National Rural Health Issues 10 th Annual Mid-South CAH Conference August 24 th, 2012 Memphis, TN Tom Morris Associate Administrator Department of Health.

National Rural Health Issues10th Annual Mid-South CAH Conference

August 24th, 2012Memphis, TN

Tom MorrisAssociate Administrator

Department of Health and Human ServicesHealth Resources and Services Administration

Office of Rural Health Policy

Department of Health & Human Services (HHS)

HHS Headquarters

• Implementation of the Affordable Care Act

• Setting the Stage for Expanded Coverage• Focusing on Improving Quality • Expanding the Primary Care Workforce

• Completion of the Medicare Payment Updates for 2013

• Inpatient• Outpatient• SNF and Home Health• Physician Fee Schedule

Key Activities

Health Resources & Services Administration (HRSA)

• Maternal & Child Health Programs• Ryan White HIV Aids Programs• Health Professions Training• Community Health Centers• National Health Service Corps

Resources• HRSA In Your State• Shortage Designation Finder

http://datawarehouse.hrsa.gov/FactSheetNav.aspx

Key Programs Supporting Rural Communities

http://www.whitehouse.gov/administration/eop/rural-council

Executive Order Establishing the Council

•Expansion of National Health Service Corps to Critical Access Hospitals

•Expanding Access to HIT Capital through an HHS-USDA Partnership

• National Call• Regional Workshops

•Expanding Training of Health Information Technology Workers

The White House Rural CouncilKey Health Activities

USDA Contacts

AR • Lawrence

McCullough, State Director

• 700 West Capital Avenue, room 3416 Little Rock, AR72201-3225

• (501) 301-3200

• www.rurdev.usda.gov/ar

TN• Bob Mack Goode,

State Director

• 3322 West End Avenue, Suite 300Nashville, TN37203-1071

• (615) 783-1300

• www.rurdev.usda.gov/tn

LA• Clarence Hawkins,

State Director

• 3727 Government StAlexandria, LA 71302

• (318) 473-7920

• www.rurdev.usda.gov/la/

MS• Trina George, State

Director

• Federal Building, Suite 831Jackson, MS 39269

• (601) 965-4316

• www.rurdev.usda.gov/ms

•Responding to the Drought Crisis•Rural Access to Capital Meeting

The White House Rural CouncilCurrent Activities and Next Steps

•Follow up from Rural Health Stakeholder Meeting

•Identifying New Policy Proposals

Office of Rural Health Policy (ORHP)2012 Budget

Office of Rural Health Policy (FY12) Rural Health Policy Development $9.8 million

Rural Health Outreach $55 million

Rural Hospital Flexibility $41 million

State Offices of Rural Health $10 million

Telehealth $11.5 million

Radiogenic Diseases $1.9 million

Black Lung $7.1 million

Improving Rural Health Initiative

“Within the total amount requested for Rural Health Activities, the Budget includes $79 million to continue the President’s initiative to improve rural health. The goal of this initiative is to improve the access to and quality of health care in rural areas.”

Current Environment Facing Rural Health

• Opportunities• Expanded Coverage• Partnership for Patients• Innovation Center• HIT

• Challenges• Industry Consolidation• Uncertainty• Transition from Volume to

Value• Meeting Meaningful Use

Opportunities and Challenges

What’s ORHP’s Role?How best to help rural communities through a transitioning health care environment?

• Community-Based Pilot Programs

• Policy and Research

• Hospital-State Programs

• Telehealth Programs and Resources

The Mid-South: A Key Focus AreaBuilding a Rural Community Health Evidence Base

Delta States Initiatives• Delta States Networking

Grants• Delta Rural Hospital

Performance Improvement Project

http://www.hrsa.gov/ruralhealth/about/hospitalstate/delta/index.html

Improving Rural Health Care InitiativeBuilding a Rural Community Health Evidence Base

Community

Health Workers Toolkit

Obesity Toolkit (in Final Review)

http://www.raconline.org/collaborate/pr_chwtoolkit.php

Improving Rural Health Care InitiativeTechnical Assistance: Sustainability

• Economic Multiplier Calculator for Community-Based Programs• Available on the Rural Assistance Center Website• (http://www.raconline.org/econtool/)• Sustainability Primer (http://www.raconline.org/pdf/sustain_primer508.pdf)

Improving Rural Health Care InitiativeUpcoming Funding Opportunities

FY 2013: Network Planning

• Guidance available: Now

• Application deadline: October 15th, 2012

• # of New Awards: 10-15

• Funding: up to $85K /yr (1yr)

• Start Date: 04/2013• Contact: Eileen

Holloran, [email protected]

FY 2013: Small Health Care Provider Quality Improvement Program

• Guidance Available: Winter 2012

• Application deadline: early Spring 2013

• # of New Awards: 50-60

• Funding: up to $100K/yr (3 years)

• Start Date: 09/2013• Contact: Ann Ferrero,

[email protected]

FY 2013: Delta States Rural Development Network Program

• Guidance Available: early Winter 2012

• Application deadline: late Winter 2012

• # of new awards: TBD

• Funding up to: TBD• Start date: 8/2012• Contact: Valerie

Darden, [email protected]

Improving Rural Health Care InitiativeOverview: Building a Rural Hospital Evidence Base

• Measuring Outcomes• Sharing Best Practices• Providing Resources• Aligning Programs to the Health

Care Environment

• Grants• Small Hospital Improvement

Program (SHIP)• State Offices of Rural Health

(SORH)• Medicare Rural Hospital

Flexibility Program (FLEX)

• Initiatives • Flex Medicare Beneficiary

Quality Improvement Project (MBQIP)

• Technical Assistance

Focus Programs

Hospital State Division (HSD)

• Pilot Project under Quality Improvement• Common Metrics• Measuring Outcomes and Demonstrating

Improvements• Sharing Best Practices

http://www.hrsa.gov/ruralhealth/about/video/index.html

Medicare Beneficiary Quality Improvement Project (MBQIP)

Improving Rural Health Care InitiativeWorkforce: Linking Rural Health Care Providers to the Federal Workforce Programs

• HRSA Programs• National Health Service Corps• Nursing Loan Repayment • Primary Care Training• Nursing Education

• Key Challenge: Linking Providers & Educational Institutions

http://www.hrsa.gov/ruralhealth/pdf/ruralhealthfundingguidance.pdf

Improving Rural Health Care Initiative

• Technical Assistance Grant with the National Rural Health Association• Sustaining & Expanding the “1+2”

Family Medicine Residences• Helping Communities Start New RTTs• Increasing Resident Interest in RTTs• www.raconline.org/rtt_new

Workforce: Rural Training Tracks

Improving Rural Health Care InitiativeTelehealth Programs: Offering a Continuum of Program Resources

• Telehealth Network Grant• Including Tele-Home Care

• Telehealth Resource Centers• Free Technical Assistance Nationally

• Telehealth Technology Assessment Center• Guidance in Matching Technology to

Need and Resources

• Licensure and Portability Program• Information and Collaboration on Cross-

State Telehealth Practice

http://www.hrsa.gov/ruralhealth/aout/telehealth/telehealth.html

Improving Rural Health Care InitiativePartnering with the Institute of Medicine

• Planning Meeting August 8-9 • Focus on the Role of Telehealth in an

Evolving Health Care Environment• Report Due in Fall

• Key Issues• Evidence Base• Reimbursement• Privacy and Standards• Infrastructure

http://www.iom.edu/Activities/HealthServices/Telehealth/2012-AUG-08.aspx

Watch the archived webcast at:http://www.iom.edu/Home/Activities/HealthServices/Telehealth/2012-AUG-08/webcast.aspx

Leveraging Our Policy and Research Activities

• Analyzing the Regulations• Collaboration with CMS

• Central Office Point of Contact• Regional Office Rural Coordinators

• Collaboration with the Office of the National Coordinator for HIT• HHS Rural HIT Task Force

• Rural Hospital Issues Group• Rural Primary Care Providers Issues

Group

Policy

Leveraging Our Policy and Research Activities

• Research Center Findings• Rural Research Gateway

• New Rural Health Systems Analysis and Technical Assistance Center

• Flex Monitoring Team Reports• Annual Compendiums of Financial and

Quality Data for All CAHs

Research

http://www.hrsa.gov/advisorycommittees/rural/publications/index.html

Leveraging Our Policy and Research Activities

• Frontier Extended Stay Clinic• Frontier Community Health

Integration Project• Working with CMS Center for

Innovation

Leveraging Demonstrations

Office of Rural Health Policy (ORHP) Activities

• Advises the Secretary of HHS on Rural Issues

• Eight Affordable Care Act Policy Briefs Available Online

National Advisory Committee on Rural Health & Human Services

http://www.hrsa.gov/advisorycommittees/rural/publications/index.html

The Goal … Helping CAHs Make the Transition

Providing Grants, Data and Technical Assistance to CAHs

Grants

•Flex •SHIP•Outreach•Network•Network Development•Quality Improvement•Telehealth Network

Technical

Assistance

•TASC•Flex Monitoring Team•RHSATA•Rural Assistance Center•Telehealth Resource Centers•Telehealth Licensure and Technology Assessment

•National Center for Rural Health Works

•Rural Health Clinic TAPolicy

•Regulation Review•White House Rural Council•National Advisory Committee on Rural Health and Human Services

•Collaboration with NRHA, AHA and NOSORH

ResourcesKey Partners & Resources

National Rural Health Association• Annual Policy Brainstorming Sessions• State Rural Health Association Support• Rural Medical Educators• Partner in Rural Hospital Issues Group

American Hospital Association• Policy Analysis

SORHs Making a Difference

• Promotion of the first Rural Health Day: November 17, 2011!• This Year: November 15, 2012

• Collaboration with USDA for Rural HIT Investment

• Promotion of Partnership for Patients• Enhanced Performance Measurement

Contact Information

Tom Morris

Associate Administrator

Rural Health Policy

Health Resources & Services Administration

U.S. Department of Health & Human Services

[email protected]

http://www.hrsa.gov

301-443-4269