Transcript Title

Hospital State Division
Kristi Martinsen
Hospital State Division Director
HSD Overview
September 2013
Department of Health and Human Services
Health Resources and Services Administration
Office of Rural Health Policy
Hospital State Division - Regional Liaisons
Jeanene Meyers
Natassja Manzanero
Dan Mareck
Keith Midberry
David Dietz
Megan Meacham
E
A
C
B
Bridget Ware
Sarah Young
D
Steve Hirsch
Hospital State Division
Collaborative Partnership
ORHP Project
Officers
Grantees
TA Partners
(NOSORH,
TASC, FMT)
Office of Rural Health Policy (ORHP) Activities
Improving Rural Health Initiative
“Within the total amount
requested for Rural Health
Activities, the Budget includes
$79 million to continue the
President’s initiative to improve
rural health. The goal of this
initiative is to improve the
access to and quality of health
care in rural areas.”
Office of Rural Health Policy (ORHP) Activities
Improving Rural Health Initiative: Key Elements
• Building a Programmatic “Evidence Base”
• Health Workforce Recruitment & Retention
• Telehealth/ HIT Coordination
• Cross Governmental Collaboration
Hospital State Division (HSD)
Overview
Focus
Programs
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Measuring and Improving Outcomes
Using and Sharing the Program Data
Collaborating and Sharing Best
Practices
Aligning Programs to the Health Care
Environment
Program Integrity
•
Grants
• State Offices of Rural Health
(SORH)
• Medicare Rural Hospital
Flexibility Program (FLEX)
• Small Hospital Improvement
Program (SHIP)
Initiatives
• Flex Medicare Beneficiary
Quality Improvement Project
(MBQIP)
• Delta Rural Hospital
Performance Improvement
Project (RHPI)
Hospital State Division (HSD)
Grants: State Offices of Rural Health (SORH)
Purpose
Awards
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State / Federal partnership
• assist States in strengthening rural
health care delivery systems
Establish & maintain clearinghouse
Coordinate activities within state to
avoid duplication of effort & activities.
Provide technical assistance
Encourage recruitment & retention of
health professionals
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FY 13 grant guidance competitive
• New 3 year project period
Submit via Grants.gov
Focus on key SORH activities for all 50
states
Hospital State Division (HSD)
SORH Grant TA Partners
• National Organization of State Offices of Rural
Health
•
Provide education, resources and TA to State SORH
Programs
• http://www.nosorh.org
Hospital State Division (HSD)
Grants: Outcomes Focus – Quality and Performance Improvement
Grantee (State) Process
Need
Assessment
Activities
Measures
Outcomes
Hospital
Level
State
Program
Level
National
Program
Level
Determine
Effective
Interventions
Refine Flex
Program
Activities
Program (National) Context
Hospital State Division (HSD)
Grants: Small Rural Hospital Improvement Program (SHIP)
Purpose
Awards
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Encouraging Networking
Strategically Using Grant Dollars
Updated SHIP Categories Aligned to
Affordable Care Act
ICD 10 Updates:
http://www.cms.gov/ICD10/
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Competitive in FY 13: Awards
coming out any day for 9/1 start date
**In 2016 will change to a 6/1 start
date
Anticipated amount of award: ~
$8800 per hospital
FY13 SHIP Focus:
• MBQIP Activities (Inpatient and
HCAHPS)
• ICD-10
• Innovations group for health IT
projects and community-based
interventions
Hospital State Division (HSD)
SHIP Grant TA Partners
• Technical Assistance and Services Center
•
Provide education, resources and TA to State SHIP
Programs
• http://www.ruralcenter.org/tasc
Hospital State Division (HSD)
Grants: Medicare Rural Hospital Flexibility Program (FLEX)
• Four Core Focus Areas:
• Support for Quality Improvement in CAHs
• Support for Operational & Financial Improvement in CAHs
• Support for Health System Development and Community Engagement
• Including integrating EMS in regional and local systems of care
• Designation of CAHs in the State
Flex In Motion
Need
Outcomes
Measures
Assessment
Activities
Hospital State Division (HSD)
Flex Grant TA Partners
• Technical Assistance and Services Center
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Provide education, resources and TA to State Flex
Programs and CAHs
• http://www.ruralcenter.org/tasc
• Flex Monitoring Team
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CAH Financial Indicator Reports
State Hospital Compare & Quality Measure Reports
Other briefs & reports yearly on quality, finance, and
community engagement
• www.flexmonitoring.org
Medicare Beneficiary Quality Improvement Project (MBQIP)
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Pilot project focusing upon quality improvement and
data reporting
Common clinical and process metrics (i.e., syncing
with NQF and Hospital Compare)
Measuring outcomes and demonstrating
improvements via evidence-based practices
Sharing evidence-based practices
http://www.hrsa.gov/ruralhealth/about/video/index.html
Hospital State Division (HSD)
Medicare Beneficiary Quality Improvement Project (MBQIP)
Total CAHs
1331
CAHs
participating
1226
% participation
92%
• Reporting on Rural-Relevant and Common National
Measures
• Measuring Outcomes and Demonstrating
Improvements
• Sharing Best Practices
Goal:
100%
Hospital State Division (HSD)
Medicare Beneficiary Quality Improvement Project (MBQIP)
Phase 1 Measures
(Begin September 2011)
Phase 2 Measures
(Begin September 2012)
Phase 3 Measures*
(Begin September 2013)
• Pneumonia: Hospital Compare CMS Core Measure (participate
in all sub-measures); AND
• Congestive Heart Failure: Hospital Compare CMS Core
Measure (participate in all sub-measures)
• Outpatient 1-7: Hospital Compare CMS Measure (all submeasures that apply); AND
• Hospital Consumer Assessment of Healthcare Providers and
Systems (HCAHPS)
• Pharmacist CPOE/Verification of Medication Orders Within 24
Hours; AND
• Outpatient Emergency Department Transfer Communication
• *Reporting tool for Phase 3 Measures is yet to be determined
http://www.hrsa.gov/ruralhealth/about/video/index.html
Health Reform Initiatives
Partnership for Patients
• Reduce harm caused to patients in hospitals.
We will accelerate the reduction of preventable harms to inpatients starting now, so that
by the end of 2013 we will observe a 40% reduction in preventable harm compared to
2010. Based on our calculations, this would mean almost two million fewer injuries to
patients and more than 60,000 lives saved.
• Reduce preventable hospital readmissions.
We will advance efforts to decrease preventable hospital readmissions within 30 days of
discharge, so that by 2013 all readmissions would be reduced by 20% compared to
2010. This would mean prevention of more than 1,600,000 hospital readmissions.
Achieving these two goals will not only save lives and greatly reduce injuries to millions of
Americans, it will also result in savings of billions of dollars that help put the nation on
the path to having a more sustainable health care system.
White House Rural Council
Expand NHSC to CAHs
• Began in 2012
• 15 clinicians receiving
repayment (July)
• 34 clinicians applied
for repayment (July)
Promote HIT in Rural
Areas
• Collaboration with
USDA
• Access to Capital
• Rural HIT Workforce
Training
• www.raconline.org/hit/
Office of Rural Health Policy (ORHP) Activities
White House Rural Council
• Access to Capital Workgroup
• August 2012
• Brought together federal partners and rural
stakeholders to discuss challenges and
opportunities
• Upcoming resource guide for SORHs and
rural hospitals on capital resources
Resources
Workforce: Linking Rural Health Care Providers to the Federal
Workforce Programs
• HRSA Programs such as...
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National Health Service Corps
Nursing Loan Repayment
Primary Care Training
Nursing Education
• Key Challenge: Linking
Providers & Educational
Institutions
• http://www.hrsa.gov/ruralhealth/
pdf/ruralhealthfundingguidance.
pdf
ORHP Affordable Care Act Activities
•Weekly Office Hour Calls
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Wednesdays, 3-4 pm Eastern Time
Call-in Number: (800) 857-3749; Passcode: ORHPACA
Adobe Connect Session: https://hrsa.connectsolutions.com/orh1/
6/13 Topic: ACA 101
6/27 Topic: ACA Medicaid Expansion 101
7/10 Topic: Consumer Assistance
7/17 Topic: SHOPs, Tax Credits/Subsidies, and the Unbanked Population
7/24 Topic: Minimum Coverage Provision, Exemptions, Subsidies and Dual
Eligibles
7/31 Topic: Consumer Assistance
•Questions and Distribution List
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[email protected]: Email this address with any questions and if you want to
be added to the ORHP distribution list for emails on resources and call information
What rural providers need to know about the
Health Insurance Marketplaces:
STEP
1:
STEP
2:
How many uninsured
individuals are in
your area?
What kind of
Marketplace does
your state have?
Ask Insurance Commissioners/Marketplace which
Qualified Health Plans (QHP) are participating.
STEP
3:
Begin
negotiating
contracts with
QHPs.
STEP
4:
Talk to your
patients about
their eligibility
and enrollment
options.
Educate QHPs
about your role
in rural
communities.
Inform QHPs if
you are an
Essential
Community
Provider.
Refer patients
to
Healthcare.gov.
Refer patients
to Consumer
Assistance
Programs in
your state.
Contact Information
Kristi Martinsen
Hospital State Division Director
301-594-4438
[email protected]
www.hrsa.gov/ruralhealth