Accountable Care Organization Rules Now Available

The U.S. Department of Health and Human Services (HHS) today released proposed new rules for Accountable Care Organizations (ACOs). According to the HHS press release, ACOs create incentives for health care providers—including doctors, hospitals, and other providers—to work together to treat an individual patient across care settings such as doctor’s offices, hospitals, and long-term care facilities. The Medicare Shared Savings Program will reward ACOs that lower health care costs while meeting performance standards on quality of care and putting patients first.  Patient and provider participation in an ACO is purely voluntary. Read the full rules and get more information. 

CRHC will be working closely with our national partners including the National Rural Health Association and the National Organization of State Offices of Rural Health regarding the implications for rural providers and communities and on public comment. We will keep you informed with information, analysis, and opportunities to weigh in as they become available.

National Quality Strategy Released

The U.S. Department of Health and Human Services (HHS) released the National Strategy for Quality Improvement in Health Care. The strategy is the first effort to create national aims and priorities to guide local, state, and national efforts to improve the quality of health care in the United States. This report describes the initial Strategy and plan for implementation. The Strategy pursues three broad aims: better care, healthy people/healthy communities, and affordable care. Read more. 

Check Out County Health Rankings

The University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation have published online a new set of reports that compare health factors and health outcomes in counties within each state. The rankings use data from vital statistics and government health surveys. Visit the website to learn more and check out information on your county. 

Colorado's Budget Negotiations

Check out an article published today in The Pueblo Chieftain about Colorado’s ongoing budget negotiations. 

Editorial on the ACA and Rural America

Today's Denver Post features an editorial titled "A health care law for rural America" by U.S. Health and Human Services Secretary Kathleen Sebelius and Agriculture Secretary Tom Vilsack about provisions of the Affordable Care Act that assist rural communities.

FY 11-12 Primary Care Fund Update

As reported in earlier posts, the Joint Budget Committee was considering significant cuts to Primary Care Funds, including eliminating the Special Distribution Fund that assisted 16 community-funded safety net clinics and rural health clinics. CRHC, ClinicNET, and many affected clinics worked diligently in recent days to educate JBC members about Colorado's diverse healthcare safety net and the need to support these clinics. Earlier this week, the JBC voted to restore funding for the Special Distribution Fund by $1.7 million and add additional monies to the Health Care Services Fund (for community health centers and other indigent care clinics) for a total of $21.5 million in federal and state funds. While these amounts still represent cuts, the funds provide some relief for these clinics. Please contact Sara for more information and we will post additional updates as the FY11-12 budget negotiations unfold.

Health Insurance Exchange Bill Introduced

On Monday, March 21, Colorado Senator Betty Boyd (D-Lakewood) and Representative Amy Stephens (R-Colorado Springs) introduced the Colorado Health Benefit Exchange Act, SB 11-200. The bill establishes the governing structure of the nonprofit public health insurance exchange, or marketplace where individuals and small businesses can shop for and purchase health insurance. The bill also creates a governing board and a legislative oversight committee. The board will consist of 9 voting members and 3 non-voting ex-officio members, with all voting members needing to have expertise in one of several specified skill sets (including healthcare delivery). Appointments shall be coordinated to provide broad geographic representation. Click here to read the bill.

CRHC is currently reviewing the bill and has not yet taken an official position. We will post additional information to the bill tracker and please contact Alicia Haywood at ah@coruralhealth.org for more information or with any questions. 

The Forum 2011: Essential Perspectives for Safety Net Providers, April 20-21

The Forum is a two-day conference that will bring together participants from across Colorado and surrounding states. Presented by CRHC and ClinicNET, The Forum is an essential educational, training, and networking event for all safety net clinics, members of the clinical team, and other interested parties. Scheduled agenda topics include federal and state policy updates, patient centered medical homes, a funders panel, and Colorado’s health insurance exchange. Opportunities for sponsorships are now available. Learn more about The Forum and register online. 

March Revenue Forecast

The Governor’s Office of State Planning and Budgeting (OSPB) and Legislative Council presented their March 2011 revenue forecasts to the Joint Budget Committee (JBC) this afternoon. The findings indicate higher than expected tax revenues and, combined with budget cuts already approved, the projected budget shortfall for FY11-12 has been revised from $1.0 billion to $450 million. Modest economic growth is expected for the near future, requiring the state to still make difficult budget cuts.  Read the OSBP and the Legislative Council reports for more information.

CRHC’s Role in NRHA’s Rural Health Congress

National healthcare issues directly impact rural providers and communities. Several CRHC staff currently serve on the National Rural Health Association’s (NRHA) Rural Health Congress and constituency groups and are committed to advocating on behalf of the interests of rural healthcare providers in Colorado and nationally to ensure NRHA policy positions are strategically designed to promote providing high quality healthcare services to rural areas.

CRHC has a long-standing, 20 year history as an organization with active membership in NRHA. CRHC founder and former Executive Director, Denise Denton, served as NRHA President in 1993. CRHC staff have held leadership roles in NRHA’s Constituency Groups (CG) which ultimately advise the Rural Health Congress in taking positions on key advocacy and policy positions for rural healthcare. Lou Ann Wilroy, CRHC CEO, has served for ten years on the Frontier Constituency Group, addressing healthcare issues in the nation’s most sparsely populated communities.  Michelle Mills, CRHC’s Program Director for Critical Access Hospitals and Rural Health Clinics, has been a member of the Rural Health Clinics Constituency Group since late 2010. Michelle is also the RHC CG representative on the Rural Health Congress. Cari Fouts, Communication & Development Director for CRHC, is a member of the State Association Council CG for NRHA and was appointed a position on the Rural Health Congress in January 2011 to represent the needs of all rural communities and state rural health associations across the nation.

Specific topics that are being addressed by the Rural Health Congress this year include:

• Health reform implementation
• Accountable Care Organizations
• Medicaid Payments
• CAH, RHC, Frontier Stay Extended Stay Clinics– discussion of potential development of new certification and payment methods (spearheaded by Tom Henton, CEO of Conejos County Hospital in Colorado; also a member of the Congress)
• Primary Care Shortages
• Rural General Surgeon Shortages
• EMTALA & Telehealth
• Mental Health in Rural America (expand to include substance abuse)
• Deleterious Impacts on Rural Multiracial & Multicultural Populations due to decrease in Welfare Programs
• Network Neutrality
• Broadband – Rural Access
• Tobacco Use in Rural America

As the Rural Health Congress moves forward in adopting positions, CRHC will seek input from our members to ensure the policy briefs meet the needs of our constituents. CRHC’s Policy & Legislative Council (PLC) guides and informs CRHC’s state and federal policy activities. If you would like more information about the PLC or are interested in participating, please contact Sara Schmitt at ss@coruralheatlh.org. If you have any questions about the Rural Health Congress, please contact Michelle Mills, mm@coruralhealth.org, or Cari Fouts, cf@coruralhealth.org. Learn more about NRHA’s Rural Health Congress.

CRHC, CCMU and ClinicNET – In Search of Health Stories to Create a Shared Statewide Vision

Got a health story to tell? The Colorado Rural Health Center, Colorado Coalition for the Medically Underserved, and ClinicNET are ready to hear it.

CRHC, CCMU, and ClinicNET will hit the road in April in search of Colorado health stories. “The purpose of Colorado HealthStory is to create an appreciation of our shared experiences of health, one conversation at a time,” said Alicia Haywood, policy analyst with the Colorado Rural Health Center. “We invite Coloradans to tell their own health stories to begin a dialogue about access to health in our communities.”

The three-year project was made possible through funding from The Colorado Trust and the Colorado Health Foundation. Over the next three years, Colorado HealthStory collaborators will engage existing and new partners to identify 250 storytellers and capture their stories. Personal health stories will be audio recorded with a family member, a friend, a care provider, a mentor or HealthStory collaborator. Each storyteller will be provided a CD of their story recording, and a second copy will be retained in the Colorado HealthStory archive.

Stories will be available on the Colorado HealthStory Web site, blog and other social media outlets, and news and media outlets will receive periodic project updates. In addition, once a body of stories is collected from each participating community, Colorado HealthStory will convene community forums known as “listening sessions.” Using information gathered from collected stories, listening sessions and local health data, the HealthStory team will create “community health profiles” for each participating community.

“Sharing your own health story is a great way to start, but there are lots of other ways you can help your family, friends and neighbors share their story,” Haywood said. “You can host a ‘HealthStory Day’ at your organization, co-author an op-ed in your local newspaper that encourages others to share their stories or link to the Colorado HealthStory site, (coloradohealthstory.org, but not yet launched) from your Web site.”
 

For more information on Colorado HealthStory, contact Alicia Haywood of the Colorado Rural Health Center at ah@coruralhealth.org or by calling 720.248.2748.

Implementation Brief: Primary Care Physician Workforce

Federal health reform legislation contains dozens of provisions related to health care workforce issues, including strengthening primary care, national workforce policy development, and increasing the supply of health care workers. A new Implementation Brief from George Washington University and Robert Wood Johnson Foundation focuses on those provisions that specifically target the strengthening of the primary care physician workforce.

2010 Colorado Health Report Card

The Colorado Health Foundation released its 2010 Colorado Health Report Card. The report card includes detailed information about 38 health indicators to provide a comprehensive picture of the health of Colorado's residents. The state's overall health grades have not improved significantly since the first report card in 2006. The only grade that improved from 2009 was "healthy aging", which moved from a B+ to an A- this year. Read more.

Updated CRHC Bill Tracker

Bill tracker is updated through March 9, 2011.

JBC Makes 2011-2012 Budget Recommendations for HCPF

Yesterday the Joint Budget Committee (JBC) conducted “figure setting” for Health Care Policy & Finance, setting budget numbers for many healthcare programs that will go into the FY 2011-2012 Long Bill, or the state’s budget. The state has an estimated $1 billion deficit for 2011-2012 and deep cuts are being made in many government services and programs. The JBC recommended several Medicaid program reductions, including a 0.75% medical provider rate cut and reduced oral health benefits, but did not recommend a provider payment delay at this time. Additional cuts included $19.2 million in Amendment 35/Primary Care Funds and reduced payments to family medicine residency programs. The JBC’s actions do not represent the final budget, as House and Senate members need to approve the Long Bill. However, further cuts may be needed if the March revenue forecast (due out later this month) is dismal. If you would like more information or have questions or concerns, please contact Sara Schmitt at ss@coruralhealth.org or 303.468.3498. 

Issue Brief: Insurance Coverage and Access to Care in Primary Care Shortage Areas

An issue brief by the Kaiser Family Foundation examines insurance coverage and access to care among the nonelderly who live in geographical primary care health professional shortage areas (HPSA). The analysis found that when compared with those who live outside geographical HPSAs, these individuals were more likely to be uninsured or be covered by government insurance and to have a chronic condition. The authors discuss the need to address healthcare workforce shortages to meet both current and future demand for services in these areas and suggest several policy options to consider. The brief is a concise summary of many issues familiar to The Rural Voice readers and rural communities. Download the report. 

Participate in Creating Colorado's Economic Development Strategy

Colorado’s “bottom up” economic development planning continues, with several meetings scheduled throughout the state in the coming days. CLICK HERE to find the meeting in your region. Please consider attending and serving as a voice for healthcare in this discussions. 

Attend the Rural Economic Development Summit in Greeley on March 14. Click here for the schedule and more information.

Please attend these events and underscore the importance of healthcare as a rural economic driver.  Consider these facts: 

• Many healthcare providers are self-employed entrepreneurs; 
• Assuming the same ratio of providers to overall population, Colorado will add 5,000 new healthcare jobs per year for the foreseeable future; 
• On average, one in eight Colorado jobs is in the healthcare sector. In rural counties, the average is closer to one in six jobs; 
• Taking into account multiplier effects, each healthcare job supports about two additional jobs. 

·         As a powerful economic engine across Colorado, healthcare must be at the table during economic development talks. For more information, contact Clint Cresawn at 720.248.2745 or 800.851.6782, ext. 255, or by email at ccr@coruralhealth.org. 

CRHC Updated Bill Tracker

Bill tracker is updated through March 3, 2011.

State Budget Primer

As Colorado works to balance its current budget and plan for the upcoming year, a resource from The Colorado Fiscal Policy Institute provides helpful information and background. The Colorado Budget Primer is a detailed explanation of how the state’s budget is formed, the major players in the process, terms for understanding the state budget, and state and federal limits on revenue and spending.

Define Rural Before You Budget for It

How many times have you been asked to define rural? Timothy Collins, assistant director of the Illinois Institute for Rural Affairs, was asked to address this issue before the U.S. House Agriculture Subcommittee on Rural Development, Biotechnology, and Foreign Agriculture last month. A quick answer for Collins, and for many of us in a pinch, typically is ‘you know rural when you see it’ but he suggests that “this approach doesn’t fly when it comes to policy implementation and the distribution of billions of dollars for rural development projects.” Read his post in Daily Yonder. 

2010 Colorado Health Insurance Report Available

The 2010 Colorado Health Insurance Report contains information about the cost of health insurance and the factors that drive the cost of health insurance premiums on an individual and group basis in the state. Released by the Division of Insurance annually, the report includes financial information on health carriers and how Colorado’s health coverage and options compare nationally. Read the report.