Update from the CEO: Members Receive $1.5 Million in Program Support

The Fourth of July is truly a time for celebration in our Country and I hope you all enjoyed some well-deserved time with your family and friends.

This is an exciting month with multiple noteworthy announcements.  First, please see the newly revised Colorado rural, urban, and frontier map.  As a resource that is frequently referenced by multiple state and private organizations, we are proud to present the updated version based on the new USDA rural definition.  Additionally, we’re thrilled to introduce our 2012annual report which is highlighted in this month’s Special Delivery.  We’ve undergone multiple changes, but the accomplishments outlined in the report showcase the strength of the CRHC team and the dedication of our members. 

As many of you closed out your fiscal year in June, CRHC also finalized its work with organizations throughout rural Colorado by awarding over $1.5 million in program support last month to our members.  I’d like to dedicate this article to the amazing work these organizations are providing in rural Colorado healthcare.  The following is a tribute to the programs and people that received financial support from CRHC.

Emergency preparedness is planning for natural or man-made disasters--what you, your organization, and your community can and will do in case of an emergency. Within this program is the Hospital Preparedness Program (HPP), which enhances the ability of hospitals and other healthcare entities to prepare for and respond to all hazards and other public health emergencies.  During June, program participants across Colorado received over $1.4 million in support.

CREATE assists private and public organizations in improving and expanding the emergency medical and trauma system in Colorado. Applicants must have as their purpose the provision of emergency medical and trauma services in Colorado to be eligible. This grant is intended to provide funding for education and training for emergency medical and trauma services.  Last month, $64,000 was awarded to participants.

The overall goal of the Small Hospital Improvement Program (SHIP) is to assist small rural hospitals in addressing delivery system challenges and barriers related to the focus areas: Value Based Purchasing, Accountable Care Organizations, and Payment Bundling.  This resulted in the payment out of $44,499 to participating members.

The CROP award is a loan repayment program for rural providers who may be ineligible for the Colorado Health Service Corps or National Health Service Corps programs.  After a one year commitment that ended in June, two rural providers were awarded their loan repayment CROP funds.

·         Mara Pacyga, Kremmling Memorial Hospital

·         Regina LeVerrier, Colorado West Mental Health, Grand Junction

The Marva Jean Jackson Rural Community Health Scholarships support rural “grow your own” efforts.  Evidence has shown that one of the factors that will influence a provider’s choice of practice location is their “roots.”  People from a rural area are more likely to practice in a rural area.  Programs that support healthcare training and education for people from rural areas have proven to be an effective tool in helping address the rural workforce shortage.

·         Penni Wilson, Eastern Plains Medical Clinic, Calhan, will receive funds for a wound educators course

The Seed grant is available for rural projects whose intent matches the mission of CRHC.  Funds are intended as “seed” money to develop a new program or service.

·         Valley Assisted Living, Silver Cliff, will receive funds to purchase a new wheelchair scale for their residents.

I’d like to congratulate all of our members who were recipients of awards in June, and to emphasize the vital work they are providing in rural healthcare throughout Colorado.  Thank you for your continued dedication to improving the health of your communities.  We look forward to continuing to serve rural Colorado.

Spanish Peaks Regional Health Center Recognized as a Rural Leader in Hospital Management by the Colorado Rural Health Center

Nestled on the north side of the Cucharas River on the high plains of Southeastern Colorado, the city of Walsenburg is home to just over 4,600 residents. Settled in the mid-1800’s, with a rich coal mining history the city grew steadily over the next century. Providing care to residents of Walsenburg and surrounding counties, Spanish Peaks Regional Health Center (SPRHC) located just three miles west of Walsenburg, has provided care to the area for over 20 years.  The SPRHC is operated by the Huerfano County Hospital District, which is under contract with the State of Colorado and directed by a five member Board of Directors.  As a level 3 Patient Centered Medical Home, SPRHC includes the Spanish Peaks Hospital, the Colorado State Veterans Home, the Spanish Peaks Family Clinic, Outreach Clinic and Specialty Clinic, in addition to the La Veta Clinic. SPRHC is dedicated to providing the highest quality of care to a service area of nearly 12,000 people and growing.     

The hospital is licensed as a Critical Access Hospital with 25 acute care beds and operates a 24-hour level IV trauma emergency care center.   The SPRHC is highly engaged as a member of Colorado Rural Health Center (CRHC) through various initiatives and programs, including the Improving Communication and Readmission (iCARE) project, which aims to reduce readmissions, particularly for heart failure, pneumonia, and diabetes patients. They also participated in the Improving Performance in Practice (IPIP) initiative to meet measures and objectives that show quality patient treatments and outcomes. Courtnay Ryan, Project Coordinator in CRHC’s Programs Department said she has learned much from working with the staff at SPRHC, “They are highly engaged in quality improvement and proactive in their efforts to provide the highest level of care for their patients.”  In addition, the SPRHC was awarded funds in 2012 through the Colorado Rural Health Care Grant Program for continued renovation of the Spanish Peaks Outreach Clinic, which included the installation of new carpet, windows and heat. 

As a longstanding member of CRHC, it is with great pride that Spanish Peaks Regional Health Center is recognized as the July Member of the Month.  Earlier this year, CRHC began highlighting one member every month in order to spotlight the many achievements of its membership.  CRHC’s Director of Workforce and Outreach, Melissa Bosworth, stated that their members are the true success behind the programs CRHC manages, “We kept hearing inspiring stories about our members and we realized it is the dedicated administrators and front line staff at the hospital and clinics that work tirelessly everyday implementing the projects that makes them successful.”  Also recognized nationally for their high level of satisfaction the SPRHC State Veterans Home was recognized in 2012 with the Excellence in Action Award which recognizes nursing homes that achieve the highest levels of satisfaction excellence.  It is clear that SPRHC continues to blaze the path as a leader in rural health care and CRHC is excited to continue partnering to see that vision happen.  To learn more about SPRHC, visit http://www.sprhc.org/.

Primary-care physicians are in demand

This time of year, recent high school graduates are shopping for supplies, packing their bags and perusing brochures and course listings from their selected college or university.

Freshman orientation is just around the corner. It makes me wonder how many, like my younger self, are considering careers in primary-care medicine?

 

To be sure, the practice of medicine faces some interesting challenges, ranging from political to scientific to socioeconomic. Yet there has perhaps been no better time to consider a career in medicine.

 

It is yet unclear exactly what effect recent health-care reform efforts will have on the medical workforce. However, the combination of expanded Medicaid coverage in many states (including Colorado) and the requirement for most Americans to carry health insurance starting in 2014 will certainly increase demand on the health-care system.

 

Add to this the fact that the aging baby-boom generation is adding millions of new Medicare enrollees each year. As our population ages, the demand for medical care will continue to increase. Click here to read the full article published in the Durango Herald.

American Way of Birth, Costliest in the World

LACONIA, N.H. — Seven months pregnant, at a time when most expectant couples are stockpiling diapers and choosing car seats, Renée Martin was struggling with bigger purchases.
      

At a prenatal class in March, she was told about epidural anesthesia and was given the option of using a birthing tub during labor. To each offer, she had one gnawing question: “How much is that going to cost?”

      

Though Ms. Martin, 31, and her husband, Mark Willett, are both professionals with health insurance, her current policy does not cover maternity care. So the couple had to approach the nine months that led to the birth of their daughter in May like an extended shopping trip though the American health care bazaar, sorting through an array of maternity services that most often have no clear price and — with no insurer to haggle on their behalf — trying to negotiate discounts from hospitals and doctors.

 

When she became pregnant, Ms. Martin called her local hospital inquiring about the price of maternity care; the finance office at first said it did not know, and then gave her a range of $4,000 to $45,000. “It was unreal,” Ms. Martin said. “I was like, How could you not know this? You’re a hospital.”  Click here to read the full article by by ELISABETH ROSENTHAL, as published in the New York Times.  

Colorado insurance commissioner Riesberg stepping down

Colorado Insurance Commissioner Jim Riesberg, who led the state through arguably the biggest insurance reform in history, said Friday that he will step down from his post next month, confident his staff can push the final few changes to the state rules across the line before the end of the year.Both insurers and consumer advocates have lauded Riesberg, a former state legislator and former insurance company executive, for his fairness and for his open-door policy that allowed all groups to sit down with him and craft policies for the state to follow after Jan. 1, when federal law dictates that all Americans must purchase health insurance.

Gov. John Hickenlooper’s office and Barbara Kelly, executive director of the Department of Regulatory Agencies that oversees the insurance division, will begin a search for Riesberg’s replacement immediately, as his last day will be July 8. Public Utilities Commission Director Doug Dean, a former House speaker and Colorado insurance commissioner, will serve in Riesberg’s place until an appointment is made. Click here to read the full article as published in the Denver Business Journal.

Ed Sealover
Reporter- Denver Business Journal
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Mental health services in rural long-term care: challenges and opportunities for improvement

Mental Health Services in Rural Long-Term Care: Challenges and Opportunities for Improvement

Jean A. Talbot, PhD, MPH • Andrew F. Coburn, PhD
Overview
To facilitate quality improvment efforts, more research is needed on the current status of mental health services in rural long-term care. Also needed are new tools promoting the targeted use of provisions in the Affordable Care Act (ACA) to address the mental health needs of rural long-term care (LTC) recipients. Over 10 million chronically disabled Americans require long-term services to assist them with activities of daily living.1 Mental health comorbidities are common in these long-term care populations. Inadequately treated, these conditions can become debilitating and costly. Yet our long-term care system often fails to deliver necessary mental health care to those it serves, especially in rural areas. In this brief, we explore novel practices that hold promise for enhancing mental health services in rural long-term care. We focus primarily on the needs of rural elders who reside either in nursing facilities or in their own homes in the community. Click here to read the full article by the Maine Rural Health Research Center.

Obamacare: Because Mom said so

All those groups trying to get the “young, invincible” 20-somethings to sign up for Obamacare health insurance have identified a secret weapon.

Mom.

Advocacy groups from “Moms Rising” to AARP are working to reach the healthy, young adults who don’t think they need insurance — and their mothers who think they do. The groups plan to use everything from paid advertising — to guilt.
“We’re going for the heartstrings,” said Nicole Duritz, vice president of health and family education and outreach at AARP, which will be stepping up messaging later this summer as the Oct. 1 sign-up date nears. Click here to read the full article by JOANNE KENEN with POLITICO.

White House delays ACA's employer-coverage mandate for one year

The Obama administration is delaying for one year the employer mandate requiring companies to offer their employees health insurance.

Assistant Treasury Secretary for Tax Policy Mark Mazur posted a blog late Tuesday confirming that the 2014 mandate on employers with more than 51 full-time workers to offer qualifying health insurance coverage to their employees or face a penalty was being delayed until 2015.

The delay was meant to give time to simplify reporting requirements and to adapt health coverage and reporting systems, he wrote. It means that one of the key provisions of the Patient Protection and Affordable Care Act, which is unpopular among many business groups, will not take effect until after the 2014 congressional elections.

Bloomberg News reports that the White House plans to invite employer groups to discuss ways of easing administrative burdens created by the mandate. Click here to read the full article by By Rich Daly and Jonathan Block.

Promise of price cut on hospital bills is in limbo

Huge list prices charged by hospitals are drawing increased attention, but a federal law meant to limit what the most financially vulnerable patients can be billed doesn't seem to be making much difference.

A provision in President Barack Obama's healthcare overhaul says most hospitals must charge uninsured patients no more than what people with health insurance are billed.

The goal is to protect patients from medical bankruptcy, a problem that will not go away next year when Obama's law expands coverage for millions.  Click here to read the full article by Ricardo Alonso-Zaldivar with the Associated Press.

Is health insurance an antidepressant?

New findings show that wider coverage has one clear effect on the population, and it’s not one that anyone is talking about.

For those who support President Obama’s health care law, which has already begun to expand the number of Americans with health insurance, the rationale is a no-brainer: Having medical coverage makes people healthier and enables them to get the care they need when they get sick or injured. And broader coverage could help control our national health care bill by encouraging regular doctor visits and preventive care that cuts down on expensive emergency treatment.
But over the past several years, a stream of new information has dealt blows to both those ideas. Data from a pioneering Medicaid program in Oregon suggest that expanding health coverage hasn’t saved the state any money—in fact, it increased annual health care spending by about 35 percent. Even more surprising is that, after two years, having Medicaid has done little to improve people’s physical health. Click here to read the full article written by By Leon Neyfakh with the Boston Globe.