June edition of At a Glance

Please find the link to the June edition of At a Glance below. This Department of Health Care Policy and Financing publication provides information on major initiatives including policy changes and program updates. Please feel free to share it with your colleagues.

Thank you for your interest!

At a Glance

Medicare Part A Immediate Recoupment Requests

https://www.novitas-solutions.com/parta/alerts.html

The Medicare Part A fax number used to request immediate recoupment is temporarily out of order. Please discontinue faxing immediate recoupment request to 412-802-1836. All new immediate recoupment requests as well as any request sent after 12:00 PM on 6/10/2013 through 6/14/2013 need to be sent to our alternate fax number, 412-802-1756. This message is until further notice. We apologize for this inconvenience.

Healthy Transitions Colorado – Join the Campaign!

Healthy Transitions Colorado is a collaborative effort, focused on aligning and accelerating existing efforts to improve transitions of care for Coloradans. Join the Healthy Transitions Colorado campaign and be part of a broad and growing base of health care providers and partners who have pledged their commitment to help reduce avoidable hospital readmissions in Colorado. Join the campaign today by completing the Community Partner Participation Pledge and faxing it to 720-549-9189. Also, join CIVHC and Healthy Transitions Colorado operating partners at the Healthy Transitions Colorado Kickoff event on July 8 to hear from key leaders across the state including keynote speaker US Senator Michael Bennet and learn how you or your organization can pledge to participate in this important statewide initiative. For more information and to register, click here.

ICD-10 Billing & Coding Workshops with RT Welter

R.T. Welter & Associates, Inc.: Participants will learn about ICD 10 coding with an emphasis on common rural diagnosis. In addition we will review what documentation changes will need to be made and how providers can prepare. This year we are excited to include hands on exercises that will be tailored to your individual clinics! This educational activity is geared towards clinicians, billing and coding staff at rural hospitals and clinics. All healthcare providers, particularly physicians, are invited to attend. CEU’s will be available.

Three locations are being offered. Click on the location name for more details:

Rifle - September 19, 2013

Lamar - September 24, 2013

Yuma - September 26, 2013

Delay in Encounter Reimbursements to FQHCs and RHCs

On June 19, 2013, the Department of Health Care Policy and Training released a statement concerning a delay in encounter reimbursement to FQHCs and RHCs directly from the CHP+ MCOs.

Please click here to see the letter and for more information.

We need your help!!!

The Colorado Patient Navigator and Community Health Worker Collaborative hopes to learn more about the resources available to clients and activities underway in the area of patient navigation, community health work and care coordination. We hope the results of this survey will help to better coordinate services within communities through an understanding of what is needed to support this work and the current status of community health work, patient navigation and care coordination in Colorado to advance the field.

As a partner in this effort, the Colorado School of Public Health is helping conduct this survey (COMIRB #13-1524).

This survey is intended to capture information about the persons involved in the following role(s):

• Section I: Persons actually delivering the service/care to clients
• Section II: Persons directing or managing programs
• Section III: Persons involved in training
• Section IV: Persons conducting research
• Section V: Persons involved in policy work/advocacy
• Section VI: Persons who are not currently involved but have an interest

 Link: https://redcap.ucdenver.edu/surveys/?s=LZJV4g

Please provide input about ALL areas applicable to your work or services. On average, the survey will take 15 minutes to complete. If you chose to share your contact information and allow your information to be released, you will receive the results of the survey. If you do not wish your contact information to be shared, the data will NOT be provided to outside agencies. We encourage you to forward this survey along to your networks and colleagues. Within the survey, there is an opportunity to provide information about networks and individuals you plan to forward/share information; or you can reply to this e-mail or andrea.dwyer@ucdenver.edu if you have any questions or ideas about survey dissemination. The results and a survey summary will be shared at the Public Health in the Rockies Conference in Breckenridge in September. There will be a special focus on patient navigation and community health work on September 19th and 20th. To register for the conference, please visit: http://www.coloradopublichealth.org/conference/.

Thank You-

Colorado Patient Navigator and Community Health Worker Collaborative

Regionalization Subcommittee

 To Learn More about the Colorado Patient Navigator and Community Health Worker Collaborative, please visit: https://sites.google.com/site/copnchwcollaborative/

"Evaluation and Management Score Sheet 101 Basics" Webinar

July 2, 2013 (10:00am - 12:00pm ET, 9:00am - 11:00am CT)

J12/JH Part B Webinar Handout: "Evaluation and Management Score Sheet 101 Basics"

Join us as we discuss the latest feedback from the Comprehensive Error Rate Testing (CERT) Program, review the principals of medical documentation, examine the evaluation and management (E/M) key components. You will get familiar with the format of the score sheet and utilize tools to assist with your search options. You do not want to miss this event! Register Now!


https://www.novitas-solutions.com/calendar/partb/webinar/index.html

Patterns of Care for Rural and Urban Children with Mental Health Problems

Policy Brief
Full Report

Research indicates that privately insured, rural adults have lower use of office-based mental health services, but higher use of prescription medicines than their urban counterparts. Patterns for rural children may be different from urban children because of the limited supply of pediatric mental health providers in rural areas, which may lead to reduced access and lower use of mental health services in rural areas versus urban. Using data on children ages 5-17 from the 2002-2008 of the Medical Expenditure Panel Survey, we find that rural children are significantly less likely to be diagnosed and treated for non-ADHD mental health problems than urban children and are less likely to receive mental health counseling. The rural-urban difference is greatest among those children scoring in the “possible impairment” range on the Columbia Impairment Scale.

Contact information:
Jennifer D. Lenardson, MHS
Maine Rural Health Research Center
Phone: 207-228-8399
jlenardson@usm.maine.edu

JH Part A Webinar Handout: "Website Tour" 

June 27, 2013 

(2:00pm - 3:30pm ET, 1:00pm - 2:30pm CT)

https://www.novitas-solutions.com/calendar/parta/webinar/index.html

Please join us for this interactive webinar of the Novitas Solutions website. If you have questions regarding the Customer Service Center (CCC), Provider Enrollment Services (PES), Electronic Data Interchange (EDI) and more, then you need to attend this webinar. Register today and learn what and where each center is located on the Novitas Solutions website. You don't want to miss this event.

Clinical Documentation Improvement for ICD-10

Workshop Objective: to help your CDI team (coders, physicians, other healthcare providers) understand the NEW documentation requirements in preparation for ICD-10 implementation, through the integral relationship of patient care, documentation, coding and compliance.

Why your CDI Team Should Attend: ICD-9-CM (International Classification of Disease, 9th Clinical Modification) has been the only diagnostic coding system most of us have ever known. In fact, the last clinical took place more than 35 years ago. With the conversion to ICD-10-CM set to take effect October 1, 2014 the time is now to educate both providers and staff involved with revenue cycle functions of the considerable changes in the structure of ICD-10-CM and the “explosion” of codes to manage. Three to five (3-5) digit codes are replaced with three to seven (3-7) digit codes and the 13,000 codes in ICD-9-CM will be replaced with the more than 68,000 codes in ICD-10-CM.

With a good understanding of the coding conventions and some careful consideration during the documentation and coding processes, ICD-10-CM can be successfully managed but only with buy in from the top down. Solid documentation will be critical!

This workshop is meant for team attendance - your hospital CDI team should include at least:

1 physician, 1 nurse, HIM Director, coder, QI Director, other hospital staff involved in clinical documentation and/or revenue cycle functions

For more information and registration, click on the location names:
Ft. Morgan - July 23rd
Rifle - July 24th
Alamosa- July 25th

Joint Commission Updates – Requirements for Emergency Management Oversight

New Joint Commission requirements and revisions address leadership accountability for hospital wide emergency management in hospitals and critical access hospitals. The prepublication requirements and revisions, announced earlier this week, provide a clearer description of leadership-level oversight of emergency management, according to The Joint Commission. To access the Prepublication Requirements, click here.

2014 IPPS Proposed Rule - CAH, Medicare Dependent Hospital, Sole Community Hospital Updates

In June 2013, NRHA commented on the Centers for Medicare and Medicaid Services notice of proposed rulemaking for updating the 2014 Inpatient Prospective Payment System (IPPS) provisions. Among other concerns, NRHA commented on the proposal in the rule to change the payment mechanisms for residents training at Critical Access Hospitals, changes to CAH Conditions of Participation, as well as payment calculations for Sole Community Hospitals. To read NRHA’s comment letter, click here. To access the notice of proposed rulemaking, click here. CRHC will continue to provide updates. If you have any questions, please contact cs@coruralhealth.org.

ORHP Webinars on the ACA

The Federal Office of Rural Health Policy is pleased to announce the second in a series of webinars around the Affordable Care Act being held specifically for our grantees. This Thursday, June 27th, at 3-4pm EDT we will provide an overview of the implications of states’ decisions on expanding Medicaid coverage and where states currently stand. We will also highlight the re-launch of healthcare.gov and the new customer call center (described below). We plan to reserve the last 30 minutes to answer your questions, though you can send questions before and after the webinar to ORHP-ACAQuestions@hrsa.gov. Audio will be available over the phone or online through the Adobe Connect Virtual Meeting session. Slides will be distributed immediately after the call along with a link to the recording.

ORHP ACA and You Webinar: Medicaid Expansion
June 27, 2013
3-4 pm Eastern

Call-in Number: (800) 369-2001
Passcode: CALL1

Adobe Connect Session: https://hrsa.connectsolutions.com/orh1/

Colorado ICD-10 Task Force – Summer Classes Near You

ICD-10 ROAD SHOWS

The ICD-10 Road Shows will be taught by Colorado’s own AHIMA-Approved ICD-10 Trainers. These cost-effective seminars will allow you to get started on your ICD-10 education while learning from some of the industry’s best coding professionals. Cost includes 1-½ day seminar presented by ICD-10-CM/PCS experts, seminar materials, breakfast on both days, and lunch on Friday.

For more information on dates and times, please click here.

Members of the U.S. Senate Rural Health Caucus have introduced a bill that would allow general supervision by physician or nonphysician providers (NPPs) for many outpatient therapy services, politicalnews.me reported.

Please click on this link to see more information.

SAVE THE DATE!

CRHC is excited to bring our fall ICD-10 Regional Workshops to the rural areas of Colorado. Please join us for the day and learn about ICD 10 coding with an emphasis on common rural diagnosis. In addition we will review what documentation changes will need to be made and how providers can prepare. In addition, there will be hands on exercises tailored to your individual clinics! This educational activity is geared towards clinicians, billing and coding staff at rural hospitals and clinics. All healthcare providers, particularly physicians, are invited to attend. Breakfast and Lunch will be provided. ICD-10 Books will also be available for purchase.

• September 19 - Rifle, CO
• September 24 - Lamar, CO
• September 26 - Yuma, CO
• Webinar - TBD

To register for a workshop near you, or for additional information please contact Courtnay Ryan at cr@coruralhealth.org.

CMS Revision to Free-Standing RHC Cost Report

Please see the following links for the updated Free-Standing RHC cost report released by CMS on May 31, 2013. GME cost pass thru, bad debt reductions and sequestration have been added, as well as other streamlining.

INDEPENDENT RURAL HEALTH CLINIC AND FREESTANDING FEDERALLY QUALIFIED HEALTH CENTER COST REPORT FORM CMS-222-92

RURAL HEALTH CLINIC COST REPORT

CREATE Q&A Call

Fiscal Year 2014

Program Updates 

Q & A Conference Call!

Tuesday June 25th at 2:00 p.m.

As we prepare for the new CREATE year (starting July 1, 2013), exciting changes to the program will be taking place. Some of these changes include a new application format, intended to make the application process smoother, as well as new definitions for eligible students. Join us for a special Q & A session with Colorado Rural Health CREATE staff and members of the ERC (Expert Review Committee) to answer your questions, learn how the changes will impact your CREATE grant applications in fiscal year 2014. Sign-up for this special session beforehand and receive a preview of the Grant Guidelines before the conference call and prior to the July 1 new year start date. Having the guidelines early can be beneficial if you are planning courses during the transition period and want to be prepared for the changes.

To register, please click here.

CDPHE Family Planning Unit – Free Webinar

The Colorado Department of Public Health and Environment’s Family Planning Unit is offering a free provider training webinar with CME credits on July 19 on Long Acting Reversible Contraceptive options for patients. For more information, click here or contact Nicole.pfeiffer@state.co.us for more information.

Healthy Transitions Colorado Kickoff Event!

Please join CIVHC and operating partners for the Healthy Transitions Colorado Kickoff event on July 8 from 7:30am-10:00am at the University of Colorado Hospital, Anschutz Campus to hear from key leaders across the state including keynote speaker US Senator Michael Bennet and learn how you or your organization can pledge to participate in this important statewide initiative. Healthy Transitions Colorado is a collaborative initiative focused on aligning and accelerating existing care transitions efforts, advancing shared goals, and promoting best practices across the state. HTC helps break down the silos of individual facilities and programs to foster true community care coordination across facilities, specialties, and practices with a focus on improving the health and lives of Coloradans. For more information and to RSVP click here.

SAVE THE DATE

National Dialogues On Behavioral Health 

54th Annual Conference

Partnering with

The Western Interstate Commission for Higher Education (WICHE) Mental Health Program

And

The National Association of County Behavioral Health and Development Disability Directors (NACBHDD)

Presents : The Evolving World of Behavioral Health on the Eve of ACA Implementation

November 10-13, 2013
Renaissance Arts Hotel, New Orleans, LA

Suggested Audience: Physicians, Social Workers, Counselors, Psychologists, Addiction Counselors, Case Managers, Administrators, Behavioral Healthcare Providers, Policy Makers

Planning forms have been submitted for review for continuing education credit.

Be sure to check you email within the next two to three weeks for speaker and agenda information!

Resources in Your Community for Your Older Adult Patients and Their Caregivers

Tuesday, June 25, 2013
12:30 - 1:30 pm (MT)

Register now at: http://www.cfmc.org/provider/provider_register_csnghoa_6-25-13.aspx

Join this webinar to learn about resources throughout the State of Colorado for your older adult patients and their caregivers that address their social needs. Resources include nutritional needs, transportation, case management, assistance with applications, Medicare Counseling, disease management, and much more.

Speakers:
Leighanna Konetski and Peggy Spaulding, Colorado Department of Human Services, State Unit on Aging

For more information contact Ann Williams at 303.784.5792 or at awilliams@cfmc.org.

For the promotional flyer, please click here. 

Information from Novitas Solutions

Medicare Learning Network Matters Articles from CMS
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM8339.pdf


New: MM8339 – Coding Requirements for Laboratory Specimen Collection Update
Availability of Education Handouts
https://www.novitas-solutions.com/training/index.html
Currently, education handouts are purged from the Novitas Internet website after 30-days from the date of the presentation. Providers asked that these handouts be available for a longer period of time. We heard your request and have extended this timeframe to 6 months from the date of presentation effective with presentations hosted 06/10/2013 and going forward. The handouts will continue to be available from the same location they are available from now.

Providers are encouraged to locate handouts by taking these steps:

• Utilize this link. 
• Select appropriate event type (will include handouts if any were used): 
• Webinars
• Teleconferences 
• Scroll to bottom of screen to the ‘Previous’ section
• Look for the presentation/date that was missed
• Retrieve handouts

Inpatient Prospective Payment System NPRM

On April 26, 2013 the CMS issued a notice of proposed rulemaking (NPRM) for inpatient prospective payment systems (IPPS) and long-term care hospitals (LTCHs). Comments will be accepted until June 25. Below is a summary of some of the proposals including the ones impacting CAHs. Click here for more information

• CAH Conditions of Participation (COP): The proposed rule clarifies the COPs to require that CAHs have the capacity to provide inpatient care on-site. Approximately 1% of CAHs do not currently provide inpatient services. 
• Graduate Medical Education (GME): The Centers for Medicare and Medicaid Services (CMS) proposes to revise the GME policy addressing inpatient labor and delivery days in the inpatient Medicare utilization calculation. This may also impact "like hospital" determinations when considering designation as a sole community hospital or conversion to a CAH. CMS also proposes that a hospital may not claim FTE residents training at a CAH for indirect medical education (IME) and/or direct GME purposes. However, if a CAH incurs the costs of training the FTE residents while on rotation at the CAH, the CAH may receive 101% of those Medicare reasonable costs. 
• Medicare Disproportionate Share Hospitals (DSH): The ACA changes the methodology for calculating payments to DSHs, which serve a large proportion of low-income people, to account for the decreased in the number of the uninsured beginning in 2014. DSH payments will be reduced to 25% of the amount under current policy. The remaining 75% will be adjusted for decreases in the rate of uninsured individuals nationally, and then distributed to currently-eligible hospitals based on their share of uncompensated care relative to all Medicare DSH hospitals. 
• Value-Based Purchasing Program: The ACA adjusts payments to hospitals according to the quality of care they deliver. For FY 2014, CMS is increasing the percent reduction - the portion of Medicare payments available to fund the VBP Program's incentive payments - to 1.25%, which would provide approximately $1.1 billion. The NPRM also proposes new VBP measures. 
• New Hospital-Acquired Condition (HAC) Reduction Program: The ACA mandates a HAC program. Beginning in FY 2015, hospitals that rank among the worst quartile with regard to HACs will receive a 1% payment reduction. The NPRM proposes HAC ranking criteria and methodology. 
• Hospital Readmissions Reduction Program: The maximum payment reduction increases from 1% to 2% (statutory). CMS proposes to add two readmission measures for use in calculating FY 2015 penalties. 
• FY 2014 Payment Update: The proposed rule would increase IPPS operating rates by 0.8% after accounting for adjustments, such as the required recoupment (American Taxpayer Relief Act) of $11 billion in overpayments resulting from documentation and coding changes that occurred after CMS implemented new patient severity classifications in FY 2008. LTCH PPS payments would increase by 1.1%. 
• Medicare-Dependent Hospital (MDH) Program: The American Taxpayer Relief Act extended the MDH program through FY 2013. The NPRM includes the expiration of the designation for discharges occurring on or after October 1, 2013. 
• Low-Volume Hospitals: The temporary changes to low-volume hospital definition and payment adjustment methodology provided for by the ACA for FY 2011 through FY 2013 are expiring. CMS is proposing in FY 2014 to return the hospital definition and payment adjustment methodology that was in place prior to FY 2011.

Fundamental Critical Care Support Course

This course, offered by the University of Colorado Hospital, is a comprehensive multi-disciplinary course addressing essential management principles for critically ill patients. The next course will take place from September 25-27, 2013 and offers 20.0 continuing education credits. For more information click here or contact shannon.johnson@uch.edu.

CREATE webinar

Fiscal Year 2014

Program Updates 

Q & A Conference Call!

Tuesday June 25th at 2:00 p.m.

As we prepare for the new CREATE year (starting July 1, 2013), exciting changes to the program will be taking place. Some of these changes include a new application format, intended to make the application process smoother, as well as new definitions for eligible students. Join us for a special Q & A session with Colorado Rural Health CREATE staff and members of the ERC (Expert Review Committee) to answer your questions, learn how the changes will impact your CREATE grant applications in fiscal year 2014. Sign-up for this special session beforehand and receive a preview of the Grant Guidelines before the conference call and prior to the July 1 new year start date. Having the guidelines early can be beneficial if you are planning courses during the transition period and want to be prepared for the changes.

To register, please click here.

Take Advantage of CRHC's Peer Review Program

CRHC’s peer review network is an effective and economical option for rural hospitals to improve patient care through the identification of opportunities for improving the process and delivery of patient care. The CAH-PRN also satisfies Medicare’s Conditions of Participation for hospitals, Joint Commission on Accreditation on Healthcare Organization (JCAHO) and National Integrated Accreditation for Healthcare (NIAHO) accreditation requirements for addressing the quality improvement level of care provided.  The program is a collaborative effort among the Critical Access Hospitals in Colorado. As a means of reducing costs, reviews are performed by same specialty physicians from other participating rural hospitals in the state. CRHC has established confidential rotation groups to perform the peer review function. The cost to have a chart reviewed is $50 per chart to cover shipping, handling, and administrative costs. If a second opinion review is requested, the chart will be sent to an out-of-state contracted peer review organization.

Does your facility currently utilize other peer review services?  If so, would your physicians be interested in volunteering as a periodic reviewer for other CAH communities with limited resources? 

For more information about the peer review program or to join, please contact Courtnay Ryan at cr@coruralhealth.org  

We've heard the surveyors are out...

Are you ready for the 

unannounced state survey? 

Is your clinic manual out of date? 

Spring is upon us, and that means the surveyors may be hitting the roads! This month CRHC is excited to offer you a special discount on our Policy & Procedures manual when you schedule your mock survey with our Quality Improvement Specialists. CRHC provides a comprehensive evaluation of compliance with existing requirements for certified RHC's. This service includes onsite clinic inspection and basic review for RHC Policy and Procedures.

Take advantage of scheduling the mock survey service now and receive $75.00 off the P&P manual for your clinic! Our QI specialists with review the clinics annual evaluation processes, as well as conduct a review of medical charts (paper or electronic). A professional follow up summary, recommendations, and report of findings is also included.

To receive this offer, please schedule your mock survey by May 24th. Services must be completed by early July, and the discounted Policy & Procedures manual is available to you upon payment. Please contact Samantha Hiner at sh@coruralhealth.org for questions or to schedule this service.

Please join the Centers for Medicare & Medicaid Services (CMS) Regional Offices for an informative webinar on ICD-10 for health care providers, professional coders, clearing houses, vendors and others.

The ICD-9 code sets that are currently used to report health care diagnoses and inpatient procedures must be replaced with ICD-10 code sets. Mandated by law, this change will take place on October 1, 2014. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA).

WHAT: CMS ICD-10 Webinar
DATE: June 20, 2013
TIME: 1:00 pm – 2:00 pm PDT

For more information on the event, as well as how to register, please click here.

The Challenge of Change - Part I Webinar

As healthcare continues to transform at a rapid pace, hospital leaders feel the challenges associated with the resistance to change. Studies show that the number one (bad) reason employees resist change is because they are protecting themselves! So where does that leave the patient and the organization?

Even though change is mandated, when it comes to changing culture (how we do, say and think about things) the challenge can be a real puzzle. The Challenge of Change webinar will outline the seven steps to helping your employees embrace soft-skill changes that will help you transform your patient satisfaction outcomes for the better. 

Part I Webinar – August 19, 2013 - 11 am - 12 pm

To register, visit: https://cc.readytalk.com/cc/s/registrations/new?cid=upuz4455ry4p or contact Caleb Siem at cs@coruralhealth.org for additional information. For the event flyer, please click here. 

Information on a QHi benchmarking tool for RHCs

An initiative of the Kansas Rural Health Options Project, the Quality Health Indicators (QHi) benchmarking tool has allowed small rural hospitals to benchmark against self-defined peer groups to learn best practices and set targets for improvement. Currently, over 250 small rural hospitals in 16 states are participating in QHi including several of Colorado’s Critical Access Hospitals. Recently, the system has been expanded include Rural Health Clinics. Twelve Clinical Quality Measures (all NQF) and 7 Financial/Operational Measures (all Annual) have been identified and are be available for collection and reporting – see attached list of RHC measures. QHi anticipates the Library of Indicators will continue to grow.

QHi is beginning the new RHC implementation with a ‘pilot’ phase where RHCs can have free access to the site from now through August. In August, RHC’s that wish to continue utilizing the system will be charged an annual fee between $200-$500. Click here to view an informational powerpoint demo about QHi.

If you are interested in trying QHi during this pilot phase, please contact Courtnay Ryan at cr@coruralhealth.org or fax to 303-832-7496.

Community Health Work training program

The Women’s Health Leadership Institute’s Community Health Worker (CHW) training  program is coming to Denver!  

We are looking for experienced Community Health Workers to be involved in this wonderful institute and movement to improve health in our communities.  Entrance is limited and the application deadline is upcoming.   

When: June 12, 13, and 14

Who: Community Health Workers or similar who are part of Region VIII (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming)

Where: Downtown Denver

How: The application must be submitted no later than Friday, May 24, 2013. Please email the application to Carmen Ferlan, Master Trainer Supervisor at cferlan@mariposachc.net

Note: This training is currently offered in English only.

Please click here for the official announcement.

Please click here for Frequently Asked Questions.

Please click here for the application.

Pueblo Community Action Meeting

Please join the Colorado Foundation for Medical Care (CFMC) for this meeting on June 12 from 12:30-5:00 at Parkview Hospital, convening providers, community-based organizations, and other leaders that are actively developing strategies and tactics to reduce avoidable readmissions. Who Should Attend – Pueblo-area physicians, healthcare providers, and local and state community-based organization members. Register online by clicking here. For more information, contact Lacey McFall at lmcfall@cfmc.org.

The Medical Services Board is considering a rule change for hospitals changing ownership

This new rule will streamline the enrollment process for hospital institutions which are changing ownership. The rule will allow less contractual process and less administrative burden pro providers and department staff. The rule clarifies financial liability information formerly kept in a contract process for hospital institutions.

The proposed rule or amendment may be found at:

http://www.dora.state.co.us/pls/real/SB121_Web.Show_Rule?p_rule_id=5141.

A hearing on the proposed rule or amendment is set for Friday, June 14, 2013 at 09:00 am at The Capitol Center, 225 East 16th Avenue, 6th Floor, Denver CO 80203.  For more information about the proposed rule or amendment, you can contact Judi L Carey, MSB Coordinator at 303-866-4416 at the Department of Health Care Policy and Financing.

Need assistance?

The CAH Quality Network provides quarterly webinars surrounding quality improvement the upcoming topics are,

• July 18^th “Process for responding to Quality Concern”
• September 19^th, “Hospital Inpatient Quality Reporting Process”
• Nov 21^st, “Patient Engagement for Health”

Please contact Caleb Siem at cs@coruralhealth.org to ensure you are on the list serve to receive the invitations

CRHC is also pleased to provide:

Remote & Onsite Quality System Assessment

A periodic review of your organization’s quality system’s processes, structures, and outputs to help determine whether the system is meeting current internal and external needs and goals as well as identify ways to improve performance. This assessment reviews various quality system documents including:

1.       The quality plan

2.       Strategic plan/objectives

3.       Relevant policies and procedures

4.       Meeting minutes

5.       Reports

6.       Improvement initiatives

7.       Other relevant documentation

A written report with recommendations is provided to your organization.

The Onsite Quality System Assessment also incorporates onsite interviews with various organization staff members and leaders. 

Management’s Role in Quality Improvement (QI) & Performance Improvement (PI)

This education program will help administrative and clinical manager and leaders enhance their role in QI/PI to lead the organization in attaining its goals. Topics covered include

1.       Aligning QI/PI efforts with the organization’s strategy

2.       Using QI as a strategy to accomplish goals

3.       Using data effectively

4.       Leading and coaching other in QI/PI initiatives

5.       Promoting and maintaining performance excellence

Inpatient Prospective Payment System NPRM

On April 26, 2013 the CMS issued a notice of proposed rulemaking (NPRM) for inpatient prospective payment systems (IPPS) and long-term care hospitals (LTCHs). The rule affects approx. 3,400 acute care hospitals and 440 LTCHs. Comments will be accepted until June 25. Below is a summary of some of the proposals. Click here for more information

• FY 2014 Payment Update: The proposed rule would increase IPPS operating rates by 0.8% after accounting for adjustments, such as the required recoupment (American Taxpayer Relief Act) of $11 billion in overpayments resulting from documentation and coding changes that occurred after CMS implemented new patient severity classifications in FY 2008. LTCH PPS payments would increase by 1.1%. 
• CAH Conditions of Participation (COP): The proposed rule clarifies the COPs to require that CAHs have the capacity to provide inpatient care on-site. Approximately 1% of CAHs do not currently provide inpatient services. 
• Graduate Medical Education (GME): The Centers for Medicare and Medicaid Services (CMS) proposes to revise the GME policy addressing inpatient labor and delivery days in the inpatient Medicare utilization calculation. This may also impact "like hospital" determinations when considering designation as a sole community hospital or conversion to a CAH. CMS also proposes that a hospital may not claim FTE residents training at a CAH for indirect medical education (IME) and/or direct GME purposes. However, if a CAH incurs the costs of training the FTE residents while on rotation at the CAH, the CAH may receive 101% of those Medicare reasonable costs. 
• Medicare Disproportionate Share Hospitals (DSH): The ACA changes the methodology for calculating payments to DSHs, which serve a large proportion of low-income people, to account for the decreased in the number of the uninsured beginning in 2014. DSH payments will be reduced to 25% of the amount under current policy. The remaining 75% will be adjusted for decreases in the rate of uninsured individuals nationally, and then distributed to currently-eligible hospitals based on their share of uncompensated care relative to all Medicare DSH hospitals. 
• Value-Based Purchasing Program: The ACA adjusts payments to hospitals according to the quality of care they deliver. For FY 2014, CMS is increasing the percent reduction - the portion of Medicare payments available to fund the VBP Program's incentive payments - to 1.25%, which would provide approximately $1.1 billion. The NPRM also proposes new VBP measures. 
• New Hospital-Acquired Condition (HAC) Reduction Program: The ACA mandates a HAC program. Beginning in FY 2015, hospitals that rank among the worst quartile with regard to HACs will receive a 1% payment reduction. The NPRM proposes HAC ranking criteria and methodology. 
• Hospital Readmissions Reduction Program: The maximum payment reduction increases from 1% to 2% (statutory). CMS proposes to add two readmission measures for use in calculating FY 2015 penalties. 
• Medicare-Dependent Hospital (MDH) Program: The American Taxpayer Relief Act extended the MDH program through FY 2013. The NPRM includes the expiration of the designation for discharges occurring on or after October 1, 2013. 
• Low-Volume Hospitals: The temporary changes to low-volume hospital definition and payment adjustment methodology provided for by the ACA for FY 2011 through FY 2013 are expiring. CMS is proposing in FY 2014 to return the hospital definition and payment adjustment methodology that was in place prior to FY 2011.

Healthy Transitions Colorado Kickoff Event

Please join CIVHC and operating partners for the Healthy Transitions Colorado Kickoff event on July 8 from 7:30 am-10:00 am at the University of Colorado Hospital, Anschutz Campus to hear from key leaders across the state including keynote speaker US Senator Michael Bennet and learn how you or your organization can pledge to participate in this important statewide initiative. Healthy Transitions Colorado is a collaborative initiative focused on aligning and accelerating existing care transitions efforts, advancing shared goals, and promoting best practices across the state. HTC helps break down the silos of individual facilities and programs to foster true community care coordination across facilities, specialties, and practices with a focus on improving the health and lives of Coloradans. For more information and to RSVP click here.

EHR and Meaningful Use Boot Camp

Interested in learning how you can optimize the use of your EHR? 

Do you need help meeting Meaningful Use objectives?

Attend the free EHR & Meaningful Use Boot Camp and learn how to incorporate Meaningful Use objectives into your practice to increase efficiency, improve patient outcomes and make the most of the expense and time you put into your EHR adoption. For more information, click here.

To be held at the DoubleTree Hotel – Westminster, 8773 Yates Drive Westminster, CO 80031

June 27th, 2013 from 11:30 a.m. to 5:00 p.m.
Register online at
http://bit.ly/124ArgI
Or call CORHIO at 720-285-3200

AgriSafe Webinar

The AgriSafe Network is offering a free distance learning webinar on June 19th (12 PM CDT) on Grain Safety, presented by Dan Neenan, director of the National Education Center for Agricultural Safety. Webinar participants will learn about the proper way to enter a grain bin, Lock-Out Tag Out procedures and proper use of body harnesses when working with grain. To register, click here.

Never Burn Another CD!

One of the fundamental aspects of radiology services is the sharing of digital exams with providers. Exam sharing is the means by which continuity of care is ensured. To provide the highest quality medical care, rural clinics and hospitals are now seeking new ways to share their images. Storing and sharing data via film and CD is becoming obsolete.

The Problem
Radiology departments are burdened with the task and cost of burning and storing CD's. Industry statistics reveal an average cost of between $8.00 and $15.83 per CD, per month for burning and storage. Putnam County Memorial Hospital, an average 14-bed critical access hospital located in northeast Missouri, burns an average of 20 CD's per week - with a total cost of $690.00 to $1,266 per month. Multiply this figure by your average patient throughput - that's a staggering amount of money!

Then there's the question of time, "How much is yours worth?" From physicians to support staff to frustrated patients toting around CD's from appointment to appointment, no one wants to think about where the only copy of a CD might have wandered. What if your patients forget to bring their CD to their next appointment, assumes a copy will be available or simply misplaces it? This could lead to rescheduled appointments, costly replacements and in some instances, effectively throws HIPAA right out the window.

The Solution
OffSite Image Management, Inc., the nation's leader of "cloud" Vender Neutral Archiving services is pleased to introduce you to Honeycomb LiteTM, our new robust digital Health Information Exchange platform. This Virtual CD effectively replaces your current CD burning process with a custom URL. The encrypted, and password protected URL can be printed or emailed to your patient. The provider has the option print the exam, view it in the cloud or download it into their PACS. This and more is now being offered to our NRHA Partners starting at $350/month.

For more information on this, or any of our "cloud" Disaster Recovery (DR) or Business Continuity (BC) solutions, please visit our website at www.offsiteimagemgt.com or call Lasha Dalakishvili at 816.244.8132 or David Sarowski at 913.449.1547.