Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  June 1, 2015

VRHA News Virginia News National News Mark your calendar
Resources
Funding Opportunities
VRHA Site

RuralHealthWorks

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VRHA News

VRHA in the News 

By Beth O'Connor - Roanoke Times

Michael Thompson’s April 26 commentary “Rural hospitals don’t need Medicaid expansion,” only serves to demonstrate — again — his misunderstanding of how hospitals serve their communities.

He points out repeatedly that the “largest business group supporting Medicaid expansion was the hospitals.” Since hospitals are the entities losing the most money through the lack of Medicaid expansion, this is logical. If there was proposed legislation to assist restaurants in making up for the loss of revenue from customers who had skipped out on their bill, restaurants would be the loudest voices in support of that bill.

Read the full editorial.

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Student Scholarships


VRHA has funds available to assist students who wish to attend the VRHA 2015 Annual Conference.  Any full-time student studying a health-related profession may apply. Funds will cover conference registration fees.

Completed forms must be e-mailed to boconnor@vcom.vt.edu on or before September 4th.  Winners will be announced on September 11th.

Download the application form or click the logo for more information about the event.
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Telehealth Webinars

VRHA has partnered with WeCounsel to offer you a 3-part webinar series on telehealth.  This series will provide a high level understanding of what it takes to effectively implement a successful telehealth program.

  • June 23: will highlight reimbursement policies for the state of Virginia in regards to telehealth. Getting paid is critical to any successful telehealth program.  Join us as we discuss the reimbursement landscape for Medicare/Medicaid and private payers in regards to telehealth, and how telehealth can be a successful revenue stream for your practice. 
  • July 20: will outline effective use cases and how to develop an effective business model for a Telehealth initiative. This webinar will cover exactly how to plan, develop and implement a successful telehealth initiative. 

The webinars are free to all Virginia rural health stakeholders, regardless of VRHA membership status - so feel free to pass this information along!

Visit the VRHA webinar page for details, registration and an archive of the May 19th presentation on regulations.

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Virginia News

Dental Sealant Access

By Amy Trent - News & Advance

Virginia’s high-need children remain less protected than they should from tooth decay, according to a new study that looks at what states can do to improve such children’s access to dental sealants. 

According to the annual study by the Pew Charitable Trusts, “States Stalled on Dental Sealants,” “dental care remains one of the greatest unmet health needs among U.S. children.”Since 2010, Virginia has received a C grade; this year, the score was lowered to a C-, based on 2014 data.

The study evaluates all 50 states on their performance in sealing the teeth of low-income children. Virginia is one of 19 states to receive a C or C- grade.

Read the full article.

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NCQA Certification

By Amy Trent - News & Advance

The greater Lynchburg area now boasts 13 nationally certified patient-centered medical homes.  On May 1, Centra’s Lynchburg Internal Medicine and Central Virginia Family Physician’s Appomattox, New London, Piedmont, Forest, Monelison, Rustburg and Timberlake family practices received the National Committee for Quality Assurance’s highest level of Patient-Centered Medical Home approval possible — level 3 certification.

[VRHA member] Blue Ridge Medical Center, Centra’s Lynchburg Family Medical Center, The Johnson Health Center’s adult and pediatrics sites and Central Virginia Family Physician’s Staunton River Family Practice already are certified by the National Committee for Quality Assurance (NCQA), a private nonprofit that aims to improve health care by holding providers to high standards through continual measurement and analysis of performance.

Read the full article.

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Close to Home

By Alton Strupp and Laura Ungar - USA TODAY

Obamacare flooded into these remote Appalachian hills last year like the War on Poverty had a half-century earlier — another government program promising to save some of America's most vulnerable citizens.  Since then, it has given many of the poor and sick a key to long-neglected health care. It's also brought skepticism and fear, and some business owners argue it's stunting their growth in a region that can't afford another economic blow.

Amid predictions that bad health habits would be hard to break, scores of newly insured residents, mostly covered by Medicaid, have sought care in hospitals, mental health centers and drug treatment facilities. Providers have proved plentiful. Unreimbursed care costs are down. The county's under-65 uninsured rate is half what it was — dropping from 19% before the ACA to 10% at the close of 2014.  Some who dismissed Obamacare because of its political associations with a president blamed for the decline of coal industry say their opposition has softened. 

Last year, fast-food worker Melinda Watson echoed the law's unpopularity here — convinced it would kill jobs and create long waits for "horrible" socialized medicine. She bought a subsidized insurance plan on the state exchange only to avoid paying federal penalties. But she soon realized the benefits: going to the doctor regularly and undergoing MRIs for her epilepsy. Her employer didn't cut her hours, as she feared.

Read the full article.

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National News

Expansion Gains

Jesse Cross-Call - Center on Budget Policy & Priorities

In the short time since states have been able to expand Medicaid to low-income adults under health reform, a clear divide has emerged between states that have expanded Medicaid and those that have not. Since the major coverage provisions of the Affordable Care Act (ACA) took effect in 2014, insurance coverage rates have improved across the country, but the gains are far greater in the states that have expanded Medicaid. As a result, hospitals in expansion states are treating fewer uninsured patients, and the amount of uncompensated care they are providing is declining steeply. Moreover, contrary to critics' claims that Medicaid expansion is financially unsustainable for states, there is increasing evidence that expansion has saved states money, and these savings are expected to grow over time.
 
The Medicaid expansion has had an especially dramatic impact in Arkansas and Kentucky, which both had high uninsurance rates and limited Medicaid eligibility for non-elderly adults before health reform. Both states' uninsurance rates have fallen by half in just over a year, and the expansion is expected to save each state more than $100 million by the time their current state fiscal years end on June 30.
 
Meanwhile, the states that have not expanded Medicaid are falling further behind. In the non-expansion states, large numbers of low-income people remain uninsured and without access to affordable health coverage. These individuals are caught in a "coverage gap" because their incomes are too high for Medicaid but too low for subsidies to purchase coverage in the marketplace. Hospitals in these states continue to provide large amounts of uncompensated care, and the states are missing the opportunity to leverage billions of dollars in new federal funding through the Medicaid expansion.

Read the full article and a review of the data from the Robert Wood Johnson Foundation.

 

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Rural Managed Care 



Some mental health providers in rural Missouri are raising concerns about a provision passed by the Missouri Senate that would shift about 200,000 Medicaid recipients onto privatized managed care programs.

Loretta Fuge is a psychologist based in Mansfield, Mo. Currently, Fuge is reimbursed for seeing Medicaid patients through the state’s fee-for-service model. She has some experience with managed care and, she says, she isn’t a fan. A recent failure to get fully reimbursed through managed care has made her cautious about the viability of managed care in small communities.

Read the full article.

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Reimbursement Formulas

By Ron Shinkman - Fierce Health Finance

Rural hospitals fighting what they perceive are unfair reimbursement formulas devised by the U.S. Department of Health and Human Services have lost a round in federal appeals court.  The District of Columbia Circuit Court of Appeals upheld a lower court's decision that ruled the HHS's formula for keeping payments to rural hospitals neutral was fair.

Some 60 rural hospitals had filed the suit. The plaintiffs claimed that HHS had improperly used budget neutrality adjustments in prior years to make calculations in base years. They claimed under statute that HHS must make calculations in years beyond the base period. The court's judges ruled that that requirement actually applied to inflation adjustments and was irrelevant to their case. 

Read the full article.

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OB Challenge

By John Commins - HealthLeaders Media

A perverse formula encourages critical access hospitals to dump obstetrics, even though there is ample evidence of the physical and psychological risks associated with eliminating this vital link in the population health chain. Pick any issue adversely affecting urban hospitals and that issue is almost always more difficult for rural hospitals. There are fewer economies of scale to provide an offset.

Obstetrics, for example, is expensive and difficult for rural providers, to the point where many smaller hospitals have abandoned those services and referred patients to larger providers in more-urban settings.

In Tennessee, only one of the state's 16 critical access hospitals provides "active" obstetric services. "From a rural perspective, it is an ongoing challenge," says Joe Burchfield, spokesman for the Tennessee Hospital Association. "Many hospitals are looking at eliminating it because, while it is definitely a community benefit, it is costly. That's the reality that we are seeing here."

Read the full article.

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Mark Your Calendar

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

June 4: Transformation in the Health Care Industry - Richmond
June 23: Telehealth Reimbursement Policies - webinar
June 24: What Research Infrastructure Do We Need to Reduce Suicidal Behavior - webinar
July 15-17: Rural Quality & Clinical Conference - Minneapolis, MN
July 20: Effective Business Models for Telehealth - webinar
September 29-30: Rural Health Clinic Conference - Kansas City, MO
September 30-October 2: Critical Access Hospital Conference - Kansas City, MO
October 13-14: VRHA Annual Conference - Staunton

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Resources

Medicare Learning Network: Provider e-news

Critical Access Hospitals - Updated with new FAQs. Visit the guide to learn about the purpose of the program, requirements and benefits of CAH status, locations of CAHs, and much more.

Rural Health Clinics - Includes information on the advantages of RHC designation, rules and regulations, Medicare/Medicaid reimbursement policies, and more. 

Rural Emergency Medical Services and Trauma - Learn more about the need for, and challenges to, providing EMS services in rural communities, finding funding to support the purchase of equipment, and how rural hospitals can be part of a statewide trauma system. 


Regional Blueprint for Action
Illustrating regional trends on health disparities and the social determinants of health in the Mid-Atlantic. 

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Funding Opportunities

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

Rural Quality Improvement Technical Assistance Cooperative Agreement
Application deadline: Jun 22, 2015
Awards funding to one organization to provide technical assistance to beneficiaries of FORHP quality initiatives such as grantees, Critical Access Hospitals, and other rural providers, including: data collection and analysis; understanding measure specifications; benchmarking and target-setting; developing and implementing efficient and effective improvement strategies; and tracking the outcomes of quality improvement efforts.


Avon Foundation Campus Grants Program
The Avon Foundation Campus Grants Program provides support to colleges and universities for bystander projects aimed at reducing campus sexual assault and dating abuse. Funded projects should generate awareness by instilling a sense of responsibility for students and faculty to step in and take action when abuse is suspected or observed and provide the training and skills necessary for bystanders to safely intervene. Funded projects may include skills-building workshops to increase the number of trained students and faculty; campus-wide outreach tactics including social media campaigns, theater projects, or peer-to-peer trainings; development of awareness materials such as resource guides/pamphlets, website pages, and posters; and video or print PSAs or short films. Twenty-five grants of $10,000 each will be awarded. The application deadline is July 1, 2015. 

Evangelical Lutheran Church in America Domestic Hunger Program
The goal of the Evangelical Lutheran Church in America (ELCA) Domestic Hunger Program is to provide relief and development assistance for those who suffer from hunger and injustices related to hunger in the United States. Priority is given to nonprofit organizations that help people with the fewest resources to meet their basic needs as well as programs to assist women and children living in poverty. Grants are provided in the following categories: relief, development, organizing, and advocacy. Funded projects must have some connection to the ELCA through its synods, congregations, affiliates, or ministries. Interested organizations should read all the requirements before they begin the application process. The application deadline is July 10, 2015.

Foundation of the American Academy of Pediatric Dentistry: Healthy Smiles, Healthy Children
Healthy Smiles, Healthy Children, an initiative of 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 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 programs supporting the age-one dental visit and providing care to special needs patients. These grants of up to $20,000 require cash or in-kind matching funds equal to the grant request dollar amount. Online letters of intent must be submitted by August 3, 2015. 

Innovating for the Underserved Challenge
Application deadline: Jul 22, 2015
Gives monetary awards for ideas that show how innovative technology can address access to services, childhood obesity, or connecting data between systems. Proposed innovations must show how technology and data can address challenges faced by underserved and vulnerable populations.

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