Update from the Interim CEO - Save the Date for CHRC's 21st Annual Conference 2012

CRHC’s 21st Annual Rural Health Conference, October 25-26, at the Antlers Hilton in Colorado Springs is a two-day event that brings rural communities together to celebrate the great work over this past year.

Thank you to our friends, members, foundations, and partners for sharing your thoughts on the conference content. CRHC strives to tailor the conference to your interests and needs. Based on your feedback, the agenda will include innovative sessions addressing healthcare reform, preserving access to care in rural America, public health, hospital, clinic and community health center collaborations, patient centered medical home, and accountable care organizations/collabortives.

Join us and take advantage of the educational and networking opportunities designed specifically for those that are serving rural communities. Reserve your seat by registering at www.coruralhealth.org/events/annual.htm today!

To join us and take advantage of the opportunity to support and connect with rural communities, we have sponsorship and exhibitor forms available here.

I hope this conference offers you the ability to take back new information, experiences, insights and friendships that can be shared in your community.

On behalf of the Colorado Rural Health Center, thank you for supporting our mission and vision to serve rural communities.

Save the Date for the 3rd Annual Safety Net Clinic Week!

In an effort to raise awareness of Colorado's healthcare safety net providers, the Colorado Rural Health Center and ClinicNET are pleased to announce the third annual Safety Net Clinic Week, August 20-24, 2012. The week will be devoted to educating the public and policy makers about these vitally important health care clinics - federally certified Rural Health Clinics (RHCs) and Community-Funded Safety Net Clinics (CSNCs).

Colorado has 53 federally certified RHCs that provide health care in rural and remote areas of Colorado, and there are currently 35 identified CSNCs in Colorado that are free and charitable clinics, community clinics and family medicine residency clinics. These safety net facilities provide primary care and chronic care services to low-income, uninsured, and underinsured Colorado residents.

Safety Net Clinic Week Project Coordinator, Charlotte Kaye, will be collaborating with clinics to make this year’s Safety Net Clinic Week a great success! Are you interested in hosting a public official or candidate for office for a site-visit? Do you have an event or activity the same week that could be highlighted by Safety Net Clinic Week? Please contact Charlotte directly if you are interested in participating in Safety Net Clinic Week. She can be reached at

HPSA scores: What does it mean to me and my clinic?

Living and working in rural Colorado, you have most likely encountered the acronym, H-P-S-A. For many clinic administrators and providers, you are proficient in the world of HPSA scores and know exactly what a Health Professional Shortage Area score means and why it is important to you and your clinic. For those of you who probably have heard this word and know that it is significant to you and the work that your particular clinic does, but are not positive why, we hope the explanation below can shed some light and give you a reason to pay a little more attention to the benefits of having one.

What exactly is a HPSA score? This score is a federal designation assigned to a geographic area, population group (such as low-income), correctional facility, state or county mental health hospital, or public or nonprofit facility that can demonstrate a shortage of health professionals in the service area. HPSAs can be created for primary medical care, dental health, or mental health. They reflect the level of provider shortage for a service area and are on a scale of 0 to 26, higher scores indicating higher relative need than lower scores.

What is the benefit of having a HPSA score? Your clinic may benefit from having a HPSA score in three ways. The first one is recruitment and retention. Your primary care physicians, Nurse Practitioners, Physician Assistants and Mental Health workers may be eligible to apply for loan repayment dollars through the Colorado Health Service Corps and National Health Service Corps loan repayment programs. Also by having a HPSA, you may be eligible to participate in the J-1 Visa waiver program. Secondly, your providers caring for patients on Medicare are eligible for the Medicare Incentive Program. This will provide them with a 10% monetary bonus on Medicare services billed. Lastly, if your clinic is located in a HPSA, you may be eligible to become a Certified Rural Health Clinic and receive cost-based reimbursement.

In the last few months we have seen several rural and frontier counties lose their HPSA scores. Every three years, Colorado’s State Primary Care Office (PCO) evaluates the HPSA designations in Colorado and re-assigns scores based on specific criteria. Part of the criteria that is often misinterpreted by clinics and their providers are the reporting of numbers of hours spent by providers providing direct patient care in the medical setting. It is important when submitting patient numbers to the PCO that your providers are submitting only hours spent directly caring for patients and the time spent charting and following up with those patients. Practice management, personnel management and administrative duties should not be counted. Incorrect reporting could indicate there is less need than there is in reality.

On a positive note, Gunnison County has recently been given a HPSA score! Congratulations to Dr. John Tarr at Gunnison Health Department for working tirelessly with the assistance of Colorado Rural Health Center’s Quality Improvement Specialist, Kathryn Steele, and the Primary Care Office to obtain a score for Gunnison County!

For more information on HPSA score designation, contact Kitty Stevens at the PCO at kitty.stevens@state.co.us, 303.692.2298.

For more information on the benefits of having a HPSA score, contact the Colorado Rural Health Center at info@coruralhealth.org, 303.832.7493.

2012 Rural Health Excellence Award Nominations

The Rural Health Excellence Award is given annually by Colorado Rural Health Center to honor those who have made a notable contribution to health, healthcare, or a healthcare delivery system in rural Colorado. For 2012, the award will be presented during the 21st Annual Colorado Rural Health Conference October 25-26, at the Antlers Hilton in Colorado Springs. The winner and their family will be invited to attend the conference as guests of CRHC. The person submitting the winning nomination can help plan the presentation and personally present the award if s/he wishes to participate.

To be eligible for the award, a candidate must have made a significant contribution to the health, healthcare, or a healthcare delivery system in a rural Colorado community, area, or region. Healthcare providers, board members, administrators, volunteers and others are eligible for nomination. Despite their enormous contributions, CRHC Board Members are not eligible for nomination while serving on the Board.

Click here for more information and to download the nomination form.

Workman's Compensation Survey

We are conducting a survey on Workman's Compensation on behalf of Pinnacol Assurance, one of Colorado Rural Health Center's many Classic Sponsors. Please click here and take a moment to complete the short survey! Your time and responses are appreciated - Thank You!

Stay Connected With CRHC!

Stay up to date on all the latest in rural healthcare by subscribing to Colorado Rural Health Center's weekly blogs in addition to the monthly Special Delivery! You can also like us on Facebook, follow us on Twitter, check out our videos on YouTube and follow CRHC on LinkedIn.

Weekly Update
Targeted to Critical Access Hospitals and Rural Health Clinics, this weekly blog highlights Medicare updates, webinars and trainings, funding opportunities, and other program- and service-related information.

The Rural Voice
Interested in what's going on at the capital? The Rural Voice provides news and updates on health reform, CRHC's policy and advocacy activities, and Colorado health care legislation that impacts rural Colorado.

THE Consortium
This weekly blog is focused on Health Information Technology (HIT) news and updates, Meaningful Use explanations, and scheduled webinars targeted to hospitals and clinics implementing Electronic Health Records.

Colorado Rural Health Center is Hiring!

CRHC is hiring for the following positions:

Director of Workforce Programs
The Director of Workforce Programs reports to the Chief Executive Officer and is responsible for the management, oversight and success of the CRHC Workforce programs including the Colorado Provider Recruitment program and Colorado Sustainable Towns: Rural Innovation, Development, Expansion, and Success (STRIDES). This position is responsible for the workforce program’s success to achieve health needs assessment and community engagement objectives; recruitment and retention objectives; develop and implement innovative recruitment and retention programs and activities; provide strategic direction to the workforce team to expand and develop services to meet the needs in rural Colorado to strengthen the healthcare workforce.

Program Assistant, Outreach Department
The Program Assistant for the Outreach Department supports the effective and efficient administration of CRHC programs and activities by providing direct assistance to program staff.

For all positions, submit a resume, cover letter, and salary requirements to hr@coruralhealth.org, with the position title in the subject line

Advance Payment ACO Model: New Opportunity To Apply

The Advance Payment ACO Model is an Innovation Center initiative for participants in the Medicare Shared Savings Program. It’s designed for physician-based and rural providers who have come together voluntarily to give coordinated high quality care to the Medicare patients they serve. Through the Advance Payment ACO Model, selected participants will receive upfront and monthly payments, which they can use to make important investments in their care coordination infrastructures.

CMS announced last October that applications would only be accepted for April 1, 2012 and July 1, 2012 start dates.

However, the Innovation Center has now announced that beginning August 1, 2012, it will be accepting applications for an additional round of Advance Payment ACOs that would begin on January 1, 2013.

Organizations interested in the Advance Payment ACO Model should start their application process by submitting a Notice of Intent to apply for the Medicare Shared Savings Program performance period that begins January 1, 2013. This Notice of Intent (NOI) is due June 29, 2012. Organizations that submit this NOI will then have the opportunity to submit applications to both the Medicare Shared Savings Program and the Advance Payment ACO Model.

The Advance Payment ACO Model is an important part of the CMS Innovation Center’s work to help providers at all levels of readiness.

The CMS Innovation Center was created by the Affordable Care Act to test innovative payment and service delivery models that have the potential to reduce program expenditures while preserving or enhancing the quality of care. More information is at innovation.cms.gov.

Community Transformation Grant Funding Available

The U.S. Department of Health and Human Services (HHS) announced available funding of $70 million to improve the health of small communities across the nation. The small-community investments are part of the Community Transformation Grant (CTG) program, a comprehensive prevention and wellness initiative launched in 2011 by HHS and administered by the Centers for Disease Control and Prevention (CDC).

The CTG Small Communities program targets intervention populations of up to 500,000 in neighborhoods, school districts, villages, towns, cities and counties in order to increase opportunities for people to make healthful choices and improve health. These areas can be specific counties, cities, towns and villages with populations up to 500,000 or neighborhoods, sections, or subgroups of the population (e.g., children or seniors) within a metropolitan area.

The official funding opportunity announcement for the Community Transformation Grant program Small Communities component can be found here. The letter of intent deadline is June 18, 2012 and the application deadline is July 31, 2012, 5pm Eastern Daylight Savings Time. To learn more about the Community Transformation Grant program, including a list of the current 68 awardees, please visit their website.

For more information about how the Prevention and Public Health Fund is helping promote prevention in every state, click here. For an overview fact sheet about the Community Transformation Grant program, click here.

Medicare Fee-For-Service to Reject Version 4010 Electronic Transactions July 1, 2012

Effective July 1, 2012 only ASC X12 Version 5010 (Version 5010) or NCPDP Telecom D.0 (NCPDP D.0) formats will be accepted by Medicare Fee-For-Service (FFS). Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected by this change. Now is the time to contact your software vendor, billing service or clearinghouse, when applicable, if you have not done so already to ensure you are ready. Transactions conducted by Medicare Administrative Contractor (MAC), fiscal intermediary (FI) or carrier telephone interactive voice response (IVR) systems, Direct Data Entry (DDE) and Internet Portals, for those contractors with Internet Portals, are not impacted.

Claims (837 I and P)
All claims received after normal close of business cutoff times on June 29, 2012 must be sent as ASC X12 Version 5010 or NCPDP D.0. Any Medicare FFS claims received in version 4010 format after normal close of business on June 29 will be rejected back to the submitter. The specific message you receive if a claim is rejected will depend on your MAC. A detailed list of 4010 rejection error messages by MAC can be found on the Important 4010 - 5.1 Rejection Information Page.

Claim Status (276/277)
The last Claim Status Inquiry will be accepted in version 4010 at the end of the business day on June 29, 2012. Following that date, all Claim Status activity will be in ASC X12 Version 5010.

Remittance Advice (835)
During the transition period Medicare FFS experienced issues with the Remittance Advice (835); therefore Medicare FFS will be allowing an additional 30 days to complete the 835 transition. Information will be forthcoming concerning the final cutoff and cycle timing for the Remittance Advice.

Coordination of Benefits (837)
CMS has directed its MACs, FIs, and carriers to begin sending all claims to the Coordination of Benefits Contractor (COBC) in version 5010 as of June 29, 2012. This will ensure that all claims that the COBC will issue to COB payers as of its July 2, 2012 evening crossover claims cycle will be properly transmitted in the version 5010 format. Therefore, all COB payers will have to be in version 5010 COB production by June 29, 2012.

Medicare FFS will continue to coordinate additional outreach and education activities and messages throughout June. In addition, Medicare FFS will be participating in a series of Regional Webinars on Wednesday, June 20. Please watch for listserv messages on registering for these calls.

For more information on ASCX12Version 5010 and NCPDP D.0, please visit the Versions 5010 and D.0 website.