Update from the CEO: Inspiration, engagement and change


Last week, along with many readers of our Special Delivery, I attended the Colorado Health Foundation’s Symposium.  During three full days I was captivated by the speakers’ insights and re-awakened by the energy of my fellow attendees.  On the way home, three sentiments stayed with me – inspiration, engagement and change.  How can we raise the rural voice to navigate our future?

Dolly Parton was born and raised in Sevierville, TN, population 14,807.  We’ve learned that some of the greatest scientists, artists, and general minds have rural roots.  In regards to inspiration, Parton has said “when I’m inspired, I get excited because I can’t wait to see what I’ll come up with next.”  The phrase is simple, yet it holds true for all of us.  Whether we’re introverted and gain inspiration internally, or extroverted and gain inspiration from absorbing the energy of our peers, inspiration causes excitement.  Excitement then leads to motivation which results in engagement.

Many great minds have commented on the impact of engagement, including Robert Nozick, a prominent American political philosopher in the 1970s and 1980s.  He stated that “through the evolutionary process, those who are able to engage in social cooperation of various sorts do better in survival and reproduction.”  His comment is particularly timely because of the Symposium’s Rebecca Costa, a sociobiologist, who spoke about the keys to success in a world that has out-grown the human brain’s capacity.  She uses evolution to illustrate that the growth of technology is now beyond our immediate understanding and we are in a period of adaptation.  To survive the next cycle of evolution, we must be able to engage others around us who are inspired by the same topics – in our case this would be rural healthcare.

The third sentiment that has lingered in my mind is change and how the rural voice must be raised to engage healthcare leaders, whether urban or rural.  With a collective voice of advocates, the best ideas will be inspired and motivation for engagement will follow.  Although Colorado is undoubtedly a leader in healthcare innovation, we can see that others, even across the world, are engaging in the same thoughts.  In 2012 there was an initiative, financially supported by the United States government that hoped to result in 10,000 new inventions from rural residents living in India.  Many of these inventions have direct correlations to healthcare and only needed a nudge to bring the inspired creations to our globalized market through “frugal innovation.”  Included among the products is the refrigerator made out of terracotta that does not need electricity and a hand pump that purifies water from any source.

In our own rural backyards we can also discover actions of engagement.  The National Rural Health Association recently hosted March for Rural Hospitals in Washington D.C.  This event shows the strength of the rural voice which has been proven to engage congressional leaders in supporting rural healthcare.  Next week is Safety Net Clinic Week where the work of safety net facilities and providers will be celebrated throughout Colorado.  The celebrations will be happening all over the state and clinic stories are sure to inspire any listener.  Please listen and help spread the rural voice.  More information about the events can be found on CRHC’s website.

To close, we must all remember to act upon our inspirations by telling others and developing new innovation that will lead us into the next generation of healthcare.  The remarkable inventions, whether organizational, conceptual, systemic, or simply a new gadget, are what drive progress.  Inspire others through your voice and get engaged by through their inspirations.

The Forum 2014

Save the Date
 
The 14th Annual Forum Conference
Co-hosted by Colorado Rural Health Center and ClinicNET will again be held at the Denver Sheraton West in Lakewood. 

April 9-11, 2014

Check back for updates at www.coruralhealth.org  

CRHC grant funded AED saves a life in Limon, CO

Limon Family Practice opened their doors one year ago. 
 
Eleven months later...a life is saved.

A male patient entered the Limon Family Practice clinic, complaining of chest pain. Robyn Horner took his vitals, then proceeded to do an echo …the gentleman coded and she immediately grabbed the AED (Automated External Defibrillator).

The patient received one shock and was then transported to Limon Airport where he was air lifted to a Denver metro hospital and treated for a blocked artery. 

Things are “back to normal” at the clinic and the patient is home and doing fine. His family and the Limon community are glad the clinic was there to save him.



Robyn Horner, RN (pictured on the right with Mark Morrison, Paramedic) has worked at the Limon Family Practice Clinic since it opened a year ago..

Mark is the Head of Transport Service at Lincoln Community Hospital and Nursing Home in Hugo, CO. 

Mark oversees the placement of AEDs in the community and surrounding area as well as managing the training for proper use of the AEDs throughout the community.

Both Robyn and Mark are natives of the Limon area and both have been providing healthcare for this rural community for many years.

Through a grant managed by Colorado Rural Health Center, a total of 66 AEDs were placed in 33 communities throughout the state of Colorado in 2012. The AED Robyn used was one of them. Robyn said “Time matters in these situations – the AED is quick, easy to use and save's lives."

Safety Net Clinic Week begins on Monday!!

 
We would like to thank all safety net providers for the wonderful work they do everyday!
 
ClinicNET and CRHC conducted a Safety Net Clinic Week Countdown.  Check out ClinicNET's Twitter or CRHC's Facebook for details. 
 
What else is happening?
 
Thursday, August 15th
  • Kick off to Safety Net Clinic Week at Doctors Care in Littelton
Wednesday, August 21st
  • Open house at Rocky Ford Family Health Center in Rocky Ford (celebrating 10 years of providing care to their community!)

More job opportunities available for physicians

More than half of physicians are receiving up to three employment solicitations per week, according to a report published by American Medical Association (AMA).

According to a study from the physician recruiter Medicus Firm, released in June, more than half of practicing physicians receive at least three employment solicitations per week, and almost 29 and 23 percent, respectively, receive three to five and six to 10 notices per week. The Medicus Firm's survey also reported that nearly 28 percent of residents received three to five solicitations per week and 9 percent received 21 to 50 notices weekly.

Although the physician shortage is one reason for increased recruitment of physicians, with a shortage of 46,100 primary care doctors and 45,400 specialists estimated by 2020, more physicians are working for health systems and hospitals and doctor turnover is higher. Read the full article here.

Replace the med school interview with fMRI: A modest proposal

A fashion faux pas almost prevented me from getting into my dream medical school. Midway through the interview there, the interviewer pointed to my left earlobe and said, “Do you really think we accept men who wear … those things?”

I had no idea what he was talking about at first, but then remembered the gold post I’d forgotten to remove. In a disdainful southern drawl the interviewer let me know how dark a shadow this stylistic error cast on my otherwise favorable application.

I left his office fairly sure I would not be admitted. I also doubted whether I wanted to be admitted to a school that selected physicians on the basis of their jewelry. Really?

Find out what happened 20 years later by reading the full article here.

Rural primary care shortage growing

A desire to help the elderly lured Dr. Arden Aylor to practice primary care in the area. For two years, he has served the local community, most recently with the Talladega Primary and Urgent Care Center, owned by Regional Medical Center.

But though Aylor has enjoyed the work, it has not been easy.

"I like it — I've got a passion for senior citizens," Aylor said. "The problem is you can't see people fast enough."

Aylor is not the only rural primary care physician facing a growing demand for his services.

According to a new report in the June edition of the journal Academic Medicine, fewer U.S. medical students are choosing to enter primary care — about 25 percent — and of those only 4.8 percent practiced in rural areas. Read the full article here.

Is GME snubbing rural America?

Theories abound as to why young physicians won't practice in rural areas. But the key reason why young medical doctors don't fill these much-needed roles readily is a lack of accountability in publicly funded Graduate Medical Education programs, researchers suggest.

A new round of metrics doesn't bode well for rural healthcare.

The U.S. Census for 2010 says that one in five people —19.3% of the population, about 59.4 million people—live in rural America. Unfortunately, a new report this month from George Washington University School of Public Health and Health Services says that only 4.8% of new physicians plan to establish a practice in rural areas, despite the critical need. Read more by clicking here.

Northland hospitals get creative to attract doctors

There’s no one right approach to the growing shortage of doctors in rural America, experts say.

Terry Hill, the executive director of the National Rural Health Resource Center in Duluth, summarized what was said in a conversation among leaders of four of the biggest health-care systems in the country:

“The shortage of primary-care physicians is going to be so acute that there’s no way we can continue to provide primary care as we've been providing it.” Read the full article here.

Surgery residents exposed to rural settings inclined to stay

Surgical residents who completed a year in rural practice were more likely to enter general surgery practice than those who did not. They were also more likely to practice in areas with populations of less than 50,000, an Oregon Health and Science University study shows.

Evidence suggests that a good way to lure young physicians into rural practice is to provide them with that experience while they are medical residents.

A new study out of Oregon this month in JAMA Surgery, for example, finds that exposing fourth-year surgery residents to rural practices increases the likelihood that they will practice general surgery in a similar location, even if their initial plans were to further specialize or settle in more-urban areas. Read the full article here.

Path to United States practice is long slog to foreign doctors

Thousands of foreign-trained immigrant physicians are living in the United States with lifesaving skills that are going unused because they stumbled over one of the many hurdles in the path toward becoming a licensed doctor here. The involved testing process and often duplicative training these doctors must go through are intended to make sure they meet this country's high quality standards, which American medical industry groups say are unmatched elsewhere in the world. Some development experts are also loath to make it too easy for foreign doctors to practice here because of the risk of a "brain drain" abroad. Read the full story here.

New and developing medical schools: Motivating factors, major challenges, planning strategies

Fifteen new allopathic medical schools have been established in this country since the AAMC policy statement was issued in 2006. As a result, there are now 141 allopathic medical schools in the country.

Based on projected enrollment figures, it would appear that by the end of the decade, the new schools will be graduating approximately 1,800 students each year, thereby contributing about one-third of the additional graduates called for by the AAMC in its policy statement.
Since the AAMC statement was issued, 10 of the 15 schools established have already enrolled their charter classes, four more will do so later this year (2013), and one is scheduled to do so in 2014.


Read more about how four of the schools will graduate their charter classes this year by clicking here.

Nurses use Google Hangouts to collaborate on technology

Google Hangouts are getting more and more interesting. The ability to easily start a live video conference with colleagues all over the world, share screens, and see each other -- all in real time -- is opening many doors for innovation.

Sure, live video conferencing has been around for years, and it's been quite good for some time. But it hasn't been as easily and freely available as Hangouts on the ubiquitous Google infrastructure. Now, anyone with a Google account can start a live video conference. Read more here.

Mobilizing health information technology

We've all heard that electronic health record adoption has tripledsince 2010, which is especially noteworthy considering that the field of health information technology is still in its relative infancy. But while EHRs are top of mind in most health IT discussions, they're only one facet of a rapidly growing and evolving industry.

It's time to start expanding our health IT focus to encompass devices and applications that are much more accessible to patients, who are increasingly using smartphones and tablets to capture their health data. These data paint a more complete picture of their health and have significant potential to positively change our health care delivery system.

This new kind of data is termed "observations of daily living," or "ODLs." They're the bits of information that are defined and recorded by people during the course of their daily lives, based on health information that is personally relevant and meaningful to them.

Read more on how ODLs provide tangible, real-world feedback about how patients are doing here.

Answer to healthcare's million dollar question could snag $2M in rewards

The Knight Foundation is levying its lance alongside a quartet of healthcare's heavy hitters to spur new ideas to harness healthcare data technology for community health.

The Miami-based media conglomerate is launching a health innovation contest with the Robert Wood Johnson Foundation, California HealthCare Foundation, Clinton Foundation and Health Data Consortium. The contest challenges participants to answer the question, "How might we harness data and information for the health of communities?"

The right answer could be worth up to $2 million...read more here.

Getting the most out of gadgets and gizmos

Grantees adapt technology to educate patients, prevent domestic violence, improve physician-patient visits, and even make us happy.

As a teenager, Kyna Fong’s after-school job was quite a challenge. Kyna and her brother Conan where charged with helping their dad work with insurance companies and assist patients in his primary care practice.

Those early encounters gave Fong, a former Robert Wood Johnson Foundation (RWJF)Scholar in Health Policy Research (2008-2010), an intimate look at the needs of patients and providers. “That’s why my brother and I knew there was a need for a new type of electronic medical record [EMR],” she said.

Fong, who now has a PhD in economics, is one of many RWJF grantees who are maximizing the potential of technology to improve health. They are breaking new ground by finding innovative ways to use some of our favorite gadgets to perform research and inspire people to live healthier lives. Read the full article here.

Calhoun County Community Dental Access Initiative

This program began in 2007 to address the oral health needs of poor and largely uninsured residents of Calhoun County, Michigan. In the Community Dental Access Initiative (CDAI), patients volunteer at community non-profits in exchange for dental care. To ensure that the urgent need for care diminishes over time, patients also receive oral health education.

Dentists can join the Dentists’ Partnership Initiative (DPI) at different levels of commitment, ranging from 2-3 visits per month to 8 or more per month. Participating dentists can see their work is valued because the patients have paid for services through their volunteer work. Dentists receive community recognition of their service and, depending on the level of participation, support for purchases to improve their practice or enhance patient care.

Read who the program is a community partnership is made of here.

'My dear Watson' -- from 'Jeopardy' to a doc's office near you

Best known for beating brilliant humans at “Jeopardy,” Watson, the super computer, soon may be coming to a hospital or insurance company near you.

But don’t call him (or her) Dr. Watson. The more appropriate reference may be to Sherlock Holmes’ “my dear Watson,” the indispensable right-hand man — or woman as Lucy Liu now portrays Dr. Joan Watson in the re-imagined TV show, “Elementary.”

IBM’s Watson is actually named to honor the company’s founder, Thomas J. Watson. But as Watson’s creators dream up future roles for their intelligent machine — medical sleuth, patient watchdog and reading buddy to humans may be a handful of them — IBM is now trying to tap the silicon genius’ remarkable ability to digest information in nanoseconds for a variety of health care applications. Read more here.

Healthy newborn size varies with ethnicity: study

For newborn babies, taking ethnicity into consideration may help determine how small is too small, according to Canadian researchers.

They found that birth-weight standards based on population averages did not predict which babies born at or near full term were likely to suffer problems associated with being small for their gestational ages.

"The results are not necessarily surprising, but there has been controversy regarding whether customizing growth distributions is necessary," said lead author Gillian Hanley of the School of Population and Public Health at the University of British Columbia in Vancouver. Click here to read more.

Accountable care organizations in rural America

Key Findings
  • Medicare Accountable Care Organizations (ACOs) operate in non-metropolitan counties in every U.S. Census Region. 
  • 79 Medicare ACOs operate in both metropolitan and non-metropolitan counties. 
  • Medicare ACOs operate in 16.7% of non-metropolitan counties. 
  • 9 ACOs operate exclusively in non-metropolitan counties, including at least 1 in every U.S. 
  • Census Region.
Read more about the study's key findings here.

The Frontier Extended Stay Clinic Model: A potential health care delivery alternative for small rural communities

Key Findings
  • The Frontier Extended Stay Clinic (FESC) demonstration project provided expanded emergency services and extended clinic stays to remote rural communities. 
  • Although the FESC demonstration ended this year, the FESC model may be appropriate in rural communities other than the five original demonstration sites. 
  • FESCs may also be alternatives to very low-volume rural hospitals. 
Read more about the key findings here.

Rural women less likely to get radiation therapy after lumpectomy for breast cancer

Rural women with breast cancer are less likely than their urban counterparts to receive recommended radiation therapy after having a lumpectomy, a breast-sparing surgery that removes only tumors and surrounding tissue, a study by Mayo Clinic and others found. The difference is one of several rural disparities in breast cancer diagnosis and treatment the researchers discovered. The findings are being presented at the AcademyHealth Annual Research Meeting in Baltimore.

"These study results are concerning," says Elizabeth Habermann, Ph.D., associate scientific director, Surgical Outcomes, Mayo Clinic Center for the Science of Health Care Delivery. "All women should receive guideline-recommended cancer care, regardless of where they live." Read the full article here.

Cycling surges, so do concussions, collisions

For bicyclists, the rewards – from improved physical fitness and stress release to the minimal commuting costs – are obvious. So are the risks.

Former Gov. Bill Ritter, an avid cyclist, suffered broken ribs after colliding with another bicyclist on one of his regular morning rides in 2010. Then-President George W. Bush attended his daughter’s engagement party sporting cuts, scrapes and a bandage on his chin after crashing on his mountain bike on his Texas ranch in 2004. Author Stephen Covey died last year at the age of 79 of complications from injuries incurred in a bike wreck in Utah.

Countless other cyclists have been injured in pursuit of their passion, and high-profile cases of motorists harassing cyclists in Colorado – some causing serious injuries or even death – have grabbed public attention. Read the full article here.

Senior tsunami threatens Colorado's healthy outlook

Colorado faces daunting challenges in providing a healthy environment for both its oldest and youngest citizens, according to a new report from the Colorado Health Institute. 

The report, “Reaching Our Peak: Creating a Healthier Colorado,” assesses how Colorado rates in five major areas that affect health: schools, workplaces, communities, medical providers and places where we age.

The Colorado Health Institute unveiled the report at this week’s Colorado Health Symposium, a gathering of state and national health leaders sponsored by the Colorado Health Foundation.

Colorado scores lowest for healthy aging...read more here.

The Affordable Care Act: A hidden jobs killer?

Opponents of the ACA have labeled the health care bill a jobs killer. It seems implausible that the bill could be expected to have much impact on employment except among the relatively small number of firms that are near the 50-worker cutoff. However the bill does provide a clear incentive to reduce workers' hours below 30 per week and many employers claim to be making such reductions in hours. This issue brief looks at data from the Current Population Survey and finds only a small number (0.6 percent of the workforce) of workers report working just below the 30-hour cutoff in the range of 26-29 hours per week. Furthermore, the number of workers who fall in this category was actually lower in 2013 than in 2012, the year before the sanctions would have applied. Read more here.

Declining childhood obesity rates - Where are we seeing signs of progress?

In recent years, the national childhood obesity rate has leveled off. However, reports from across the country confirm that childhood obesity rates have declined in some cities, counties, and states. This brief presents data from those reports and summarizes resources that document their efforts to address the epidemic.Click here to read the full article.

Telemedicine helps doctors beam into rural hospitals, treat newborns

A premature baby born at high altitude faces challenges uncommon among newborns in Denver that often can't be treated by rural physicians. But expanded technology is helping beam the expertise of neonatal specialists in the city into critical-care situations at 33 remote hospitals in Colorado, Kansas and Wyoming.

Rural physicians have been called the heroes of medicine — they're jacks of all trades, sometimes work at high altitudes and are constantly under pressure. Still, there are times they can only do so much. Click here to read the full article on how telemedicine is supporting rural. Written by Ally Marotti, The Denver Post.

Reform update: HHS to award $54 million for navigator training

HHS is preparing to award $54 million in grants to navigators—organizations that will provide impartial information to the public about signing up for coverage on the state health insurance exchanges. Navigators are not allowed to recommend particular health plans. These grants will go to navigator organizations in states where the federal government will operate the exchanges. The states operating their own exchanges are choosing navigator groups on their own. To read more click here.

Rural health policy: The Frontier Extended Stay Clinic Model

The Frontier Extended Stay Clinic (FESC) model may be a viable means of maintaining essential services in remote rural areas. Based on published evaluations of the demonstration project in Alaska and Washington, FESC operations in isolated remote areas can yield cost savings and improve quality of care. This Policy Brief presents data showing potential use of the FESC model in five rural states with substantial frontier area, using distance criteria from the demonstration project. Click here to read the full policy brief. Questions, contact Keith Mueller, PhD at keith-mueller@uiowa.edu.

PBGH policy brief: Price transparency

The Institute of Medicine estimates that $105 billion of annual waste in health care spending can be attributed to lack of competition and excessive price variation. A lack of public information on the price of health care services contributes to this waste by denying employers, purchasers, and consumers the information they need to make smart choices.

This brief from the Pacific Business Group on Health explains the problems created by the lack of price transparency and outlines what can be done to reveal health care prices more. The brief recommends that state and federal government work with the private sector to develop and implement public policies ensuring health care markets support consumers and purchasers using price information. The following are specific state- and federal-level policy recommendations:read more here.

Member of the Month: Delta Family Physicians


Delta Family Physicians recognized as a leading rural private practice providing comprehensive, high quality healthcare on the western slope

(August 2013) Aurora, CO – Located on Colorado’s western slope where the Uncompahgre and Gunnison Rivers meet, the City of Delta is home to more than 8,000 residents.   The City of Delta began as a trading post in 1828 and was used by traders, trappers and Native Americans – in fact, visitors to Delta can tour the original, reconstructed fort located just 1.5 miles from the city.  Providing care to residents of Delta and surrounding areas, Delta Family Physicians, has provided care since the late 1960s.  The privately owned family practice was incorporated in 1992 by Doctors Richard Dysart and Samuel Kevan.  Delta Family Physicians is staffed by six family physicians and a nurse practitioner with a mission focused on creating a medical home that provides high quality primary care to residents.   

The Colorado Rural Health Center (CRHC), headquartered in Aurora, functions as both the State Office of Rural Health and the association for Colorado’s extensive rural health organizations.  Each month, the CRHC recognizes one of its members whose work supports the CRHC’s vision that all rural Coloradans have access to comprehensive, affordable, high quality healthcare. 

The CRHC’s Program Manager, Bridgette Olson, oversees the organization’s membership program and works with staff at the CRHC to select which members will be featured.  “Our staff was discussing the unique challenges of small, rural private practices - this led to a discussion of practices that have overcome some of those challenges and Delta Family Physicians was called out for their creativity, capacity and commitment for providing care in their community.”

Delta Family Physicians is a highly engaged member of the CRHC.  They regularly attend conferences, webinars, and workshops.  They also contract with the CRHC’s recruitment program which is currently recruiting a primary care physician for the clinic.   In addition, Delta Family Physicians worked with the CRHC to complete two Healthy Clinic Assessments and a HIPAA Security Risk Analysis.   Delta Family Physicians was also the recipient of a $50,000 grant thru the CRHC’s Colorado Rural Health Care Grant Program.  Funds were used to expand their capacity to serve patients by improving their use of health information technology, remodeling the clinic to increase the number of exam rooms, and improving the quality of their exam equipment.      

Diane Dockter, the Clinic Manager at Delta Family Physicians, was excited to learn they had been selected this month, “We are so grateful to be a part of such a great organization as CRHC and are thankful for all the support they have given to our clinic”.  

Delta Family Physicians is fully functional with Electronic Health Records and has attested to Meaningful Use. They are also Certified National Rural Health Medical Coders through the Association of Rural Health Professional Coders, and with great turn around in their billing office have seen an increase in the clinic’s revenue.  Currently, they have started the ICD-10 conversion and are prepared to test and transition in early 2014. They provide extensive outpatient primary care services for the entire family at all stages of life, in addition to numerous surgical procedures.  Delta Family Physicians has a long history of providing care to the underserved populations in Delta and does not limit the number of Medicare, Medicaid or uninsured patients they see. 

Delta Family Physicians continues to provide the highest level of care to their patients and community by continually improving and innovating services.  Although not immune to the struggles facing rural practices, Delta Family Physicians, should be recognized for their commitment to providing care for residents of Delta and surrounding areas.  The CRHC applauds the staff and physicians for their dedication and leadership in rural health.    

Free educational webinar on Locum Tenens, hosted by Colorado Provider Recruitment

Colorado Provider Recruitment in collaboration with Locum Leaders is excited to announce a FREE educational webinar, “Locum Tenens: Best Practices, Techniques and Trends”

We know that hiring a Locum Tenens provider is not always the most ideal option, but they may be a better choice than you think. “Locum Tenens: Best Practices, Techniques and Trends” is a learning opportunity where you will be able to ask questions and receive information from experts in the field.

The webinar will cover:
· The appropriate use of Locum Tenens
· Billing procedures
· Malpractice coverage
· What to expect from a Locums company
· And more!

When: Thursday, August 29, 2013
Time: 1:00-2:00pm
Cost: Free!
To register please click here!

Locum Leaders matches qualified healthcare providers with temporary assignments in healthcare facilities. Their goal is to provide outstanding and personalized customer service aided by state-of-the-art technology. During the webinar, we will here from Dr. Bob Harrington, Chief Medical Officer of Locum Leaders and a Family Physician. We will also hear from Joe Winings, VP of Business Development at Locum Leaders. To learn more about Locum Leaders you can visit their website at www.locumleaders.com.

For questions, please contact:
Sara Leahy, Colorado Provider Recruitment Program Manager
sl@coruralhealth.org
303.565.5848

Self-serve Healthcare calls for CAHs to reconnect

Last week, my wife noticed that our Golden Retriever, Autumn, seemed a bit out of sorts. Her symptoms didn’t appear to be serious, so we did what any concerned pet parents would do: We Googled.

After 30 minutes of online research, we agreed there was no need to call the vet. Autumn was simply adjusting to the hot summer temps. Point being…

We have become a generation of “self-serve, want-it-convenient-fast-and-free” consumers. That holds true when it comes to healthcare – whether it’s for our pets – or for ourselves. Just ask the estimated 15 million people who use WebMD every month.

In many cases, these consumers don’t contact a healthcare provider unless their condition becomes critical. That’s why it’s critical for your clinic or CAH to stay connected with patients and prospective patients. You want to make sure you’re first on their list when they decide to seek care.

One way to engage consumers is by offering something of value that’s free. For example:
  • One rural hospital offered a free manicure with a mammogram.
    • Immediate ROI was a significant increase in the number of digital mammograms provide
    • Long-term ROI may be even more valuable. The hospital was able to reconnect with many patients as well as build new relationships with other community members. That can translate into long-term loyalty and top-of-mind awareness for the hospital.
  • Your hospital could offer free mobile phone apps or a free monthly eHealth newsletter. Give consumers something of value and they’ll want to come back for more!
  • Free seminars not only educate consumers, they can also help you target specific segments of your community. For example, if you serve an aging population.
    • Consider partnering with an assisted living or nursing home facility to host a presentation about   aging and long-term care.
    • Topics may include: staying healthy as you age; specialty services your hospital offers (e.g., knee/hip replacement); and local organizations that can provide a continuum of care.
Whatever you do, stay connected. It’s a dog-eat-dog world out there. If your CAH doesn’t connect with patients on a regular basis, your competition will.

Demand for Family Physicians fuels salary, compensation Increases

Median first-year guaranteed compensation for family physicians who do not practice obstetrics jumped by $7,000 between 2011 and 2012, from $163,000 to $170,000. This increase was driven in large part by a greater demand for family physicians, according to a recent survey released by MGMA (formerly, the Medical Group Management Association).

According to the survey, the median compensation for all primary care physicians increased by $5,000 from 2011 and 2012. Such large increases reflect the growing shortage of primary care physicians, as well as an increased demand for these physicians. Hospitals, in particular, have emerged as more active players in the health care marketplace by putting together accountable care organizations and integrated health care systems, which require the services of primary care physicians, said Kenneth Hertz, a principal with the MGMA Health Care Consulting Group. Read the full article here.

Rural nurse residency program

The University of Colorado, Nursing Innovation and Outcomes program is working with rural Colorado hospitals for the potential opportunity to sign up for the last year of the Idaho Rural Nurse Residency Program for no fee. This program is an established program for CNO’s to be trained to establish a rural nurse residency program. Several towns in Colorado are already involved and the program would like to welcome any hospital CNO’s interested in discussing the future of the program to join the conversation. Please contact Mary Krugman at Mary.Krugman@uchealth.org for more information.

Top EHR Software

Electronic Health Record (EHR) software gives medical professionals access to patient medical records from a centrally-accessible system. With a market size estimated to hit $6 billion by 2015, growing at a rate of over 16% per year, EHR's typically include medical history, laboratory results, medication, allergies and even billing information to help create a more streamlined process for patient care. Below is a look at the most popular options as measured by a combination of their total number of customers, users, and social presence. To see a comprehensive list, please visit Electronic Medical Records Software Directory.

More health care providers adopting electronic health record technology

A new study of electronic health records adoption shows 44 percent of hospitals have at least basic EHR, an increase of nearly 19 percent since 2011.

The study by the Robert Wood Johnson Foundation, Harvard University School of Public Health and Mathematica Policy Research evaluated data to gauge progress toward EHR adoption since 2008.

The research also showed that in 2012, 40 percent of office-based physicians had adopted at least a basic EHR system. These physicians were mostly primary care practitioners in a physician group owned by a hospital or other health care organization.

These records allow health care providers to record patient information electronically and use the systems to achieve benchmarks leading to better patient care. To read more click here.

2012 Annual Report,The Colorado Trust : Achieving access to health for all Coloradans

This annual report includes: an 'about us' introduction, a letter from the leadership, details of grant making activities in the areas of health data and information, health advocacy and policy, health care services and systems, and health and well-being, financial information, and information about the board of trustees and staff of the organization. Click here to read the full annual report.

America's health rankings senior report: A call to action for individuals and their communities

The 2012 Edition of America's Health Rankings revealed that Americans are now living longer lives, but with increased rates of preventable chronic disease. If our nation's seniors are unhealthy, can we be healthy as a society?

Today, 1 in 8 Americans are aged 65 or older. By the year 2050, this age group is projected to more than double in size, from 40.3 million to 88.5 million. The increasing number of older adults combined with increasing rates of obesity, diabetes, and other chronic diseases are on track to overwhelm our health care system.

In no other aspect is this more true than the cost of health care. Adults aged 65 and older spend nearly twice as much as 45 to 64 year olds on health care each year. They spend 3 to 5 times more than all adults younger than 65.3. Click here to read the full report.

Health law alone won't reverse inequities

The Affordable Care Act may leave many of the poor and people of color behind.

That’s the view of this year’s president of the American Public Health Association, Dr. Adewale Troutman, who spoke in Denver last week.

“We are trying to incorporate 30 million people into a health care insurance system that is broken. The system is fragmented. Inequalities flourish and prevention is an afterthought,” Troutman said during an event on health equity sponsored by The Colorado Trust.

“The system doesn’t necessarily change just because you have more people in it,” he said.

While the Affordable Care Act, which goes into full effect next year, will help millions of people get health insurance, it does not guarantee that they’ll get decent care. Nor does it go far enough to reverse disparities that cost lives every day, Troutman said. Read more about Dr. Troutman's presentation here.

Is mental health stigma overrated?

The Kaiser Health Tracking Poll is a fascinating window into the public’s thinking about gun violence, gun control, and the adequacy of the nation’s response to the needs of those living with serious mental illness. All of the poll responses are revealing but some seem to be particularly important to those of us who fashion ourselves as mental health advocates.

According to the Kaiser poll, most Americans (75 percent) across age, race, insurance status, and even political party favor “requiring insurance companies to offer benefits for mental health and substance abuse services that are equivalent to benefits for other medical services.” But fewer than four in ten knew that there is a federal requirement that most plans providing mental health benefits have the same rules regarding copays, deductibles, and coverage limits for mental health and substance use benefits as for other medical services. Read more here.

State legislative tool kit: Mental health first aid

In response to rising local and state interest in improving the awareness, recognition and ability to appropriately respond to the needs of persons experiencing symptoms of a mental illness or who may be in crisis, the National Council for Community Behavioral Healthcare (National Council) and Mental Health First Aid—USA offers resources designed to inform and guide policymaking discussions. In particular, this toolkit provides talking points, the evidence base and sample policy language for use by your organizations to advance the use of Mental Health First Aid training in your state. To read more click here.

A national commitment is needed to eradicate health disparities

David R. Williams, PhD, MPH, is a leading social scientist whose work has consistently broken new ground in research about the complex ways that race, discrimination and socioeconomic status shape physical and mental health. He is a professor of public health at the Harvard School of Public Health.

Williams, who lectured on race, ethnicity and health at the June 2013 Robert Wood Johnson Foundation (RWJF) Center for Health Policy at Meharry Summer Institute, is also a former RWJF Investigator in Health Policy Research (1994).

A few days after the reconvening of the RWJF Commission to Build a Healthier America, of which Williams is staff director, he sat down with RWJF for a Q&A. He discusses why the nation has failed to stop health disparities and how the problem can be solved.

Q: Has the United States made significant progress toward eliminating health disparities linked to race or socioeconomic status?
Q: Do you think that the implementation of the Affordable Care Act (ACA) will help to reduce disparities?
Q: America has invested billions in stopping health disparities. Why have we failed?
Q: What advice do you have for health care providers? How can they reduce the disparities they see among their patients?
Q: Are you working on any new research related to disparities?
Q: What is the most important thing we can do to eliminate health disparities?
Click here to read more of their Q and A session.

In nursing homes, an epidemic of poor dental hygiene

Katherine Ford visited her father, Dean Piercy, a World War II veteran with dementia, at a nursing home in Roanoke, Va., for months before she noticed the dust on his electric toothbrush. His teeth, she found, had not been brushed recently, so she began doing it herself after their lunches together.

But after he complained of a severe, unrelenting headache, she said, she badgered the staff to make an appointment for him with his dentist. The dentist found that a tooth had broken in two, and he showed Ms. Ford the part that had lodged in the roof of her father’s mouth.

“I was livid,” said Ms. Ford, 57, a court reporter. “I’m there every day, pointing out he’s in pain — and he had dental insurance. So there’s no reason this wasn’t addressed.” Read more here.

State participation in the Affordable Care Act's expansion of Medicaid eligibility

Visit the following link to hover your mouse over a map of the United States to see state wide expansion statuses and  the impact of the expansion of Medicaid eligibility on the uninsured; data courtesy of the Kaiser Family Foundation.

Oregon delays wide access to Obamacare insurance exchange

The online insurance exchange that Oregon established under President Barack Obama's healthcare law will not allow residents to sign up for coverage on their own when enrollment begins nationwide on Oct. 1, state officials say.

The state is the first to say it won't be open for all comers by that date, raising concerns that other states running their own "Obamacare" exchanges might also be struggling.

The decision by Oregon, an enthusiastic supporter of the Affordable Care Act, gives ammunition to opponents who have warned of an Obamacare "train wreck."

Instead of enrolling in health insurance online themselves, at least through mid-October Oregonians will need the help of an insurance broker or an aide trained by the state to log on, Cover Oregon spokeswoman Lisa Morawski said on Friday.

They also will need assistance to see what policies are available, and to determine which federal subsidies they might be eligible for. Click here to learn more.

Richest resort counties rank worst for health coverage

Two ritzy resort counties in Colorado have made a list of the 50 worst counties in the U.S. for working people who are living without health insurance.

Eagle County, home to swanky Vail and Beaver Creek, ranked 42nd worst among U.S. counties with nearly 29 percent of people who earn between 138 and 400 percent of the poverty level surviving without health insurance. Garfield County, home to many service workers for Aspen in neighboring Pitkin County, also made the list. Garfield ranked 48th worst in the U.S. with about 28.5 percent of working people lacking health insurance, according to U.S. Census data from 2010.

In Colorado’s ski resort towns, workers often have multiple jobs, none of which comes with health insurance. Even people earning decent salaries have to spend so much money on living expenses that many can’t afford health insurance. To read more click here.

Implementing the Affordable Care Act: Key design decisions for state-based exchanges

The Affordable Care Act requires the establishment of new health insurance marketplaces -- known as exchanges -- in every state by October 1, 2013. This report examines key design decisions made by the 17 states and the District of Columbia that chose to establish a state-based exchange. The analysis finds that states made significant progress in structuring their exchanges, with states varying in their design decisions. Many states expect to exceed some federal requirements -- to collect and display quality data, for instance -- for 2014. These findings suggest that states capitalized on the flexibility provided by the Affordable Care Act to tailor their exchanges to their unique needs and made decisions with an eye towards outcomes, such as enrollment, consumer experience, and sustainability. These findings also suggest that states' initial decisions will inform future exchange implementation and that states will adjust their decisions while continuing to adopt innovative approaches to accomplish policy goals. To read more click here.

Building health places: Three models in Colorado

Healthy Places: Designing an Active Colorado is a five-year, $4.5 million initiative sponsored by the Colorado Health Foundation (CHF). The goal of Colorado’s Healthy Places initiative is to reduce and prevent obesity by fostering a built environment where it is easy to walk, play, and engage in daily activities that encourage movement and connection with other people. Click here to read the full article by Edward McMahon on August 12, 2013.

Colorado Health Service Corps Loan Repayment application cycle opens September 1st

The Colorado Health Service Corps (CHSC) Loan Repayment Program fall 2013 application cycle will open September 1, 2013. The application cycle is open for one month, closing on September 30, 2013. Don’t let your providers miss their opportunity for loan repayment! The CHSC provides loan repayment to fully trained primary care providers in exchange for either a two or three-year full-time service obligation in an underserved community. Click here to learn more and to apply!

NIMHD social, behavioral, health services, and policy research on minority health and health disparities (R01) grant

Funding Opportunity Number: RFA-MD-13-006

The purpose of this Funding Opportunity Announcement (FOA) is to solicit innovative social, behavioral, health services, and policy research that can directly and demonstrably contribute to the elimination of health disparities. Projects may involve primary data collection or secondary analysis of existing datasets. Projects that examine understudied health conditions; examine the effectiveness of interventions, services, or policies for multiple health disparity populations; and/or directly measure the impact of project activities on levels of health disparities are particularly encouraged. For more information click here.

NINDS phase III investigator-initiated efficacy clinical trials (U01) grant

Funding Opportunity Number: PAR-13-278

The purpose of this Funding Opportunity Announcement (FOA) is to provide a vehicle for submitting grant applications to conduct multi-site, randomized, controlled, Phase 3 clinical trials to the National Institute of Neurological Disorders and Stroke (NINDS). The trials may address questions within the mission and research interests of the NINDS. Information about the mission and research interests of the NINDS can be found at the following link.

Centers of Excellence for Big Data Computing in the biomedical sciences (U54) grant

Funding Opportunity Number: RFA-HG-13-009

Biomedical research is becoming more data-intensive as researchers are generating and using increasingly large, complex, and diverse data sets. This era of "Big Data" taxes the ability of biomedical researchers to locate, analyze, and interact with these data (and more generally all biomedical data) and associated software due to the lack of tools, accessibility, and training. In response to these new challenges in biomedical research, NIH has developed the Big Data to Knowledge (BD2K) Initiative. Under this FOA, BD2K Centers of Excellence are sought to conduct research to advance the science and utility of Big Data in the context of biomedical and behavioral research, and to create innovative new approaches, methods, software, tools, and related resources. The Centers will advance the ability of the biomedical research enterprise to use Big Data by producing tools and resources from early-stage to mature development that will be broadly useful to the research community. Read the full grant description here.

Money follows the person rebalancing demonstration grant: Tribal Initiative Grant

Funding Opportunity Number: CMS-1LI-14-001

The purpose of the Centers for Medicare & Medicaid Services (CMS) Money Follows the Person (MFP) Tribal Initiative (TI) is to offer existing MFP state grantees and tribal partners the resources to build sustainable community-based long term services and supports (CB-LTSS) specifically for Indian country. The funds are subject to all the terms and conditions of the MFP Program. The TI may be used to advance the development of an infrastructure required to implement CB-LTSS for American Indians and Alaska Natives (AI/AN) using a single, or a variety of applicable Medicaid authorities. Funding is intended to support the planning and development of: 1) An in-state Medicaid program CB-LTSS (as an alternative to institutional care) tailored for AI/AN who are presently receiving services in an institution; and 2) A service delivery structure that includes a set of administrative functions delegated by the state Medicaid agency to Tribes or Tribal organizations (T/TOs), such as enabling tribe(s) to design an effective program or package of Medicaid community- based LTSS, and operating day to day functions pertaining to the LTSS program(s). The TI may be used to cover costs necessary to plan and implement activities consistent with the objectives of this funding and within Federal grant regulations. Read more here.

Improving Diabetes Management in Young Children with Type 1 Diabetes (DP3) Grant

Funding Opportunity Number: RFA-DK-13-022

The goal of this Funding Opportunity Announcement (FOA) is to support research to develop, refine, and pilot test innovative strategies to improve diabetes management in young children with type 1 diabetes (5 years old and under). At the end of the funding period, there should be a well-developed and well-characterized intervention that has been demonstrated to be safe, feasible to implement, acceptable in the target population, and, if promising, ready to be tested in a larger efficacy trial. To see a full description click here.

Public Education Efforts to Increase Solid Organ Donation Grant

Funding Opportunity Number: HRSA-14-013

This announcement solicits applications for the Public Education Efforts to Increase Solid Organ[[]1] Donation Program. Qualified public and non-profit private entities are eligible to apply. This grant program is administered by the Division of Transplantation (DoT), Healthcare Systems Bureau (HSB), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS). The mission of this grant program is to educate the public about the need for solid organ donation and to encourage positive deceased donation decisions, documentation, and family discussions. The specific purpose of this two (2)-year grant program is to promote broader implementation and evaluation of interventions that increase public commitment to solid organ donation. All projects funded under this grant program are intended to support public education and outreach strategies...to read the full description click here.

Centers for Medicare & Medicaid Services Planning and Demonstration Grant for Testing Experience and Functional Tools in Community-Based Long Term Services and Supports (TEFT) Modification

Funding Opportunity Number: CMS-1H1-13-001

The purpose of this funding opportunity announcement is to solicit applications for participation in the Testing Experience and Functional Tools (TEFT) in Community-Based Long Term Services and Supports (CB-LTSS) planning and demonstration grant. The TEFT initiative furthers adult quality measurement activities under Section 2701 of the Patient Protection and Affordable Care Act. The Centers for Medicare & Medicaid Services (CMS) strategy for implementing Section 2701 is to support state Medicaid agencies in collecting and reporting on the adult core measures. The goals for the work conducted under the TEFT are consistent with the National Quality Strategy, Section 3011 of the Affordable Care Act, and CMS? priorities to achieve better care, a healthier population, and more affordable care. To see the grant's full description click here.

Research to Improve the Care of Persons at Clinical High Risk for Psychotic Disorders (R34) Grant

Funding Opportunity Number: RFA-MH-14-212

Given the highly disruptive and disabling nature of psychotic disorders, early intervention has been recommended as a means of preventing psychosis onset among at-risk individuals, as well as averting other adverse outcomes such as mood syndromes, substance abuse disorders, and functional decline in social, academic, and vocational domains. This funding opportunity announcement, along with the companion announcements, aims to support research that will inform a step-wise approach to early psychosis intervention in the United States. The goals of this initiative are to encourage applications that (1) propose intervention development and pilot feasibility studies of strategies to target symptomatic and functional difficulties associated with clinical risk states for psychosis; (2) explore mediators/mechanisms of action of these interventions; (3) contribute to an evidence base to inform stepped-care models of early psychosis intervention; and (4) determine the feasibility for implementing such approaches in community-based treatment settings. To view the grant's full description click here.

Development of a Public Health Science Training Institute to Increase Student Interest in Public Health Grant

Funding Opportunity Number: CDC-RFA-MN11-11010301SUPP13

The primary purpose of this supplemental fund is to expand the current pipeline program funded under FOA MN 11-1101 to support under-represented students in public health for entry into graduate schools of public health with special emphasis on the training exposure to a variety of research methodologies in the areas of biostatistics, epidemiology, environmental health, minority health and health disparities, and occupational safety and health, areas where these students are greatly underrepresented on careers in public health science. The specific objectives are to...read more here.

Behavioral and social science research on understanding and reducing health disparities (R01) grant

Funding Opportunity Number: PA-13-292

The purpose of this FOA is to encourage behavioral and social science research on the causes and solutions to health and disabilities disparities in the U. S. population. Health disparities between, on the one hand, racial/ethnic populations, lower socioeconomic classes, and rural residents and, on the other hand, the overall U.S. population are major public health concerns. Emphasis is placed on research in and among three broad areas of action: 1) public policy, 2) health care, and 3) disease/disability prevention. Particular attention is given to...click here to read more.

Adolph Coors Foundation – Colorado Entrepreneurship & Integrative Medicine Grants

With no medical training, and often against the advice of medical professionals, Americans are treating themselves to an expanding menu of complementary and alternative medical practices (CAM). Other than common sense, most of us have no way of sorting out reputable CAM therapies from quackery, but that has not slowed demand. Almost 40% of all Americans use some form of CAM, a figure that jumps to 62% if prayer is included as a therapy (NCAAM, 2004). In 2007, we spent $34 billion on complementary or alternative medicine, and that amount increases exponentially each year (WebMd Health News).

The Adolph Coors Foundation has launched a multi-pronged project of medical research and demonstration projects to coalesce the public -– and other donors -- around the most promising integrative medical practices. By wisely applying this knowledge, our citizens will be able to live richer and healthier lives, take a more proactive role in managing their health and, in the process, show our leaders the real secret to reducing health care costs. Read more here.

Help women, enter the Care Counts Challenge

Women are often at the center of healthy and resilient families; they make approximately 80% of all family health care decisions and are more likely to be the primary caregivers for children and elderly parents. To help make women aware of the important benefits available to them and their families through the Affordable Care Act, HHS is initiating this Challenge.

The Affordable Care Act is already making a difference in the lives of millions of Americans. Starting October 1, 2013, millions of uninsured Americans will be able to find affordable health insurance that meets their needs at the new Health Insurance Marketplace (Marketplace). The Marketplace is a one stop shop where people can learn about health insurance, get accurate information on different plans, and make apples-to-apples comparison of private insurance plans. For the first time, comprehensive information about benefits and quality, side by side with facts about price, will help each consumer make the best coverage decision. For more information about how the Marketplace will work, including important deadlines and milestones, visit HealthCare.gov (English) or CuidadoDeSalud.gov (Spanish). Read the full description here.

HRSA-14-025 Health Center Service Area Competition

Download the instructions and application to the following grant here.

CFDA Number: 93.224: Consolidated Health Centers (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, Public Housing

Opportunity Number: HRSA-14-025: Service Area Competition
Competition ID: 5827
Competition Title: Service Area Competition
Agency: Health Resources & Services Administration
Opening Date: 06/13/2013
Closing Date: 10/09/2013

10 quality provisions in the FY 2014 HIPPS rule to know

CMS' final rule for the Hospital Inpatient Prospective Payment System in fiscal year 2014 includes several changes related to quality and patient safety.

Here are some of the major quality- and safety-related provisions in the final rule, based on a CMS fact sheet:

1. CMS will implement the Hospital-Acquired Condition Reduction Program in FY 2015. Under this program, hospitals in the lowest quartile for medical errors or hospital-acquired infections will receive a 1 percent penalty on reimbursement.

Performance will be based on two domains included in the Inpatient Quality Reporting program. The first is a composite that includes eight individual measures, including pressure ulcer rate, postoperative hip fracture rate and postoperative sepsis rate. The second domain will include central line-associated blood stream infections and catheter-associated urinary tract infections for FY 2015. CMS will add surgical site infections to this domain in FY 2016 and methicillin-resistant Staphylococcus aureus and Clostridium difficile in FY 2017.

2. The maximum penalty under the Hospital Readmissions Reduction Program will be increased from 1 percent to2 percent for FY 2014.

To read more click here.

Featured News: Don't fear failure. Fail fast, harness data and adapt

If Silicon Valley venture capitalists were trying to fix broken health care systems, they would invest in multiple solutions at once and expect most to fail. But they would take action.

That was the message from Rebecca Costa, an evolutionary biologist and a keynote speaker at the Colorado Health Symposium sponsored by the Colorado Health Foundation.

In nature, diversification ensures survival. In health care, Costa sees big organizations that want to meet endlessly, hold focus groups, then move tentatively, if at all, as they embark on singular solutions destined to fail at a glacial pace.

“Singularity is a drive toward extinction,” said Costa, a former CEO of a Silicon Valley marketing firm, a radio host and author of the book, “The Watchman’s Rattle: A Radical New Theory of Collapse.”

“Any time anybody is betting on one solution, you’ve got a problem,” Costa told health experts from around Colorado and the U.S. as they gathered to ponder how to harness the power of change. Read more here.

The new normal? Shift to outpatient care, payer pressure hit hospitals

Three years ago, Henry Ford Health System began to overhaul how its doctors and nurses care for patients outside the Detroit-based system's six hospitals. Now it must face the economic strains of its own success, as fewer patients turn up to fill hospital beds.

Since January, the number of patients admitted to Henry Ford hospitals has declined 6%, compared with a 2.5% inpatient decline overall in Southeast Michigan; Medicare patients who returned to the hospital within 30 days after discharge fell 19% during the same period. A boom in births has offset fewer patients who need cardiac, pulmonary or kidney care—but only partially.

“We think it's beginning to have an effect,” Dr. William Conway, Henry Ford's executive vice president and chief quality officer, said of the system's broad strategy to prevent hospitalizations. “These things really are working.” To read more click here.

Improving incentives to free motivation

“Improving Incentives to Free Motivation,” calls for an approach to payment reform that harnesses the inherent motivation that doctors and patients have to make good decisions about health care. The authors reject the assumption that health care costs will drop and quality will improve if policymakers and payers simply find the right mix of rewards (“carrots”) and punishments (“sticks”).

The report draws on a large body of research that shows external incentives designed to change simple behaviors, like improving productivity in rote tasks, do not work for more complex behaviors. They can actually be harmful when used for complex behaviors, undermining assets like creativity and drive, which are essential to the success of health professionals. To read the full article click here.


Fewer hospitals may lead to higher prices

On July 16, two New York City hospital networks announced they were merging to create the largest health care system in the metropolitan area and one of the biggest in the country. The CEO of one of the hospitals said the merger would pave the way for more “efficient” and “integrated” care. Joining the two networks into one entity — to be called the Mount Sinai Health System — would also compensate for “the inability of the federal government or the state governments to be able to pay for the health care that people in the past have demanded,” he told the New York Times.

Put another way, the new large system will have more market power that may allow it to demand higher reimbursements from private insurers, ultimately raising costs for consumers.

Consolidation like this is happening all over the country...read the full article here.

Those hospital rankings could use a healthy dose of skepticism

The U.S. News & World Report "Best Hospitals" rankings for 2012-13 were released last week, followed by the usual media hoopla and a few chest-thumping press releases from hospitals at the top of the list. Whether the rankings actually mean anything is an entirely different story.

The highest-ranked hospitals are always quick to tout their rankings in hopes of attracting new patients who will pay top dollar. Many Americans will consult the U.S. News list when they are selecting a hospital for their next elective procedure or care consultation. Why go to the third-best cancer center in your area when you can go to the best!

But a quick look shows that these rankings are not all they're cracked up to be. The methodology that U.S. News uses to rank hospitals yields a list that is flawed to the point of being nearly useless. It also may be counterproductive, since some of the so-called quality criteria U.S. News cites can encourage investments in higher-cost and lower-quality care.

The problems with hospital rankings are similar to the problems with U.S. News scoring for colleges and universities. Read more here.

How safety-net hospitals are improving the patient experience

Despite some unique challenges, safety-net hospitals are achieving strong patient satisfaction results by focusing on compassionate care and quality outcomes.

Do hospitals that treat more low-income, ethnically diverse patients with multiple comorbidities have a tougher time getting good patient experience scores than other hospitals, as some organizations contend?

And if so, should those hospitals merit an adjustment for socioeconomic status or payer mix, especially when millions in value-based purchasing incentive pay is now at stake?
Safety-net advocacy groups say the Hospital Consumer Assessment of Healthcare Providers and Systems surveys should be adjusted for race, ethnicity, income, and health literacy as well as insurance status because HCAHPS misses a measure of hospital cultural competence.

But to date, the Centers for Medicare & Medicaid Services has disagreed, arguing that existing adjustments—such as for age, education, and the patient's primary language—are adequate. To read more click here.

Medicare announces plans to accelerate linking doctor pay to quality

Medicare is accelerating plans to peg a portion of doctors’ pay to the quality of their care.
The changes would affect nearly 500,000 physicians working in groups. The federal health law requires large physician groups to start getting bonuses or penalties based on their performance by 2015, with all doctors who take Medicare patients phased into the program by 2017.
The program is a major component of Medicare's effort to shift medicine away from its current payment system, in which doctors are most often paid for each service regardless of their performance. The current system, researchers say, financially encourages doctors to do more procedures and is one of the reasons health costs have escalated. The health law required Medicare to gradually factor in quality into payments for hospitals, nursing homes, physicians and most medical providers. Click here to read more.

CMS names ACOs leaving Pioneer program

Several Medicare Pioneer accountable care organizations that didn't produce savings in the first year of the Obama administration's most ambitious test of the accountable care model have told the CMS they will leave the Pioneer program and enter the Medicare Shared Savings Program model, while another two participants have indicated they will leave Medicare accountable care entirely, the federal agency announced Tuesday.

At the same time, the CMS said all 32 Pioneer participants did well on reported quality measures and earned incentive payments for their quality achievements. The Pioneer ACOs bested provider performance in traditional fee-for-service Medicare for all 15 quality measures in which comparable data are available, the agency said.

But while all did well on meeting quality benchmarks, only 13 produced enough savings to share some of that money with the CMS. Those 13 yielded gross savings of $87.6 million in 2012, saving about $33 million for Medicare.

Still, the CMS reported that costs for the nearly 670,000 Medicare beneficiaries connected to Pioneer ACOs grew by only 0.3% in 2012, compared with an increase of 0.8% for matched beneficiaries who did not take part in the Pioneer program. To read the full article click here.

Opinion: The cost curve on health care – it’s bending

The biggest long-term concern with the American health care system is cost. The affordability of premiums, access to care and the impact of Medicare and Medicaid on state and federal budgets are all linked to the ever-rising costs of health care. Unless we bend the cost curve, the nation’s health care system will become increasingly unsustainable.

The good news is that, even though costs and spending continue to increase, we have started to see a slowdown.

Over the years, the news on this front has been consistently bad. For 31 of the last 40 years, health care has grown significantly faster than the U.S. economy. Between 1960 and 2012, costs more than tripled, from 5.2 percent of gross domestic product to 17.9 percent. That means almost 18 cents of every dollar is spent on health care.

To put these increases in perspective, if the cost of commodities had gone up at the same rate as health care since 1945, a dozen eggs would cost $55, a gallon of milk would be $40 and a dozen oranges would cost $134, according to the Institute of Medicine. To read the full article click here.

A summer smile: Colorado Rural Health Center's sporting equipment drive to Sun Valley Youth Center


During the month of July, Colorado Rural Health Center’s Wellness Committee hosted a sporting equipment and sports safety equipment drive for Sun Valley Youth Center. Sun Valley is incredibly deserving, located in one of the poorest neighborhoods in the Denver Metropolitan area. Sun Valley Youth Center focuses on transforming the lives of at-risk youth in the low-income, public housing neighborhood by providing everything from day care, to youth development and mentoring.

The Colorado Rural Health Center knew this equipment drive was a big project and reached to other companies in the community. The response was overwhelming! We collected everything from Frisbees to bicycle helmets, hockey sticks and many things in between! We were able to deliver two boxes and several bags worth of goodies to the youth center at the end of the month. Bringing over the boxes, CRHC was met by all the excited children helping to unload the car.
 
To find out more about Sun Valley Youth Center and how you can get involved please click here. http://www.sunvalleyyouthcenter.org/