ISSUES IN RURAL HEALTH PLANNING

WEBINAR 2 THURSDAY, JULY 21, 2011

1:00 – 2:00 PM

UNDERSTAND THE PROS AND CONS OF RURAL HEALTH

CLINICS

Learning Objectives

Understand the role and function of a Rural Health Clinic

Identify the primary benefits of opening a Rural Health Clinic

Learn the process of being certified as a Rural Health Clinic

Explore the downside of opening a Rural Health Clinic

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Definition of a RHC

Established through Public Law 95-210, the Rural Health Clinic Services Act, 1977, to increase the provision of primary care services for Medicare and Medicaid patients residing in rural communities.

RHC can be provider-based or independent (freestanding).

Provider-Based: integral part of a hospital, nursing home, home health agency

Independent: stand alone clinics

Status can be public, private, or not-for-profit

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Requirements for a RHC

Staffed with a mid-level practitioner practicing at least 50% of the time

Provide basic laboratory services

Develop written clinical protocols and operational policies and procedures

Conduct an annual evaluation

Gain certification by Medicare

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RHC Location Requirements

Must be in a Health Professional Shortage Area (HPSA) or Geographic Primary Care or

Must be in a Medically Underserved Area/Population (MUA/P)

Designation must be less than 3 years old

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Benefits of Opening a Rural Health Clinic

Potential of significant higher reimbursement (looking at all payors in the aggregate)

Increased coordination between hospital and physicians

Increased clinical integration with hospital

Greater flexibility in financing and efficiencies with administration and shared staff

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Potential Downsides of Operating a RHC

Increased costs related to hospital wage and benefits

More facility costs

Less effective cost management

Decreased physician control of practice staff

Less control of financial accountability and productivity

Steps Necessary for RHC Certification

Confirm site eligibility Evaluate financial feasibility Assess cost of hiring needed staff Complete a RHC application and a CMS provider

enrollment form Receive RHC certification inspection by ADHS File a CMS cost report to have the Medicare rate

determined

Current RHC Reimbursement Rate ??

Current RHC maximum encounter rate - $78.07

Important Resources

Center for Medicare and Medicaid Web Site: https://www.cms.gov/center/rural.asp

National Association of Rural Health Clinics Web Site: www.narhc.org Listserve:

http://www.narhc.org/members/members_listserve.php

Rural Assistance Center Web Site: www.raconline.org Toll Free #: 1.800.270.1898

Revised Arizona Rural Health Clinic Manual, 2011 (available soon)

Questions + Contacts

Connie Belden, Team Leader, ADHS Licensing Connie.Belden@azdhs.gov

Joyce Hospodar, Rural Health Office hospodar@u.arizona.edu; 520.626.2432

Ron Smith, CFO, Wickenburg Community Hospital Ron.Smith@wickhosp.com; 928.684.5421

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