying leading state-based strategies to address health equity. The case studies are an in-depth examination of the data from ASTHO’s 2007 Minority Health Survey and State Snapshots. They describe health equity strategies and programs in depth in ten states: Arizona, California, Georgia, Massachusetts, Michigan, Montana, North Carolina, Ohio, Oklahoma and Virginia.  

Which Medical Schools Produce Rural Physicians?
Despite continued federal and state efforts to increase the number of physicians in rural areas, disparities between the supply of rural and urban physicians persist. The authors examined the training of the rural physician workforce in the United States.

Research Dispels Myths About Rural Fitness
Inform article tells how a handful of universities are looking at ways to encourage active living, health and wellness in rural places.

Case Studies of Developments in Rural Health: Profiles of Three Rural Counties in Difficult Economic Times
The United States’ health care crisis is especially obvious in rural communities and has been made worse by the current economic downturn. Americans face diminishing access to care, escalating health care costs, and persistent gaps in quality, and these problems may be particularly severe for rural communities.
The RUPRI Center profiled three rural communities to show how providers and others are faring during these difficult economic times:

• Leake County, Mississippi
• Walthall County, Mississippi
• Nemaha County, Nebraska

Mark your calendar

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

May 19 - 21: NRHA's Annual Rural Health Conference - Savannah, GA
June 2-5: National Association for Rural Mental Health Annual Conference - Denver, CO
June 9 - December 15: NOSORH Grant Writing Institute: Rural Health Grant Writing
June 16-18: Medication Use in Rural America Conference - Kansas City, MO
July 21-23: NRHA's Quality and Clinical Conference - Portland, ME

Resources

CMS has developed a variety of educational products and resources to help health care professionals and their staff become familiar with coverage, coding, billing, and reimbursement for Medicare-covered Preventive Services:

• The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers and Other Health Care Professionals ~ This comprehensive resource contains coverage, coding, and payment information for the many preventive services covered by Medicare.  
• Quick Reference Information: Medicare Preventive Services ~ This chart contains coverage, coding, and payment information for the many preventive services covered by Medicare in an easy-to-use quick-reference format. 
• The Bone Mass Measurements Brochure ~ This brochure provides coverage, coding, and billing information on Medicare-covered bone mass measurements.
• The Bone Cancer Screenings Brochure ~ This brochure provides coverage, coding, and billing information on Medicare-covered cancer screenings, including screening mammographies, pap tests, and pelvic exams.
• The Medicare Preventive Services Series: Part 3 Web-Based Training Course (WBT) ~ This WBT  includes lessons on coverage, coding, and billing for several Medicare-covered preventive services, including screening mammography, pap tests, pelvic exams, and bone mass measurements.  To access the WBT, please visit the MLN homepage at: http://www.cms.gov/mlngeninfo Scroll down to “Related Links Inside CMS” and click on “WBT Modules”
• The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for Medicare Learning Network (MLN) preventive services educational products and resources for health care professionals and their staff.
  

Funding Opportunities

Active Living Research: Building Evidence to Prevent Childhood Obesity
Letter of Intent (Required): Jul 1, 2010
Application deadline: Applications accepted on an ongoing basis.
Funding to support opportunistic, time-sensitive studies on emerging or anticipated changes in physical activity-related policies or environments.

Bound Tree Medical Legacy Scholarship
Application deadline: May 28, 2010
Scholarships for students to pursue an EMT career or to further their training.

Flex Rural Veterans Health Access Program
Application deadline: Jun 4, 2010
Grants to provide mental health services and other services to veterans and other residents of rural areas.

Rehabilitation Training: Rehabilitation Long-Term Training
Application deadline: Jun 7, 2010
Financial assistance to provide training in areas of personnel shortages in rehabilitation.

Training and Information for Parents of Children with Disabilities--Community Parent Resource Centers
Application deadline: Jun 17, 2010
Grants to local community parent resource centers for parents of children with disabilities.

AcademyHealth Health Services Research Impact Award
Application deadline: Jul 30, 2010
Awards for health services research that has made a positive impact on health policy and/or practice.

Community Access to Child Health (CATCH) Implementation Funds Program
Application deadline: Jul 30, 2010
Funding supports pediatricians in the initial and/or pilot stage of developing and implementing a community-based child health initiative.

Community Access to Child Health (CATCH) Resident Funds Program
Application deadline: Jul 30, 2010
Grants to support pediatric residents in the planning of community-based child health initiatives.

Healthcare X Prize
Application deadline: Applications accepted on an ongoing basis.
The Grand Challenge for this Healthcare X PRIZE will be to create an optimal health paradigm that empowers and engages individuals and communities in a way that dramatically improves health value.