Virginia Rural Health Association - Weekly Update
VRHA Weekly Update
In this Issue  May 2, 2016

VRHA News Virginia News National News Mark your calendar
Funding Opportunities


Newsletter now available





Reviving Lee

By Cassandra Sweetman - WCYB

For the first time in months, concrete steps were taken to re-open a Southwest Virginia hospital. Three years ago the Lee County Hospital closed but [VRHA member] Lee County Hospital Authority has been working to bring it back.

The hospital authority hasn't met since December. The vice chairman, H. Ronnie Montgomery, said the Wellmont Health System and Mountain States Health Alliance merger was holding up progress, but on Tuesday they made some big decisions.

First they appointed a committee to negotiate a lease agreement with Mountain States. The plan is to open in stages, first with an urgent care at the hospital in about four months. Then, in about a year, they hope to open an emergency room. 

Read the full article.

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Deadline Approaching

Seeking Student Representatives

VRHA is accepting applications from students who wish to serve as a representative on the VRHA Board of Directors.  Up to five students will be selected for a one year appointment.  

The VRHA Student Representatives to the Board of Directors are expected to serve as a communication link between the current leaders of VRHA and the future ones.  In order to meet this expectation, the students selected will need to interact with both the VRHA Board Members and students in a wide variety of health-related programs.

The students selected will help VRHA achieve its strategic goals, with particular emphasis on increasing awareness of VRHA and the benefits of VRHA membership among students.   

Whenever possible, the students selected will represent different academic programs/ professions.  This will be a non-voting position on the board.  Students selected will receive a complimentary registration and hotel room at the VRHA Annual Conference.

Click here for more information and the application form.

Applications must be submitted no later than May 13, 2016
Results will be announced on May 23, 2016

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VRHA Office Schedule

The VRHA offices will be closed next week as the staff will be attending the NRHA Annual Conference in Minneapolis, MN.  Offices will re-open and the Weekly Update will resume on May 16.

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Virginia News

Rural Hospital Bill

From the Office of Senator Mark Warner

U.S. Sens. Mark R. Warner and Tim Kaine (both D-VA) introduced bipartisan, budget-neutral legislation to ensure hospitals are fairly reimbursed for their services by the federal government so they are able to remain open and functioning, especially in underserved and economically struggling regions of Virginia. The Fair Medicare Hospital Payments Act of 2016 would correct a flawed formula that results in disproportionately low Medicare reimbursement payments to hospitals in rural and low-wage areas.

“Rural hospitals are a lifeline to hundreds of thousands of Virginians, and are at the heart of many of our communities. However, hospitals in rural areas face unique challenges, and many struggle to stay afloat – challenges that are exacerbated by the federal government’s skewed payment system for services provided to Medicare beneficiaries at these hospitals,” Sen. Warner said. “The bipartisan Fair Medicare Hospital Payments Act would do much to help keep Virginia’s rural hospitals financially viable, by ensuring that the Medicare funding they receive is reflective of their costs of providing care. Under this bill, hospitals in five of Virginia’s 11 statistical areas would receive fairer reimbursements that more accurately reflect their operating costs.” 

“Rural hospitals are vital to the communities they provide care for, but they are faced with difficult financial challenges that affect access to care and long-term viability,” Kaine said. “The bipartisan Fair Medicare Hospital Payments Act aims to reform the way hospitals are reimbursed by Medicare for services by establishing a national standard, as opposed to the status quo which places an undue burden on rural hospitals in economically disadvantaged areas.”

This legislation has been endorsed by the Virginia Hospital Association and the National Rural Health Association.

Read the full press release and related media from WDBJ7Staunton News Leader, and NBC29.

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Pharmacy Bills

By Marcy Hernick - Roanoke Times

One serious problem that continues to plague Southwest Virginia is health care. Statistically, our region ranks among the worst in health outcomes (e.g., length of life, quality of life) and factors (e.g., health care access, quality of health care, social and economic factors, physical environment) in Virginia. While there are many factors that contribute to the poor health statistics in this area, one of the major contributors is limited access to quality health care.

Access to quality health care should not be as limited as currently exists. Simple changes to Medicare billing and better utilization of the skills of qualified healthcare professionals would significantly increase health care access.

H.R. 592 would recognize pharmacists as providers and allow pharmacist-provided services in MUAs to be reimbursable under Medicare Part B, thereby increasing patient access to these necessary health care services.

H.R. 793, also known as “Any Willing Pharmacy Legislation,” would allow community pharmacies in MUAs to participate as preferred pharmacies in Medicare drug plans as long as they are willing to accept the terms and conditions that other in-network providers operate under. This legislation would also serve to increase patient access to needed health care services in MUAs.

Read the full editorial.

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Close to Home

By Harris Meyer - Modern Healthcare

Rebecca Jarboe, expecting her third child, began what turned out to be a difficult labor on Valentine's Day. A snowstorm blanketed the 14 miles of mountain roads that separated her home from the nearest hospital.

The Jarboes, who live just across the state line in Kentucky, were fortunate to have a hospital nearby that does deliveries. A year ago, it looked as if the not-for-profit facility would close because of the deteriorating economics of running hospitals in small towns. With a population of 2,300, it's located in the heart of the economically depressed Appalachian region of eastern Tennessee.

The hospital's financial woes can be only partially blamed on the state's refusal to expand Medicaid to low-income adults. Like hundreds of rural facilities across the nation, the hospital suffers from a payer mix skewed toward low-paying government programs. Good-paying jobs with health benefits have dwindled in the region.

Read the full article.

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National News

Expansion Saves

By Susan Morse - Government Health IT

The 31 states and District of Columbia that have expanded Medicaid are saving millions -- and in some cases, tens of millions -- compared to states that have not adopted the federal program, according to a report released by the Robert Wood Johnson Foundation.

The report said hospitals in expansion states fare better financially than providers in states without the Affordable Care Act initiative. Specifically, hospitals in expansion states have less uncompensated care due to a rise in the number of patients covered.

The newly-released report confirmed that hospitals' uncompensated care costs are estimated to have been $7.4 billion, or 21 percent less in 2014 than they would have been in the absence of Medicaid expansion. In 2014, expansion states saw a reduction in uncompensated care costs of 26 percent, compared to a 16 percent reduction in non-expansion states, the report said.

As of September 2015, the percentage of rural hospitals at risk of closure is about twice as high in non-expansion states in comparison to expansion states, it said.

Read the full article.

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Post-discharge Communication

By Virgil Dickson - Modern Healthcare

The American Academy of Family Physicians is asking the CMS to push hospitals to more freely share patients' medical records. It says the current logjam of patient data is causing costly readmissions and putting patients at risk.

“Unfortunately, due to a lack of communication between hospitals and other healthcare facilities with primary-care physicians, the transmission or release of discharge information to the primary-care physician often does not occur at all,” the group said in a letter (PDF) to the CMS.

Rural hospitals, which often are identified as having the biggest challenges with interoperability and health information-technology upgrades, might be the least affected.
In a rural community, the primary-care physician often is also the admitting physician, said Maggie Elehwany, vice president of government affairs at the National Rural Health Association. “Staff is small in rural hospitals, and information is more easily kept up with,” she said.

Read the full article.

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Competition for Docs

By Andrea Clement Santiago - D Healthcare Daily

Most likely, your medical facility is actively recruiting primary care physicians, or will be very soon. Facilities must be ready to execute aggressive search strategies with a multi-pronged approach and a variety of resources, including search firms. Even the traditionally popular and desirable destinations such as metropolitan or coastal venues are now forced to retain firms to fill primary care openings. Gone are the days when the in-house recruiter could simply post a physician job online, sit back, and wait for doctors to apply.

For the first time in The Medicus Firm’s history, search and placement activity in urban and metropolitan areas outpaced that of rural (pop. 25,000 or fewer) and mid-sized communities. Now that urban and metro practices are putting additional resources into the battle for primary care physicians, the competition has never been so intense. Recruiters and administrators in rural areas must step up their game even further, to attract and sign the doctors they need.

Facilities must utilize as many resources as possible from a financial and logistics standpoint. Resources include internal and external recruiters, marketing campaigns, job boards, and more. The process includes conducting thorough marketing, screening and presentation strategies, and hosting engaging, comprehensive interviews. It is also paramount to act promptly on candidates of interest, and extend a viable contract quickly, as soon as possible after concluding the candidate’s interview.

Read the full article.

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VA Improves Payments

From the US Department of Veterans Affairs

To enhance Veterans’ access to care and eliminate delays in Choice provider payment, the Department of Veterans Affairs (VA) is eliminating administrative burdens placed on VA community providers. Previously, payments to Choice providers were not allowed until a copy of the Veteran’s medical record was submitted. Now, community providers, under the Choice program, will no longer be required to submit medical records prior to payment being made. To facilitate the change, VA has modified the Choice Program contract, making it easier for Health Net and TriWest to promptly pay providers.

VA continues to require pertinent medical information be returned to ensure continuity of care; however, it is no longer tied to payment. VA is taking these steps to more closely align with industry standards.

Read the full press release.

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Mark Your Calendar

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

May 10-13: NRHA Annual Rural Health Conference - Minneapolis, MN
June 9: 2016 Health Care Conference - Richmond
July 13-15: Rural Quality & Clinical Conference - Oakland, CA
September 20-21: Rural Health Clinic Conference - Kansas City, MO
September 21-23: Critical Access Hospital Conference - Kansas City, MO

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CMS Provider News

CDC Releases State Profiles of Reproductive Health
Staff from CDC’s Emergency Operations Center (EOC) and Division of Reproductive Health (DRH) have compiled profiles of reproductive health for all 50 U.S. states, the District of Columbia, and Puerto Rico. Each jurisdictional profile offers a snapshot of key reproductive health-related statistics, including the number of women of reproductive age and the number of unintended pregnancies, as well as an overview of the services available for women.

Association of Blood Lead Levels in Children 0-72 Months with Living in Mid-Appalachia: A Semi-Ecologic Study
A study comparing the blood lead levels in children ages 0 – 72 months in Mid-Appalachia with children of same age in the U.S. Includes a relational comparison of the number of housing units built before 1950 and 1940 in both regions. 

PACE Provides Much-Needed Rural Supports and Services for Older Adults
Describes advantages of PACE (Program of All-Inclusive Care for the Elderly), an interdisciplinary healthcare service designed to allow older residents of rural communities to remain in their homes as long as possible.

ARC Data
The Appalachian Regional Commission compiles data, creates maps, and conducts research and evaluations on key economic, demographic, and quality of life factors that affect the current and future development prospects of the Appalachian Region. The most frequently requested reports, maps, and data are available online.

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Funding Opportunities

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

FCG Consulting Services
FCG’s core mission is to connect graduate student consultants with opportunities to apply their policy analysis skills to benefit community organizations in Charlottesville. FCG provides support and completes capacity building projects that help community organizations better and more effectively fulfill their missions. In the past, FCG consultants have completed projects on data management, strategic planning, cost benefit/effectiveness analysis, and survey design.
Deadline: June 1, 2016

Inez Duff Bishop Charitable Trust
Funds to support a broad range of activities especially assistance for the visually impaired, and hospital and medical care for those in financial need. The Trust has a practice of primarily supporting organizations located in Charlottesville or Albemarle County, Virginia.
Deadline: September 1

National Health Service Corps Recruitment and Retention Assistance Site Application
Provides recruitment and retention assistance to healthcare facilities located in a Health Professional Shortage Area.
Application Deadline: Jun 7, 2016 

Enhance Physical Education with the Presidential Youth Fitness Program
Propel physical education with the Presidential Youth Fitness Program.  Schools and districts can apply now to receive resources to enhance implementation of the nation’s youth fitness education and assessment program.  Eligible schools and districts (10 or more schools) can receive up to $1,000 in resources including software, student recognition items and more! Let’s Move! Active Schools that have completed their school assessment are eligible to receive up to $2,000 in resources.  

Healthcare Connect Fund
Provides funding to healthcare providers for telecommunications and Internet access services, as well as network equipment, at a flat discounted rate of 65 percent. Participants can apply as a member of the consortium or a stand-alone entity.
Application Deadline: Jun 1, 2016 

Health Center Program New Access Point Grants
Grants to support the establishment of new health service delivery sites for underserved and vulnerable populations.
Application Deadline: Jun 17, 2016 

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