CEO Update: A Year of Transformation

If you’re like me, you may be astounded that 2013 is coming to a close.  What a whirlwind of a year!  Each month this article has, in some way or another, emphasized that our industry is transforming at staggering rates.  I’ve stressed the significance of partnerships as the main imperative to successfully survive this transition and the Colorado Rural Health Center’s (CRHC) importance as your catalyst to collaboration.  Throughout this month’s editorial, please note the testimonials of our members and partners.

The Affordable Care Act (ACA) is upon us!  Time for speculation about what provisions will survive has passed, and scenario planning for the ACA’s implementation must now be our mission.  In 2013, our policy agenda focused on the highest priorities for rural healthcare providers and their patients, which all aligned with the forthcoming ACA implementation. 

Access to care aimed to support legislative action that would increase our rural residents’ abilities to acquire quality and affordable services at the appropriate time.  With Colorado’s Medicaid expansion, we hope our advocacy efforts will show fruitful results in allowing thousands new access to care.

Commercial coverage was introduced into the marketplace with the intention of creating a capitalistic platform for payers to compete. Tied into access to care, our priority was to advocate for the rural voice and to promote options that would cover the most rural residents at the highest reimbursement rates for our members.

Accountable care was a 2013 policy priority focused on securing resources for programs that would help providers meet new standards while maintaining a high level of quality care.  Various state legislations surrounded accountable care, and we were there in each discussion assuring that our policymakers understood the uniqueness of rural healthcare facilities.

Integration of care was a conversation surrounding projects to increase the cohesiveness between physical and behavioral healthcare, which has been a problem exacerbated in rural areas of Colorado.  We feel this is an area where our advocacy helped make great strides as part of larger united voice among our partner organizations.

Workforce priorities spotlighted incentives, such as loan repayment, and scope of practice.  We educated our state and federal legislators on the importance of loan repayment as a recruitment tool for underserved communities.  Additionally, we advocated for scope of practice policy that would increase the number of providers in rural areas, while also maintaining high quality of care.

Safety net payments were a common topic throughout the legislative session while we, and our partner organizations, took action against proposed policy that would reduce payments to these vital healthcare facilities.  We continue to strategically evaluate the intended and unintended consequences of healthcare payment reform through our policy and advocacy efforts.

You’ve told us that rural healthcare policy is your priority, and we will be putting forth our excellent degree of advocacy in 2014.  As over half of our members have renewed for 2014 and we’re welcoming many new healthcare facilities to our organization, we understand that you value having our voice unite yours.  Here’s a peak at what to expect in policy during the next year…

2014 will be an interesting year for healthcare in Colorado, but it is likely to have a softer presence in the legislature.  Given that implementation is in full swing, it’s not anticipated that there will be any major policy proposals in healthcare.  It is possible that funding and oversight for K-12 and higher education will take the center stage.  Additionally, it’s likely we’ll see some bills that address the social determinants of health such child care tax credits, child care assistance program and other anti-poverty proposals.    

The state’s financial position continues to improve as evidenced by the Governor’s policy proposal in November.  Funding is being restored to many programs, and the state reserves are being rebuilt after the wildfires and flooding.  For healthcare, the proposal included an increase in Medicaid provider rates, funding for the increased Medicaid caseload, new resources for programs that serve people with developmental disabilities, and funding for a new project called the Primary Care Specialty Collaborative.

Please be sure to enjoy the holidays, because next year we know you’re going to be busy!  We expect to hear a lot from you regarding our support with implementation of the ACA.  As always, I like to close this article by sincerely thanking our members and partners on behalf of myself and our staff.  It’s truly an honor being able to serve and advocate for Colorado’s rural healthcare.

Rural Health Amendments Pass the Senate Finance Committee

Last week the Senate Finance Committee approved the “Chairman’s Mark” of the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013.  A number of rural provisions were included as amendments and adopted by the Committee.  The bill would permanently repeal the Sustainable Growth Rate (SGR) and permanently extend a number of rural Medicare extenders.  The National Rural Health Association (NRHA) has been leading the fight for a number of Medicare extenders, essential to rural providers, to be extended at current levels in perpetuity.  Additionally, NRHA has sought for regulatory burden reduction that would alleviate the burdens placed on various rural providers.  A number of amendments offered at last week’s mark-up accomplished these purposes.  Among the important actions taken at the hearing, Amendments 117 and 121 were adopted in the Chairman’s Mark at the beginning of the hearing and, therefore, did not require a vote.

 

Thanks to the National Rural Health Associations’ Government Affair’s team, here is a rundown of the amendments impacting rural health: 

Amendment 117 (Thune/Bennet/Enzi/Roberts 1): This amendment would return supervision requirements for outpatient therapy services furnished at Critical Access Hospitals back to “general supervision.” This was the supervision level observed at nearly every CAH prior to 2009.

Amendment 121 (Thune/Wyden/Roberts/Rockefeller/Enzi/Stabenow 5): This amendment would ensure that the new Alternative Payment Models do not interfere with or inhibit the development of telehealth technologies that are critical to the future of delivering care in rural America.

Additionally, the following amendments passed with unanimous voice vote:

Amendment 18 (Schumer/Grassley 1): This amendment would permanently extend, at current levels two crucial rural hospital payments, the Medicare Dependent Hospital program and Low Volume Hospital Adjustment.

Amendment 82 (Grassley 13): This amendment would set a permanent floor on the work component of the Geographic Practice Cost Index (GPCI) at its current level of 1.0 creating a stable and more equitable reimbursement rate for rural physicians.

Amendment 118 (Thune/Casey/Enzi Amendment 2): This amendment would establish demonstration project for telehealth remote patient monitoring services. This demonstration would help show the efficacy remote patient monitoring in keeping patients in their homes rather than in hospitals.

Passing these amendments in the Senate Finance Committee is a win for rural health.  Stay tuned for updates as the budget setting process continues.  Email and call us with your stories and questions as we prepare to visit our elected officials during NRHA’s 25^th annual Rural Health Policy Institute Feb. 4-6 in D.C.

Member of the Month: Yuma District Hospital

Yuma District Hospital is a 22-bed Critical Access Hospital and Level IV Trauma Center located outside of Yuma, CO - serving over 7,000 residents from Yuma and Washington counties. They offer inpatient care, surgical care, obstetrics and delivery, 24 hour emergency room, diagnostic imaging, laboratory, rehabilitation services, swing bed care, and home health care. The Yuma Clinic – a Federally Certified rural health clinic - is affiliated with the hospital and serves as a rotation site for physicians in Colorado family practice residency programs. In addition, the Center for Specialty Medicine, also located in the hospital, provides space for visiting specialists in a wide range of specialties. Also affiliated with the hospital is the Akron Clinic, which is staffed by a Family Practice Physician and Nurse Practitioner. The Akron Clinic offers laboratory and x-ray services on-site, physical therapy, independent exercise and home health care services.

Yuma County was formed in 1889 from a portion of Washington County. Located on the Northeastern Colorado Plains with Nebraska and Kansas at its border, Yuma County has an area of approximately 2,379 square miles. To learn more about the region’s public health priorities, check out the 2013 Public Health Improvement Plan. For other resources visit the City of Yuma website, West Yuma County Chamber, Yuma School District or the Yuma County website.

The Yuma District Hospital has been a member of the Colorado Rural Health Center (CRHC) for over a decade. The hospital is highly engaged in numerous programs and services offered through CRHC. Yuma is currently participating in the Improving Communication and Readmission (iCARE) project, which offers Colorado’s CAHs and their clinics the opportunity to engage in a statewide improvement project aligning with national trends and funding priorities demonstrating sustainable improvements and outcomes.

In addition, the hospital participates in the Small Rural Hospital Improvement Program (SHIP) Grant, which is a statewide collaborative project focusing on creating and refining quality improvement systems and processes with the goal of meeting electronic health record (EHR) Meaningful Use criteria.

Yuma District Hospital is also contracted with CRHC’s Colorado Provider Recruitment (CPR), a nonprofit recruitment program. Currently, CPR is recruiting a mid-level provider (Family Nurse Practitioner or Physician Assistant) for the Yuma Clinic. 

“The staff at Yuma are incredible!” said Courtnay Ryan, Quality Improvement Specialist at CRHC.

 “The hospital and clinics provide an amazing level of care to their patients. They are truly providing high quality healthcare in their community,” added Ryan.  

Staff and leadership at Yuma District Hospital and Clinics regularly attend CRHC sponsored events and educational webinars and workshops. They also participate in Healthly Clinic Assessments, Peer Review, the CREATE program, Health Information Technology services and a variety of fee for services. As a highly engaged member with CRHC, we are proud to announce Yuma District Hospital as December’s Member of the Month. 

Opinion: Protecting patients central to physical, behavioral health reforms

For just a moment, forget the politics of health care reform — they won’t go anywhere, I promise. Picture a low-income family able to stay safe and whole, because a parent can afford to see a therapist for anger. Think about what it would be like if fewer people ended up in prison, and more of them in jobs, because they were able to get help for mental illness and addiction earlier in life.

Your friend was struggling to stay in treatment for depression, but kept falling out when her yearly allotted visits were through; now she can remain in therapy for as long as she needs, and you’re not worried anymore about checking in with her every morning. Imagine a future where alcoholism takes fewer lives, where fewer mothers and fathers overdose in front of their kids; where suicide is no longer the second leading cause of death for Coloradans under the age of 35. Click here to read the full by Michael Lott-Manier.

Opinion: Resources, commitment needed to improve health of Colorado’s American Indians

Every year since 1990, the President has designated Novemberas a time to honor American Indian heritage and culture. This year, on Oct. 31, President Obama signed the proclamation and urged us to celebrate the incredible impact American Indians have had on the shaping of the U.S. while not ignoring the painful history they have endured. He finished the proclamation by calling for a new generation of leadership that works together to “ensure this country’s promise is fully realized for every (American Indian).” Click here to read the full article by Joe Sammen.

The Colorado Trust grants $20,000 to Rural Philanthropy Days participants

The Colorado Trust today announced it has made $20,000 in grants to strengthen the work of four nonprofit organizations working to advance the health and well-being of rural Coloradans. The Colorado Trust, a health foundation dedicated to achieving health equity, made the grants after meeting with nonprofit organizations at Rural Philanthropy Days in September in Winter Park, Colorado. Click here to read the full press release issued November 2013.

School-Based Health Care Initiative 2012-13 Evaluation Report

This report from the Colorado Health Foundation outlines the evaluation of the School Based Health Center initiative in efforts to determine if the initiative was effective in moving its grantees toward self-sustainability. Click here to read the full report.

The 10 Biggest Hospital Stories of 2013

2013 was a challenging year for healthcare, and one marked with much uncertainty.

Perhaps the most uncertainty in the industry stemmed from the rollout of the Patient Protection and Affordable Care Act's healthcare exchanges. For months leading up to their launch, health systems worried as they struggled to estimate, and therefore plan for, the number of patients who would enroll in plans offered on the exchanges and reimbursement rates under these plans.

When the exchanges did launch, they launched in the midst of a federal government shutdown. And, the federal exchange website, www.Healthcare.gov, experienced weeks of technical difficulties, forcing the Obama administration to delay the start date for imposing penalties on the uninsured by six weeks, at the time this issue went to press. What other issues impacted hospitals and health systems the most during 2013? Following are 10 of the biggest stories covered in the pages of Becker's Hospital Review throughout the year.

White Paper: Healthcare system reduces complexity, reduces volatility, improves pension funded status

To download this whitepaper, click here.

Nominations for 2014 Great Hospitals in America List

Becker’s Hospital Review is currently accepting nominations for the 2014 list. Download the nomination form here. Please email completed nomination forms to Heather Punke, Becker's Hospital Review assistant editor, at hpunke@beckershealthcare.com. Nominations must be received by Jan. 17, 2014 to be considered.

CRHC Receives $350,000 Grant from the Colorado Health Foundation

The Colorado Rural Health Center (CRHC) announced that the Colorado Health Foundation has awarded a fourteen-month, $350,000 grant to support general operations. The grant continues effective services and programs offered by CRHC to rural healthcare providers and facilities throughout the state. Click here to read the full press release issued December 4, 2013.

Take Control of Your Purchased Services Spend: Best practice success stories

Webinar

Thu, Jan 16, 2014 1:00 PM - 2:00 PM MST
Click here to register

Webinar Summary:
Hospitals allocate nearly 30% of their Operating Budgets to Purchased Services, nearing $100 billion per year. Additionally industry trends expect purchased services to increase by 13% over the next 5 years, further impacting strained budgets. Combined with looming cuts in reimbursement, the financial hurdles for hospitals may seem impossible to overcome.

This webinar will focus on how two leading hospital systems, SSM and St. Joseph’s, put a process in place to identify areas of opportunity in order to reduce, consolidate and manage their purchased services spending and improve their contracting process. Additionally MD Buyline will showcase their decades of experience in purchased services and how they are enabling systems like SSM and St. Joseph’s in reaching their objectives to reduce spending and better manage the purchased services process.

The Life of a Healthcare CIO: Mt. San Rafael Hospital's Michael John Archuleta

In collaboration with CHIME, Becker’s Hospital Review’s new "Life of a Healthcare CIO" series features leading hospital and health system CIOs from across the country who are sharing their experiences, best practices and challenges. An interview with Michael John Archuleta, director of IT at Mt. San Rafael Hospital in Trinidad, Colo. Click here to read the full article by Helen Gregg, posted on Becker’s Hospital Review.

Archived Health IT and Quality Webinars

Check out the HRSA HIT and Quality Improvement webpage for archived webinars available. Include the following categories…

Quality Improvement and Reporting

Health IT Due Diligence/Selecting a Health IT System

Health IT Implementation/Operations/Workflow/Budgeting

Meaningful Use

Workforce and Safety Net Providers

Health and Quality Programs/Topics

Physician community webinar series "Delivering Value through Health Information Exchange"

January 16, 2014 1:00 PM – 2:00 PM Central Time
Register Now!
Source: HIMSS Physician Community

Webinar
Member Cost: $0
Non-Member Cost: $0

Health information exchange continues to be one of the greatest challenges in establishing the infrastructure required to support healthcare reform. This session examines the factors shaping health information exchange and the implications of payment reform and other public policy levers. This session will help providers understand what these evolving structures and alternative models for public vs private HIE will mean for healthcare providers. CPHIMS and CAHIMS approved course; 1 enduring credit hour.

Supply Chain: Untapped data mine for enhancing cost, quality and outcomes

Critical to enhancing cost, quality, and outcomes, health IT professionals realize that the supply chain function can provide the kind of data necessary for hospitals and healthcare systems to drive the clinical and financial performance improvements required to meet the objectives of healthcare reform. With better alignment between supply chain and clinical and financial systems and processes, health IT professionals can yield insights into total costs of healthcare delivery and the role of products play in achieving better quality care, improved patient satisfaction, and optimized reimbursements. Click here to download the presentation slides from the November webinar. Interested in future EHR webinars click here.

Physician Community Webinar Series "Medical Informatics Primer"

December 20, 2013 1:00 PM – 2:00 PM Central Time
Register Now!
Source: HIMSS Physician Community

Webinar
Member Cost: $0
Non-Member Cost: $0

In this session, Ken Ong, MD, defines Informatics, examines how HIT is applied in provider settings and what innovations have been applied through Informatics. This session will also touch on how federal legislation, ARRA, is providing financial incentives for healthcare providers that demonstrate Meaningful Use of HIT from a physician leader on the HIMSS Board. CPHIMS and CAHIMS approved course; 1 enduring credit hour.

Announcements from the Federal Office of Rural Health Policy

The Federal Office of Rural Health Policy is pleased to announce the release of the fiscal year 2014 Rural Health Network Development Planning Grant Program. The purpose of this program is to assist in the development of an integrated healthcare network. Applications must be submitted into grants.gov by January 16, 2014. To access the application visit: http://www.grants.gov/web/grants/search-grants.html and type in HRSA-14-043 in the funding opportunity box.

Rural health care shortage needs better public policy

More than a third of rural Americans live in Health Professional Shortage Areas. Nearly 82 percent of rural counties are classified as Medically Underserved Areas. Fewer than 10 percent of America’s physicians practice in rural areas. Most rural areas in the nation have a shortage of all forms of health care professionals. Rural medical professionals are also aging. Health care professional educators, state governments, the federal government, rural schools, and rural communities must all do more to address this crisis. Click here to read the full article posted on press-citizen.com.

Senator wants rural health, telehealth included in SGR repeal

Despite the progress made yesterday toward repealing the sustainable growth rate (SGR) and making changes to Medicare payments physicians, one member of Congress believes the measure are not doing enough for rural healthcare providers and patients. 

Only hours after the United States House of Representatives passed a temporary solution to the sustainable growth rate (SGR), Senate Committee on Finance passed its SGR Repeal and Medicare Beneficiary Access Improvement Act seeking a permanent solution. (An interesting wrinkle in the latter is the requirement for EHR systems to be interoperable by 2017.) Click here to read the full article by Dr. Kyle Murphy, published on EHR Intelligence.

Recap of 2013 DBJ stories about ACA rollout in CO

2013 brought a bumper crop of news stories with major impact on Colorado business, from real estate and energy to travel and technology. Here, as part of the Denver Business Journal's Year in Review package of stories, we continue our look back at 13 of the most significant local business news stories covered by the Denver Business Journal through the year, in print and online, as voted by the DBJ news staff. Look for more top stories of 2013 every business day through New Year's Eve. And click here for more Year in Review coverage. Click here to read stories from the DBJ about the ACA rollout in CO.

Access to health care coming soon to homeless in Colorado

Harry Stahl walked into Colorado Springs emergency rooms twice this year, and went under a surgeon's knife once in Wyoming. He left each hospital feeling better - but without a home to go to while he healed. And being homeless, he left no doubt on his ability to pay for most of those medical bills. 

Come Jan. 1, access to health care for homeless people such as Stahl should vastly improve, and the level of care they receive could become far more advanced and holistic, homeless advocates and health care providers say. Meanwhile, the cost to hospitals for treating homeless people could decline - potentially reducing the amount of charitable care offered each year. Click here to read the full article by Jakob Rodgers.

Colorado Provider Recruitment Placements!

Colorado Provider Recruitment (CPR) has recently placed two physicians to rural Colorado! A general surgeon found a home at Spanish Peaks Regional Health Center and will start working in January. Also a psychiatrist will begin work at Heart of the Rockies Regional Medical Center in February!

Need help finding a provider for your vacancy? Contact CPR at cpr@coruralhealth.org.

CPR now recruits for Registered Nurses! Enquire for more information.

iCARE Storyboard Exhibited at IHI’s National Forum

CRHCexhibited a Storyboard about its Improving Communication and Readmission (iCARE) program at the Institute for Healthcare Improvement’s (IHI) National Forum this month in Orlando, FL. The storyboard provides an overview of the program since its beginnings in 2010 and highlights the accomplishments of program participants in relation to the three overarching iCARE program goals:

• Improving communication in transitions of care
• Reducing readmission rates
• Improving clinical processes that contribute to readmissions, particularly for heart failure, pneumonia, and diabetes patients

Sixteen critical access hospitals and fourteen rural health clinics across the state are currently participating in the program. For more information about iCARE, contact CRHC’s CAH Program Manager, Caleb Siem, at cs@coruralhealth.org. To view the iCARE Storyboard, click here.

Zenzinger named to fill Hudak's Colorado Senate seat

Rachel Zenzinger, an Arvada City Council member, has been named to fill the Colorado state Senate seat left vacant by the resignation of Evie Hudak. "I am eager to get to work on the tough issues facing our state, including economic development, job creation, education, transportation and health care," Zenzinger said. Click here to read the full article by Mark Harden with the Denver Business Journal.

University of Colorado Health system jumps into insurance business

University of Colorado Health will offer third-party administration service for companies' self-funded health insurance plans beginning in 2014, becoming the first hospital system in the state to get into that business. The new division -- UCHealth Plan Administrators -- expects that it can enable companies of at least 75 workers that have not self-funded their coverage before to do so, thereby learning more about how their disease-management and other health plans are effective or ineffective, said Kathy Major, executive director and vice president of the effort. Click here to read the full article by Ed Sealover with the Denver Business Journal.

Colorado launches effort to grow health and wellness industry

Colorado officials plan to make the state a hub for wellness and digital health companies -- a strategy fraught with potential hurdles, but one they believe can put them at the leading edge of a new movement in health care. Ken Lund, executive director of the Colorado Office of Economic Development and International Trade, announced the plan Wednesday at a gathering of state business and health care leaders. Click here to read the full article by Ed Sealover at the Denver Business Journal.

Taking care: Small rural hospitals face uncertain future under ACA

The rollout of the Affordable Care Act has already set off significant change and uproar around individual insurance plans. As the ACA settles into place in 2014, more change and concerns are coming to small rural hospitals. Under the ACA, small rural hospitals will see significant reductions in traditional Medicare payments, and some will see new payment requirements for patient care. Rural hospitals rely on Medicare payments – which primarily cover older people – for almost 45 percent of their annual income. Click here to read the full article by Cristina Janney.

Extra ambulance funding important in rural areas

An amendment to extend extra funding for Medicare payments to ambulance services is particularly important for rural communities, Sen. Charles Schumer said Wednesday. He's looking to get a five-year extension of extra funding for ambulance providers added to the "doc fix" bill. That's a measure that increases Medicare payments for doctors to offset a change in the formula introduced in 1997. The extra funding is set to expire Jan. 1, 2014, which would lead to a three percent cut for rural providers. Even with the extra money in place now, a 2007 report from government accountants said ambulance providers were getting 6 percent less than actual cost of services. Click here to read the full article written by James Post.

Overview of the FCC’s Healthcare Connect Funds webinar

Participants of this webinar will: click here to view the flyer

• Understand discounts for broadband for public and not-for-profit health care providers
• Learn eligibility and application process
• Recognize how to participate as a consortium

Wednesday, 12- 18-2013 at 2:00 p.m. EST.

How to Register –

1. Go to - https://nosorh.webex.com/nosorh/onstage/g.php?t=a&d=661047402

2. Click Register.

3. On the registration form, enter your information and then click Submit.

This call will be recorded and the viewable recording will be available on the NOSORH website - http://www.nosorh.org/news/webinars.php

Study Examines Transport Time of TBI Patients

Transporting directly to trauma centers is a bit of a hot topic lately. For urban providers, it’s a simple decision, but for rural providers, a trauma center may not be nearby, even by air transportation. Last month we discussed the national field triage decision scheme, which recommends all critical trauma patients go to the closest Level I or II trauma center. Although the benefits of immediate surgical intervention are well documented for most trauma patients, there’s little research correlating transport time with the condition of traumatic brain injury (TBI) patients. Click here to read the full article by Alexander Trembley and Davide Page.

Long Term Care Leadership Development

January 2014, Denver Metro

For Long Term Care Leaders ... January 23-24 & 29-31, 2014. Denver Metro TBD.

The Colorado Center for Nursing Excellence presents a 5-day Leadership Workshop for Directors of Nursing and Assistant Directors of Nursing in Long Term Care. Leaders will develop greater skills and expertise in change management, diversity and culture, effective communication, conflict resolution and creating excellence in the workplace. Click here to read more details.

Clinical Scholar Workshop

March 17-21, 2014 [Open]

Are you an experienced nurse who would like to share your wealth of knowledge with men and women entering your profession? If so, we need nurses like you to become Clinical Scholars!

What is a Clinical Scholar?

A Clinical Scholar is a Baccalaureate level or more highly academically prepared registered nurse who will work with a school of nursing to instruct nursing students in a clinical setting. In general, Clinical Scholars maintain their current employment in a clinical facility and ideally host nursing students there. Click here read more.

Use of Dental Services in Medicaid and CHIP

States’ efforts over the past decade have resulted in improved access to dental care for children covered by Medicaid and CHIP. Between 2007 and 2011, almost half of all states achieved at least a 10 percentage point increase in the proportion of enrolled children who received a preventive dental service during the reporting year. Click here to read the full report.

Residency Slots: A Crisis in the Making?

Alicia Billington can't help but be more nervous than usual about this coming spring's Match Day.

Last March, Billington, a fourth year MD-PhD candidate at the University of South Florida College of Medicine in Tampa, saw several classmates end up unmatched to any residency program at the end of the excitement-filled day. Read more here.

Migration After Family Medicine Residency: 56% of graduates practice within 100 miles of training

With state planners working to address primary care shortages and federal graduate medical education payment reform looming, regional retention statistics for family medicine residency programs are a subject of high interest. Click here to read more.

Health Insurance Decreasing in Cost in CO's Rural Communities

DILLON, Colo. - The talk of higher premiums reported by Colorado's rural residents as a result of the Affordable Care Act - such as in Garfield and Summit Counties - is prompting analysts to take a closer look. The Colorado Center on Law and Policy found that residents living outside of the Front Range will in many cases pay less, when the tax credits available in those areas are taken into account. Click here to read the full article posted on publicnewsservice.org.

How does Stage 2 Meaningful Use challenge rural providers?

Even with the proposed extension of the timeline for eligible professionals and hospitals to complete Stage 2 Meaningful Use and begin Stage 3, eligible providers still face the challenge of meeting the thresholds for patient engagement required by next phases of the EHR Incentive Programs. This challenge is particularly more pronounced for healthcare organizations and providers working in rural areas where limited access and capability create significant obstacles. Click here to read the full article posted on EHRIntelligence.com.

Two Case Studies of Regional Extension Centers Serving Rural Practices

• Minnesota & North Dakota
• North Carolina

These two case studies focus on the experiences of HIT Regional Extension Centers working with rural physicians in their respective service areas. They are intended to serve as companions to our recent article in The Journal of Rural Health, which examined the national impact of the REC program and the role of the RECs in helping rural physician practices achieve “meaningful use” of Electronic Health Records. The two RECs were selected for these case studies based on their high rankings among the 62 RECs nationwide on the number of rural providers that had signed up for REC services, implemented EHRs, and attained meaningful use as of May 2012.

The case studies feature commentary and advice from key staff at the RECs as well as selected physician practices serving rural areas. For further information contact Michelle Casey, MS, University of Minnesota Rural Health Research Center at 612.624.6151or mcasey@umn.edu.

Critical Access Hospital Policy Briefs

• Implications for Beneficiary Travel Time If Financially-Vulnerable Critical Access Hospitals Close
• Change in Profitability and Financial Distress of Critical Access Hospitals from Loss of Cost-Based Reimbursement
• Rural/Urban Differences in Inpatient Related Costs and Use among Medicare Beneficiaries

CO officials strategize on offering access to healthy food and recreation

More than 100 elected officials, city planners and health officials from across the state participated in the recent LiveWell Colorado HEAL Cities & Towns Campaign summit in Westminster, Colo., to discuss the role of municipalities in improving access to healthy foods, enabling active lifestyles and encouraging workplace wellness.

Seventeen cities and towns across Colorado are currently participating in the HEAL Cities & Towns Campaign of Colorado, a partnership effort of LiveWell Colorado and the Colorado Municipal League. As part of the program, LiveWell Colorado provides free training, support and technical policy assistance to community leaders as they work toward implementing healthy eating and active living policies - known as "HEAL" policies. Read more about Colorado Officials Strategize on Offering Access to Healthy Food and Recreation - BWWFitnessWorld by www.broadwayworld.com

National Association of Broadcasters launches mental health campaign geared toward teenagers and young adults

The National Association of Broadcaster’s local television and radio stations, broadcast networks and entertainment industry partners have joined together to get the word out about OK2TALK. The campaign includes TV and radio PSAs that will run nationwide to open the door for more in-depth conversations about mental health in schools, the workplace, and among families and friends. The goal of OK2TALK is to create a community for teens and young adults struggling with mental health problems and encourage them to talk about what they’re experiencing by sharing their personal stories of recovery, tragedy, struggle or hope. Visit ok2talk.org for more information.

New AHRQ evidence-based guide helps implementation of health assessments in primary care settings

AHRQ has published an evidence-based guide designed to help primary care doctors, nurses and other staff successfully select, adopt and implement health assessments, which help primary care providers evaluate a patient’s health status and risks. The information is used to identify potentially problematic but treatable health behaviors and factors such as anxiety, alcohol use, depression, unhealthy eating and sedentary lifestyle that patients often don’t bring up during a medical visit. 

Research shows that many patients do not receive an assessment of health risks or a plan to address those risks. However, the Affordable Care Act authorizes Medicare coverage of annual wellness visits and specifies that a health risk assessment be included as part of those visits.

The AHRQ guide, Health Assessments in Primary Care: A How-to Guide for Clinicians and Staff, provides evidence-based methods to implement health risk assessments and ultimately to engage patients in making lifestyle changes to improve their health. It employs the best current evidence for successful implementation of health assessments in the primary care setting and includes tools to help clinicians decide which health assessments to use, how to integrate them into their daily workflow and how to maintain the process. The guide is designed for practices that use electronic health records as well as those that use paper charts. The guide gives clinicians sample health assessment questions for seniors, adults, adolescents and children. It also provides a crosswalk of health assessments related to incentive and quality programs. Sample health assessment information for patients and a patient feedback survey are included.

One Colorado hospital makes list of top facilities

The Leapfrog Group on Tuesday named the top hospitals in the United States, including one in Colorado. The Washington-based group, which earlier this year graded hospitals on patient safety, picked the recipients of its top hospitals honor after surveying 1,324 facilities nationwide. The hospitals were divided into three categories: urban, rural and children's. The only hospital in Colorado included on this year's list is East Morgan County Hospital, a 25-bed rural hospital in Brush. The complete list can be viewed here. Click here to read the full article from the Denver Business Journal.

Information for nurses getting a certificate to work in the OR

http://origin.library.constantcontact.com/download/get/file/1109296406022-8/Perioperative+Flyer+2014.pdf

Tammi Clark’s appointed Prowers County Public Health & Environment Director

Tammi Clark’s appointment as the Prowers County Public Health & Environment Director was made official by the county commissioners during their meeting on Thursday, November 21. Clark, a Registered Nurse with 20 years medical experience in the community, was hired as deputy director on July 15. She has lived in Lamar for almost 30 years, serving as head nurse for the Lamar RE-2 School District and Clark worked for the Lamar Area Hospice as well. Click here to read the full article.

Refer a doctor to rural Iowa and earn $10,000

An alarming new study published in Health Affairs says that by the year 2025 the U.S. will have a need for more doctors, mostly due to an aging population. But locally that need is already upon us.

The decision to come back to rural north Iowa to practice was an easy one for Dr. John Brady.

"The lifestyle, I mean the sense of community you don't get in some of the larger cities, the school system I think are great in the Midwest,” says Brady.

But right now, the north Iowa native is busier than ever. Learn more here.

CSU Global is now offering $5000 scholarships to rural Colorado

CSU Global is now offering $5000 scholarships to residents in rural Colorado. More information can be found here.

Column: Protect rural health care

Like the rest of us, Garrison Keillor’s Lake Wobegon is aging. It won’t be long until he is telling us that “all elders are strong, all health care is local and all children are returning home.” Healthy rural places are needed now more than ever. AARP in its handbook “Aging in Place” reminds us “that aging in place is simply a matter of preserving the ability for people to remain in their home or neighborhood as long as possible. The current healthcare system has not been coordinated with in-home care to efficiently and effectively support the senior population.” AARP suggests that there are five key principles for any community to promote aging in place. Click here to read the full article by Tim Size.

CEO Update: A Season of Thanks

November is the traditional month of thanks and I would like to personally thank all of our members, partners, and supporters!  As we get closer to Thanksgivings, I’m reminded of the Charlie Brown’s Thanksgiving show and the lessons we can take from our childhood stories about being grateful.

To get us into the holiday spirit, here is a clip where Snoopy, with his classic antics, is preparing a unique dinner for his friends.

During this time of year it’s especially important for us to remember the contribution of our rural farms to our dinner tables.  Colorado rural communities represent 31.6 million acres of farmland across the state, they produce $7 billion annually to the state’s economy, and the rural agriculture business provides over 105,000 jobs annually.  Whether you’re enjoying an office treat or sitting down to dinner with family and friends, be thankful of our rural farmers who contributed to your holiday.

At the CRHC, we are thankful of our members.  Without you, we would not be relevant and we’d like to express our deep gratitude for engaging in our programs, services, activities and events.   As our 2014 membership and sponsorship campaign is in full swing, we hope you feel that we are as valuable as we find you. 

Member participation in CRHC programs has been incredible and we’re excited to keep the momentum going in 2014.  This year nearly eight out of ten members participated in services, programs and activities and 100 percent actively subscribed to communications, like the Special Delivery. 

This year we measured the retention rates of those qualified healthcare providers that we’ve recruited to your communities and our rates are higher than the national average.  Since we have a high retention rate, our members asked us to expand our recruitment to include Allied Health Professionals. This new service rolled out earlier this month.   You are also helping raise awareness of the great work that is done in rural Colorado through your participation in the Improving Communications and Readmissions (iCARE) project.  This year 15 critical access hospitals (CAHs) and 12 rural health clinics (RHCs) participated, their average readmission rate is 5%.   RHCs are also focused on solidifying basic business operations through our Healthy Clinic Assessment.  We continue to offer you funding for emergency responders training, equipment as well as emergency preparedness.  We advocate for your communities and provide you with the most current information facing rural healthcare today; in a timely manner.  This is just the short list of what we do because we believe in what you do as rural healthcare facilities and providers.

This November, the staff at CRHC wants to thank you for choosing us to be your vehicle to strengthen healthcare in your communities.  Whether you’re reading this as a member, partner or supporter of rural health, we sincerely appreciate your engagement!

 

CRHC hires Outreach Coordinator Matt Enquist

Welcome Matt!

Matt works with the Outreach Department assembling grant proposals and writing, editing, designing and otherwise assisting with many of the organization’s publications. A native of Illinois, he graduated from Chicago’s North Park University and worked in the field of non-profit land conservation in Northeastern Illinois after graduation. He enjoys rock climbing and backpacking and is always planning another expedition.

Send Matt a welcome at me@coruralhealth.org.

 

10 WARNING SIGNS OF ALZHEIMER’S DISEASE

KNOW THE 10 WARNING SIGNS OF ALZHEIMER’S DISEASE:

EARLY DETECTION MATTERS

Unfortunately, most Americans are unaware of the symptoms associated with Alzheimer’s Disease, the most common form of dementia.  Specifically, and in addition to memory loss, behavioral changes like decreased judgment, difficulty in completing tasks, and withdrawal from activities may all be signs of Alzheimer’s.

The Alzheimer’s Association “Know the 10 Signs: Early Detection Matters” campaign is designed to heighten awareness of the warning signs of this horrific disease and explain the benefits of early diagnosis.

This campaign encourages all Coloradoans to seek a diagnosis from a doctor if they exhibit any of the warning signs.  Early diagnosis provides individuals the access to prescribed medications, the chance to enroll in clinical trials of new treatment alternatives, and the opportunity to plan their own future as well as receive support from the Alzheimer’s Association. Early detection begins with awareness.   

Doctors can now diagnose Alzheimer’s with 90% accuracy. To understand what to look for, a thorough review of these 10 Warning Signs is essential.

10 Warning Signs of Alzheimer’s:

1.    Memory changes that disrupt daily life; e.g., forgetting important dates, or asking for the same information over and over.

2.    Challenges planning and solving problems; e.g., unable to keep track of monthly bills, or unable to follow a familiar recipe.

3.    Difficulty completing familiar tasks; e.g., not being able to remember the rules of a familiar game, or having trouble driving to a familiar place.

4.    Confusion with time and place; e.g., not knowing the season, or not remembering how to get home.

5.    Trouble understanding spatial relationships or visual images; e.g., having difficulty reading, driving, or telling time.

6.    New problems with speaking or writing; e.g., calling objects by the wrong word, or not being able to complete a conversation.

7.    Misplacing things and losing the ability to retrace steps; e.g., finding car keys in the oven, or becoming paranoid that others may be stealing.

8.    Decreased or poor judgment; e.g., mismanaging money, or paying less attention to grooming and hygiene.

9.    Withdrawal from work or social activities; e.g. not attending club meetings or church, or no longer having an interest in a favorite sports team.

10. Changes in mood or personality; e.g., becoming more confused, suspicious, fearful or agitated.

For those individuals reaching the age of 65, when one in eight will be diagnosed, there are things that may reduce the risk of developing Alzheimer’s and other forms of dementia. While we can’t prevent Alzheimer’s Disease, here are a few tips for “brain health” as we age:

·         adopt a diet of low fat, high antioxidants, and high omega-3 foods;

·         exercise your brain with puzzles, Sudoku, math, and socializing with others;

·         stay active and physically fit;

·         lower your cholesterol;

·         maintain a normal blood pressure;

·         reduce your risk for stroke;

·         watch your sugar levels, and reduce your risk for diabetes;

·         promote good circulation; and

·         manage your stress -- find effective ways to relax. 

Every single day, science unlocks more mysteries of the brain.  But, we do not have all the answers yet.  What we do know is, like other parts of the body, the brain may lose some agility as we get older.  And, it can deteriorate even more without care.  A good rule to remember:  WHAT’S GOOD FOR YOUR HEART IS GOOD FOR YOUR BRAIN. 

For anyone with questions or concerns, the Alzheimer’s Association provides free counseling, information and resources, educational classes and community presentations, and assistance.  In Colorado, please feel free to call our 24-hour Helpline at 800-272-3900 and via our Website at www.alz.org/co. 

Serving all metropolitan, suburban, and rural areas in the state, the Colorado Chapter of the Alzheimer’s Association has office locations which include Denver, Colorado Springs, Durango, Grand Junction, Evans for Northeast Colorado, and Pueblo for Southern Colorado.

No one has to take this journey alone. Individuals, family caregivers, and professionals are all encouraged to reach out for help. 

Submitted by:

Ann Carter, MPA, Regional Director, Southern Colorado / Alzheimer's Association Colorado Chapter / 4104 Outlook Boulevard, Bldg. B, Pueblo, Colorado 81008 / 719-544-5720 / 800.272.3900 HELPLINE / alz.org/co 

November is National Alzheimer’s Disease Awareness Month and National Caregiver Month. In the United States, there are more than 15 million Alzheimer's and dementia caregivers. 

Post a tribute for a caregiver in your life: www.alz.org/nadam