The rain here in Colorado over the
past several days has surpassed our annual totals and our thoughts are with
those individuals and communities that are experiencing the destructive aspects
of this weather.
2013 is passing quickly and fall is
nearly upon us and the implementation of the Affordable
Care Act (ACA) is just around the corner. As we venture into this new territory we are
filled with a sense of uncertainty as well as the complexity of the ACA. Recently, the Office of the Inspector
General (OIG) released recommendations to reduce Medicare
reimbursements that would jeopardize two thirds of the nation’s critical access
hospitals. The Colorado marketplace, Connect for Health
Colorado, will open October 1st and will
bring private health insurance into a public market. Healthcare providers have increasing
pressures to improve population health resulting in reduced hospital
readmissions through the CMS
Readmission Program. Further, the ACA calls for improved
mechanisms for the recruitment and retention of the healthcare
workforce. And
the triple
aim is the foundation of all these efforts – to
improve quality and outcomes, while reducing costs.
As your Colorado State Office of
Rural Health (SORH), it is our responsibility to provide the education,
linkages, tools, and energy necessary for our members during this time of
profound healthcare evolution. In 1991,
the SORH was developed as a Federal-State program. Today, Colorado is still unique in that we
are one of three states that operate their SORH as an independent
501(c)(3). Our organizational structure
allows us to broaden our response to current healthcare trends through vital
technical assistance programs.
In August, Colorado’s U.S. senators and representatives were
home in their districts while Congress was in recess. Recess provided an
opportunity for CRHC to connect with the federal electeds, as well as members
of their staff. CRHC engaged members of Congress regarding a recent
report from the Office of the Inspector General. If the recommendations
in the report were adopted, the necessary provider status and related funding
would disappear from 35 percent of Colorado’s Critical Access Hospitals
(CAHs). In addition, CRHC partnered with ClinicNET to celebrate the
fourth annual Safety Net Clinic Week. Elected officials at all levels of
government participated throughout the week by touring Rural Health Clinics or
community safety net clinics in their district. Also, two CRHC board
members were among a small group of stakeholders who met with Senator Bennet
regarding the SGR (Sustainable Growth Rate). The Senator was collecting
feedback as members are in support of a full repeal and replacement of the SGR
this fall.
To read more about the OIG report, Safety Net Clinic Week
activities, the SGR conversation, or to find out how you can participate in the
conversation, read the full article here.
CRHC is taking a holistic approach
to working on readmissions and the triple aim.
In 2010, CRHC started a program called iCARE (Improving Communications
and Readmissions) as an opportunity to engage crucial access hospitals in a
statewide improvement project aligning with national trends and funding
priorities. This program is funded
through the Health Resources and Services Administration (HRSA) FLEX dollars. In 2012, we expanded the program to include
provider based rural health clinics and 2013 we are partnering with local
public health departments and patient navigators/care coordinators. As the hub of healthcare in their rural
communities, critical access hospitals and rural health clinics are
well-positioned to be leaders and have a significant impact on the communities
they serve.
The initiative focuses on three
primary goals:
(1) improve
communication in transitions of care,
(2) maintain
low readmission rates, and
(3) improve
clinical processes contributing to readmissions, particularly for heart
failure, pneumonia and diabetic patients
Read more about the program here.
Achieving the triple aim is
certainly a huge undertaking and one that has a great deal of moving
parts. While some of our rural health
clinics are poised to actively engage in our iCARE program others are working
towards the triple aim through our Healthy Clinic Assessment work, which
involves making improvements in basic business operations.
In addition to the activities listed
above our rural hospitals and clinics have been actively engaged in
implementation of Stage 1 Meaningful Use, which is certainly another step
towards quality improvement, care coordination and connection among patients
and providers.
As you know, rural providers are
among the most difficult to recruit and retain to healthcare positions. CRHC is the only Colorado organization with a
department solely devoted to addressing this problem through direct
recruitment. Studies show that one rural physician annually generates
approximately $1.5 million in community revenue, nearly $1 million in payroll,
and 23 additional jobs. In August,
Colorado Provider Recruitment (CPR), the CRHC recruitment department, placed
three providers to rural communities.
Read more about these placements here.
We exist because of the healthcare
professionals dedicated to serving our rural communities. Because of the incredible efforts of our
members, we strive to be the voice of Colorado rural health. Our programs are quantitatively validated by
a high level of participation. In fact,
out of the 109 healthcare provider and facility members, 80 percent are
actively engaged in our services. Mia
Hamm, the famous American soccer player, said “I am a member of a team, and I
rely on the team, I defer to it and sacrifice for it, because the team, not the
individual, is the ultimate champion.”
Together, we are the champions for rural health in Colorado.
We end this year by planning for an
unprecedented future in healthcare. We
hope our current members will continue to support one another and take
advantage of our invaluable services. We
also hope future members will join our network to further strengthen our united
voice. You can find out how to get more
involved here.
