MHA's Center for Rural Health

GAO: Small, rural hospitals less likely to receive EHR incentive payments

Large and urban hospitals were much more likely than small and rural hospitals to receive a Medicare incentive payment for meaningful use of electronic health records in 2011, the first year of the incentive program, according to a report released July 26 by the Government Accountability Office. Just 16% (761) of the estimated 4,855 eligible hospitals received incentive payments in 2011, which totaled $1.3 billion, GAO found.

Hospitals paid under the inpatient prospective payment system were more than twice as likely as critical access hospitals to receive an incentive payment. Hospitals in the top third in terms of numbers of beds were 2.4 times more likely than hospitals in the bottom third to have been awarded an incentive payment. About two-thirds of hospitals receiving incentive payments were in urban areas.

[ via AHA News Now ]

FCC seeks further comment on proposed rule for rural health care program

The Federal Communications Commission will accept additional comments through Aug. 23 on a 2010 proposed rule to reform its Rural Health Care program, which uses universal service fees to support expanded broadband access in rural areas. The proposed changes seek to make greater use of available funds, which have not historically been fully deployed.

Among other topics, the FCC seeks input on the broadband needs of rural health care providers, including telemedicine, electronic health records and other telehealth applications, such as training. The notice also asks for comments on issues such as inclusion of urban providers and how to structure the permanent program.

Participants in the current pilot program are especially encouraged to comment. The American Hospital Association submitted comments on the initial notice of proposed rulemaking in September 2010.

CMS: Capital leases allowable cost for CAH EHR incentive payments

After extensive meetings and discussions on the issue with the American Hospital Association, the Centers for Medicare & Medicaid Services has agreed to change its policy and to now allow critical access hospitals to include the cost of capital leases for certified electronic health record technology in their Medicare EHR incentive payments.

A capital lease “is essentially the same as a virtual purchase agreement” and “meets the intent of the statute and regulation to qualify the leased asset as a purchased asset,” CMS states in a new Frequently Asked Question on its website. “Therefore, the CAHs’ incentive payment may include the ‘cost’ of such leased asset, which must be based on the fair market value of the asset…at the date the lease was initiated.”

Project expands access to specialty care for veterans

The Department of Veterans Affairs on July 11 launched an initiative to help primary care providers in rural and other areas care for veterans with complex chronic illnesses. The Specialty Care Access Network-Extension for Community Healthcare Outcomes project uses videoconferencing technology to conduct weekly virtual clinics where specialists share their medical knowledge with primary care providers.

Eleven VA medical centers are pilot testing the program for the first nationwide implementation of the Project ECHO model, created by a liver disease specialist at the University of New Mexico Health Sciences Center in Albuquerque. The Robert Wood Johnson Foundation has provided a five-year grant to expand the Project ECHO model across the U.S.

[ via AHA News Now ]