Walsenburg Health Clinic Buried in Paperwork from Hundreds of Insurance Plans

By Michael Booth, The Denver Post

WALSENBURG — There are jobs for 2 1/2 doctors at the county health clinic in this hardscrabble southern Colorado town. Getting health insurance companies to pay those doctors takes 9.6 file clerks.

Last year, the Spanish Peaks Regional Health Center sent bills to 193 commercial health insurance plans.

That would seem to make Medicare and Medicaid a piece of cake for finding the rest of the clinic's revenue. Except that with veterans, federal employees, military personnel and others, Spanish Peaks also had to bill 22 separate governmental insurance plans.

Read more: Walsenburg health clinic buried in paperwork from hundreds of insurance plans - The Denver Post

CRHC’s Role in NRHA’s Rural Health Congress

National healthcare issues directly impact rural providers and communities. Several CRHC staff currently serve on the National Rural Health Association’s (NRHA) Rural Health Congress and constituency groups and are committed to advocating on behalf of the interests of rural healthcare providers in Colorado and nationally to ensure NRHA policy positions are strategically designed to promote providing high quality healthcare services to rural areas.

CRHC has a long-standing, 20 year history as an organization with active membership in NRHA. CRHC founder and former Executive Director, Denise Denton, served as NRHA President in 1993. CRHC staff have held leadership roles in NRHA’s Constituency Groups (CG) which ultimately advise the Rural Health Congress in taking positions on key advocacy and policy positions for rural healthcare. Lou Ann Wilroy, CRHC CEO, has served for ten years on the Frontier Constituency Group, addressing healthcare issues in the nation’s most sparsely populated communities. Michelle Mills, CRHC’s Program Director for Critical Access Hospitals and Rural Health Clinics, has been a member of the Rural Health Clinics Constituency Group since late 2010. Michelle is also the RHC CG representative on the Rural Health Congress. Cari Fouts, Communication & Development Director for CRHC, is a member of the State Association Council CG for NRHA and was appointed a position on the Rural Health Congress in January 2011 to represent the needs of all rural communities and state rural health associations across the nation.

Specific topics that are being addressed by the Rural Health Congress this year include:
• Health reform implementation
• Accountable Care Organizations
• Medicaid Payments
• CAH, RHC, Frontier Stay Extended Stay Clinics– discussion of potential development of new certification and payment methods (spearheaded by Tom Henton, CEO of Conejos County Hospital in Colorado; also a member of the Congress)
• Primary Care Shortages
• Rural General Surgeon Shortages
• EMTALA & Telehealth
• Mental Health in Rural America (expand to include substance abuse)
• Welfare impact on Rural Multiracial & Multicultural Populations
• Network Neutrality
• Broadband – Rural Access
• Tobacco Use in Rural America

As the Rural Health Congress moves forward in adopting positions, CRHC will seek input from our members to ensure the policy briefs meet the needs of our constituents. CRHC’s Policy & Legislative Council (PLC) guides and informs CRHC’s state and federal policy activities. If you would like more information about the PLC or are interested in participating, please contact Sara Schmitt at ss@coruralheatlh.org. If you have any questions about the Rural Health Congress, please contact Michelle Mills, mm@coruralhealth.org, or Cari Fouts, cf@coruralhealth.org. For more information on NRHA’s Rural Health Congress, please click here.

CRHC, CCMU and ClinicNET – In Search of Health Stories to Create a Shared Statewide Vision

Got a health story to tell? The Colorado Rural Health Center, Colorado Coalition for the Medically Underserved, and ClinicNET are ready to hear it.

CRHC, CCMU and ClinicNET will hit the road in April in search of Colorado health stories. “The purpose of Colorado HealthStory is to create an appreciation of our shared experiences of health, one conversation at a time,” said Alicia Haywood, policy analyst with the Colorado Rural Health Center. “We invite Coloradans to tell their own health stories to begin a dialogue about access to health in our communities.”

The three-year project was made possible through funding from The Colorado Trust and the Colorado Health Foundation. Over the next three years, Colorado HealthStory collaborators will engage existing and new partners to identify 250 storytellers and capture their stories. Personal health stories will be audio recorded with a family member, a friend, a care provider, a mentor or HealthStory collaborator. Each storyteller will be provided a CD of their story recording, and a second copy will be retained in the Colorado HealthStory archive.

Stories will be available on the Colorado HealthStory Web site, blog and other social media outlets, and news and media outlets will receive periodic project updates. In addition, once a body of stories is collected from each participating community, Colorado HealthStory will convene community forums known as “listening sessions.” Using information gathered from collected stories, listening sessions and local health data, the HealthStory team will create “community health profiles” for each participating community.

“Sharing your own health story is a great way to start, but there are lots of other ways you can help your family, friends and neighbors share their story,” Haywood said. “You can host a ‘HealthStory Day’ at your organization, co-author an op-ed in your local newspaper that encourages others to share their stories or link to the Colorado HealthStory site, (coloradohealthstory.org, but not yet launched) from your Web site.”

For more information on Colorado HealthStory, contact Alicia Haywood of the Colorado Rural Health Center at ah@coruralhealth.org or by calling 720.248.2748.

About The Colorado Rural Health Center
CRHC was founded in 1991 as Colorado’s nonprofit State Office of Rural Health. CRHC works with Federal, state and local partners to offer services and resources to rural healthcare providers, facilities and communities. CRHC has a diverse and inclusive statewide constituency of over 3,500 people and organizations. For more on the Colorado Rural Health Center call 303-832-7493 or go to www.coruralhealth.org.

About ClinicNET
ClinicNET affiliated clinics are Community-Funded Safety Net Clinics (CSNCs) and Rural Health Clinics (RHCs) throughout Colorado. The clinics provide primary health care services to low-income, uninsured and underinsured Coloradans. For more information about ClinicNET call 720-233-7375 or go to www.clinicnet.org.

About the Colorado Coalition for the Medically Underserved
Launched in 1997 by Dr. Gary VanderArk, and independently incorporated in 2003, CCMU has a diverse membership that includes health care providers, insurance providers, advocates and individuals. For more information about CCMU call 303.832.7727 or go to www.ccmu.org.

Letter from the CEO: One Method of Keepin’ Docs “Home on The Range”

How do you keep the doctor and his family “home on the range” when the bright lights of the city are beckoning?

Help with student loan repayment is the most common tool used to attract and keep physicians in rural areas, but a recent study I co-authored with the University of Colorado Health Sciences Center demonstrated that loan repayment is far from a perfect solution. What if the physician doesn’t need help with loans? What if it is family pressure that is the real driver back to the city?

The Colorado Rural Outreach Program (CROP), administered by CRHC, was created for challenges exactly like this. The program’s creators understood that creativity and flexibility are called for when the goal is getting, and keeping, health professionals in rural and underserved areas.

“How creative can they be?” you ask. Try this one on for size. One doc’s family -- his teenage daughter in particular -- was pushing him to move to the city. The girl was bored in the country. The solution: use the CROP program to give the doctor an incentive bonus he could use to buy his daughter a horse. Might sound crazy, but it worked. The daughter was thrilled to get a horse she had long wanted, and the doc was happy to make a continued commitment to stay in his rural community.

CROP was started in 1998 by the Colorado Medical Society and has been administered by CRHC since 2005. In recent years, the program has been primarily supported by The Colorado Trust, but thanks to funds from the Colorado Health Foundation, we have been able to make a $25,000 per year donation to CROP for the next three years that was equally matched by our partners at the Colorado Community Health Network. In addition, the Colorado Medical Society recently provided a generous $10,000 grant to the program and the Caring for Colorado Foundation granted an additional $30,000. The El Pomar Foundation also generously awarded $20,000 to CROP for 2011. (Add up all of the new donations and we have $110,000 new dollars for CROP!)

Grants from the program can be used for loan repayment or healthcare provider bonuses (like the money for the aforementioned horse). All grants made through CROP require a one-to-one community match, ensuring the locals have “some skin in the game” too.

The program’s grants can be paid to a wide variety of providers, so this isn’t just a doc thing.

For more information on CROP and loan repayment programs, click here. To read the study on the impact of loan repayment programs click here.

Nurse Staffing and Rural Hospital Performance Improvement (Policy Brief) Now Available

This study examines the impact of nurse staffing on rural hospital performance improvement in the CMS/Premier Inc. Hospital Quality Incentive Demonstration project. Higher registered nurse (RN) staffing hours per patient day are associated with higher scores on composite quality measures for pneumonia, heart failure, acute myocardial infarction and a hospital-wide composite score. The relationship between RN staffing and quality measures does not differ based on rural or urban location, the number of staffed beds, or medical school affiliation.

For more information, contact:
Ira Moscovice, PhD
Upper Midwest Rural Health Research Center
Phone: 612-624-8618
mosco001@umn.edu

Wilroy and Ravindran Recognized Nationally for Rural Leadership

Denver, Colo. – February 24, 2010 – Two Colorado leaders have been recognized nationally for their contributions to rural healthcare. Colorado Rural Health Center (CRHC) Chief Executive Officer, Lou Ann Wilroy, has been elected president-elect of the National Organization of State Offices of Rural Health (NOSORH), and Legislative Health Policy Advisor for Senator Michael Bennet, Rohini Ravindran, was recently awarded the National Rural Health Association (NRHA) Legislative Award.

Wilroy will serve a three-year leadership term at NOSORH, as president-elect in 2011, president in 2012 and past-president in 2013. She has been with CRHC for over 10 years, and has held the title of CEO since August 2007. CRHC was created twenty years ago as Colorado’s state office of rural health to administer programs and services to ensure that rural Coloradans have access to comprehensive, affordable healthcare services.

As president of NOSORH, Wilroy will be responsible for ensuring the national organization meets its mission of increasing the capacity of state offices of rural health across the country through leadership development, advocacy, education, and partnerships. All 50 state offices of rural health depend on the support of NOSORH to increase awareness about rural health issues and actively engage in solutions at the state and national levels.

In January, the National Rural Health Association awarded Rohini Ravindran with the NRHA Legislative Staff of the Year Award for 2010 for her dedication and commitment to the health of rural Americans. Ravindran was instrumental in ensuring vital rural healthcare funding was included in last year’s senate health reform bill. “During healthcare reform, Rohini went above and beyond the call of duty to ensure it included issues important to rural America,” stated NRHA president Alan Morgan. Hailing from the very rural state of Colorado, Senator Bennet has been recognized as a true rural advocate largely due to Rohini’s behind-the-scenes efforts. According to Wilroy, “Congressional leaders, the people of Colorado, and rural America are all better served because of her dedicated service.”

COO Position Available at CRHC

CRHC is currently hiring a Chief Operating Officer. Click here to view a detailed job description. Interested candidates should send their resume and cover letter, with salary requirements, to info@coruralhealth.org.

Mark Your Calendars for CRHC's 2011 Events!

Don't miss CRHC's two major annual events for 2011! Registration is now available for The Forum, and Sponsorship/Exhibit opportunities are available for both the Forum and our Annual Rural Health Conference. Sign up now for the best rates!

The Forum 2011: Essential Perspectives for Safety Net Providers: April 19-21, 2011
The Forum serves as an essential educational, training, and networking event for all safety net clinics, members of the clinic team, and other interested parties, and it reaches out to include other states and clinic types in order to address the central issues facing us all. As an attendee, you will learn the latest best practices in Health Information Technology, Patient Centered Medical Home and other vital topics including heatlhcare reform and how it will impact safety net providers. By sponsoring/exhibiting at this event, your organization will have exposure to rural and safety net providers including administrators and CEOs, top level management and clinical providers, as well as other national and local stakeholders and Foundations. Click here to Register, and Click here for more information on becoming a Sponsor or Exhibitor.

20th Annual Colorado Rural Health Conference: August 11-12, 2011
The Colorado Rural Health Conference provides participants with a wide range of educational topics from national healthcare reform to innovative access to care solutions in rural areas. Mark your calendar today to help us celebrate our 20th anniversary at this statewide event. By sponsoring/exhibiting at this event, your organization will have exposure to over rural providers and community members including hospital, clinic, and long-term care clinical and leadership staff, as well as other national and local stakeholders and Foundations. Click here for more information on becoming a Sponsor or Exhibitor and check our website for more information on the event.

If you have questions about one or both of these events, please contact Nadine Gressett at ng@coruralhealth.org or 303.832.7493.

USDA Invites Applications for Grants to Bring Improved Health Care and Educational Services to Rural Communities

The USDA is accepting applications for telecommunications grants to provide access to education, training and healthcare resources in rural areas. The Distance Learning and Telemedicine (DLT) Grant Program provides funds to improve rural access to education and health care.

DLT grants can be used for the purchase of eligible equipment and to provide technical assistance. To be eligible, applicants must serve a rural area, demonstrate economic need, and provide at least 15 percent in matching funds. Awards range up to $500,000.

Completed applications must be received by April 25, 2011. For further details about eligibility rules and application procedures visit http://www.rurdev.usda.gov/UTP_DLT.html.

USDA Rural Development Energy Efficiency/Renewable Energy Grants Available

USDA funding is now available for rural businesses for energy efficiency and renewable energy projects. Eligible applicants are limited to Rural Small Businesses (populations under 50,000 which includes Grand Junction) and farmers and ranchers. Non-profits and government entities are not eligible for this program.

Eligible purposes include energy efficiency improvements to commercial buildings, or installation of renewable energy for commercial purposes. Residential is NOT eligible.

The website where an application template and documents may be found is:
http://www.rurdev.usda.gov/ia/rbcs_RE-EE_Section_9006.html. If you would like assistance writing this grant or researching/writing other grants, visit CRHC's website for more information on our Grants, Writing, Research and Opportunities (GROW) program.