Critical Access Hospital Advisory Council. Cari Fouts, Program Director Jen Dunn, CAH Program Coordinator. Welcome!. Introductions What’s in your binder? Housekeeping. CAH Advisory Council Agenda. Overview of current CO CAH program Update on current, new and developing CAH programs
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Cari Fouts, Program Director
Jen Dunn, CAH Program Coordinator
What’s in your binder?
Overview of current CO CAH program
Update on current, new and developingCAH programs
Explore HIT/ARRA requirements and opportunities
Strategic planning for future programs and project development
Learn about the QHi Benchmarking Tool
Balanced Budget Act 1997
Rural area, or special provision
25 acute care beds, additional 10 distinct part rehab or psychiatric allowable
Average length of stay, 96 hours or less
35 miles from nearest hospital or CAH, or more than 15 miles of mountainous terrain, OR necessary provider before 12/05
Enhanced Payment through Medicare
Most inpatient/outpatient services 101% of reasonable and allowable costs
Ambulance services owned/operated receive 101%
Provider-Based rural health clinics receive cost based reimbursement
Medicare Rural Hospital Flexibility Program (Flex), created in 1997
Funding to support conversion and infrastructure to strengthen rural health care
Quality Improvement (Hospital Compare?)
Financial and Operational Performance Improvement
Community Engagement and Impact (regional and local collaborations)
Health Information Technology
Colorado Department of Public Health and Environment
Colorado Foundation for Medical Care
Colorado Hospital Association
Centers for Medicare & Medicaid
Board Webinar series
Member only Website access (tools and resources)
RAC resources –
QHi Benchmarking Resource
Nurse Leadership Training
Capital Equipment Purchases - RACE Program
Grant Writing Program – GROW
RHC Technical Assistance Services
Colorado Credentialing Network
Revenue Cycle Management Services
Peer Review Network Expansion
Swing Bed Online Training
Observation and UM Manual/Training
Community Paramedic Program
Senate proposal has combined the Finance Committee and the HELP (Health, Education, Labor, and Pension) Committee.
Proposal being analyzed by the Congressional Budget Office (CBO) to determine costs.
Senate bill content unclear - not publicly released.
Rural amendments that NRHA is working to get included, once a bill is brought to the floor:
Still many unknowns and uncertainty if there are enough votes to avoid a filibuster.
Timeframe was set for this week or next, but there is talk that things could get pushed out until 2010.
Combined three bills (current bill almost 2,000 pages) and received an approximate $1 trillion price tag from the CBO.
Hoped to have a floor vote this week; not likely to happen.
There are not enough votes to pass the current bill (need 218).
Points of contention: public plan option, cost, immigration, etc.
Note: House introduced a bill (H.R. 3961) that addresses the Sustainable Growth Rate (SGR) that would fix the current mandated cuts that must be addressed each year concerning Medicare rates to physicians. The Senate voted down a similar bill in October.
SGR not being addressed in any of the health reform proposals due to the price tag ($245 billion over 10 years)
FY09-10: ~ $1.4 billion General Fund shortfall addressed during 2009 legislative session
Since then, an additional $589 million shortfall has been addressed
1.5% Medicaid Provider cuts effective September 1st; an additional 1% Medicaid Provider cuts effective December 1st
Delayed Medicaid payments – final two weeks of payment for FY09-10 will be shifted into FY10-11
Cuts and delayed payments will not apply to RHCs
H1N1 Waiver available if bed capacity is reached:
Final CMS OPPS Rule – outpatient therapeutic services supervision
Capacity Building Grant to spread funding opportunity across all CAHs.
28 CAHs awarded funding
HIT and Regulatory Compliance
EMS Budget Tool Training
Quality Improvement - 6 CAHs for Total of $20,691
HIT - 4 CAHs for Total of $28,825
Regulatory Compliance - 4 CAHs for Total of $19,000
Education/Capacity Building - 14 CAHs for Total of $83,425
Additional Funding Options (Outmigration Studies)
Grant guidance NOW AVAILABLE!
Each hospital eligible for $8000 for 09/10
Applications due back December 4, 2009
Approximately $9000 available
HIT Consortium Opportunity
16 Hospitals Participating in Consortium
Center for Improving Value in Health Care (CIVHC)
HIT Regional Extension Center
RHC HIT Solutions
Association of Rural Health Clinics of Colorado (ARHCC)
Hospital Quality Incentive Payment
What do you find most beneficial about the Flex grant?
How can we improve what we are currently doing?
In a perfect world ($ no object!), what would the Flex grant provide?
CHA Rural Hospital Conference/CAH Workshop Merging in 2010
Quality Improvement Workshops in conjunction with Annual Conference
Frequency (Monthly, Bimonthly, Quarterly, TBD)
HIT Consortium Advisory Committee
Peer Review Network Expansion Pilot