RuralHealthValue.org

Understanding and Facilitating Rural Health Transformation

News

  • CPC+ Round Two Participant Applications Open for Four New Regions

    June 1, 2017

    On May 17, 2017, CMS announced four new regions for Comprehensive Primary Care Plus (CPC+) and opened the application process to primary care practices in those regions. Along with the Greater Buffalo metropolitan area of New York, the Round 2 regions include Louisiana, Nebraska, and North Dakota, opening participation to rural PCPs in those states. CMS will select up to 1,000 providers in these regions and practices operating in Round 1 regions are not eligible. Eligible practices located in these regions may apply via online portal through July 13, 2017. More...

  • State Telehealth Laws and Reimbursement Policies

    April 2017

    The Center for Connected Health Policy's (CCHP) newly released report is the most comprehensive report on state telehealth laws, regulations, and Medicaid policies available. It contains the most current and up-to-date telehealth information for all 50 states and the District of Columbia. CCHP has identified several telehealth trends. For example,

    • Reimbursement for store-and-forward and remote patient monitoring continues to increase slowly, yet remains significantly lower than for live video.
    • Restrictions requiring that a patient live in a rural area to receive services are being eliminated.
    • The patient’s home is increasingly eligible as an originating site.
    • Reimbursement for certain specialties, including tele-dentistry and physical/occupational therapy, is expanding. More...

  • CMS Awards $347M for Patient Safety

    September 30, 2016

    CMS recently awarded $347 Million to 16 organizations across the United States that are dedicated to increasing patient safety through Healthcare Engagement Networks (HENs). In order to supplement the already existing HENs, CMS has developed Hospital Improvement and Innovation Networks (HIINs) to motivate facilities to create new, innovative initiatives to achieve a 20 percent reduction in overall incident volumes, and a 12 percent reduction in 30-day readmission rates by 2019. During the baseline years from 2010-2014, over 2 million patient accidents were avoided and $20 billion was saved due to collaboration across metro and rural facilities. Over half of the 16 recognized organizations have identified rural communities and institutions as partners in the journey to advance patient safety across identified metrics. CMS is currently developing an interactive map and comprehensive list of all affiliated members that will be published online in the coming months. More...

  • Population Health Strategies of Critical Access Hospitals

    September 12, 2016

    Hospitals and health systems are increasingly embracing population health strategies as they move toward accountable care models of health care delivery and financing and seek to demonstrate accountability to local stakeholders. The Flex Monitoring Team has just released a full-length briefing paper examining the population health strategies of eight CAHs that have made substantial commitments to population health and community health improvement. More...

  • CPC+ & MSSP ACOs Policy Change

    May 27, 2016

    Since the announcement of Comprehensive Primary Care Plus (CPC+) in April, CMS has received feedback from a variety of stakeholders expressing interest in the dual participation of primary care practices in both an ACO and in CPC+. CMS will now offer the opportunity for up to 1,500 eligible primary care practices currently participating or applying for participation in Tracks 1, 2, or 3 of the Medicare Shared Savings Program (MSSP) as of January 1, 2017, to also participate in CPC+. More...

  • Rural Services Integration Toolkit

    March 15, 2016

    This toolkit identifies evidence-based and promising models and resources that will benefit rural communities seeking to implement health and human services integration programs. The toolkit is made up of several modules. Each concentrates on different aspects of services integration programs. Modules also include resources for you to use in developing a program for your area. More...

  • Back From The Brink, A Rural Texas Hospital Shines

    March 11, 2016

    Investing in healthcare value pays off. After experiencing a clinical tragedy that might have closed the already financially distressed rural hospital, hospital leadership committed (financially and operationally) to a "fervent and never-ending focus on improving patient care." Strategies included a Toyota-like focus on efficiency and a Ritz Carlton-like focus on customer service. More...

  • Rural Hospitals Embrace Population Health in Quest for Relevance

    March 4, 2016

    As rural hospitals in the U.S. try to come up with new ways of changing with the imminent shift to value, administrators in North Carolina are no exception. These administrators are preparing for the future and have determined that in order to establish a population health-based plan they need to focus on factors such as health literacy and behavioral healthcare. Additionally aligning with groups like The Duke Endowment in hopes of improving rural health initiatives and population health-based outcomes. More...

  • How to Create Care and Payment Models to Achieve the Triple Aim

    February 23, 2016

    The American Hospital Association has studied new care delivery systems and innovative payment models to transform health care. In January, the AHA released a report, "Care and Payment Models to Achieve the Triple Aim." This report covers how hospitals and health care systems can develop new care delivery and payment methods that meet the needs of their organizations and communities. More...

  • Physician Engagement - A Primer for Healthcare Leaders

    February 16, 2016

    For successful rural hospital volume to value transformation, engaging physicians (and other providers) will be essential. The Rural Health Value team has just released new physician engagement resources. Physician Engagement - A Primer for Healthcare Leaders highlights the importance of physician engagement and describes strategies to build effective physician relationships and trust. The primer also includes links to additional physician engagement information. More...

  • PCMH Improves Quality, Reduces Cost

    February 16, 2016

    A recently published report found that advanced primary care practices built on the principles of the patient-centered medical home improve quality and reduce the cost of health care. A blog post by the AAFP Senior Vice President for Advocacy, Practice Advancement and Policy has the details. More...

  • Rural family physicians can apply for grants to improve patient health

    February 15, 2016

    The Health Resources and Services Administration is accepting applications for the Small Health Care Provider Quality Improvement Program, which will provide up to 21 recipients with as much as $200,000 each year for three years. The grants, which are open to those working in public or nonprofit settings, will go to rural family physicians and other clinicians and health care facilities to put toward efforts to improve overall patient health and decrease chronic disease-related hospital emergency department visits. The AAFP National Research Network will help family physicians with the application process. More...

  • 2015 Value-Based Payment Study

    January 5, 2016

    A national study of value based payment for care provided by family physicians conducted by the American Academy of Family Physicians and Humana, Inc. found that 33 percent of the 626 family physicians surveyed were actively pursuing VBP. Study results include information about current status, strategy, or motivations regarding VBP, the distribution of payments within practices, and availability of VBP models. Given the role of family physicians in providing care in rural communities, results of this national study help us understand the evolution of VBP in rural places. A Data Brief with study results is available from this site. More...

  • Toolkit to Provide Technical Assistance for Rural Providers is Now Available

    October 2, 2015

    The National Center for Frontier Communities has made a toolkit available for download which provides information on best practices in technical assistance for rural-based providers. The toolkit is designed to help providers during this time of health care transformation. The free manual consists of three sections including 11 modules that address several transformation issues, including working with IT systems and improving care quality. More...

  • Trinity Health Makes Large Investment with Aim to Reduce Major Health Risk Factors

    November 19, 2015

    Michigan-based Trinity Health is investing roughly $80 million over the next five years in programs to improve the health of the communities they serve. The programs funded will take aim at reducing major health risk factors such as obesity and smoking rates. Through collaborations with a number of organizations, Trinity Health plans to work towards reducing health care costs by focusing on the root causes of poor health conditions and by training Community Health Coordinators to help individuals obtain the right care and resources. More...

  • Health System to Offer Refunds Based on Patient Satisfaction

    November 9, 2015

    Pennsylvania based Geisinger Health System is planning to offer refunds to patients based on how satisfied they are with their hospital visits. The CEO, Dr. David Feinberg, has announced that through the use of a smartphone app patients can submit their satisfaction scores and request anywhere from $100 to $2000 for reimbursement. The app is called Geisinger ProvenExperience and the goal is to address problems raised through this input to improve care for future patients. More...

  • Critical Access Hospital Financial Pro Forma

    October 20, 2015

    To help illustrate the imperative for incorporating value-based strategies into strategic discussions and plans, the Rural Health Value team has released a new Excel-based financial modeling tool that allows rural hospitals to explore long term financial projections under the current FFS/cost-based reimbursement systems. More...

  • CAH Operating as a Pay-For-Performance Hospital

    September 16, 2015

    A small CAH in Illinois is seeking to behave like a pay-for-performance hospital. By focusing on quality outcomes and reducing readmission's this hospital is seeking to avoid any Medicare penalties and be in the bonus/earn-back pool they would be subject to if they were not a CAH. This hospital has focused on CMS guidelines and for 29 months straight have recorded perfect core measure compliance. More...

  • The Rural Emergency Acute Care Hospital (REACH) Act

    April 15, 2015

    Senator Grassley (R-Iowa) has introduced Senate Bill 1648 – the Rural Emergency Acute Care Hospital (REACH) Act. The REACH Act would establish a new Medicare payment designation, the Rural Emergency Hospital to sustain emergency services in rural communities.

    • Critical Access Hospitals and rural hospitals with 50 beds or less as of December 31, 2014 would be eligible to become Rural Emergency Hospitals (this includes facilities as described that have closed within 5 years prior to enactment).
    • The Emergency Hospital would not operate any inpatient acute care beds.
    • The Emergency Hospital would have to:
      • Provide emergency medical care and observation care (not to exceed an annual average of 24 hours or greater than 1 midnight), 24 hours a day, 7 days a week by on-site staff.
      • Have protocols in place for the timely transfer of patients who require a higher level of care or inpatient admission.
    • The Medicare payment rate for services furnished at a Rural Emergency Hospital (both emergency care and outpatient services) would be 110% of reasonable cost.
    • In addition to emergency care, Rural Emergency Hospitals could provide other medical services including (but not limited to): observation care, skilled nursing facility care, infusion services, hemodialysis, home health, hospice, nursing home care, population health, and telemedicine services. More...

  • Rural Taxonomy of Population and Health-Resource Characteristics

    April 15, 2015

    The Rural Health Value team has developed a rural taxonomy of community population and health-resource characteristics to provide a systematic tool for classifying and identifying similar rural communities and places. The classification tool can be utilized by policy makers and rural communities to assess the community’s own profile, identify similar communities, and develop strategies for improving health and health care using a comparative framework. More...

  • Using a Strategic Cycling Process to Increase Organizational Effectiveness

    February 12, 2015

    Strategic cycling is an effective technique to ensure that your strategy adapts to a changing environment, focuses on what is important, and remains effective over time. Successful healthcare organizations will steer a consistent course and prioritize performance improvement in response to the external cacophony. With a few exceptions, you can accomplish strategic cycling fairly rapidly, especially after the first cycle. The eight steps of strategic cycling and examples of each are outlined in this RuralHealthValue document. More...

  • Rural Hospitals Adapting to Reform

    January 15, 2015

    Some small and rural hospitals are exploring innovative ways to respond to new health care imperatives. In a video, Hospitals and Health Networks Daily previews their January cover story on rural hospitals, as well as a look at how states are advancing risk-based payment reform. More...

  • Rural Hospitals Innovate to Meet New Health Care Challenges

    January 13, 2015

    Hospitals and Health Networks Daily describes how size and agility can be advantageous in meeting new health care demands and payment models. Nevertheless, some rural hospitals worry about their ability to remain independent. More...

  • New ACO Investment Model

    October 16, 2014

    The Centers for Medicare & Medicaid Services (CMS) announced the availability of a new initiative for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. The ACO Investment Model is a new model of pre-paid shared savings that builds on the experience with the Advance Payment Model to encourage new ACOs to form in rural and underserved areas and current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk. The new ACO Investment Model will provide up to $114 million in upfront investments for up to 75 ACOs across the country. More...

  • Get Involved: NQF Multistakeholder Committee for Performance Measurement Issues for Rural and Low-Volume Providers

    October 10, 2014

    In the wake of the Affordable Care Act's implementation of CMS pay-for-performance programs, rural and low-income providers are failing to integrate these new changes into their own system. To do so would require a better means of measure for issues such as low payment volume and scarcity of resources. As a stakeholder, you have the opportunity to help improve performance measures necessary for rural provider integration. The National Quality Forum is accepting nominations through October 27th to become a member of their multistakeholder committee, which will brainstorm rural-relevant recommendations for the Department of Health and Human Services during a series of public web meetings and a 2-day in-person meeting in Washington, DC. A public comment period in 2015 will provide another opportunity to offer input. More...

  • Recommendations from the CCHP Telehealth and the Triple Aim Project: Advancing Telehealth Knowledge and Practice

    October 9, 2014

    The Center for Connected Health Policy (CCHP) has released the report Telehealth and the Triple Aim project: Advancing Telehealth Knowledge and Practice. The report discusses the significance of telehealth and the benefits of incorporating its practice in modern healthcare. It particularly focuses on how telehealth fits in the Triple Aim objectives of health reform, both currently and looking to the future. Even though telehealth is still a new addition to the field, the idea of remote care is gaining significant popularity in a time of changes and opportunities and is of particular interest to a rural setting. More...

  • Qualitative exploration of rural focus group members' participation in the Chronic Disease Self-Management Program, USA

    October 8, 2014

    Nearly half of rural residents in the USA have at least one chronic condition, and meeting the complex needs of these individuals has become a challenge for the current healthcare system. The purpose of this qualitative, exploratory study is to explore the benefits perceived by rural residents due to their participation in six weekly group sessions, which are referred to as the Chronic Disease Self-Management Program (CDSMP). This article demonstrates the value of rural CDSMPs and can support rural health planners wishing to implement a CDSMP. More...

  • New Resource Highlights Evidence-based Community Interventions

    August 18, 2014

    Community Health Advisor is a new online resource with detailed information about evidence-based policies and programs to reduce tobacco use and increase physical activity in communities. The site includes an interactive tool that generates estimates of health and cost impact of implementing community interventions. Data can be viewed by national, state and county levels, as well as demographic groups based on sex, age and race/ethnicity. Communities can find recommendations and evidence from the Community Preventive Services Task Force and information to help estimate the cost of implementing interventions in their own communities. More...

  • Health Care Innovation Awards Round Two

    July 9, 2014

    The Center for Medicare and Medicaid Innovation (CMMI), Centers for Medicare and Medicaid Services (CMS) has announced the second round of awards for "Initiatives to Accelerate the Development and Testing of New Payment and Service Delivery Models." More...

    A number of projects will be implementing innovations in rural places. More...

  • Facilitating the Formation of Accountable Care Organizations in Rural Areas

    July 16, 2014

    Interviews with the leadership of four rural Medicare ACOs and representatives of key stakeholder groups (including board members, physicians, and information technology managers) pointed to four organizational characteristics that are instrumental in the formation of ACOs in rural areas. These findings can help rural providers interested in forming or participating in an ACO assess the status and potential gaps of their core structures and capabilities. More...

  • Frontline Innovators on Providing Patient- and Family-Centered Care

    May 21, 2014

    AHRQ has released a new video series featuring three profiles of health care professionals sharing stories about how they are working in partnership with patients and families to improve the quality of health care services delivered at their facilities. The series identifies patient and family focused strategies to improving care delivery. Although the three brief stories highlighted represent larger health care systems, they can be used to gather ideas and/or generate discussion among leaders and staff in rural provider organizations regarding opportunities to engage patients and families in their care. More...

  • The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A Second Look

    April 28, 2014

    Implementation of the Patient Protection and Affordable Care Act (ACA) of 2010 contributes to re-shaping the health care delivery landscape, particularly in rural areas. This RUPRI Health Panel document reexamines the ACA in three aspects: 1) Significant Rural Provisions/Highlights, 2) Looking Back: ACA Implementation Impact through 2013, and 3) Looking Ahead: Implementation Issues for Rural Providers and Beneficiaries. More...

  • In healthcare, what makes Maine different?

    March 19, 2014

    Northern Maine, a very poor and rural region of the country, is ranked among the healthiest places in the country. A new coordinated care model that integrates businesses with health care providers has created an interpersonal, data-driven system that has significantly improved community health outcomes. Maine providers utilize a highly advanced data system that identifies and tracks patients who may need extra attention within the region's hospitals, which reduces errors and over-testing. More...

  • Washington State highlights rural innovation with Essential Care, Everywhere campaign

    March 12, 2014

    Hospitals across Washington State are innovating to meet the changing needs of their communities. The Washington Hospital Association is committed to sharing the stories of these organizations striving to find solutions to sustain health care access to rural Washington. To share those stories they have developed brief videos highlighting the innovative solutions being implemented in rural Washington to improve access and quality of care. More...

  • Federal Office of Rural Health Policy Announces New Funding Opportunities

    February 28, 2014

    The Federal Office of Rural Health Policy has announced several new funding opportunities available through HRSA programs. Opportunities include Healthy Start and the State Loan Repayment Program (SLRP). The Healthy Start initiatives focus on improving perinatal care outcomes in rural communities, and the SLRP provides assistance to states in operating state educational loan repayment programs for primary care providers working in Health Professional Shortage Areas. More...

  • Rural Care Coordination Toolkit

    February 2, 2014

    The Rural Assistance Center and NORC Walsh Center for Rural Health Analysis developed this toolkit to help rural communities identify and implement a care coordination program. Developed by NORC on behalf of the Federal Office of Rural Health Policy (ORHP), the toolkit contains resources to help communities develop care coordination programs by building on best practices of successful care coordination program models. More...

  • Health IT and Rural Healthcare: Embracing Opportunities and Overcoming Challenges

    January 2, 2014

    The Healthcare Information and Management Systems Society (HIMSS) will be offering a pre-conference symposium at their 2014 Annual Meeting in late February. This pre-conference symposium will bring together policymakers, researchers and healthcare organizations to provide an overview of available programs, tools and best practices that rural providers can leverage to adopt and gain value from health IT. More...

  • IMPaCT (Infrastructure for Maintaining Primary Care Transformation)

    December 20, 2013

    The Infrastructure for Maintaining Primary Care Transformation (IMPaCT) project is four cooperative grants to "support model State-level initiatives using primary care extension agents in small and mid-sized independent primary care practices to assist with primary care redesign." One grantee, North Carolina, is spearheading the IMPaCT Learning Community, which has been joined by Montana, West Virginia, Maryland and Idaho. More...

  • Nebraska FPs Betting on Success With Their Own ACO

    December 13, 2013

    Nebraska family docs are betting on success with their own ACO. Nine small, independent family practices have joined forces to form an Advance Payment ACO in the Medicare Shared Savings Program.The ACO received a $400,000 advance payment from Medicare. Medicare will recoup its investment from savings the ACO generates. With no affiliated health system or hospital, the family practices are free to refer to specialists of their choice, those who provide high quality and offer reasonable costs regardless of health system affiliation. More...

  • Selecting an Innovation Strategy

    December 4, 2013

    Health care innovation can improve patient care, reduce cost, and increase market share, among other benefits. Innovation must be achieved through a deliberate strategy based on three criteria: focus area, innovation curve, and internal strategy. More...

  • Health Assessments How-To Guide

    November 27, 2013

    The U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) has released an evidence-based guide designed to assist primary care providers select, adopt, and implement health assessments. The guide includes tools to help clinicians appropriately evaluate a patient's health status and engage the patient in making changes to improve their health. More...

  • Provider Opportunities for Population Health Improvement

    November 5, 2013

    The ACA offers effective health care provider strategies to improve population health outcomes and reduce long-term health care costs. Provider tools and strategies include community transformation grants, partnerships, and community health needs assessments. More...

  • Key Senate, House Committee Chairmen Offer Plan To Fix Medicare Doctor Payments

    October 31, 2013

    Health care financing innovations tend to reward value, not volume. Two prominent Congressional committee chairs suggest a change to Medicare physician payment that freezes fee-for-service physician payments for 10 years, but offers doctors additional pay based on their performance on value-based criteria. More...

  • Independence at Home Demonstration

    October 30, 2013

    The Independence at Home (IAH) Demonstration was designed to test home-based primary care for Medicare fee-for-service (FFS) beneficiaries with multiple chronic illnesses. The IAH Demonstration offers a new model of care delivery designed to increase quality and lower health care costs for individuals with multiple chronic conditions, through highly coordinated care. More...

  • The New Rural: Innovations in Rural Health Award

    September 16, 2013

    The Kate B. Reynolds Charitable Trust has announced "The New Rural: Innovations in Rural Health Award." Open to nonprofit and for-profit organizations and units of local and state government, the $25,000 award recognizes "original, innovative solutions to drive health improvement in rural communities". More...

  • Medical Homes Can Reduce Ambulatory Care-Sensitive Emergency Department Visits

    September 9, 2013

    Early findings from a Commonwealth Fund supported evaluation of a multi-payer medical home among five small, independent practices found a significant reduction (11.6%) in ambulatory care-sensitive emergency department visits. More time is needed to see if early (2 years into the demonstration) trends in overall use of hospitalization continue and become statistically significant. More...

  • Moving the U.S. Health Care System Away from Fee-for-Service Payment

    August 27, 2013

    Fee-for-service payment fails to provide incentives for efficiency or quality and is cited as the source of fragmented care, variable quality, and growing costs in the U.S. health system. In a post to The Commonwealth Fund Blog, Stuart Guterman describes the key elements necessary to move toward alternative payment approaches. More...

  • Rural Health Value website launched

    July 18, 2013

    The Rural Health Value (RHV) project - funded by the Office of Rural Health Policy - just launched its new website RuralHealthValue.org. The RHSATA vision is to help create high performance rural health systems by spreading innovation and providing specific tools and resources that help translate knowledge into local action. More...

  • UnitedHealthcare predicts major increase in value-based payment contracts

    July 10, 2013

    UnitedHealth Group, the nation's largest health insurance company, predicts it will more than double the value of contracts it has with doctors and hospitals based on quality and cost efficiency measures. The insurance company is forecasting a growth in value-based payment contracts from $20 billion annually to $50 billion annually within five years. This projection is a product of the health payment model transitioning from fee-for-service to value-based, and could impact the delivery of care as a result of the insurer's vast size. More...