1 / 11

Rural Health Clinics: Pros, Cons, and Certification Process

Join our webinar to gain a comprehensive understanding of rural health clinics, including their benefits, downsides, and the certification process. Learn about the requirements, location criteria, and potential reimbursement rates. Take advantage of this valuable opportunity to explore the impact and opportunities of rural health clinics.

hbruni
Download Presentation

Rural Health Clinics: Pros, Cons, and Certification Process

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Issues in Rural Health PlanningWebinar 2 Thursday, July 21, 20111:00 – 2:00 PMUnderstand the pros and Cons of Rural health Clinics

  2. Learning Objectives • Understand the role and function of a Rural Health Clinic • Identify the primary benefits of opening a Rural Health Clinic • Learn the process of being certified as a Rural Health Clinic • Explore the downside of opening a Rural Health Clinic 2

  3. Definition of a RHC • Established through Public Law 95-210, the Rural Health Clinic Services Act, 1977, to increase the provision of primary care services for Medicare and Medicaid patients residing in rural communities. • RHC can be provider-based or independent (freestanding). • Provider-Based: integral part of a hospital, nursing home, home health agency • Independent: stand alone clinics • Status can be public, private, or not-for-profit 3

  4. Requirements for a RHC • Staffed with a mid-level practitioner practicing at least 50% of the time • Provide basic laboratory services • Develop written clinical protocols and operational policies and procedures • Conduct an annual evaluation • Gain certification by Medicare 4

  5. RHC Location Requirements • Must be in a Health Professional Shortage Area (HPSA) or Geographic Primary Care or • Must be in a Medically Underserved Area/Population (MUA/P) • Designation must be less than 3 years old 5

  6. Benefits of Opening a Rural Health Clinic • Potential of significant higher reimbursement (looking at all payors in the aggregate) • Increased coordination between hospital and physicians • Increased clinical integration with hospital • Greater flexibility in financing and efficiencies with administration and shared staff 6

  7. Potential Downsides of Operating a RHC • Increased costs related to hospital wage and benefits • More facility costs • Less effective cost management • Decreased physician control of practice staff • Less control of financial accountability and productivity

  8. Steps Necessary for RHC Certification • Confirm site eligibility • Evaluate financial feasibility • Assess cost of hiring needed staff • Complete a RHC application and a CMS provider enrollment form • Receive RHC certification inspection by ADHS • File a CMS cost report to have the Medicare rate determined

  9. Current RHC Reimbursement Rate ?? • Current RHC maximum encounter rate - $78.07

  10. Important Resources • Center for Medicare and Medicaid • Web Site: https://www.cms.gov/center/rural.asp • National Association of Rural Health Clinics • Web Site: www.narhc.org • Listserve: http://www.narhc.org/members/members_listserve.php • Rural Assistance Center • Web Site: www.raconline.org • Toll Free #: 1.800.270.1898 • Revised Arizona Rural Health Clinic Manual, 2011 (available soon)

  11. Questions + Contacts • Connie Belden, Team Leader, ADHS Licensing • Connie.Belden@azdhs.gov • Joyce Hospodar, Rural Health Office • hospodar@u.arizona.edu; 520.626.2432 • Ron Smith, CFO, Wickenburg Community Hospital • Ron.Smith@wickhosp.com; 928.684.5421 11

More Related