VRHA Weekly Update
In this Issue September 25, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


October 25 & 26
South Boston, VA




Deadline #1

Registration fees for the Virginia Rural Providers Conference is $200 for VRHA members and $275 for the general public.

  • For registration, click here.
  • VRHA Student Members are eligible for the student rate of $100 for the full event or $75 for the first day and $30 for the second.
NOTE:  This prices will increase as we get closer to the conference.  Starting October 1st, member rate will be $230; non-member $290. Get your registration in early and save! 

Event registration fees include 2018 VRHA membership dues.

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Deadline #2

Once you have registered for the Virginia Rural Providers Conference, don't forgot to make your hotel reservation! Lodging will be at the Berry Hill Resort.

The resort is nestled amongst a tree-lined forest covering 650 acres in the heart of historic South Boston, Virginia. This former antebellum plantation estate and (now) National Historic Landmark welcomed its first guests to the beautiful Virginia countryside in 1728. Since that time, the mansion has undergone an impeccable restoration process that has elevated it into a world-class destination resort that includes a plethora of modern amenities and services, while retaining both its' architectural and cultural history.

Rooms are set aside at the discounted rate of $89/night for the conference.

You must reserve by October 4th to ensure a room at this rate. 
Phone: 434-517-7000.

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Rx Abuse Forums

VRHA and the Virginia Department of Health are partnering with One Care of Southwest Virginia to host Prescription Drug Abuse Forums.  These free events provide health care providers with knowledge and skills to apply in clinical practice regarding prescribing controlled substances.

Upcoming events are scheduled for October 28th in Fishersville and October 29th in Lynchburg. Additional forums will be held next spring in Martinsville and Roanoke.

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Virginia News

Lack of Choices

By Luanne Rife - Roanoke Times

When it comes to health care insurance and what it will cost, there is still much that is not known for those who purchase individual policies. One thing does appear certain for 2018: for much of Virginia, and the nation, consumers will lack choices.

Anthem Blue Cross and Blue Shield announced that it would re-enter the market and offer policies in the western part of Virginia. The coverage will come at a price. Anthem is asking for premium increases of between 42.5 percent and 64.1 percent. Optima, which is the sole provider in other areas, asked for an 81 percent increase.

Read the full article and related story from the Commonwealth Institute.

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Merger Approved in TN

From the Citizen Tribune

The proposed merger between Mountain States Health Alliance and Wellmont Health System reached an important milestone on Tuesday with approval of the systems’ Certificate of Public Advantage (COPA) application by Tennessee officials.

Tennessee Commissioner of Health John Dreyzehner announced the decision following the department’s review of the health systems’ commitments to protect rural access to care, invest in needed healthcare services, reduce the pace of healthcare cost growth and establish regional programs to improve population health.

Virginia officials are set to render their decision on the systems’ cooperative agreement application by the end of the month.

Read the full article, and related stories from WJHL, Johnson City Press, WJHL (merger deal), and US News & World Report.

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Dealing with NAS

Jess Nocera - Bristol Herald Courier

Since Cassandra Caffee began working as regional coordinator of Smart Beginnings Southwest Virginia about a year ago, opioid abuse and neonatal abstinence syndrome have become the “topic of conversation.” 

“I have seen it really accelerate, and it now seems to be the topic of conversation in all the different groups that we work with, and I think part of that is because the opioid crisis is more in the news and there have been reports of higher instances of infants being born drug-exposed,” Caffee said.

Smart Beginnings is one of the two United Way Southwest Virginia programs that have a direct connection to NAS children and families, said Briana Fillers, marketing and communication manager for United Way.

“Smart Beginnings serves as a backbone organization, connecting existing systems who care for and about young children and provides opportunities to build early childhood support in our region,” Fillers said. “Smart Beginnings serves 13 counties and three cities and has five local coalitions grouped by geographic location and one regional advisory coalition that allow representatives from multiple organizations to come together to address issues in the region.”

Read the full article.

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National News

Graham-Cassidy Threat

By Dave Barkholz - Modern Healthcare

Leaders of cash-strapped rural hospitals worry that the latest proposal to repeal and replace the Affordable Care Act could destroy them.

With higher rates of Medicaid patients than their urban counterparts, rural hospitals would be disproportionately hurt by an end of the Medicaid expansion proposed in the so-called Graham-Cassidy Senate bill, said Maggie Elehwany, vice president of government affairs at the National Rural Health Association.

Elehwany said that rural hospitals would be hit especially hard by legislation that increases the uninsured, boosts deductibles for patients or threatens already shrinking Medicare payments.

Read the full article, a statement from Governor McAuliffe, and additional analysis from Kaiser Family FoundationThinkProgress, RollCall, Slate, Reason, Avalere, Center for Budget & Policy Priorities, The Hill, New York Times, Washington Post.

VRHA urges you to contact Senator Warner and Senator Kaine and encourage them to vote "NO" on Graham-Cassidy.

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Nowhere to Give Birth

By Carolyn Y. Johnson - Washington Post

At Meadows Regional Medical Center in rural Vidalia, Ga., the number of babies born each year has more than doubled over the last 15 years — increasing from about 400 births in 2000 to more than 800 in recent years, according to the hospital's chief executive Alan Kent.

It might sound like a significant baby boom for the community of nearly 11,000 people. Instead, Kent says the uptick is a symptom of a phenomenon that is playing out in rural areas nationwide: The hospitals around Meadows Regional have either winked out of existence or canceled their obstetrics services over the years. The medical center now keeps a strategy map of its primary service area, which extends in each direction about 30 to 40 miles, Kent said.

“Most of the rural hospitals around us, at one time or another delivered babies over the last eight to nine years. Two hospitals have closed. The three remaining hospitals that had maternity wards ceased their women's services and stopped delivering babies,” Kent said. “We're seeing an increase in women who deliver with no prenatal care.”

Read the full article.

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EMTs Carrying Nitrous Oxide

From CBS News

Normally used in dentist's offices and hospitals, nitrous oxide — yes, laughing gas —is starting to turn up again in ambulances in some rural areas where medical workers with clearance to provide more traditional painkillers often aren't on board.

It gives advanced emergency medical technicians, who are a step down from higher-level paramedics, a way to help relieve patients' pain and anxiety on what can sometimes be long trips to a hospital.

It is also not an opioid, a bonus as the country grapples with a drug crisis. Experts have blamed prescription opioids for spikes in overdoses, and some patients simply might not want to be given an opioid, or their injury doesn't require something so strong.

Read the full article.

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Contract Doctors

By Max Blau - Stat

Dr. Colin Zhu thought about starting a family practice. But the 33-year osteopathic physician realized all the management, paperwork, and financial overhead might distract him from what he enjoyed most: seeing patients. So Zhu went freelance.

The practice is known in the industry as “locum tenens” (Latin for “to hold a place”) — working shorter, contract gigs instead of taking a full-time job. That choice used to come with a stigma; patient data suggested freelance doctors weren’t as skilled as those with more stable careers. Today, though, the skills gap seems to have closed as more and more doctors opt for the flexibility of contract work — and more and more hospitals, desperate to fill staffing shortages, bring them on board.

“We’re a necessary evil,” said Rob Gleason, chief operating officer with Fusion Healthcare Staffing, a recruiting agency based in Sandy, Utah. “We’re staffing rural hospitals where many physicians don’t want to go permanently.”

Read the full article.

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Mark Your Calendar

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

September 26: Rural Tobacco Control and Prevention - webinar
October 24 & 25: Rural Health Documentation & Coding Bootcamp  - South Boston, VA
October 25 & 26: Virginia Rural Providers Conference - South Boston, VA
October 28: Rx Abuse Forum - Fishersville
October 29: Rx Abuse Forum - Lynchburg
November 2: 2017 Virginia Oral Health Summit - Richmond
November 12 & 13: Virginia Telehealth Network Summit - Richmond
November 15: Synthetic Narcotic & Opioid Abuse Prevention Summit - Abingdon

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Marketplace Changes
Medical Society of Virginia developed information sheets to help navigate health insurance marketplace changes; one for physicians and one for patients.

Interactive Training Series
The CDC has an eight-part online training series to help health care providers apply CDC’s prescribing recommendations in their clinical settings through interactive patient scenarios, videos, knowledge checks, tips and resources. Topics in the series include communicating with patients and treating chronic pain without opioids.

Balanced Scorecard and Strategy Map Templates
The Transition to Value Strategy Map and Balanced Scorecard Templates are provided as separate downloadable Microsoft Word documents. The templates are ready to use and are designed to allow hospital and network leaders to incorporate and expand their organizations' strategic plans to provide a framework that supports population health preparedness.


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Funding Opportunities

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

Healthy Smiles, Healthy Children
Healthy Smiles, Healthy Children, The Foundation of the American Academy of Pediatric Dentistry is committed to improving the quality of pediatric oral health in the United States. Healthy Smiles, Healthy Children Grants support dentist-led, community-based initiatives throughout the country that provide dental care and ultimately serve as a Dental Home to underserved/limited access children. Special consideration will be given to initiatives that support the age-one dental visit, emphasize care to patients up to age five, provide care to special needs patients, address the needs of specific underserved demographic groups, and incorporate systemic health, i.e., diabetes, cancer, etc. Single-year grants of up to $20,000 are provided.
Online proposals must be submitted by December 15, 2017. 

NBCC Foundation Rural Scholarships
Offers scholarships to students residing in rural areas who are currently enrolled in a master's level counseling program and are committed to practicing in rural communities after graduation.
Application Deadline: Oct 31, 2017 

NIH Health Disparities Research Loan Repayment Program
Offers loan repayment assistance for health professionals who commit to research projects related to health disparities.
Application Deadline: Nov 15, 2017 

Smart Rural Community Collaboration Challenge
Provides funding to support the development and implementation of innovative broadband-enabled solutions to support rural commerce, healthcare, public safety, economic development, education, energy, or other community-oriented initiatives.
Application Deadline: Dec 1, 2017 

HRSA Look-Alike Initial Designation Technical Assistance
Technical assistance resources to assist organizations in the application for Look-Alike Initial Designation under the Health Center Program.
Applications accepted on an ongoing basis 

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