Free Webcast: Health Outcomes Among Children and Families Living in Rural Communities, December 1st and 2nd

The National Institute of Child Health & Human Development (NICHD) will be broadcasting a multi-agency rural health research conference intended to identify gaps in research that address emerging differences between health outcomes for children and families living in rural communities compared to those in urban areas. This conference will be broadcast live via webcast both days, beginning at 6:30 AM MT on December 1 and 6:45 AM MT on December 2. Get additional information about the conference, including the agenda, and click here to access the webcast. 

Next Steps for Federal Deficit Reduction

With the failure of the Super Committee to reach agreement, mandatory budget cuts via sequestration are scheduled to begin January 2013. Under sequestration, Medicare provider reimbursement is subject to up to a 2% reduction from 2013-2021 while Medicaid and Social Security will not be reduced by sequester. Many issues will impact the overall sequestration before it takes effect, including any possible changes in federal receipts, the tax code, and efforts to modify the reductions by members of Congress and advocates. Click to read more about the anticipated reductions and the National Rural Health Association’s response.

Report from the HPSA/MUA Negotiated Rulemaking Committee

In 2010, Health & Human Services Secretary Kathleen Sebelius created a 28-member negotiated rulemaking committee to review criteria for the designation of Medically Underserved Areas (MUA) and Health Professional Shortage Areas (HPSA). The Director of Colorado’s Primary Care Office Steve Holloway served on this committee. HPSA and MUA designations allow clinics, hospitals, and healthcare providers access to many federal incentives including loan forgiveness programs, Medicare bonus payments, increased reimbursement rates, and the ability to be designated as a Rural Health Clinic. The Committee’s report provides recommendations to the Secretary for revising the designation criteria and process. Changes that HRSA may chose to make to the designation process will be open to the public for comment when they are available. CRHC will be sharing more information about the Committee’s recommendations and any changes that occur in the designation process. Please contact Sara with questions or comments. 

CHI Releases Portrait of Colorado’s Nursing Workforce

In its recently released report titled Colorado’s Nurse and Nurse Aide Workforce: A Portrait, the Colorado Health Institute (CHI) brings together findings from three surveys that it conducted between 2006 and 2008 on certified nurse aides, licensed practical nurses, and registered nurses. Click here to download the report. 

Update on Super Committee

Prospects look dim that the Super Committee will reach an agreement to reduce the nation’s deficit by $1.2 trillion over the next ten years. Lawmakers are already looking ahead to required sequestration, to begin in January 2013, that would cut $1.2 trillion from the federal budget over ten years through reductions in defense, discretionary spending, and Medicare provider rates (up to 2%). NRHA has prepared a fact sheet that looks at the impact of sequestrationon Critical Access Hospitals. Additional resources and information will be posted on our website as they are available. 

New Deadlines Announced for Advance Payment Model

Last month, the Centers for Medicare and Medicaid Services announced a new Advance Payment Model for physician-based and rural Accountable Care Organizations selected to participate in the Medicare Shared Savings Program. The selected ACOs will receive advance payments that will be recouped from the shared savings they earn. Organizations interested in applying for the Advance Payment Model must complete separate applications for the Shared Savings Program and the Advance Payment Model. 

Deadlines for the Advance Payment Model application are: April 1, 2012 start date (applications accepted between January 3 and February 1, 2012) or July 1, 2012 start date (applications accepted between March 1 and March 30, 2012). Only ACOs that enter the Shared Savings Program in April 2012 or July 2012 will be eligible for advance payments. For more information about the Advance Payment Model, visit the Advance Payment website.  

New Series on Primary Care Workforce Stats

The Agency for Healthcare Research and Quality’s Center for Primary Care, Prevention and Clinical Partnership will be issuing a “Facts and Stats Series” on primary-care topics on primary care's workforce, capacity and growth needs. While a foundational element of the country’s healthcare system, primary care is struggling under increasing demands and expectations, diminishing economic margins, and increasing workforce attrition. Click here to read more about the series and download the first two fact sheets. 

The Affordable Care Act: An Update from the National Advisory Committee on Rural Health and Human Services

The Rural Assistance Center is hosting a free webinar on December 2, 2011 at 1:00pm MT with The National Advisory Committee on Rural Health and Human Services. The Committee has devoted its work this year to the effects of the Affordable Care Act (ACA) on rural areas. The Committee's 2011 Report to the Secretary, released in March, included a section on Rural Implications of Accountable Care Organizations and Payment Bundling. Click here for more information and to register. 

2011 Colorado Health Access Survey Released

The Colorado Health Access Survey (CHAS), a program of The Colorado Trust and administered by the Colorado Health Institute, is the only statewide survey that focuses on Coloradans’ health insurance status, access to care, usage of health care services, and affordability. The CHAS data are categorized into 21 Colorado Health Statistics Regions. The 2011 CHAS found that an increasing number of Coloradans (more than 1.5 million) are uninsured or underinsured. Click here to visit the CHAS website and download more information, reports, and briefings.

Health Care Innovation Challenge Announced

The Health Care Innovation Challenge will award up to $1 billion in grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the highest health care needs. The Health Care Innovation Challenge will encourage applicants to include new models of workforce development and deployment that efficiently support their service delivery model proposal. Click here for more information and to learn about a webinar on the initiative scheduled for Thursday 11/17 at 12:00pm MT. 

Supreme Court to Hear Challenge to Affordable Care Act in 2012

The U.S. Supreme Court has agreed to decide the constitutionality of the Affordable Care Act. Oral arguments are likely to be held in late February or March, with a ruling by June 2012. Read more.

Medicare Shared Savings Program Application Available

The Centers for Medicare and Medicaid Services (CMS) released the Medicare Shared Savings Program (ACO) application and will begin accepting applications on December 1, 2011. CMS also posted fact sheets for rural providers and on the ACO AdvancePayment model.

Providers and facilities interested in learning more about ACOs have two opportunities this week, a National Provider Call on November 15 and a meeting with CMS on November 16. 

Economic Impact of Colorado's Hospitals

A study commissioned by the Colorado Hospital Association (CHA) found that hospitals in Colorado’s rural regions directly contribute $2.9 billion in economic activity and add  21,400 jobs, creating $4.1 billion in total output and 30,800 jobs due to a multiplier effect. Statewide, Colorado hospitals were responsible for about $18.8 billion in economic output last year and added more than 4900 jobs from 2007 to 2010. The report and an executive summary is available on CHA’s website. 

Celebrate the Power of Rural—National Rural Health Day, November 17

November 17 is the first annual National Rural Health Day, a day to “Celebrate the Power of Rural”. Nearly 62 million Americans, and 20% of Coloradans, live in rural and frontier communities. Rural communities possess a selfless, community-minded, "can do" spirit that has helped our country thrive; they also have unique healthcare needs that should not be overlooked and need to be addressed. How you choose to celebrate National Rural Health Day is entirely up to you, we just ask that you celebrate! CRHC has created a toolkit of resources, information, and ideas for you to use. For more information or to share how your community is celebrating National Rural Health Day, contact Cari Fouts.   

Medicare Shared Savings Program National Provider Call: Application Process and Overview of the Advance Payment Model Application

The Centers for Medicare & Medicaid Services is hosting a call on Tuesday, November 15, 2011 from 11:30-1 pm MT to discuss the application process for the Medicare Shared Savings Program (to create Accountable Care Organizations) and the Advance Payment Model. The Advance Payment Model is intended to provide additional support through upfront resources to physician-owned and rural providers.

In order to receive the call-in information, you must register for the call. Registration will close at 10:00 pm on Tuesday, November 15 or when available space has been filled. No exceptions will be made. Please register early. Please click here for more details and instructions on registering for the National Provider Call.

A Notice of Intent to Apply memo is currently available on the Shared Savings Program Application page and the program application will be posted to this website prior to the call. Call participants are encouraged to review the application prior to the call. 

Health Care Policy & Financing 2010 Annual Report

The Department of Health Care Policy and Financing 2010 Annual Report is available online. The report highlights the Department’s programmatic priorities and outlines progress made toward its 2010 initiatives. 

Community Forum to Discuss Relocating DHS Services to HCPF, November 16

The Department of Health Care Policy and Financing (HCPF) and the Department of Human Services (DHS) submitted a legislative report to the Joint Budget Committee regarding the possible relocation of the Division of Developmental Disabilities, the State Unit on Aging, and the Children's Residential Habilitation Program from DHS to HCPF. This move is being considered to leverage federal health care reform dollars, to streamline the Long Term Care system, and to improve client services. The Departments are seeking public input on the proposal to relocate these programs. The first of several community forums will be held on November 16, 8:15am - 10:15 am at the Fort Logan Auditorium. An option to call in is available: 1-877-820-7831, Participant pass-code: 447596. If you plan to attend, please RSVP by November 14. 

Update to Medicare's 2012 Physician Payment Rates

On January 1, 2012, a 27.4% cut in Medicare payment rates to physicians will take effect due to the Sustainable Growth Rate formula. Congress has intervened to prevent these projected cuts annually since 2002. As the deadline approaches, Congress, the administration, and other government agencies are deciding whether to pass another short-term "doc fix," or find a longer-term solution. A new policy briefby Health Affairs provides the history of this issue, examines some of the proposals under consideration, and suggests what might come next. 

CoverColorado Soliciting Feedback from Providers

CoverColorado, the insurance plan for individuals with pre-existing conditions, is soliciting feedback from all health care providers caring for CoverColorado members on its provider fee schedule that was implemented April 1, 2011. CoverColorado seeks provider input to evaluate the effectiveness of the present schedule and inform any potential changes to the 2012 fee schedule. Written comments are due by December 20, 2011 and can be emailed or submitted to: CoverColorado Attn: Executive Director, Fee Schedule, 425 South Cherry Street, Suite 160, Glendale, CO 80246. CoverColorado is also holding an open meeting on Tuesday, December 13 from 4:00 pm - 6:00 pm in the Molly Blank Auditorium at Denver's National Jewish Hospital where comment will be taken. 

Governor Hickenlooper Releases FY 2012-2013 Budget

Today Governor Hickenlooper delivered his proposed FY 2012-2013 budget to the Joint Budget Committee (JBC). The budget request totals $20.09 billion. His proposal contains few cuts to healthcare programs. No Medicaid provider rate cuts were proposed and Amendment 35 funding will not be transferred to the General Fund but will be granted out through CDPHE to local organizations for prevention and health promotion activities. Cost-sharing for higher income beneficiaries of Medicaid and CHP+ is proposed. New revenue-generating measures are not in the plan; however, it calls for education budget cuts of $90 million for K-12 and $60 million for higher education.

We will share more information about the Governor’s budget as it becomes available. The budget represents the first step in the FY 2012-2013 budget process, continuing with JBC hearings and briefings beginning this month. The JBC will draft the Long Bill that requires the full legislature’s approval and the Governor’s signature.

CHP+ Cost Sharing Proposed Changes

As posted previously in The Rural Voice, new cost-sharing changes are being proposed for the Child Heatlh Plan Plus (CHP+). Upon final approval on November 18, there will be changes in both the annual enrollment fee and copayment structure. This factsheet from Health Care Policy & Financing describes the changes.