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TRANSCRIPT
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Paul Moore, DPhSenior Health Policy Advisor
Federal Office of Rural Health Policy Health Resources and Services Administration
Federal Office of Rural Health PolicyJune 9, 2016
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Improve Access to
Quality Health Care and Services
Strengthen the Health
Workforce
Build Healthy Communities
Improve Health Equity
Strengthen HRSA Program
Management & Operations
HRSA Strategic Goals
Build Healthy Rural
Communities
Policy & Research
Community Based Programs
TelehealthPrograms
State & Hospital
Programs ValuesAccountable Knowledgeable Collaborative RespectfulInnovative Responsive
MissionFORHP collaborates with rural communities and partners to support programs and shape policy that will improve health in rural America.
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State Offices of Rural
Health Grants
Rural Health Care Delta Program
Radiation Exposure
Screening and Education
Program (RESEP)
Flex Funding
SHIP Grants
MBQIP Rural Health Information Technology
Network Development
GrantsRHC Specific
Quality Measure Set
Network Planning Grants
Network Development
Grants
TCPI
MIPS
DSRAPMs
Small Provider Quality
Improvement Program
Rural Health
Workforce Development Grants
Black
Lung/Coal Miner Clinics
Program
Rural Health Care Services Outreach Grant
OATEvidence-based Tele-emergency grant program
Telehealth Network
Grant Program
ImprovedPopulation
Health
FORHP Programs and Grants
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Key Considerations for Rural Health
Legislation moving toward value has
emphasized standard payment
The Rural Safety Net
CAH Cost-Based Reimbursement
Rural Health Clinic and FQHC
Payment
Swing Bed Payment
Method II Billing
Traditional Medicare
DRGs
Physician Fee Schedule
Medicare DSH
Medicare GME
Unique rural payment
methodologies not often included
in quality reporting
requirements
Are the rural payment protections a dividing line?
A Transitioning Landscape Toward Value
• Potential Alignment with Rural Health• Transforming Clinical
Practice Initiative
• Health Learning Action Network
• ACO Investment Model (AIM)
• Global Budgeting RFI• MACRA TA• Chronic Disease Campaign
Delivery System Reform Support Declining Rural Life Expectancy
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Source: Singh GK, Siahpush M. American Journal of Preventive Medicine. 2014;46(2):e19-e29 (updated data)
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1969-1971 1975-1977 1981-1983 1987-1989 1993-1995 1999-2001 2005-2009
Metro, Both Sexes Non-Metro, Both Sexes
Metro Males Non-Metro, Males
Metro, Females Non-Metro, Females
Findings from the 2016 RWJ County Health Rankings
Drug-related deaths 45% higher in rural
Rural communities have a history of substance abuse
• Rural has greater prevalence of risk factors and fewer options for treatment.
Rural residents are most likely to be prescribed opioid painkillers
Though opioid abuse and opioid-related death has been on the rise nationally, rural communities are disproportionately affected.
Opioid Use Disorder
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January 2005 to February 2016, 110 rural hospitals have closed
2005 – 2016 Was the Western Region the front edge?
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Articles
• Improving Quality
• Improving Finances
• Strengthening Health
Systems
FORHP Assisting Hospitals
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Assisting Critical Access Hospitals - Data
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FORHP ProgramsBlack Lung Clinics Program’s (BL) Miners Colfax Medical Center (MCMC) serves coal miners across the state of New Mexico
Radiation Exposure Screening & Education Program’s (RESEP) University of New Mexico (UNM) Health Sciences Center serves New Mexico’s former Uranium Miner populations
InnovationCreation of a “one stop shop” for miners for 20 sites across New Mexico through a collaborative approach using telemedicine, MCM’s mobile unit and UNM’s specialty provider
Outcomes• Videoconferencing technology enables miners to interact directly
with pulmonologist, which increases access to specialty care• 6,685 eligible miners screened using this method from 1989-2014• 100% patients rated their services as good or very good (2015-
2016)• 45% of patients at last four clinics were returning patients (11/2015-
3/2016)• Addresses transportation barriers and service delivery challenges
Grants in Motion….ting to
• Community Health
• Supporting Rural Hospitals
• Leveraging Telehealth
Investing in Rural Communities
• Increasing Interest and Attention
• Integrating the Technology into the Broader Value Discussion
• Informing the Policy Discussion
Telehealth
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http://www.telehealthresourcecenter.org22
• Serving as a Voice …
• Technical Assistance
• Focus on Partnerships• NOSORH
• State Offices of Rural Health
• National and State Associations
Policy & Research
http://www.ruralhealthresearch.org/
Policy & Research
• ORHP funded through the National
Association of Rural Health Clinics
• Listserv
o Exchange info, ask questions
o Sign up at http://03672e4.netsolhost.com/?page_id=712
• Conference Calls
o 6 per year on range of topics
o Sign up and review previous calls at http://www.hrsa.gov/ruralhealth/policy/confcall/index.html
Rural Health ClinicTechnical Assistance Series
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https://nosorh.org/nosorh-members/nosorh-members-browse-by-statee/
• Source for information on rural health issues and resources from state and federal level
• Provide technical assistance to rural communities.
• Encourage recruitment and retention of health professionals in rural areas.
• Coordinate activities within the state to avoid duplication of effort and activities.
State Offices of Rural Health
http://www.hrsa.gov/advisorycommittees/rural/publications/index.html
Health Challenges Moving Beyond the Clinical
To sign up: Email Michelle Daniels at:[email protected]
Sign up for our Weekly Announcements …
• Rural-focused Funding opportunities
• Rural Research findings
• Policy updates from a Rural Perspective
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Paul Moore, DPh
Senior Health Policy Advisor
Federal Office of Rural Health Policy (FORHP)Health Resources and Services Administration (HRSA)
Email: [email protected]
Phone: (301) 443-1271
Web: hrsa.gov/ruralhealth/
Twitter: twitter.com/HRSAgov
Facebook: facebook.com/HHS.HRSA
Contact Information