Nebraska Rural Health Association
NeRHA E-News December 2006
Message from the Executive Director
As we close another year and begin a new one, I am reminded that NeRHA has experienced much growth since its inception more than a decade ago.
Yet through the efforts of the NeRHA Board of Directors and staff, the guiding principle of NeRHA - to be the leading advocate of equitable access to improved health status for Rural Nebraska – has remained constant. From hardworking dedicated founders to a membership of over two hundred and fifty throughout Nebraska, NeRHA is still realizing its potential.
It is important to realize that the strength of NeRHA remains in the membership; this is not only recognized but embraced by association leaders as well. Association events are designed to empower members while increasing awareness of and finding solutions to challenges in rural health care.
I encourage you to maximize your membership in NeRHA in 2007 by becoming involved in NeRHA activities and services. Without you, our members, NeRHA loses its relevance and we welcome, value, and need your input.
NeRHA is your organization. I look forward to your participation in the process of preserving and promoting rural health care in Nebraska. Should you have any questions about membership or programs, please do not hesitate to contact me by calling the office at 402-421-2356.
On a final note, I would like to wish each and every one of you a happy and healthy holiday season!!
Rural Health Clinics Technical Assistance Conference Call Series
Don't forget that the Federal Office of Rural Health Policy (ORHP) conducts a conference call series designed to provide Rural Health Clinic staff with valuable technical assistance and RHC specific information. Presentations include RHC billing, quality improvement, best practices, and more. There is no charge to participate in the Rural Health Clinics Technical Assistance Conference Call Series.
Each call is one hour in length and includes a 45 minute speaker presentation with 15 minutes for a question and answer session. Participants will be able to ask questions during this 15 minute "open line" or questions can be submitted prior to the call by emailing them to info@narhc.org.
If you have any questions regarding this initiative, please contact the Project Director, Bill Finerfrock at (202) 543-0348 or by email at info@narhc.org.
Click here, to sign up for the conference call series
Flex Grants to States Support Quality Improvement Activities
In this newly released briefing paper from the Flex Monitoring Team, the authors provide an in-depth description of quality and performance improvement activities proposed by states during the 2005 grant year, representing 30 percent of requested funding. This briefing paper provides Flex administrators and other stakeholders ideas to consider as they address their own state issues.
Categories of quality improvement activities included improving clinical, operational, and financial performance; financial and organizational performance; promoting a culture of quality improvement; participating in national quality efforts; implementing health information technology (HIT) systems; and addressing patient safety and satisfaction issues.
Click here, for the full report
Medicare Drug Plans Troubling for Rural Pharmacies
Medicare Part D Plans could have a negative effect on the finances of rural pharmacies across the nation, according to the National Rural Health Association (NRHA) after reviewing a newly released study.
The study, The Experience of Sole Community Rural Independent Pharmacies with Medicare Part D: Reports from the Field, was released this week by The North Carolina Rural Health Research and Policy Analysis Center and The RUPRI Center for Rural Health Policy Analysis.
This study gathered first-hand reports from 12 rural independent pharmacists located at least 10 miles from the next nearest pharmacy. Some important findings from the study are that at the time of the interviews (summer, 2006):
Payment per prescription was lower from Medicare PDPs than from either Medicaid or cash amounts paid by individuals who previously lacked drug coverage. In some instances payment from PDPs was less than the combined cost of stocking the medications and dispensing them.
The time from service to receipt of payment was longer when PDPs were involved, as compared to Medicaid and most commercial plans.
Pharmacies had few opportunities to negotiate payment rates with PDPs.
Pharmacists had difficulty communicating with Medicare PDP representatives, with problems including excessive amounts of time on hold and an inability to reach someone knowledgeable about the problem.
The study’s recommendations include creating a category of safety-net rural pharmacies that receive reimbursement at a level that equals or slightly exceeds their costs, developing a grant program to provide financial assistance to small independent pharmacies that need to implement new information systems, and other steps designed to decrease administrative burden and ease interactions between pharmacies and PDPs.
Click here, for a copy of the study
Rural Health Providers Face Pay-for-Performance Challenges
A recently completed study reveals that the conditions for successful participation in pay-for-performance initiatives affect rural health care providers differently than urban providers. The study calls for future initiatives to include technical assistance for participating rural hospitals and also ensure that clinical areas that are tied to payment are relevant to the type of services delivered by small rural hospitals.
These findings are part of a report just released by the Upper Midwest Rural Health Research Center (UMRHRC), a partnership between the University of Minnesota and the University of North Dakota, in collaboration with Premier, Inc., titled, “The Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration Project.”
Pay-for-performance sets different payment levels for health care providers based on their performance on a set of measures of quality. Pay-for-performance efforts generally encompass four key elements: a set of quality measures, procedures to gather performance information, a process to disseminate the performance information, and an incentive payment approach that encourages quality practices.
The UMRHRC study looked at the rural implications of the Centers for Medicare and Medicaid Services’ Hospital Quality Incentive Demonstration Project (HQID). Rural facilities are often more isolated, provide a more narrow scope of services and have smaller patient volumes, all affecting the impact of pay-for-performance programs.
The study found that the self-evaluation that takes place through the pay-for-performance process has more of an impact on rural provider behaviors than financial incentives, especially for low-volume providers.
The study found that the majority of small rural hospitals participating in the HQID had a limited information system infrastructure, staff and capital, making the implementation of pay-for performance programs challenging.
The study calls for future pay-for-performance programs to include a range of incentives independent of patient volume including accommodating varying degrees of information system sophistication and encouraging health information network collaborations among providers.
Click here, for a copy of the report
Grant Proposal Writing Course that Involves No Travel!
Fort Hays State University is offering a two-month grant proposal writing course that involves no travel. It will begin on January 10, 2007. Students 1) study a 100 page training manual, 2) watch a video of the teacher discussing the most important points in the manual, 3) answer study questions, 4) prepare parts of fictitious proposals, 5) interact with other students through the computer, 6) receive messages from the teacher through the computer, 7) ask the teacher questions by phone before taking a certification test, and 8) take the certification test through the computer. This course will be completed in students’ homes and/or offices. The cost is $150 per person.
This course was specifically created to serve busy people who don’t have time to attend grant writing seminars or classes. There are many people who work one or more jobs and have many other responsibilities, such as families. These people do not have the luxury to physically attend seminars or classes. Yet, some of these busy people want to improve themselves professionally and make additional contributions to their communities. This training was created for busy, motivated people.
To enroll, please 1) email the Sociology and Social Work secretary, Ms. Colette Gnad, at cgnad@fhsu.edu to confirm that there is still an opening in an upcoming course. If you have any questions, please email or call Ms. Gnad at 785-628-5840.
NeRHA E-NEWSLETTER DECEMBER 2006
