MHA's Center for Rural Health

AHA submits comments on LTCH interim final rule

The American Hospital Association on June 27 urged the Centers for Medicare & Medicaid Services to update the long-term care hospital prospective payment system rate for 2009 based on the rate that was in effect for nine months of rate year 2008, instead of the 2007 amount the agency proposed in its May 6 interim final rule. In a letter to the agency, the AHA pointed out that while the Medicare, Medicaid and SCHIP Extension Act of 2007 specifically reduced LTCH payments to the 2007 standard rate for discharges occurring between April 1 and June 30, 2008, “it did not in any way refer to payments for discharges occurring during or after rate year 2009, which begins July 1.”

[ via AHA News Now ]

CMS proposes changes to rural health clinic program

The Centers for Medicare & Medicaid Services on June 27 published proposed changes to the conditions of participation requirements and payment provisions for rural health clinics and federally qualified health centers. Under the proposed rule, new and existing RHCs would have to be located in shortage areas, whose designation must be renewed at least every three years.

Existing RHCs that were no longer located in rural or shortage areas as defined by the proposed rule could keep their designation if they met certain criteria. The rule also revises the payment methodology so it is consistent with statutory requirements setting Medicare payment at no more than 80% of reasonable costs, after application of beneficiary co-payments and deductibles.

Further, the rule revises the criteria that allow certain hospital-based RHCs to exceed the per visit payment limit. RHCs also would be required to establish a quality assessment and performance improvement program.

CMS will accept comments on the proposed rule through Aug. 26.

[ via AHA News Now ]

Senate Labor-HHS bill passes out of committee

The Senate Appropriations Committee on June 26 approved a bill specifying discretionary funding for federal health and human services programs for fiscal year 2009. The Labor-HHS spending bill is expected to go to the Senate floor sometime after the Independence Day recess.

Among other allocations, the bill would provide $664.268 million for maternal child health care block grants; $361.6 million for hospital preparedness grants; $310 million for Children’s Hospitals Graduate Medical Education; $167.652 million for nursing workforce development, $51.4 million for rural health outreach grants; $39.2 million for rural FLEX grants, including $15 million for small rural hospital improvement; $9.0 million for rural health research; and $1.46 million for rural access to emergency devices.

[ via AHA News Now ]

Loan Repayment Entices New Recruits

A recent Boston Globe article outlines how student loan repayment programs are having a significant impact on medical staff recruitment.  One community hospital in Massachusetts doubled their expected recruits during their first year to participate.  The repayment program began in 2007 with a $5 million grant from Bank of America, and has staffed 35 physicians and 12 nurse practitioners at 23 health centers. [Read more]

[Via Boston Globe]

We Get Reimbursed for That?

With a high caseload of Medicare patients, critical-access hospitals often need the maximum reimbursement to survive. As it turns out, however, many of these hospitals may be leaving thousands of dollars on the table.

For the full story from HealthLeaders Media, click here.

Study: Spread of model programs could double rural physicians

Six medical school programs that address the shortage of rural physicians could be replicated nationally to double the number of rural physicians over the next decade, concludes a study in the March issue of Academic Medicine. The six programs increased graduates practicing in rural areas by an average 53%.

“If 125 medical schools developed similar programs for 10 students per class, this would result in approximately 11,390 rural physicians during the next decade, more than double the current estimation of rural doctors produced during that time frame,” the authors said.

[ via AHA News Now ]

CMS to allow CAHs to participate in outpatient quality reporting

The Centers for Medicare & Medicaid Services has granted the American Hospital Association’s request to allow critical access hospitals to submit and publicly report outpatient quality data along with other hospitals, according to AHA News Now. More information will be available from CMS later this year, including when CAHs can begin reporting data.

Hospitals participating in Medicare’s outpatient prospective payment system are required to submit data on seven outpatient quality measures to receive a full payment update in FY 2008. The program contractor last month announced that CAHs, which do not participate in the OPPS because they receive cost-based reimbursement, would not be allowed to submit the outpatient measures.

However, AHA urged CMS to let CAHs participate in the quality reporting because of their commitment to public transparency and quality improvement.

AHA urges panel to support data communications standard, rural networks

The American Hospital Association on Jan. 24 urged a Federal Communications Commission advisory committee to recommend that Congress and federal agencies prioritize the establishment of a single standard for health information capture and exchange, and complete the deployment of broadband and wireless networks in rural areas.

In a statement to the Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities, the AHA said, “It is crucial that the JAC recommend policies that will produce a roadmap for the creation of a single standard for the capture and exchange of health care information and completion of the deployment of broadband and wireless networks nationwide. It is also vital that federal policies ensure the interoperability of emergency and medical communications systems and provide for the ongoing maintenance and upgrading of mandated new technology.”

Survey Compares Rural and Urban/Suburban Physicians

The nation's current doctor shortage is most acute in rural America, and an aging U.S. population combined with an increased interest in "quality of life" issues will likely make the situation worse before it gets better, according to representatives from www.LocumTenens.com. The physician recruitment firm recently surveyed doctors to better understand their perceptions of practicing medicine in rural America versus practicing in areas with populations of 50,000 or more.

The survey found that there may be fewer differences, at least clinically, between practicing in rural areas and urban ones than one might think.

For the full story, click here.

AHA urges CMS to include CAHs in outpatient quality reporting

The American Hospital Association on Jan. 11 urged the Centers for Medicare & Medicaid Services to allow critical access hospitals to submit and publicly report outpatient quality data along with other hospitals in fiscal year 2008. Hospitals participating in Medicare’s outpatient prospective payment system are required to submit data on seven outpatient quality measures to receive a full payment update in FY 2008. CAHs qualify for cost-based reimbursement from Medicare and thus do not participate in the program’s prospective payment system.

“While there is no link between payment and the submission of quality data for critical access hospitals, they also would like the opportunity to submit data because of their commitment to public transparency and quality improvement,” the AHA said in a letter to CMS Acting Administrator Kerry Weems. The Florida quality improvement organization chosen by CMS to assist hospitals with outpatient quality reporting recently announced CAHs would not be allowed to submit the outpatient measures.

[ via AHA News Now ]