Thursday, March 26, 2015

PQRS Guidance

As previously noted, MLN Matters® Special Edition Article #SE1508, “Guidance on the Physician Quality Reporting System (PQRS) 2013 Reporting Year and 2015 Payment Adjustment for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs),” was released on March 6th. This article is designed to provide education on the PQRS 2013 reporting year and 2015 payment adjustment for RHCs, FQHCs, and CAHs. Previous issues and a link to subscribe to MLN Connects are available in the archive.

SAMHSA Suicide Prevention App

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released “Suicide Safe,” a free suicide prevention app for mobile devices. The app is based on SAMHSA’s Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) card and helps providers use SAFE-T, quickly access and share information, and locate treatment options for patients. This app is available for both Android and Apple devices from Google Play and the App Store.

In addition to the new app, SAMHSA and the Suicide Prevention Resource Center developed a Primary Care Toolkit that was originally targeted to rural providers (but has now been expanded): http://www.sprc.org/for-providers/primary-care-tool-kit-book-resources-general

Webinar: A Medicare ACO Model for Rural Providers

In light of the summer application deadline for new 2016 participants, the Federal Office of Rural Health Policy (FORHP) has scheduled a webinar, “AIM: A Medicare ACO Model for Rural Providers”, for rural health providers and stakeholders interested in learning more about the model. The webinar will feature current perspectives from an existing ACO participant, as well as items to consider when joining. The webinar will be held on April 2nd from 2:00 to 3:00 PM Eastern. An audio recording of the webinar will also be made available to participants. For more information, including call-in information and webinar log-in, please visit http://www.raconline.org/events/months/2015-04

 Note: Registration is not required for this webinar.

AIM Model Application for ACOs

As listed in last week’s announcements, the ACO Investment Model (AIM) is a Centers for Medicare and Medicaid Innovation (Innovation Center) initiative for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. One reason the AIM Model was developed was to encourage uptake of ACOs in rural areas with little ACO activity by offering pre-payment of shared savings and ongoing per beneficiary per month payments. The AIM Model application period for ACOs that will join the Medicare Shared Savings Program in 2016 opens in the summer of 2015. See http://innovation.cms.gov/initiatives/ACO-Investment-Model/ for further details on the AIM Model initiative.

Webinar: Road to 10: A Small Physician Practice’s Route to ICD-10

CMS and HRSA are offering a free webinar to help your practice make the transition to IDC-10. “Road to 10: A Small Physician Practice’s Route to ICD-10” will be held on March 27th from 2PM to 3 PM Eastern and is being offered to HRSA Program Staff and Grantees. To register for the webinar, click on the link. Dial-In Number: (800) 603-1774, Conference ID: 2164597.

Funding Opportunity for Diabetic Education

There is a funding opportunity through the American Association of Diabetic Education to fund diabetic education administered through your clinic. If your clinic has Diabetic Self Management Education accreditation through the ADA or AADE, they may be eligible for significant funding for the program. If you are interested in learning more and have this accreditation, please contact Sara Leahy at sl@coruralhealth.org or 303-565-5848.

HRSA Audits Webinar

HRSA Audits Webinar

Thursday, April 9
1:00 - 2:30 PM (Eastern)


HRSA has audited hundreds of 340B hospitals and other providers since 2012. Its findings can have a major impact on how your hospital uses 340B. In this interactive webinar, we will:
  • Discuss major audit findings about patient definition, the GPO prohibition, and contract pharmacy and their impact on your 340B operations 
  • Review what to expect if you are selected for an audit 
  • Highlight how HRSA has changed the audit process 
  • Cover how to respond to audit findings through challenges, a corrective action plan, and the public letter 
INTENDED AUDIENCE: Hospital and health system CEOs, COOs, CFOs, counsel, government relations/public relations directors, pharmacy directors and managers.

Pre-registration is required by April 7. Click here for more information.

Register for The Forum: April 8th-10th

The 16th Annual Colorado Rural Health Center Forum will once again be held at the foothills of the Rocky Mountains at the beautiful Denver Sheraton West Hotel in Lakewood. This event typically brings together over 200 rural healthcare professionals from Colorado’s 51 certified Rural Health Clinics (RHCs), non-certified rural clinics and other healthcare professionals, vendors, and leading experts in the field.

The conference planning committee is working to put together a comprehensive meeting agenda that will inspire, connect and educate rural healthcare providers and others interested in learning more about rural specific healthcare trends. We hope you will join us! Here are just a few of the top reasons to attend.
  • Six fascinating general sessions presented by leading experts in the field
  • Eighteen educational breakout sessions
  • Four hours of in-depth workshops
  • Plenty of time for networking with colleagues
  • Learn about new resources from our wide array of healthcare vendors
Click here to find more information on the conference and to register today!

CREATE Weekly Bulletin

Webinars Are Your Friends

The CREATE Grant process can be confusing. If you have struggled with the pre-application phase, application phase and/or the reporting and reimbursement phase, you are not alone! The good news is there are many resources available to you including webinars that outline individual steps in the application process.

· Click here for a Step-by-Step Guide to a Success CREATE Grant Application
· Click here for Effective Project Budget and Financial Need Narrative Writing
· Click here for How to Write a CREATE Financial Waiver Application

Thank you for all you do for all our Colorado communities! We are here to support you, so please do not hesitate to contact us with questions or concerns.

If you have any questions about the CREATE Grant process, please contact Megan Lyda at 720-248-2742 or ml@coruralhealth.org.

MLN Connects Provider eNews

MLN Connects Provider eNews for March 26th, 2015
View this edition as a PDF


In This Edition:

MLN Connects® National Provider Calls

  • Medicare Shared Savings Program ACO: Preparing to Apply for 2016 — Register Now 
  • Open Payments (Sunshine Act) 2015: Prepare to Review Reported Data — Registration Now Open 
  • How to Register for the PQRS Group Practice Reporting Option in 2015 — Registration Now Open 
  • Medicare Shared Savings Program ACO: Application Process — Register Now 
  • New MLN Connects® National Provider Call Audio Recording and Transcript 

CMS Events

  • Volunteer for ICD-10 End-to-End Testing in July — Forms Due April 17 
  • Medicare Basics for New Providers Webinar — Register Now 

Announcements

  • DOJ and HHS Announce over $27.8 Billion in Returns from Joint Efforts to Combat Health Care Fraud 
  • HHS Announces Proposed Rules to Support the Path to Nationwide Interoperability 
  • Star Ratings for Home Health Compare: Provider Preview Reports Available in Late March 
  • Medicare EHR Incentive Program Hospitals: Apply for Hardship Exception by April 1 

Claims, Pricers, and Codes

  • New RARC Alerts Providers about Upcoming Transition to ICD-10 
  • Updates to IRIS Software 
  • FY 2015 Inpatient PPS PC Pricer Update Available 

Medicare Learning Network® Educational Products
  • “Safeguard Your Identity and Privacy Using PECOS” Fact Sheet — Reminder 
  • “Internet-based PECOS FAQs” Fact Sheet — Reminder 
  • Medicare Learning Network® Product Available In Electronic Publication Format

Thursday, March 19, 2015

Medicare Part B News - Jurisdiction H for March 18th, 2015

The following information is provided by Novitas Solutions.

Medicare News

Medicare Learning Network (MLN) Articles from CMS

Revised:

Medicare Part A News - Jurisdiction H for March 18th, 2015

The following information is provided by Novitas Solutions.

Medicare News

Medicare Learning Network (MLN) Articles from CMS

Revised:

Weekly CREATE Bulletin

Having trouble with the 50% agency match requirement? Don’t give up!
An important part of the CREATE Grant is the 50% entitiy match. CREATE grants are open-competitive awards with applicants providing a local cash match. This can be a prohibitive element to some entities that want to apply, but may not be able to supply the mandatory match; however, the Financial Waiver option may provide the needed relief to allow your entity to apply for and use CREATE. 

A minimum of 10% is required, but your entity can apply to reduce the match from 50%.

There are a few important items to remember about the Financial Waiver process:

  •      You must justify the waiver. Explain your agency’s current financial status and why the entity cannot meet the 50% cash match requirement.
  •      Use the financial waiver application to justify the need, but also show a good faith          effort to obtain the cash match from other sources.
  •      If your entity is applying for a financial waiver, the application is due on or before the Financial Waiver Application deadline each month. Submission deadlines are different from CREATE application review dates.


For detailed instructions, click here

Thank you for all you do for all our Colorado communities! We are here to support you, so please do not hesitate to contact us with questions or concerns.

If you have any questions about the CREATE Grant process, please contact Megan Lyda at ml@coruralhealth.org or 720-248-2742.


Colorado APN Workforce website

The Center has developed a website that will be used to inform folks about APRN issues and Senate Bill 197. You’ll find the latest information about the progress of the bill and any new developments. Please take a look!

www.ColoradoAPN.org

CMS 2015 PQRS & Value Modifier Webinar: March 31, 2015

REGISTER NOW: CMS 2015 PQRS & Value Modifier Webinar: March 31, 2015

The Philadelphia Regional Office of CMS will be hosting a new webinar on Tuesday, March 31, 2015 at 12:00 Noon EDT to provide an overview of the requirements of the 2015 Physician Quality Reporting System (PQRS) and the Value-based Payment Modifier (VM). The link to register for this call can be found here:

https://www.eventbrite.com/e/2015-pqrs-and-value-based-payment-modifier-programs-registration-16185617618

This call is intended for eligible professionals, practice managers, office staff, and all other interested parties who deal with the PQRS and VM programs. The dial in number and link to the webinar will be given upon registration. If we maximize attendance on this call, there may be additional calls scheduled soon. Please share this meeting invitation with partners, members, and colleagues who would benefit from this information.

The Managers and Management We Need to Improve Care

The next WIHI broadcast — The Managers and Management We Need to Improve Care — will take place on Thursday, March 26, from 2 to 3 PM ET, and I hope you'll tune in.

Our guests will include:
  • David Munch, MD, Senior Vice President and Chief Clinical Officer, Healthcare Performance Partners 
  • Stephanie Calcasola, MSN, RN-BC, Director of Quality and Medical Management, Baystate Medical Center 
  • Kedar Mate, MD, Senior Vice President, Institute for Healthcare Improvement (IHI) 


Health care leaders have an incredibly important role to play in driving improvement initiatives in their organizations. So do people on the frontlines of care. What we aren’t as articulate about is the role that middle managers play. You know, the people with the job titles of House Supervisor or Shift Supervisor or Team Lead or Manager of the PACU (Post Anesthesia Care Unit). A growing number of experts say we can’t afford to ignore that people in these jobs are essential to improvement, too.

One of those experts is Dr. David Munch, who will help lead our discussion on the March 26 WIHI: The Managers and Management We Need to Improve Care. Dave Munch will be joined by IHI’s senior innovation and improvement capability expert, Dr. Kedar Mate, and Baystate Medical Center’s Stephanie Calcasola. All three will help us look at what middle managers do, now, on behalf of quality improvement – and what they could do more of, if their contributions and unique positioning in the organization were better utilized and understood. Especially when it comes to making improvement endeavors operational and sustainable.

Dave Munch recently wrote a blog post about this topic for ihi.org that we invite you to read ahead of the March 12 show. He’s also pointed us to some interesting research that suggests, among other things, that senior leader support for the middle management team helps build managers’ confidence and commitment to drive change and ignites enthusiasm across the organization.

No one’s capabilities and talent should be wasted when it comes to improving health and health care for those we serve. We know you agree. So, join us on March 26!

You can enroll for the broadcast here. We'd also appreciate it if you would spread the word about the show via Twitter.

ACA Implementation News--March 19, 2015

The latest issue of the Department of Health Care Policy and Financing’s ACA Implementation News is now available online here. Please feel free to forward this along to your colleagues that may find the content of interest.


If you would like to receive ACA Implementation News or our ACA Communication Updates please click here.

Save the Date: April 14 Colorado Medical Home Forum

April 14 Colorado Medical Home Forum

Presentations 

Ensuring Quality Health Care for Colorado’s Kids
presented by All Kids Covered

2015 KIDS COUNT in Colorado!
presented by the Colorado Children’s Campaign

Tuesday, April 14
4:30 - 6:45 PM
Colorado Department of Public Health and Environment
4300 Cherry Creek Dr. South
Denver, Colorado 80246
DOC Room, Building A

Webinar link
Conference call-in #:
1-877-820-7831
Participant passcode: 300218#

RSVP here.

For questions, contact:
Barbara J. Martin, RN, MSN, ACNP-BC, MPH
Health Systems Unit Supervisor
Colorado Dept. of Public Health & Environment
(303) 692-2327
barbara.martin@state.co.us

Webinar: : Improving Transitions of Care to Reduce Hospital Readmissions

Bridging the Divide: Improving Transitions of Care to Reduce Hospital Readmissions

Thursday, March 19, 2:00-3:30 ET

Register for free at: www.integration.samhsa.gov/about-us/webinars

Do you have certain clients who seem to be in and out of the hospital? As a behavioral health provider (either in a primary or behavioral health care organization), is it difficult for you to keep track of treatment plans for clients who see different providers (e.g., receiving inpatient care or at the emergency department)? Do you believe that better coordination between inpatient and outpatient services could improve health outcomes and reduce the burden on individuals and their families?

Comprehensive transitional care from inpatient to community medical and behavioral health services can improve health outcomes and reduce costs.

Join this webinar to review promising care transition models, initiatives and payment incentives that can be employed to promote collaboration between inpatient and outpatient providers; hear how one community provider implemented a successful care transition program; discuss strategies to increase success of discharge and treatment planning; and get tips on how to encourage individuals and family members to manage their care.



Presenters: Jason Martin, LCPC, CPRP, Director of Carelink Transitions and OnTrack Maryland, Family Services, Inc.; Harold A. Pincus, M.D., Professor and Vice Chair, Department of Psychiatry, College of Physicians and Surgeons, Co-Director, Irving Institute for Clinical and Translational Research, Columbia University; Director of Quality and Outcomes Research, New York-Presbyterian Hospital; Senior Scientist, RAND Corporation; National Program Director, Health and Aging Policy Fellowship.

Practice Management Bootcamp

When: Tuesday, April 21st & Wednesday, April 22nd, 2015 from 8:30am-5pm
Where: Montrose Memorial Hospital, Conference Room A and B
             800 S. Third Street
             Montrose, CO 81401

Why Attend:

  • Is your practice facing financial or operational challenges?
  • Do you understand how to create and utilize Key Performance Indicators?
  • Have LEAN operating methodologies been deployed to reduce waste and improve efficiencies?
  • Could you improve practice performance, eliminate losses and drive growth?

Through discussion and hands-on exercises, you will come away with the tools to enhance financial and operational performance.

Topics to be Covered:

  • The Strategic Importance of the Physician Practice Manager
  • Practice Management Operations (Part 1), A Day in the Life
  • Practice Management Operations (Part 2), Best Practices
  • Lessons Learned in the Field
  • Revenue Cycle Operations in Real Time
  • Efficient & Effective Care in Your Office: Managing Workflow and Reducing Waste
  • Practice Management Financials (Part 1), What Data to Monitor
  • Practice Management Financials (Part 2), The How To's
  • The Tools to Execute

And more!

Who Should Attend:

  • Medical Office Managers
  • Practice Administrators 
  • Physcians
  • Representatives of organizations interested in the success of medical office practices

       

IHI Expedition: Advancing Pain Management and Opioid Safety

IHI Expedition: Advancing Pain Management and Opioid Safety
Begins April 22
Virtual Program

Managing acute and chronic pain is a huge challenge for both patients and health care providers. Poorly managed pain leads to unnecessary suffering, longer hospital stays, and lower patient satisfaction scores. Unfortunately, prescribing opioids can sometimes lead to unintended consequences, including drug addiction and death from overdose.

To address this complicated issue, the Institute for Healthcare Improvement (IHI) is offering its latest Expedition, Advancing Pain Management and Opioid Safety (starting on April 22) to help organizations:
  • Define strategies to improve safety, reduce abuse, and treat addiction 
  • Address inpatient and outpatient pain management issues 
  • Explore a variety of alternative modalities for treating acute and chronic pain 
  • Take steps to engage patients, families, and the community 
While some organizations have made strides in effective pain management, many are still falling short. In six online sessions, participants will explore solutions to pain management and opioid safety to better serve the needs of their patients and their community.

Thursday, March 12, 2015

Medicare Part B News - Jurisdiction H for March 12th, 2015

The following information is provided by Novitas Solutions.

Medicare News
Top Claim Submission Errors (Medicare Part B)

The February Top Claim Submission Errors and resolutions are now available. Please take a moment to review these errors and avoid them on future claim submissions.


Medicare Learning Network (MLN) Articles from CMS

New:

Medicare Part B News - Jurisdiction H for March 11th, 2015

The following information is provided by Novitas Solutions.

Medicare News 

Have a question and not sure where to turn? Check out our recently updated FAQs for answers to your questions.

Medicare Part A News - Jurisdiction H for march 12th, 2015

The following information is provided by Novitas Solutions.

Medicare News

No Reimbursement Claims- Reason codes 39910 and 37187

Reason code 39910 causes claims to suspend when the provider reimbursement amount is equal to zero. Reason code 37187 is the finalized claim edit that indicates the claim has completed processing and no additional payment can be made.

These reason codes are most commonly received when the Medicare deductible amount matches the full payment amount on the claim. When no reimbursement is made to the provider due to the Medicare deductible, no Medicare payment will be issued to the provider.

These reason codes can also indicate that a billing error was made. When a claim is submitted with certain invalid or missing information, it can result in the claim receiving a zero dollar reimbursement amount. We encourage providers to confirm that their billing is correct.

Be sure to read this bulletin for more information regarding common billing scenarios that may result in a zero dollar reimbursement.


Medicare Learning Network (MLN) Articles from CMS

New:

FDA Issues Cybersecurity Guidelines for Connected Medical Devices

From the Arizona Telemedicine Program Blog:

Internet and Wirelessly Connected Medical Devices (“Devices”) are a cybersecurity concern of the Food and Drug Administration (FDA) as evidenced by guidance it issued in October 2014. The FDA Guidance does not have the force of law—but is highly influential in the medical device industry. Likely, failure of compliance will delay or prevent FDA approvals of such Devices.

Read more here...

Weekly CREATE Bulletin

You Don’t Need the Luck of the Irish to Get Your Reimbursement.

You’ve submitted your application. You’ve been approved. You’ve completed your course. Now it’s time to submit your final report so you can receive your reimbursement and close our your successful CREATE grant. Yes, after all your hard work, there’s still more to do! Unless you submit all required documentation, you will hold up or lose your reimbursement. Let’s make sure that doesn’t happen! Remember the following items are required to receive your reimbursement:

  • Reimbursement Request Form
  • Participant Data Forms
  • Student Attestation Form (if applicable)
  • Out of State Student Attestation Form (if applicable)
  • College Expenditure Form (if applicable)
  • Receipts for all expenses 
  • Grades
  • National Registry Certification copy (if applicable)
  • Course Evaluation
  • Travel Reimbursement Form (if applicable)

Some of the most common reasons for not receiving your reimbursement are: missing receipts, overdue course balance, expense completed prior to award approval, ineligible participants, late or missed report dates, not passing a course within allotted timeframe, food expenses, not following grant guidelines. Don’t let this happen to your organization!

Thank you for all you do for all our Colorado communities! We are here to support you, so please do not hesitate to contact us with questions or concerns.

If you have any questions about the CREATE Grant process, please contact Megan Lyda at ml@coruralhealth.org.





NRHA: HHS attacks rural...again

A message from the National Rural Health Association:

Here we go again: HHS targets rural hospitals

As rural hospitals rapidly close across the nation, the National Rural Health Association is appalled by yet another attempt by HHS' Office of Inspector General (OIG) to limit rural patients’ access to health care by calling for even more payment cuts to critical access hospitals (CAHs).

NRHA calls upon the Administration and Congress to stop the flood of rural hospital closures and protect access to care for millions of rural Americans.

This morning (Monday), HHS' OIG released a report suggesting the return of a failed payment system that led to the closure of 440 rural hospitals across the country in the 1980s and ’90s.

In 1997, Congress created the CAH payment system to provide equitable payments to keep rural hospital doors open and preserve access to care. Now, OIG calls for a return to the failed Medicare reimbursement system (the prospective payment system) for post-acute care patients in swing beds, resulting in over a billion dollars in cuts to CAHs, the smallest of all hospitals.

Swing beds foster quicker recovery times, provide physician choice and can be the only option for rural patients who want or need to receive care close to home.

According to a 2014 study by the University of North Carolina Sheps Center for Health Services Research, 12 percent of CAH patients require post-acute care. The vast majority of this care is for the elderly, suffering from conditions such as congestive heart failure, pneumonia, chronic obstructive pulmonary disease and fractures. These patients were able to return home a full day sooner than if the post-acute care had occurred at another facility.

Due to numerous Medicare and Medicaid cuts and burdensome regulations, 48 rural hospitals have closed since 2010. Nearly 300 more are on the brink of closure. Acting on OIG's poorly reasoned recommendations will exponentially escalate the number of rural hospital closures.

Medicare could save money in many ways. But that’s not the question; the question is what is right for our rural patients and their access to high-quality services.

Contact your members of Congress today. Protect rural patients’ access to care. Support critical access hospitals. #SaveRural

Agrisafe Network Webinar

A Vision for a National Sustainable Certified Safe Farm Intervention Program

Date: Tuesday, March 24, 2015
Time: 10:00a - 11:30am Central Time

EXECUTIVE SUMMARY

The Certified Safe Farm (CSF) is an evidence-based multimodal total worker health program that has resulted in long- term reductions in medical costs, increased use of PPE, decreased occupational respiratory illnesses, and remediation of farm hazards. Deriving from concepts originating in Scandinavia, the CSF was founded in Iowa, now translated to Wisconsin, North Carolina and Nebraska. Currently, there is no coordination among these programs. Our consultants from agribusinesses have advised us that to achieve national sustainability CSF must be consistent in programing and quality across state lines. Therefore, we envision developing a National Sustainable Model CSF Program by establishing a coalition of stakeholder's active in CSF programs. We will work by consensus to develop processes to attain consistency, quality, and coordination across state lines. Further we will seek methods to account for regional/local variances in CSF programs as necessary and market the program to potential agribusiness partners.

Objectives

1. The participants will learn about the history, and results of a nearly 20 year comprehensive program that has resulted in reduced injuries and illnesses in agricultural exposed populations.

2. The participants will learn the theory and methods involved in this program and how this concept can be applied on a broad scale.

3. The participants will learn how this program has functioned in Iowa, Nebraska, Wisconsin, and North Carolina.

4. The participants will learn the aims of a new project to develop a coalition to create methods and procedures for modifying the program to a national program, and aims for sustainability through a rewards-based incentive program for certified safe farms. 

THE Consortium Educational Webinar 3/25

Please join us for this month’s valuable webinar — in THE Consortium HIT Educational Series on March 25, 2015 at noon.

Topic: Ongoing Meaningful Use Updates-HIPAA and Patient Portals

This webinar is free for all CAHs and Small Rural PPS Hospitals participating in FY2014 SHIP grant program, as well as CRHC members. All other facilities will be invoiced $49.00 for the webinar.

Ready to register? Add this to your shopping cart and upon check out you will be sent a link to register.

Click here to register, and if you are a SHIP participant, remember to type in the member code to access the webinar at no charge.

Health Transitions Colorado Webinar

TEFT (Planning and Demonstration Grant for Testing Experience and Functional Tools in Community-Based Long Term Services and Supports)

Webinar: Wednesday, March 18 12:00pm-1:00pm MT

Hosted by the Center for Improving Value in Health Care

Click Here for Free Registration

Join Healthy Transitions Colorado for a discussion of the accomplishments and lessons learned through the TEFT (Planning and Demonstration Grant for Testing Experience and Functional Tools in Community-Based Long Term Services and Supports) - a 4 year grant from Center for Medicare and Medicaid awarded Colorado and 7 other states. The grant program is designed to field test an experience survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS record.

The TEFT effort includes four components:
  • Experience of Care Survey 
  • Care Assessment Tool 
  • PHR testing/development/implementation 
  • Standards and Interoperability (S & I) Framework for electronic records for long term support services 

We will be looking at what was accomplished during the planning year and what challenges await us as we prepare to launch phase one in 2015.

Presented by:


Pamela Russell, MS, BSW
CORHIO Development and Outreach Manager


Pamela Russell, LTC Program Director with Government Programs at CORHIO (Colorado Regional Health Information Organization) and currently managing the TEFT Grant (Planning and Demonstration Grant for Testing Experience and Functional Tools in Community-Based Long Term Services and Supports, awarded to Colorado Department of Health Care Policy and Financing.

Pamela is on the Board of Directors for CHIMSS as the Advocacy Chair-Elect and sits on many care transitions initiatives work groups in Colorado. Pamela has a degree in Social Work from Colorado State University and a Master's Degree of Science in Healthcare Systems from the University of Denver. 
 

Kelly Wilson
TEFT Grant Specialist
Colorado Department of Health Care Policy and Financing


Kelly Wilson is the TEFT Grant Specialist at the Colorado Department of Health Care Policy and Financing (HCPF) and is working on the Testing Experience and Functional Tools (TEFT) Demonstration Grant for Long Term Services and Supports.

Kelly spent nearly five years at the Colorado Department of Education as a State Professional Development Grant Consultant, where she worked on preschool and community-wide implementation of Pyramid Model practices with fidelity and sustainability.


Click Here for Free Registration

If you or your organization supports improving care transitions in your community, pledge your support today and join our network of providers, patients and community members committed to keeping Coloradans healthy.

2014-15 HPP Reimbursement Deadline Reminder

Has your clinic agreed to participate in 2014-2015 HPP funding, this is a friendly reminder of the April 15, 2015 deadline to submit your reimbursement requests. Activity #1- Develop Refine or Sustain Healthcare Coalitions is required in order for you to submit for the other activities.


Please contact Ron Seedorf at rs@coruralhealth.org with questions/concerns.

CMS, Rural Care Advocates Rip OIG Report Targeting Swing Beds

CMS, Rural Care Advocates Rip OIG Report Targeting Swing Beds

By: John Commins, for HealthLeaders Media, March 10, 2015

"They view rural as simply a small version of urban. They don't recognize that it is a different healthcare delivery system," says Alan Morgan, CEO of the National Rural Health Association.

More Analysis Here

Special Edition MLN Matters Article SE1508

On March 6, 2015, MLN Matters® Special Edition Article #SE1508, “Guidance on the Physician Quality Reporting System (PQRS) 2013 Reporting Year and 2015 Payment Adjustment for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs),” was released. This article is designed to provide education on the PQRS 2013 reporting year and 2015 payment adjustment for RHCs, FQHCs, and CAHs.

Thursday, March 5, 2015

CREATE Webinar!

Join us March 25th at 11am for a webinar to discuss two critical but often confusing parts of the CREATE process: the reimbursement process and the financial waiver process. This webinar will benefit organizations who are new to CREATE and those who have applied several times.

This webinar is free! Register here.

Weekly CREATE Bulletin

Back to Basics

Winning grant proposals must be well-written. Your cause is extremely important to your agency and the community it serves, but if your application is unorganized and ineffective it is difficult for reviewers to make it past the first paragraph. In short, winning grants must be two things: Informative and engaging. That is, it must be clear, concise and tell a compelling story.

Here are some suggestions on making your grant application stand out:

· Detail all the commitments made by partners/collaborations. Highlighting collaboration strengthens your application.
· Be very specific, detailed, clear and concise in each narrative section of the application.
· Present a reasonable strategic timeline and supportive budget with justifications of large reserves noted and explained clearly.
· Be consistent with budget costs throughout the application. Check your math. Then check it again.
· Follow the grant guidelines.
· Have others review your proposal for objective criticism prior to submission – use your
RETAC Coordinators for support in proposal writing.
· Ensure your endeavor supports EMTS systems improvement and clearly define how to your
audience – include data that supports your claim.
· Clearly define your agency efforts to meeting the financial match – elaborate on specific
hardships, events, etc. to meeting the match and include ideas to sustain in future years.

Medicare Part A News-Jurisdiction H for March 3rd, 2015

The following information is provided by Novitas Solutions.

Medicare News

Claim Issues - Part A

Update to issues related to ESRD (End Stage Renal Dialysis) Facilities concerning overpayment-

The claims have been mass adjusted. Please remember that through the mass adjustment process, there could be claims adjusted that were paid correctly. If that happens, the reimbursement would remain the same.

Update to issues related to MSP (Medicare Secondary Payer) claims -

The correction was installed on 2/23/15; however, we are still experiencing the same problems. FISS has been contacted and research continues.

Until this is resolved, claims with U6805 or U6825 are being held in SMQ163; claims with 31941, 31942, 31943, 4R005, 4R002, U6802, U6822, 3SP22, 3SP46, 3SP56, U6801, U6821 are being held in SMQ167.






March Educational Events Calendar Update

The following educational event has been added to the March Events Calendar:


Understanding the Enrollment of Clinics/Group Practices and Certain Other Suppliers (CMS-855B and CMS-855R)

Next WIHI on March 12: Bundles and Buy-In for Value-Based Care

The following message is from the Institute for Healthcare Improvement (IHI):

The next WIHI broadcast — Bundles and Buy-In for Value-Based Care — will take place on Thursday, March 12, from 2 to 3 PM ET, and I hope you'll tune in.

Our guests will include:
  • Mark P. Jarrett, MD, MBA, Chief Quality Officer, Sr. Vice President & Associate Chief Medical Officer, North Shore-LIJ Health System 
  • Susan Browning, MPH, FACHE, Vice President, Neurosciences, Head & Neck Surgery/ENT and Ophthalmology, North Shore-LIJ Health System 
  • Katharine Luther, RN, MPM, Vice President, Institute for Healthcare Improvement 
  • Mark Hiller, MBA, Vice President for Innovative Solutions & Leader, Premier Bundled Payment Collaborative, Premier 
  • Alice Ehresman, RN, Healthcare Quality Specialist, Baystate Health 
There’s no question that public and private payers in the US are moving toward more global payment arrangements with health care providers. But the picture of how health care delivery systems take up the challenge is still coming into focus. Forming or becoming part of an accountable care organization (ACO) has been one dominant response. And a growing number of health care organizations are redesigning common patient care procedures in order to enter into agreements that reward value over volume, and that tie payment to successful deployment of specific bundles of care.

It’s tempting to think of all this rejiggering as resting heavily on a hospital’s or office practice’s CFO or whoever draws up contracts with payers. But there’s so much more to it. That’s why we’ve assembled a terrific panel for the March 12, 2015 WIHI: Bundles and Buy-In for Value-Based Care. Our guests from North Shore-LIJ Health System and Baystate Health are in the thick of matching necessary staffing and cross-continuum teams to newer global payment arrangements for joint replacement, coronary bypass surgery, and stroke care. Baystate’s Alice Ehresman is working full time on operationalizing the care associated with bundled payments. NS-LIJ’s Dr. Mark Jarrett will keep our focus on the culture change required because, while the new processes may be better for patients, providers often find them challenging to adjust to. This can cause some resistance as NS-LIJ’s Susan Browning recently wrote about in a Health Affairs blog post.

We are fortunate to be able to get up close to this issue and to identify some challenges and opportunities all organizations are facing. That’s where Premier’s Mark Hiller comes and IHI’s own Katharine Luther come in. They’re both harnessing learning about global payment implementation from across the country so that everyone benefits.

So, are your care teams ready for value-based payments? Does everyone understand the relationship between better patient care and potential savings? Are there some new skill sets and mindsets required of doctors and nurses and support staff that need to be called out and called for, rather than just taking everyone’s buy-in and readiness for granted? We’re going to dig into all of this and more on the March 12 WIHI.

You can enroll for the broadcast here. We'd also appreciate it if you would spread the word about the show via Twitter.

Regional Capacity Building Technical Assistance Meeting

Community-Based Organizations
Regional Capacity Building Technical Assistance Meeting
March 19, 2015     Denver, CO
CoBank Leadership Center, 711 Park Avenue West, Denver, CO 80205

This training is designed to help organizations improve program services, look at various ways to fund program services, and develop community partnerships to meet the needs of their clients. Meeting participants will have the opportunity to learn about the Substance Abuse and Mental Health Services Administration (SAMHSA) mission to reduce the impact of substance abuse and mental illness on America's communities; SAMHSA's strategic initiatives and grant programs; and State program initiatives, grant programs, and block grant changes. In addition, through a series of workshops, participants will learn the following:

  • How to successfully attract potential funders and consumers using brochures, press releases, and public services
  • How to use social media (Facebook, Twitter, and more) to publish program services, events, and activities
  • How to raise money in a variety of ways to fund program services and program service components
  • How to partner and form long-term relationships with organizations to support the needs of clients/consumers
  • How to manage program funds, including developing budgets, hiring bookkeepers, and having an audit
  • How to develop strong and effective board leadership
  • How to use evaluation outcomes to attract potential funders
This training is designed for program directors, managers, clinical coordinators, fund developers, administrative staff, recovery support providers, and faith-based leaders (pastors, lay ministers, health ministers, ministry leaders).

Training is free! Space is limited. Early registration is encouraged. Registration deadline: March 9, 2015. You may register online at http://conference.afyainc.com/partnershipsandcapacitybuilding. For additional questions, please contact Danielle Garrett at (301) 957 3040 or via email at dgarrett@afyainc.com. 

The meeting will start at 9:00 a.m. and end at 4:30 p.m.



Webinar: Bridging the Divide: Improving Transitions of Care to Reduce Hospital Readmissions

Bridging the Divide: Improving Transitions of Care to Reduce Hospital Readmissions

Thursday, March 19, 2:00-3:30 ET
Register for free at: http://www.integration.samhsa.gov/about-us/webinars

Do you have certain clients who seem to be in and out of the hospital? As a behavioral health provider (either in a primary or behavioral health care organization), is it difficult for you to keep track of treatment plans for clients who see different providers (e.g., receiving inpatient care or at the emergency department)? Do you believe that better coordination between inpatient and outpatient services could improve health outcomes and reduce the burden on individuals and their families?

Comprehensive transitional care from inpatient to community medical and behavioral health services can improve health outcomes and reduce costs.

Join this webinar to review promising care transition models, initiatives and payment incentives that can be employed to promote collaboration between inpatient and outpatient providers; hear how one community provider implemented a successful care transition program; discuss strategies to increase success of discharge and treatment planning; and get tips on how to encourage individuals and family members to manage their care.

Presenters: Jason Martin, LCPC, CPRP, Director of Carelink Transitions and OnTrack Maryland, Family Services, Inc.; Harold A. Pincus, M.D., Professor and Vice Chair, Department of Psychiatry, College of Physicians and Surgeons, Co-Director, Irving Institute for Clinical and Translational Research, Columbia University; Director of Quality and Outcomes Research, New York-Presbyterian Hospital; Senior Scientist, RAND Corporation; National Program Director, Health and Aging Policy Fellowship.

Register now

Rural Access to Emergency Devices (RAED) Training Funds

Colorado Rural Health Center has limited funding available through the Health Resources and Services Administration’s federal Office of Rural Health Policy RAED grant, to train first responders, as well as community members in CPR/AED courses. Entities eligible for this funding must be located in rural Colorado counties (contact Ron Seedorf for questions on eligibility) and courses must have been completed between 6/01/14 and 3/1/15. For more information, please follow this link: RAED Training and Education Funds

For all questions regarding this funding contact:
Ron Seedorf at 970-302-9021 or rs@coruralhealth.org


Hospitals and RHCs- April 15 is the deadline to submit all HPP reimbursement requests to Ron Seedorf. If you have any questions, contact Ron at 970-302-9021 or rs@coruralhealth.org

New Medicaid Reimbursement Rate

The following message is from the Colorado Department of Public Health & Environment

To all Vaccine for Children (VFC) Providers:

We would like to make you aware of a recent Medicaid vaccine administration reimbursement rate change as well as remind you of the vaccine administration reimbursement rate of non-Medicaid patients. In December 2014, the Colorado Department of Health Care Policy and Financing (HCPF), the agency that administers the Colorado Medicaid program, released a Provider Bulletin (https://www.colorado.gov/pacific/sites/default/files/Bulletin_1214_B1400360.pdf) that contains information on page 5 about an increased rate for vaccine administration and expiration of the Primary Care Supplemental Payment (also known as the "Medicaid Bump").

     Increase in Medicaid Reimbursement for Vaccine Administration

     In December 2014, HCPF submitted a request to the Centers for Medicaid and Medicare Services      that the vaccine administration rate be increased to $25.22 for ALL enrolled Medicaid providers          providing vaccine administration services to any Medicaid-eligible persons. The new rate will be        retroactive to January 1, 2015 and remain in place through June 2016. Until HCPF receives                  approval for the new rate, they will reimburse for vaccine administration services at the old rate of      $6.33. While HCPF has not yet received notification of approval or rejection, they have indicated        that ALL enrolled Medicaid providers should begin billing at the new requested rate of $25.22 to        ensure they receive reimbursement at the new rate, if approved. Note that this is a new rate and not      a supplemental payment; therefore, no attestation requirements apply.


     Primary Care Supplemental Payment Ending

     The Affordable Care Act program to pay attested primary care physicians a supplemental payment      that increased reimbursement to Medicare rates ended December 31, 2014. Claims for services            after December 31, 2014 will not be evaluated for supplemental payments. Supplemental                    payments will be made in 2015 but only for services by attested physicians that were rendered in        2014.

REMINDER: Maximum Regional Vaccine Administration Fee for Non-Medicaid, VFC-eligible Patients
As a reminder, effective January 1, 2013, the maximum regional vaccine administration fee for non-Medicaid, VFC-eligible patients increased from $14.74 to $21.68. This is the maximum allowable fee that can be charged to non-Medicaid patients receiving VFC or Section 317 funded vaccine. This includes patients that are uninsured, American Indian or Alaskan Native. It also includes underinsured patients 18 and under who are served at Federally Qualified Health Centers, Rural Health Centers, or deputized Local Public Health Agencies. This fee must be waived if the patient reports they cannot afford to pay.

Colorado Medicaid Vaccine Administration Reimbursement Fee for Medicaid Patients
Maximum Regional Vaccine Administration Reimbursement Fee for non-Medicaid, VFC-eligible Patients
$25.22
$21.68


Click Here: New Medicaid Rate Memo


Once we receive notice from HCPF that the new vaccine administration rate has been approved or rejected, we will send out a new memo.

Hospital Stroke Care Capabilities

To: Hospital Administrators, please forward onto the most knowledgeable person in your facility regarding stroke care capabilities.

The purpose of this survey is to clarify facility needs to achieve acute stroke care capabilities as well as identify successful acute stroke systems. Knowledge from previous surveys expanded the understanding of stroke care and helped create efforts the board is undertaking currently.

This survey is a needs assessment and has no regulatory implications. Your facility name will be used for identifying specific needs that we may be able to assist in meeting. Data will be aggregated by the Colorado Department of Public Health and Environment before sharing survey results with the Stroke Advisory Board. We will not share specific needs without your facility's permission.

Please have the person with the most understanding of stroke care capabilities in your facility complete this survey.

Thank you in advance for participating in this important initiative. This survey should take less than 10 minutes to complete.



The survey link is: https://www.surveymonkey.com/r/acutestrokecare


For further information, please contact Eileen, the STEMI and stroke coordinator at: Eileen.shelby@state.co.us



Developmental Strategies and Challenges for Rural Accountable Care Organizations

Developmental Strategies and Challenges of Rural Accountable Care Organizations

This Policy Brief shares insights into initial strategic decisions and challenges of four Accountable Care Organizations (ACOs) with a rural presence, one from each census region (West, Midwest, Northeast, and South). Semi-structured on-site interviews were conducted with ACO leaders and key stakeholder group representatives (e.g., board members, physicians). The four ACOs were formed as a step toward a value-driven rural delivery system, recognizing that ACO participation may not have a short term return on investment. Common value-enhancing strategies included care management, post-acute care redesign, medication management, and end-of-life care planning. The four ACOs also emphasized the importance of access to data for population health management, care management, and provider participation. While several challenges need to be addressed, these insights can inform development of other rural ACOs.

Contact Information:

Keith J. Mueller, PhD
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.3832
keith-mueller@uiowa.edu
Additional Resources of Interest:

More information about the RUPRI Center for Rural Health Policy Analysis
More information from the Rural Assistance Center, Health Reform, Healthcare Access, Rural Health Policy topic guide

Chronic Disease Prevention Conference

Save the Date June 12 for Chronic Disease Prevention Conference!

DATE: Friday, June 12, 2015
TIME: 8 A.M. to 2 P.M.
LOCATION: The Inverness Hotel and Conference Center,
200 Inverness Drive West, Englewood, CO 80112
COST: Free

Event seating is limited. Priority will be given to clinical provider audience members. Formal registration to follow.

Continuing Education credits will be available.
This event aligns with the Million Hearts® initiative.*

KEYNOTE SPEAKERS

Omar Hasan, MBBS, MPH, MS, FACPVice President, Improving Health Outcomes, American Medical Association

Terri Richardson, MD
Internal Medicine, Kaiser Permanente

For more information, visit colorado.gov/cdphe/chronicdisease2015events

Webinar: Prevention of Zoonotic Diseases in Agriculture

Prevention of Zoonotic Diseases in Agriculture

Date: Tuesday, March 31, 2015
Time: 12:00pm - 1:00pm Central Time

Summary:
Agricultural producers are at high risk for acquiring a zoonotic disease related to their work environment with minimal information related to risks, symptoms and prevention. Zoonotic infections are continually changing and controlling workplace transmission involves management of animals, workers and operators.

Register Here

At a Glance - February 2015

Please find the link to the February edition of At a Glance here. This Department of Health Care Policy and Financing publication provides information on major initiatives including policy changes and program updates. 



ACA Implementation News--February 26, 2015

The latest issue of the Department of Health Care Policy and Financing’s ACA Implementation News is now available online here

If you would like to receive ACA Implementation News or the ACA Communication Updates please click here.

MLN Connects Provider eNews for February 26, 2015

MLN Connects™ Provider eNews for February 26, 2015
View this edition as a PDF

In This Edition:
  • MLN Connects™ National Provider Calls 
  • National Partnership to Improve Dementia Care in Nursing Homes and QAPI — Register Now 
  • Physician Quality Reporting Programs: Reporting Once in 2015 — Registration Now Open 

CMS Events
  • Participate in ICD-10 Acknowledgement Testing Week: March 2 through 6, 2015 
Announcements
  • It’s Still Flu Season 
  • CMS Strengthens Five Star Quality Rating System for Nursing Homes 
  • EHR Incentive Program: Deadline to Register Intent for a Public Health Measure is March 1 
  • Hospital Engagement Network Solicitation: Responses due March 30 
  • Medicare Geographic Reclassification under the IPPS Wage Index for FY 2016 
  • New FAQs on CY 2015 DMEPOS Medicare Payment Final Rule 
  • CMS to Release Comparative Billing Report in March on Modifier 25: Nurse Practitioners 
  • Sterilization of Ophthalmologic Surgical Instruments 
  • Two New ICD-10 Videos 

Medicare Learning Network® Educational Products
  • “Medicare Basics Commonly Used Acronyms” Educational Tool — Released 
  • “Medicare Fee-For-Service (FFS) Claims Processing Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10) – A Re-Issue of MM7492” MLN Matters® Article —Revised 
  • “The Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program - A Better Way for Medicare to Pay for Medical Equipment” Fact Sheet — Revised 
  • New Medicare Learning Network® Educational Web Guides Fast Fact 
  • Medicare Learning Network® Products Available In Electronic Publication Format 

Medicare Learning Network (MLN) Articles from CMS

New:

Revised:

Part A Open Issues

Preventive and Screening Services associated with MM8874, Intensive Behavioral Therapy for Obesity, Screening Digital Tomosynthesis Mammography, and Anesthesia with Screening Colonoscopy that were being held in location SM8874 have all been released.

First Quarter 2015 Medicare Report

Are you wondering what's been going on with Medicare Part B since the Fourth Quarter of 2014? Wonder no more! Stay up to date with the latest Medicare Part B information by reading the First Quarter 2015 Medicare Report currently available on our website. Get caught up. Read it today!



CMS Conducts Successful Medicare FFS ICD-10 End-to-End Testing Week

MLN Connects Provider eNews- Special Edition for February 25, 2015

CMS Conducts Successful Medicare FFS ICD-10 End-to-End Testing Week


From January 26 through February 3, 2015, Medicare Fee-For-Service (FFS) health care providers, clearinghouses, and billing agencies participated in the first successful ICD-10 end-to-end testing week with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor. CMS was able to accommodate all volunteers, which represented a broad cross-section of provider, claim, and submitter types.

Approximately 660 providers and billing companies submitted nearly 15,000 test claims. This successful week of testing continues to put us on course for successful implementation of this important initiative that better reflects modern practice of medicine by October 1, 2015.

Testing demonstrated that CMS systems are ready to accept ICD-10 claims. View the results.

Overall, participants in the January 26 to February 3 testing were able to successfully submit ICD-10 claims and have them processed through our billing systems. To the extent that some claims were rejected, most didn’t meet the mark because of errors unrelated to ICD-9 or ICD-10.

Testing allows us to identify areas of improvement, and we will work with outside entities and stakeholders to improve those very small deficiencies identified. And, we will continue to do testing, especially in those areas we identify as needing improvement.

In addition to acknowledgement testing, which may be completed at any time, two more end-to-end testing weeks will be held before the October 1, 2015, compliance date for ICD-10:
  • April 27 through May 1: Volunteers have been selected 
  • July 20 through July 24: Volunteer forms will be available March 13 on the MAC and CEDI websites 
  • Testers who participated in the January testing are automatically eligible to test again in April and July 

For more information:

MLN Matters® Article #MM8867, “ICD-10 Limited End-to-End Testing with Submitters for 2015
MLN Matters® Special Edition Article #SE1435, “FAQs – ICD-10 End-to-End Testing”
MLN Matters® Special Edition Article #SE1409, “Medicare FFS ICD-10 Testing Approach”

Telehealth Webinar: Improving care coordination & quality through statewide HIE

Telehealth Webinar: “Improving care coordination & quality through statewide HIE"
Wednesday, March 11, 2015 ~ 12:00pm MDT 

Learning Objectives: 
1. Learn about Arizona’s statewide health information exchange (HIE) and understand the benefits of securely sharing patient information through The Network.
2. Learn about the new services that Arizona Health-e Connection and The Network will be able to offer to Arizona providers, hospitals and health plans with its recent technology upgrade when the new system “goes live” in April 2015.

For more information and registration instructions go to:
http://telemedicine.arizona.edu/distant-education/upcoming-workshops