VRHA Weekly Update
In this Issue  November 27, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities

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REVIVE! Train the Trainer

VRHA is partnering with DBHDS to provide a Train the Trainer session for REVIVE!

The event will be held in Blacksburg December 1st,  click here for details.

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Members in the News


[VRHA member] James Tyler wears the pink wig well. He doesn’t seem to hesitate to don the bright head gear. That may be because a decade ago his wife of 21 years was dying with only weeks left to live.

So when Susan G. Komen Virginia Blue Ridge asked James, the chief executive officer of Smyth County Community Hospital, to serve as one of 16 community “BigWigs” this year, he agreed. Sporting their pink wigs, the BigWigs each strive to raise $1,000 to help fund local breast cancer patient services and education programs.

In the near future, women will have another advantage in the fight against breast cancer in this region. SCCH is bringing in 3D mammography. James said it gives the radiologist more sensitive detailed information, which helps to diagnose breast cancer and rule out false positives. He considers himself fortunate to work for Mountain States Health Alliance, which supports the $400,000 upgrade.
Along with technology, James regularly reminds his staff the importance of being empathetic and sensitive to patients, to imagine what it’s like to be in their shoes. “People don’t want to be in the hospital. They’re scared,” he said.

Read the full article.

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More Members in the News

By Megan Williams - News Leader

[VRHA member] Augusta Health will open a new multi-specialty clinic in Lexington.  While Augusta Health has had both a primary care and specialty presence in Lexington for several years, but this new facility has been built to allow broader and more frequent access to specialty physicians in Lexington. 

There will be more than 6,100 square feet featuring physician offices, exam rooms, procedure room, laboratory draw area, and imaging area with X-ray and ultrasound  for diagnostics.

Read the full article.

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Virginia News

Treatment Wait Lists

By Anne Giles - Roanoke Times

If a citizen asks another citizen for help with opioid addiction today in Blacksburg, help is not available. Abstinence is not a treatment for opioid use disorder. The research-backed treatments for opioid use disorder, known to cut the death rate by half or more, are the medications methadone and buprenorphine. Methadone is only administered at federally regulated clinics and we don't have a clinic in Blacksburg.

That leaves buprenorphine, an affordable medication readily available at pharmacies. However, physicians are not permitted to prescribe buprenorphine for opioid use disorder unless they've completed training and instituted highly regulated practices in their clinics. The few physicians in our town who have been willing to undertake the training, and to institute the arduous administrative protocols, are then restricted by federal law, state law, insurance company policy, and/or medical board policy as to whom they can prescribe buprenorphine and to how many. This creates artificial wait lists for opioid addiction treatment. Wait lists at cash-only private clinics can be several weeks. At social services agencies, wait lists can be six months or more.

Read the full editorial.

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The Need for Competition

From the News & Advance

In his Oct. 29 column, “Nonprofit health care, free market a bad mix,” Centra CEO E.W. Tibbs seems to be arguing against competition.

If we compare Roanoke (where there is competition) and Lynchburg where a virtual monopoly exists for medical services, we see some stark differences. For example, if we compare bottom line “profit” from the American Hospital Directory (ahd.com), Lynchburg General has a 5.3 percent profit but LewisGale Medical Center has a 2.3 percent profit and Carilion Roanoke Memorial Hospital has a 3.2 percent profit. So we have Lynchburg General with more than double LewisGale and almost double Carilion profit. Both Lynchburg General and Carillion are listed as “Voluntary Nonprofit, Other.” LewisGale is listed as “Proprietary, Corporation.” Nonprofit and free market seem to be a good fit in Roanoke where competition exists.

Read the full editorial.

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Close to Home

By Katie Zezima - Washington Post

The nation’s opioid epidemic has unleashed a secondary outbreak: the rampant spread of hepatitis C.  New cases of the liver disease have nearly tripled nationwide in just a few years, driven largely by the use of needles among drug users in their 20s and 30s, spawning a new generation of hepatitis C patients. Because a treatment that cures the disease costs tens of thousands of dollars, is limited by insurance and Medicaid, and is mostly unavailable to people who are still using illicit drugs, there probably will be financial and public health ramifications for decades to come.
Here in West Virginia, which has the nation’s highest rates of overdose deaths and new hepatitis C and hepatitis B infections, public-health officials are attempting to identify as many new hepatitis carriers as possible — and are girding for decades of repercussions.

Read the full article and related story from USA Today.

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National News

Attack on CAHs

By Maggie Elehwany - National Rural Health Association

Yesterday, the urban-centric House Ways and Means Committee is advancing legislation that will result in the closure of even more rural hospitals, further decimating access to health care and further escalating economic decline in rural communities across the country. Instead of advancing policies to improve the plight of rural America (where health disparity and mortality gaps between urban and rural populations escalate, and unemployment rates continue at levels of the Great Recession), the Ways and Means Committee calls for payment reductions to rural safety net hospitals known as Critical Access Hospitals.  And, perhaps the most hypocritical factor, is that the Committee plans to use this devastating payment cut to Critical Access Hospitals to partially pay for other important rural health programs that Congress has irresponsibly let expire.

Maybe the Ways and Means Committee is unaware that one in three rural hospitals are in financial risk of closure, and 41% of rural hospitals operate at a negative financial margin. Maybe the Ways and Means Committee doesn’t realize that when a rural hospital closes, 20% of the rural economy vanishes and other health providers in the community, who are almost always hospital based, leave the rural area. Maybe the Ways and Means Committee doesn’t understand the depth of health workforce shortages, chronic poverty and chronic disease in rural America. If they did, perhaps the Committee would advance a robust health and economic development plan for rural America, instead of a plan to decimate rural health care delivery.

We urge you to Contact Your Member of Congress and oppose cuts to Critical Access Hospitals.  Not sure who your member of Congress is?  Look it up here.

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Addressing Opioids

German Lopez - Vox

A group of more than a dozen addiction care providers gathered at a community health center one morning in September for their monthly meeting, where they chatted about their latest thorny problem. One of their patients had vanished. Again.

The discussion was lively. But there was no judgment; the group’s members were here not to criticize, but to figure out a way to help their patient should he reconnect with them. The big question was figuring out how to overcome the physical and mental hurdles in front of Tyler.

These professionals are at ground zero for Vermont’s relatively new addiction treatment program, which is unique in its comprehensiveness. Their holistic approach to Tyler’s case is emblematic of Vermont’s strategy as a whole: a focus on the science and research, with a desire to get everyone — even patients who can prove to be very difficult — in treatment to save their lives.

Read the full article.

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The Need for Hospitals

By Zak Ringelstein - New York Times

This week Maine voted to become the 32nd state to expand Medicaid despite opposition by Gov. Paul LePage, who had vetoed five previous expansion bills passed by the state legislature and has now threatened to block the results of the ballot initiative. Unless Mr. LePage succeeds, about 80,000 more Mainers will be eligible for coverage, a victory in an unsettling year for health care in America.
With the Affordable Care Act under constant threat from the Trump administration and out-of-pocket costs rising faster than wages, health care topped the list of the most important issues facing Americans this year.
However, Maine and other rural states face a health care crisis that Medicaid expansion can’t fix on its own. It’s not about affordable coverage; it’s about access: For too many rural areas, doctors and hospitals are scarce.

Read the full article.

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No Virtual Coaching

By Eric Wicklund - mHealth Intellegence

The Centers for Medicare and Medicaid Services has once again declined to cover virtual coaching platforms in the Medicare Diabetes Prevention Program, saying the mHealth and telehealth platform isn’t reliable enough to warrant reimbursement.
The decision, included in more than 1,000 pages of payment rules released by CMS late Thursday, strikes a blow to telehealth programs that use online weight management coaching to help Medicare members avoid type 2 diabetes. Several have argued that virtual programs reduce access and provider shortage issues and improve engagement for millions of Americans at heightened risk of developing the chronic disease.
"Without the inclusion of virtual providers in the benefit, millions of clinically eligible Medicare beneficiaries will not have viable options to access a service which could improve their lives based solely on the zip code in which they reside," Adam Brickman, a spokesman for Omada Health, told Politico shortly after the CMS announcement came down.

Read the full article.

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Mark Your Calendar

For more information about these and other events, visit the VRHA Calendar

November 29: Managing Major Depressive Disorder in Rural Primary Care Settings - webinar
November 30: Oral Health in Pregnancy and Early Childhood - webinar
December 1: REVIVE! Training of Trainers - Blacksburg
December 13: Changing Health Care Through Community Connections in Southwest Virginia - Lebanon (click here for registration)
February 6-8: Rural Health Policy Institute - Washington, DC
May 8: Health Equity Conference - New Orleans, LA
May 8: Rural Medical Education Conference - New Orleans, LA
May 8-11: Annual Rural Health Conference - New Orleans, LA
May 8-11: Rural Hospital Innovation Summit - New Orleans, LA

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Virginia's Hospital Efficiency
Efficiency (and Productivity) indicators reveal which facilities may waste less and provide better quality of care by streamlining and reducing unnecessary costs. This page from VHI can be used to create a  free report to see how facilities rank on their efficiency and productivity. The reports can also be purchased as a Microsoft Excel file.

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Funding Opportunities

For funding opportunities without a specific deadline, please visit the VRHA Resources page

Research into Youth Tobacco-Use Prevention 
The Virginia Foundation for Healthy Youth announces its Best Value Request for Proposals (RFP) funding opportunity for research projects. Virginia universities, nonprofit/charitable organizations, government entities and businesses are eligible to submit proposals for the three-year contract period of July 1, 2018 through June 30, 2021. Individual grant awards will not exceed $150,000 per year ($450,000 total for all three years) to implement tobacco use prevention/cessation programs in Virginia communities. This is an online application process.
Deadline: 5pm, February 2, 2018

Maternal and Child Health Field-Initiated Innovative Research Studies (MCH FIRST)
This grant will advance the health and wellbeing of maternal and child health (MCH) populations, including children with special health care needs and the Title V Block Grant populations, through 3-year grants for innovative applied and translational intervention research studies. The MCH FIRST program will promote innovation in the field by supporting the exploration of new ideas and the development of new interventions. 
Closing Date for Application: Monday, January 8, 2018


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