NEBRASKA RURAL HEALTH ASSOCIATION
Past Newsletters
September 2007
State Legislative Update - Nebraska Rural Health Incentive Program Gets Additional Funding
Professional Incentive Fund. The increased cash will be used to increase the number of loans for students agreeing to practice in a rural shortage area and for loan repayments for practitioners practicing in rural shortage area.
This legislation will fund $250,000 a year for four years. With the 50% local matching funds, the additional amount available each year is $500,000.
This Issue: NeRHA E-News -
April 2008
• State Legislative Update - Nebraska Rural Health Incentive Program Gets Additional Funding
Health Incentive Program Gets Additional Funding • 2007 National Healthcare Quality & Disparities Reports
• Proposed new designation for Health Professions Shortage Areas and Medically Underserved Populations
• Family Medicine Surges in 2008 Match Results
• NRHA sponsors safety survey opportunity for hospitals
• Million dollar donation from Reader’s Digest
The state recently entered into two settlements with the drug company Merck. The basis of the settlements is violations of price reporting of the drugs Vioxx, Zocor, Mevacor and Pepcid under the Medicaid Rebate Statute. Nebraska’s share is approximately $1 million for the state share of Medicaid payments. The Medicaid False Claims Act requires reimbursements under this act to be deposited into the Health and Human Services Cash Fund.
The Appropriations committee’s recommendation amends the statute to transfer on a one-time basis $1 million from the Health and Human Services Cash Fund to the Rural Health
The goals of HRSA are to incorporate better measures of health status and access; create a simpler system for those who seek designation by consolidating the two existing procedures and their sets of criteria; improve identification of new, currently undesignated areas of need and currently designated areas no longer in need; and minimize unnecessary disruption.
The new methodology would attempt to generate a modified population-to-provider ratio that would detail whether or not an area is underserved. In order to generate this proposed ratio, HRSA would compare the number of providers in a service area (including both physicians and mid-levels that would count as .5 of a physician FTE) to the population, with two large modifiers:
The population would be compared to national averages of ages and genders and adjusted accordingly, so a young male would count less than an older adult who needs to see a provider more often.
The population would be adjusted for health status indicators such as low birth weight, minority and ethnic status and distance in the service area, so communities with greater need that are often underserved would have a higher population-to-provider score.
States would also have the opportunity to suggest to HRSA what they are calling rational service areas (RSAs). The RSAs would, in theory, be areas/communities the state believes are serviced together by providers. States and local communities would also have the ability to give HRSA more up-to-date and accurate data than the national numbers that HRSA proposes to use for the health status indicators.
The NRHA is asking the secretary of HHS to extend the comment window. Currently, comments are due April 27. Assuming they are unable to extend the comment period, time is of the essence. We ask that all partners and members of the association look over how this proposed rule will impact your states and communities.
The Health Resources and Services Administration (HRSA) at the U.S. Department of Health and Human Services has proposed a new rule that lays out a single new methodology for designating health professional shortage areas (HPSAs) and medically underserved populations (MUPs). This new methodology would be called the Index of Primary Care Underservice.
Proposed new designation for Health Professions Shortage Areas and Medically Underserved Populations
The National Rural Health Association is partnering with the University of Nebraska Medical Center to conduct surveys and analyze data about patient safety in rural hospitals, using the Agency for Healthcare Research and Quality’s “Culture of Safety” assessment tool.
The NRHA will subsidize up to $1,000 of survey participation costs for the first 20 interested, qualified hospitals.
Hospitals can use the survey assessment tools to assess their patient safety culture, track changes in patient safety over time and evaluate the impact of patient safety interventions.
“I’m really glad to hear about the opportunity for hospitals to work through NRHA to utilize the survey and access expertise in using it for improvement,” said Karla Weng, Stratis Health program manager/Rural HIQIOSC Support. “I’d encourage any of you in a hospital setting that haven’t worked with this survey recently to consider this opportunity.”
NRHA sponsors safety survey opportunity for hospitals
An annual analysis to help health leaders identify areas of health care delivery that need quality improvement now includes important information such as each State's rate of obesity, health insurance coverage, mental illness and the number of specialist doctors.
Those and other measures—called "State contextual factors"—are part of the 2007 State Snapshots released today by the federal Agency for Healthcare Research and Quality (AHRQ). The updated State Snapshots Web tool also tracks States' progress toward reaching government-set health goals for 2010.
Highlights of the 2007 State Snapshots include:
State Contextual Factors: This new feature provides demographics that show what percentage of each state is poor, uninsured, enrolled in Medicaid, age 65 or older, black, Hispanic and lacking a college degree. It also provides health information showing what portion of each state's population is overweight, at risk for stroke and heart disease or reports poor mental health. Lastly, this feature shows how states rank when it comes to hospitalization rates, the number of people enrolled in HMOs and the number of available physician specialists.
Focus on Healthy People 2010: This new feature shows each state's progress toward meeting federal health goals established by the Healthy People 2010 initiative. Charts show how close states have come to reaching two dozen goals ranging from lowering the number of lung cancer deaths to increasing the percentage of people who had their cholesterol checked in the past 5 years.
State Rankings for Selected Measures: This section updates state rankings on 15 important quality measures, such as child vaccination rates, breast cancer death rates, the percentage of nursing home patients improving mobility and the portion of Medicare patients who received clear and respectful advice from their doctor.
Focus on Diabetes: This section offers several evaluations of diabetes care, including what portion of diabetes patients get recommended tests and how many patients are hospitalized for diabetes-related complications. The feature also estimates how much money each state might save by lowering average blood sugar levels.
Focus on Clinical Preventive Services: This feature shows how each state is doing on disease-prevention strategies, such as providing pneumonia or flu vaccines, checking cholesterol levels or advising smokers to quit.
2007 National Healthcare Quality & Disparities Reports
Family Medicine Surges in 2008 Match Results
Medical students’ interest in family medicine surged in 2008, and evidence of that growth came Thursday when the National Resident Matching Program, or NRMP, announced the 2008 Match results.
The results show that 1,172 U.S. seniors – 65 more than in 2007 – chose family medicine. Moreover, the specialty achieved a 91 percent fill rate – the best in more than a decade – for all family medicine residency positions offered. Family medicine residency programs nationwide offered 2,653 positions and filled 2,404 through the Match. More encouraging: the increase in both number and percentage of positions filled came in a year when the number of family medicine residency positions offered through the Match also grew by 33 nationwide.
The increase in students choosing family medicine could not come at a better time, according to physician workforce studies and national physician recruitment reports. All agree the nation is grappling with a deepening shortage of primary care physicians. The need for family physicians is expected to skyrocket by 2020, when the nation will need 139,531 family physicians, according to the AAFP’s 2006 Physician Workforce Report.
Already, the nation is feeling the pinch, according to the 2007 Physician Survey by national physician recruiting company Merritt Hawkins, which said demand for family physicians has shot up by 84 percent since the company’s 2003-2004 report. Compensation offers have risen by 11 percent between 2007 and 2008 and virtually all recruiters are offering signing bonuses.
“If you ask today’s pre-med and medical students what they want to be, most of them will describe a career as a family doctor,” said King. “But they’ve been discouraged from family medicine for a number of reasons. They see their educational debt going up and look at a system that, until recently, placed little value on primary care. That attitude is changing and will continue to change. The people who pay for health care – whether they’re employers buying health benefits for their workers, the federal government paying for Medicare, states funding their Medicaid programs, or the patients themselves – are demanding a system that begins with primary care.
Million dollar donation from Reader’s Digest
The Reader's Digest Foundation has announced that it will donate a total of $1 million to nonprofit organizations through a new initiative called Make it Matter.
Grants will be inspired by stories of individuals who take action and give back to their communities in significant ways. Every month, the foundation will grant $100,000 to a nonprofit organization in honor of one of those individuals.
Submissions will be accepted by the foundation on a rolling basis throughout 2008.
