VRHA Weekly Update
In this Issue  August 28, 2017

VRHA News Virginia News National News Mark your calendar
Funding Opportunities





Deadlines Approaching!

VRHA is inviting students who are in any health or public policy program to submit essays on why they want to serve rural communities.  Five essays will be selected and the authors will receive free conference registration.

The author of the winning essay will have the honor of reading the essay during the Rural Health Providers Conference and will receive 2 complimentary nights at Berry Hill Resort and free conference registration.

Download the scholarship form here

Completed forms must be e-mailed to boconnor@vcom.vt.edu on or before 
September 8.  Winners will be announced on September 15th.  

Additionally, the deadline for VRHA awards is September 2nd. Click here to download the nomination form.

Details about the Virginia Rural Providers can be found by clicking the event logo to the right.
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October 25 & 26
South Boston, VA

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​Documentation & Coding Bootcamp

In conjunction with the Rural Providers Conference, VRHA will be hosting the 2nd Annual Rural Health Documentation & Coding Bootcamp, October 24 & 25. 

With the April 2016 requirement by CMS to require RHCs to provide HCPCS code-level detail (CPT and HCPCS-2) – it has never been more important to make sure you are documenting and coding for 100% of what is done. Billing is not supposed to change – but if you aren’t documenting and coding correctly, revenue may be left on the table!  Increase revenue and reduce compliance risks.

We will present a detailed review of the AMA’s 2017 CPT Professional Edition from the perspective of rural health focusing on the services typically provided by Rural Health Clinics and small rural hospitals. We will focus on the guidelines that appear before and after key coding sections that rarely are accessible to providers and coders/billers in their EHRs and encoder software.
With Information Technology finding its way into more areas of medical facilities the difference between clinical documentation, professional coding, and medical billing have never been more important. 

We will limit the review of codes that will rarely or never be performed in community health – but will review the CPT cover to cover including guidelines, appendices, and modifiers with focus on level of visits and preventive services.

Visit the Bootcamp webpage for details and registration.

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MIPS Technical Support

2017 is the performance year for the Medicare Quality Payment Program. Clinicians must participate in the QPP or face a negative payment adjustment in 2019.
IPRO has contracted with CMS to provide technical assistance, free of charge, to MIPS-eligible clinicians in small practices.  On September 6th at noon, IPRO will host a webinar for Virginia clinics to provide an overview of the QPP, discuss available resources, and explain how IPRO can help guide your practice in transitioning to this new payment program and work with you to avoid the negative payment adjustment in 2019.

Click here to register for the webinar. We also information about the Quality Payment Program and a Resource Guide.

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Virginia News

Expansion, Again 

By Evanne Armour - WRIC

Gov. Terry McAuliffe said he has “cautious optimism” when it comes to Virginia’s fiscal health. McAuliffe said there are two big-ticket items to consider during upcoming budget deliberations — the cost of public education and health care. 

He called, once again, for Medicaid expansion. McAuliffe said, by not doing so, Virginia has now forfeited nearly $10.5 billion in federal tax dollars.  Though the idea hasn’t been widely-received by members of the General Assembly, the governor believes there will be a shift in thought next year.

Read the full article and related story by WTOP.

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Parent Peer Specialists

By Rachel Hicks - Roanoke Times

The Blue Ridge, New River Valley and Mount Rogers behavioral health agencies will share in a three-year, $3 million grant from the Virginia Department of Behavioral Health and Developmental Services to get parents involved in supporting families.

James Pritchett, executive director of [VRHA member] New River Valley Community Services, said the three agencies hope to each have one parent peer support partner hired by the end of the summer. A parent peer specialist is a mother or father of a child with mental or behavioral health issues who will support other parents with kids like theirs.

They have had experience with the mental and behavioral health system, and their job is to bond with other parents, connect them to resources and help them see they are not alone.

Read the full article.

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Unaffordable Oral Health

By Patrick W. Finnerty - Richmond Times-Dispatch

More than half of the commonwealth’s localities (68 of 135) have no dental safety-net provider — and in many of the areas that do, clinics only operate on a part-time basis. The epidemic isn’t getting any better.

We see our neighbors firsthand — lined up by the thousands at the Virginia Dental Association Foundation’s free Mission of Mercy programs across the state, addressing oral health care needs in underserved populations by providing preventative, restorative, and surgical dental care.

While providing free dental care to Virginia’s most vulnerable can be fulfilling, we know this is not the long-term answer. We need to ensure that everyone has access to affordable, comprehensive oral-health services. As we debate the pros and cons of our nation’s health-care system, our oral health should be a part of the dialogue.

Read the full editorial.

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National News

Medicaid Work Requirements

By Bryce Oates - Daily Yonder

The efforts of eight states to enact work requirements for Medicaid recipients could create special problems for rural participants, according to a new study.  Researchers Andrew Schaefer and Jessica Carson at the Carsey School of Public Policy at the University of New Hampshire found that one in four of potentially impacted Medicaid participants already worked at least part of the previous year or were motivated to work but could not find a job.
“As state policymakers consider Medicaid-related work requirements, it is worthwhile to consider the administrative costs of implementing this kind of [work requirement] waiver alongside the benefits of cost savings associated with reducing Medicaid rolls, and the expenses related to increasing the uninsured low income population,” the researchers said. “In both rural and urban places, legislators should consider whether the consequences to families losing health insurance coverage outweigh the relative benefits of enforcing work requirements.”
Rural residents participate in Medicaid at a higher rate than metropolitan residents. And rural areas generally have greater unemployment rates or discouraged workers.

Read the full article.

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MACRA and Small Practices

By Virgil Dickenson - Modern Healthcare

The CMS' attempts to reduce regulatory burden on small practices by exempting them from new Medicare requirements may actually leave them behind in the transition from fee-for-service to value-based care, providers say.

Earlier this summer, the CMS proposed that physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year would be exempt from reporting under the Merit-based Incentive Payment System under the Medicare Access and CHIP Reauthorization Act starting in 2018.

The move will exclude about 134,000 more providers from complying with the quality reporting program. The original threshold for exemption, which is in place for 2017, is $30,000 or fewer than 100 Medicare patients. 

Read the full article.

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Creative Recruiting

By Mattie Quinn - Governing

To lure more doctors to the places that need them, several states are getting creative.  As chair of the Department of Family and Community Medicine at the University of North Dakota (UND), David Schmitz's mantra for solving the rural doctor shortage is: "Training in 'the sticks,' sticks." In other words, if a doctor is trained in a rural area, she's likely to practice there as well.

But "one of the best approaches" to address doctor shortages, at least according to Alan Morgan, CEO of the National Rural Health Association, was pioneered by Missouri. In 2014, the state passed a law that allows "assistant physicians" -- graduates of medical school who haven’t been placed in a residency program yet -- to practice medicine in underserved areas under the supervision of a fully licensed doctor. The role doesn't count as a residency, but assistant physicians can work indefinitely if they like their job.

Read the full article.

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Curbing Suicide by Firearm

By Shefali Luthra - Kaiser Health News

John Yule, 53, manages Wildlife Sport Outfitters, a hunting and fishing supplies store on the edge of Manchester, N.H., and is part of a team of people on the front lines — gun dealers like himself who, in many cases, claim a rural customer base — trying a simple but radical approach to curb rates of suicide, the nation’s 10th-leading cause of death.

Their methods involve noticing certain “tells” that indicate a customer is shopping for a firearm with suicide in mind. Their goal is to keep guns, the most common method of suicide, out of the hands of those they deem at risk.

Read the full article.

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Mark Your Calendar

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

September 7: Empowering a Rural Community to Create a Culture of Health - webinar
September 11: REVIVE! Opioid Overdose Education - Abingdon
September 21: Financial Distress and Closures of Rural Hospitals - webinar
September 25 & 26: The Governor's Summit on Rural Prosperity - South Boston, VA
October 24 & 25: Rural Health Documentation & Coding Bootcamp  - South Boston, VA
October 25 & 26: Virginia Rural Providers Conference - South Boston, VA
November 12 & 13: Virginia Telehealth Network Summit - Richmond

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QPP Support for Small Practices 
FREE Quality Payment Program Resources and Educational Presentations to help your practice transition to the QPP, guide you along the right path and make sure you are prepared. We want you to be able to participate successfully in the QPP and continue to focus on what matters most: providing your patients with the best care possible.

Interactive Maps
Voices for Virginia's Children now has interactive maps and charts. To view data for each domain of child well-being listed below, click on the image. Then, you will be able to to move through the story and learn a little about child well-being in the Commonwealth. Each story is an interactive opportunity to visualize a brief overview of key indicators in child well-being for Virginia.

Webinar Recording: Behavioral Health Workforce Supply
Rural-urban disparities exist across the spectrum of behavioral health providers. Holly Andrilla, MS, and Eric Larson, PhD, both from the WWAMI Rural Health Research Center, presented findings from a recently completed study quantifying Census Division differences in the per capita supply and distribution of five types of behavioral health providers, (psychiatrists, psychologists, social workers, psychiatric nurse practitioners, and counselors) across metropolitan, micropolitan, and non-core counties.  You can: View the presentation online [Flash], View the presentation slides [PDF], View the transcript [PDF] 

The Dangers of Other Tobacco Products
Developed by the Virginia Foundation for Healthy Youth, this module is to provide prevention education to youth in middle and high school about Other Tobacco Products (OTPs). Pre- and Post-test surveys conducted with hundreds of youth in Virginia showed significant increases in knowledge related to students’ understanding of the addictive qualities and dangers of OTPs such as smokeless tobacco, hookahs and e-cigarettes.

Women and Opioids
The Office of Women’s Health released a final report on Opioid Use, Misuse, and Overdoes in Women. The study found that death rates from drug overdose for women are more pronounced in the rural South and Midwest. The report identified a possible explanation being that rural areas often lack access to treatment for substance use disorder. 

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Funding Opportunities

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

Tobacco-Use Prevention & Cessation Programs with Youth Request for Proposals (RFP) Virginia nonprofits, governmental and charitable organizations (school systems, faith centers, community service boards, parks and rec departments, clubs, etc.) 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 $50,000 per year ($150,000 total for all three years) to implement youth tobacco-use prevention/cessation programs in Virginia communities. 
Deadline: October 16

Future of Nursing Scholars
A Robert Wood Johnson Foundation program  to develop the next generation of PhD-prepared nurse leaders who are committed to long-term careers that advance science and discovery, strengthen nursing education, and bring transformational change to nursing and health care. Schools with research-focused PhD programs in nursing are eligible to apply for the program. Program funds are used to increase the number of PhD students in nursing that are admitted to the selected schools. 
Deadline: September 14

AHRA and Toshiba Putting Patients First Program
The AHRA (Association for Medical Imaging Management) and Toshiba Putting Patients First Program seeks to improve pediatric and adult patient care and safety in diagnostic imaging. In 2017, the program will provide six grants of up to $7,500 each to single-site hospitals and imaging centers located in the United States. Three grants will be awarded for projects that improve the safety and comfort of pediatric imaging and three grants will be awarded for projects that improve diagnostic imaging. In addition, one grant of up to $20,000 will be awarded to an Integrated Delivery Network (IDN) or hospital system for projects that improve overall patient care and safety in imaging implemented across the IDN/hospital system. The projects funded by these grants will be used to create a best-practices tool to share with other hospitals and institutions. The application deadline is October 30, 2017. 

Address suicide research gaps in rural communities 
National Institutes of Health (NIH) will provide up to $300,000 to colleges and universities, local governmental bodies, nonprofit agencies, and other eligible organizations to uncover the risk factors for, and the burden of suicide. NIH requests that applicants link mortality data to health care data related to suicidality, specifically on the type, severity, and timing of suicide predictors. 
Deadline: November 2

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