CEO Update: Rural communities build a culture of health

Fall is on its way and kids are returning to school. Over the past few years I have been working with my daughter to transition her to managing her own healthcare and now realize just how important it is to engage kids in the conversation of health.

We know that in order to meet the continuing healthcare needs in rural communities we need to build upon the rich rural culture of community and build a culture of health. Nearly 14 percent of Coloradoans live in rural - that’s 1 out of 10 people - and rural communities have an average age segment between 45 and 65. In fact, by 2018 the only growing population is expected to be the 65 and older age demographic in most of our rural communities. Rural challenges are real; 9.7 percent of families live in poverty, 13.7 percent face a lack of transportation, and 21 percent were uninsured in 2013. This is why it is imperative that we as rural communities foster relationships and create awareness of resources that exist in the community.

Through excellent customer service and asking the important questions rural communities continue to build a culture of health. Twenty rural communities have completed a community health needs assessment with the Colorado Rural Health Center as a key way of building the culture of health. A community health needs assessment is a process that incorporates a comprehensive review of the county data, facilitating and compiling results of community group meetings and surveys, and taking action to improve community health. Through engaging community members in the conversation of health, healthcare providers have the opportunity to understand the importance of healthcare from the perspective of those that utilize services. Upon understanding areas of importance and with the goals of fostering collaboration around community health, healthcare, and healthy living, an action plan can be developed. The implementation of these action plans and the commitment of all community members help create the culture of health in rural communities. From the communities that have completed a community health needs assessment with us, we know that the following areas of opportunity exist across rural Colorado: oral health access, behavioral health services and scope, workforce shortages or misdistribution, balancing reimbursement rates with operational efficiencies, pharmacy services, transportation, and helping residents age in place.

While we know that this was the start of the conversation, it will not be the end. Ongoing educational opportunities, making connections, and creating careful, thoughtful language are not only important -they are imperative to building the culture of health. Our rural communities have a strong history and culture of providing quality care and access and will continue to build the culture of health.

This week we are celebrating the fifth year of Safety Net Clinic Week and I’d like to thank all 51 of the Federally Certified Rural Health Clinics for everything they do for their communities to build the culture of health. Rural Health Clinic staff work tirelessly day in and day out in service to their communities. Thank you for all you do!

Special Opportunity for NNOHA Members: Henry Schein Global Product Donation Program

Once again this year, the Henry Schein Cares Foundation has reserved spots for up to ten NNOHA member organizations to benefit from the Global Product Donation program. Through Henry Schein Cares’ Global Product Donation Program, in 2013 the company provided nearly $6 million of product to medical, dental, and veterinary community health clinics and humanitarian organizations. The deadline for applications for NNOHA organizational members is August 31, 2014. Note: Only NNOHA organizational members are eligible to apply. Please read the description below for more information. NNOHA is grateful for this generous benefit for our members.

Henry Schein, Inc.'s Global Product Donation program provides a broad selection of health care products and supplies to community medical or dental organizations. All products are new and usable, although in many instances, they may be imperfectly packaged.

Participating organizations will receive a product selection based on the type of service that each organization provides (medical and/or dental) for two years. Each participating organization typically receives large pallets of product donations valued at $5,000–$25,000 each over the course of those two years.

Based on the discretion of Henry Schein Cares, organizations may apply for a renewal at the end of each two-year cycle. The Henry Schein Cares Foundation serves as the administrator of the program.

The Global Product Donation program does not offer financial grants. The types and quantities of available supplies will vary and does not generally include pharmaceutical products, including drugs and vitamins. However, under certain circumstances when these types of products are available, the participating organization will be notified before any shipment is sent. The Global Product Donation program does not accommodate requests for specific products or items.

For application information, visit:

Apply by August 31, 2014. For questions, contact Phillip Thompson at

Attention! Loan Repayment Alert for both Sites and Providers:

Please be aware of the following updates regarding the Colorado and National Health Service Corps Loan Repayment programs. Please be sure to also pass this information along to any providers at your clinic or hospital who may be interested in applying for loan repayment.

Colorado Health Service Corps (CHSC):
Application cycle for PROVIDERS will open on September 1, 2014 and close on September 30, 2014. Applications for SITES are accepted all year long on a rolling basis. Application information for both sites and providers can be found here. A list of sites already approved for CHSC can be found here.

National Health Service Corps (NHSC):
Application cycle for SITES seeking recertification will open on September 2, 2014 and close on November 3, 2014. Information about recertification can be found here.

Health Professional Shortage Area (HPSA) Update

Health Resources and Services Administration (HRSA) will be completing an update to the software they utilize to process Health Professional Shortage Area (HPSA) score applications. This will affect healthcare sites nationwide and during the transition, application submissions for new or updated HPSA scores will be put on hold until the overhaul is complete. The expected date of completion for the software update will be December 2014. HRSA will also be changing the schedule previously used for applicants to submit information for HPSA score updates. Applicants will be notified by the state Primary Care Office when an application is due.

Annual Rural Behavioral Health Practice Conference

The University of Minnesota-Morris will be holding the 6th Annual Rural Behavioral Health Practice Conference on October 24, 2014. The theme of this year’s conference is Integrated Care in Rural Practice. The purpose of the Rural Behavioral Health Practice Conference is to make quality continuing education available to behavioral health professionals interested in the particular practice issues involved in working with rural people and communities. The conference will include APA-approved CEs. Registration is $100. For more information, contact Kay Slama, Conference Coordinator at (320) 796-5871 or email

Attend the 2014 Corps Community Day event in Denver to network with health professional students and residents interested in rural jobs!

Each year during National Primary Care Week, the National Health Service Corps and state-level partner organizations celebrate Corps Community Day. Corps Community Day highlights primary medical, dental and behavioral healthcare for the underserved in Colorado. It is an opportunity for students, residents, providers and Colorado’s safety-net healthcare facilities to network. Furthermore, the event celebrates accomplishments of National Health Service Corps and Colorado Health Service Corps providers. Safety-net healthcare facilities in attendance include: rural health clinics, federally qualified health centers and other sites meeting the primary care needs of Colorado’s underserved.

This year, Colorado’s Corps Community Day will be on Friday, October 10th at the Crown Plaza in Stapleton. This is a chance to network with medical students, health professional students and physician residents who are eager to learn about primary care job opportunities in a safety-net setting! If you are interested in attending, contact Ashley Mills at or 303-407-2031.

CMS Launches Restructured Quality Improvement Program

As you may know, the Centers for Medicare & Medicaid Services (CMS) is restructuring the Quality Improvement Organization (QIO) Program, effective August 1, 2014. The QIO Program is an integral part of the U.S. Department of Health and Human Services’ national quality strategy for providing better care, better health at lower costs, and providing “boots on the ground” technical assistance through a national network of independent organizations working to improve care delivery at the community level. The updated approach to improving care will allow for greater efficiencies across the program, eliminate any perceived conflicts of interest and will continue to emphasize the need for greater patient-centered care in support of the needs of Medicare beneficiaries.

New Contact for Medicare Coverage Appeals and Quality of Care Concerns
The restructuring of the QIO Program separates medical case review and monitoring activities from the traditional quality improvement activities of QIOs, creating two separate structures:
          Medical case review – to be performed by Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIO)
          Quality improvement initiatives and technical assistance – to be performed by Quality Innovation Network Quality Improvement Organizations (QIN-QIO)
These contracts cannot be held by the same organization and CFMC has chosen to pursue the quality improvement work as a QIN-QIO. We will continue to perform clinical review work, including the Medicare appeal reviews until July 31, 2014.

In early May, CMS awarded the BFCC-QIO contracts to Livanta, LLC, located in Annapolis Junction, Maryland and KEPRO, located in Seven Hills Ohio. These contractors will be responsible for conducting case review functions such as complaint reviews, quality of care reviews, discharge appeals, higher weighted diagnostic related groups (DRG) requests and Emergency Medical Treatment and Active Labor Act (EMTALA) reviews.

Beginning August 1, 2014, Colorado hospitals, hospital swing beds, skilled nursing facilities, home health agencies, hospice agencies, and comprehensive outpatient rehabilitation facilities must contact KEPRO, the new BFCC-QIO that will serve Colorado, toll-free at 1-844-430-9504 for all appeal requests and Quality of Care concerns. All outstanding Higher-Weighted DRG medical record requests after the above date should be mailed to:

Rock Run Center
5700 Lombardo Center, Suite 100
Seven Hills, Ohio 44131

Likewise, beneficiaries who have a concern about the quality of care they have received from a Medicare certified setting such as a physician’s office or settings such as those listed above for appeals, will also have a new point of contact.
Steps You Will Need to Take
          Update all copies of the Notice of Non-Coverage forms which inform benefi­ciaries that Medicare may stop paying for their care
          Replace all print and electronic copies of beneficiary resources that include the QIO’s contact information
          Update policies and procedures that contain a reference to contact CFMC (contacts, address, telephone numbers, fax numbers)

Quality Innovation Network QIOs

Quality Innovation Network QIO (QIN-QIO) contract awards are expected to be announced in July. QIN-QIOs will be responsible for working with providers, practitioners, and the community on multiple data-driven quality initiatives to improve patient safety, reduce harm, and improve clinical care at the local and regional levels. The new QIN structure requires a multi-state, regional approach, but much of the work will still be performed at state level with each QIO offering tailored education, tools, and resources to health care providers in their states. The multi-state approach provides opportunities to share successes across states to facilitate rapid improvement.
More information on the QIO Program can be found at or by contacting 1-800-MEDICARE.