CEO Update: Let the Games Begin!


Let the games begin! As you can see I’m obsessed with the Hunger Games. With the recent release of the new installment that focuses on teamwork and an eye on a higher goal, I thought I would start my letter this month with a focus on the Affordable Care Act (ACA).

I hope you all saw our video promoting this year’s annual Forum, a dynamic conference dedicated to addressing the most pressing issues faced by Colorado’s safety net. As a healthcare leader, we want you to attend and join the conversation. Next month, April 9th -11th will bring together experts from across the state to learn about the latest system topics, while also providing opportunities to share solutions. One of the sessions I’m most excited about is Healthcare Reform Realities, which will take place on Thursday morning. This general session will foster a conversation about how the ACA has stacked up against your expectations, and what we should all be anticipating in the coming months. To prepare, it might be helpful to provide a refresher on the provisions of the ACA, specifically focusing on those affecting the rural safety net.

I promise this bulletin won’t be 2,400 pages, but let’s just start at the beginning. The ACA is broken into ten sections, each addressing multiple provisions. Title I focuses on affordable healthcare with high quality. The ideology of the marketplace is detailed. From October to March 1st, our state’s marketplace, Connect for Health has connected 84,881 Coloradans with commercial health insurance. By the time of the Forum, open enrollment will be closed and we’ll be able to measure the impact of the marketplace on rural communities.

Title II describes the role of public programs. This includes Medicaid expansion. As we know, rural communities have a dense population of Medicaid eligible residents. Families living below the poverty level constitute 9.7 percent of the rural population, compared to 9.1 percent in urban areas. With Medicaid now covering up to 400 percent of the FPL, many more people will now have the ability to be insured and for care to be reimbursed. Patient navigators are also a focus under Title II. An entire breakout session at the Forum has been scheduled to address patient navigators and community health workers. In additional, many of the rural safety net clinics are owned and operated by rural hospitals, and the disproportionate share hospital (DSH), outlined in Title II might be of interest to Forum attendees. On February 28th, CMS released the 2014 DSH rates by state.

Title III covers quality and efficiency by examining value-based purchasing, the ACO model, and the patient centered medical home (PCMH). Because this month’s article is highlighting the safety net clinics, I’d like to focus my refresher around the transition to quality reporting and ultimately PCMH. I presented earlier this week at the IHI Summit on Improving Patient Care, and I’m proud to say that 17 of our 52 RHCs are participating in iCARE (Improving Communications and Readmissions) and are collecting diabetes data that shows in one year’s time a reduction of 15.5% in A1c levels. RHCs are accomplishing this work by participating as an interdisciplinary team with the CAH and RHC, attending monthly webinars to focus on sharing best practices, gaining new knowledge and leveraging resources. In Colorado we currently have two RHCs with NCQA PCMH recognition and several others are working towards certification. Click here to find out what value PCMH priorities can give your facility and attend the Forum session to learn more.

Prevention and public health encompasses Title IV, and the Forum will be covering many of the topics outlined in these provisions. Oral health and behavioral health are now hot topics, and this is especially appreciated in our rural communities. In 2012, 41 percent of rural Coloradans went without a dentist visit, and that same year, 41 percent of people over 65 who visited the dentist had tooth loss due to periodontal disease. Further, although rural citizens report a much higher level of emotional and social support (nearly 15 percent higher than urban); there are only four mental health providers per 1,000 people. Luckily, the Forum has breakout sessions dedicated to oral health initiatives in Colorado and telemedicine innovations focusing on behavioral health. The ACA is attempting to bridge the gaps between public health and clinical. How do you do this, and where has this been successful? The Forum will host a breakout session presented by a public health expert who has made this happen.

Title V is all about workforce. Unfortunately, many of the provisions, like the national commission, have yet to be funded. One victory, however, is the increase in funding for the National Health Service Corps, which provides loan repayment for clinicians wanting to practice in underserved communities. Primary care residencies were also planned to be expanded, and Colorado is taking the lead by appropriating funds to evaluate three new rural residency programs for family medicine. The Forum will have a session discussing preceptors and the need for more clinicians willing to train our future workforce.

For the sake of your attention and to pick out the most pertinent provisions related to rural healthcare, I’m going to briefly touch on Titles VI through X. Title VI, transparency and integrity address Medicaid fraud. Title VII, access to new therapies, gives direction on how to give drug purchasing discounts to the safety net. Title VIII really focuses on long-term care self-insurance options, while Title IX covers tax credits and other revenue-related material. One rural relevant topic under Title IX is the community health needs assessment. By now most all 501(c)(3) hospitals have conducted their assessment in accordance with IRS guidelines. CRHC is proud to have facilitated these in eighteen communities. Within the coming months, we will be publicizing our expansion of this process through our new data bank. Be on the watch for more information… Finally, Title X is a bit of a catch-all that discusses topics ranging from community-based care over skilled nursing facilities to additional dollars for other social programs.

Phew. With all that information to digest, I’m looking forward to Healthcare Reform Realities, and hearing your experiences. We’ll also have many stimulating speakers talking about the provisions described above. First, however, you need to register if you haven’t already. Click here for more information, and I look forward to seeing you!

Prowers Medical Center Nominated as Featured Member of the Colorado Rural Health Center


RELEASE DATE: March 17, 2014
Contact: Bridgette Olson, Outreach Program Manager
303-832-7493 or bo@coruralhealth.org

Prowers Medical Center Nominated as Featured Member of the Colorado Rural Health Center
Prowers Medical Center is a great example of a rural hospital taking positive steps to implement performance improvement programs, provide for patient safety initiatives, and meet the needs of their communities.

Denver, CO—Prowers Medical Center, a Critical Access Hospital in Lamar, CO, is owned and operated by the Prowers County Hospital District and governed by a board of directors elected by the citizens who reside in the district (Prowers and Baca Counties).

Many organizations recognize excellence in healthcare in the form of awards, accreditation, or designations of excellence. CRHC began recognizing a featured member of the month in early 2013 to shed light upon the excellent healthcare delivery in rural Colorado by its membership.

“Our membership includes nearly 200 hospitals, clinics and other healthcare facilities serving rural Colorado,” said Melissa Bosworth, director of workforce and outreach. “We wanted to create a method to showcase the innovation and success stories that continues to impact the quality of healthcare delivery in these communities.”

Prowers Medical Center has been a CRHC member for more than a decade and participates in a variety of quality improvement programs and educational activities.

The hospital is currently involved with a rigorous program to reduce avoidable readmission rates and improve communications in transitions of care. Tackling this issue is an opportunity to improve quality and reduce costs.

The hospital is also involved with the Small Rural Hospital Improvement Program, a statewide collaborative project that provides an opportunity for rural hospitals to enhance billing and reimbursement, improve HIPAA compliance, decrease medical errors, support adoption of health information technology, and improve the quality of care provided to rural communities.

“We’re thrilled that this distinction was given to Prowers Medical Center,” said Courtnay Ryan, quality improvement specialist.

Ryan works extensively with the hospital’s two affiliated rural health clinics; the Lamar Medical Clinic and the Las Animas Family Practice. “This recognition reinforces that the hospital and clinics are focused on delivering the highest quality of care to meet the needs of the people they serve.”

The clinics themselves are highly engaged with activities and programs offered at CRHC. Specifically, they are involved with the Healthy Clinic Improvement Program, a project focusing on creating a seamless patient encounter through the improvement of basic business operations and workflow processes. “The goal is for clinics to establish a strong foundation of normal business operations in order to prepare them to take on more robust quality improvement initiatives,” said Ryan.

The clinics are also involved with activities to assist the hospital in reducing readmission rates. The focus and goals for the clinics is around chronic disease management, specifically diabetes. The project aligns with national trends and funding priorities demonstrating sustainable improvements and outcomes.

Prowers Medical Center has a long history within the community, beginning as early as 1928 when the Charles Maxwell Hospital was built. Almost twenty year later the Dominican Sisters of the Immaculate Conception purchased the hospital, which was renamed Sacred Heart Hospital, until 1968 when the Prowers County Hospital District was formed.

It wasn’t until 1978 that the current hospital was moved and rebuilt at its current location. To learn more about Prowers Medical Center visit their website at www.prowersmedical.com/.

The Colorado Rural Health Center is proud to recognize Prowers Medical Center as this month’s featured member of the month. The hospital is also recognized nationally by iVantage Health as a 2013 HealthStrongTM Award winner for Excellence in Efficiency.

About The Colorado Rural Health Center
The Colorado Rural Health Center was established in 1991 as Colorado's State Office of Rural Health. As a 501(c)(3) nonprofit corporation, CRHC's serves dual roles as the State Office of Rural Health with the mission of assisting rural communities in addressing healthcare issues; and as the State Rural Health Association, advocating for policy change to ensure that rural Coloradoans have access to comprehensive, affordable healthcare services of the highest quality. For more information visit www.coruralhealth.org, call 303-832-7493, or call toll free 800-851-6782 from rural Colorado.

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Conference for Safety Net Providers and other healthcare professionals!

The 14th Annual Forum will be held next month, April 9-11th at the Sheraton Denver West in Lakewood.  The Forum serves as an essential educational, training, and networking conference for all safety net clinics and other interested parties.


SPECIALS & DISCOUNTS


Colorado Nurses Association to Co-sponsor Spring Health Care Career Event at Sports Authority Field at Mile High on Tuesday, May 6th


On Tuesday, May 6th the Colorado Hospital Association and the National Healthcare Career Network will host their 5th health care career fair at Sports Authority Field at Mile High. The event will feature Michael Slubowski, FACHE, FACMPE, President and Chief Executive Officer, SCL Health System who will welcome job seekers. The Colorado Nurses Association, the Greater Metro Denver Healthcare Partnership, and the Association of Surgical Technologists will be co-sponsoring the event.

Attending health care jobs seekers will have the opportunity to meet recruiters from Colorado hospitals and other health care employers. More than 700 health care job seekers are expected to attend.

The Colorado Hospital Association is offering a special discounted rate for facilities outside of the Denver metro area with less than 60 beds. Cost is $450.00 and includes a free 30-day job posting to the National Healthcare Career Network (value $450). Visit the CHA Career Center to reserve your booth or contact kellie.bonthron@cha.com.

HWIC Farewell


The time has come to say farewell. The Health Workforce Information Center (HWIC) has not been re-funded. And so, this is the final issue of Health Workforce News and the HWIC website (www.hwic.org) will no longer operate after February 28th. While the online library will no longer be available, we have archived some of the original content developed by HWIC staff, including topic overviews and Health Workforce News articles. The archived content can be accessed on the University of North Dakota Center for Rural Health's website, at http://ruralhealth.und.edu/projects/hwic/archive.

Thank you for using HWIC products and services over the past five years. We hope that you found our services to be valuable in the important work that you do. It has been an honor and a pleasure to serve you.

— Kristine Sande, HWIC Program Director

National Health Service Corps Deadline Extended!


The deadline for the 2014 NHSC Loan Repayment Program has been extended to Monday, March 24, 2014 at 7:30 pm ET.

Applicants may log into the Customer Service Portal and follow the steps to submit their completed application. Please refer applicants to the 2014 Application and Program Guidance to review program requirements and encourage them to visit the application checklist on the NHSC website. Additional questions can be addressed to the Customer Care Center at 1-800-221-9393.