federal office of rural health policy policy research team overview
TRANSCRIPT
Federal Office of Rural Health Policy
Policy Research Team Overview
• Tom Morris – Associate Administrator
• Sahira Rafiullah – Deputy Associate Administrator
• Aaron Fischbach – Policy Coordinator• Alicia Swenson O’Brien, Sarah Young, Helen Newton, Suzanne Stack,
Craig Caplan, Marty Rice, Natassja Manzanero, & Anthony Oliver – Policy Analysts
• Paul Moore & Dan Mareck – Clinical and Quality Advisors
• Steve Hirsch – Executive Secretary, National Advisory Committee
• Curt Mueller – Research and Evaluation Director
• Sarah Bryce – Research and Evaluation Associate
Policy Research Team
• Serve as HHS-wide resource on rural health services and data issues
• Review and comment on all HHS regulations
• Review legislation and reports to Congress
• Conduct rural health services research
• Staff the National Advisory Committee on Rural Health and Human Services
• Staff the White House Rural Council
ORHP Policy Research Activities
PRT Grants and Cooperative Agreements
Policy/Research:
Rural Policy Analysis
Rapid Response to Quick Data Turnaround
Rural Health Research Centers
Rural Training Track Technical AssistanceRural Health System Analysis and Technical Assistance
Demonstrations with CMS:
Frontier Extended Stay Clinic
Frontier Community Health Integration
Rural Health Research
Research from ORHP-funded rural health research centers past and present
http://www.ruralhealthresearch.org
HOSPITAL• Critical Access Hospital (CAH)• Sole Community Hospital (SCH)• Disproportionate Share Hospital
(DSH)• Rural Referral Center (RRC)• Medicare Dependent Hospital (MDH)• Rural Prospective Payment Hospital
PHYSICAN• Bonus Payments
– Shortage Areas– Primary Care
• Graduate Medical Education (GME)
AMBULATORY• Rural Health Clinics (RHC)• Federally Qualified Health Centers
(FQHC)• Community Health Centers (CHCs)
POST-ACUTE• Skilled Nursing Facility (SNF)• Home Health Agency (HHA)• Hospice• Swing Beds• Long Term Care Facilities
Rural Provider Types
• Inpatient Hospital Payment• Outpatient Hospital Payment• Physician Payment• Inpatient Rehab Payment• Inpatient Psych Hospital Payment• Skilled Nursing Facility and Long
Term Care Payments• End Stage Renal Dialysis
Payments• Home Health Payments• Hospice Payments
• Ambulance Fee Schedule• Medicare Advantage• Medicare Part D• Rural Health Clinics• Federally Qualified Health
Centers• Medicaid Waivers/SPAs• Medicare GME• EHR/Meaningful Use• Telehealth• ACA related insurance
provisions
Key Rural Regulatory Issues
Regulation Proposed Pub. Date Eff. Date
Inpatient Prospective Payment System April August October
Outpatient Prospective Payment System July November January
Skilled Nursing Facility Prospective Payment System
April July October
Home Health Prospective Payment System
May September October
Inpatient Rehabilitation Facilities April August October
Inpatient Psychiatric Facility Prospective Payment System
January March July
Physician Fee-Schedule July November January
RHCs & FQHCs N/A N/A N/A
Hospice N/A N/A N/A
Rural-Relevant Medicare Regulations
This is not an official calendar endorsed by CMS.
ORHP Policy Focus for 2014-2015
Health Insurance Marketplaces and State Medicaid expansionsACA Outreach, Education, and EnrollmentQuality
Rural hospitals – Partnership for Patients, VBP, etc. CAHs - MBQIP RHCs – quality measures cohort
Outpatient Supervision at rural PPS and CAHsStage 2 MU implementation and Stage 3 planningPrimary care accessRural and Frontier DemonstrationsRHSATAWhite House Rural Council activities
The White House Rural Council
Created by Executive Order June 9, 2011
HHS Policy Ideas• Expand NHSC to CAHs
• Expand Health IT Funding
• Reduce Regulatory Burden
National Advisory Committee on Rural Health and Human Services
• Advises the HHS Secretary on Rural Issues
• Policy Briefs on Current Issues
• Rural Site Visits
http://www.hrsa.gov/advisorycommittees/rural/
Affordable Care Act Update
ACA Outreach and Enrollment
CMS Outreach and Education Websitehttp://www.cms.gov/Outreach-and-Education/Outreach-and-Education.html
ORHP ACA Office HoursWednesdays, 3-4 pm EasternCall-in Number: (800) 857-3749 Passcode: ORHPACAAdobe Connect Session: https://hrsa.connectsolutions.com/orh1/
E-mail name and organization to [email protected] to join the listserv
Archive of prior calls: http://www.hrsa.gov/ruralhealth/affordablecareact/index.html
ACA rural fact sheet: http://www.hhs.gov/healthcare/facts/factsheets/2013/09/rural09202013.html
2014-2015 Enrollment
Special enrollment opportunities: https://www.healthcare.gov/how-can-i-get-coverage-outside-of-open-
enrollment/special-enrollment-period/
2015 Open Enrollment begins November 15 Shorter, 3-month period CMS recently issued regulations about continuation coverage and eligibility
redeterminations
ACA Coverage to Care
If you’re a provider, staff, or someone helping people who are new to insurance, there are a few resources to address topics such as: What it means to have health insurance How to find a provider When and where to seek health services Why prevention is important
Resources: http://marketplace.cms.gov/help-us/c2c.html A Roadmap to Better Care and Healthier You
http://marketplace.cms.gov/help-us/c2c-roadmap.pdf
Discussion Guides for Community Partners Your Roadmap to Health (poster) Provider Newsletter
Resources
Policy Resources
Rural Assistance Center• One stop shopping for all rural health and human services• www.raconline.org
Rural Health Research Gateway Access to all RHRC products on a range of rural health topics
www.ruralhealthresearch.org
Medicare www.cms.gov/Medicare/Medicare.html Rural Providers Resource Guide:
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Rural-Health-Suite-ICN908465.pdf
Policy Resources
Legislation and statutes http://thomas.loc.gov/
Social Security Act compilation (Medicare and Medicaid are Titles XVIII and XIX) http://www.ssa.gov/OP_Home/ssact/comp-ssa.htm
Code of Federal Regulations -- Public Health (HHS) -- Title 42• http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?
sid=1ea2f8fcbc9a2ec1c2b44ef1c2374ab0&c=ecfr&tpl=/ecfrbrowse/Title42/42tab_02.tpl
Federal Register https://www.federalregister.gov/
CMS interpretive guidelines (or state operations manuals) http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/index.html?
redirect=/Manuals/
CMS Rural Resources
• CMS Regional Office Rural Liaisonshttps://www.cms.gov/ProspMedicareFeeSvcPmtGen/downloads/RO-RH-Coordinators.pdf
• CMS Rural Open Door Forum- Sign up at:http://www.cms.hhs.gov/OpenDoorForums
• CMS National Provider Callshttp://www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Calls-and-Events.html
• CMS Rural Health Clinics Centerhttp://www.cms.hhs.gov/center/rural.asp
Key CMS Rural Resources
A Few Key Websites
www.healthcare.govwww.cms.gov
http://aspe.hhs.gov www.kff.org
www.nashp.orgwww.commonwealthfund.org
Questions?