Message from the Executive Director
March 2007
Nebraska Representatives Rally in Washington!
More than 300 rural health representatives from 46 states gathered at the National Rural Health Association’s (NRHA) Policy Institute in Washington, D.C. recently. These individuals met with top government health officials, senators and representatives, and other state rural health leaders to discuss the complex issues and programs that surround rural health today. Nebraska leaders carried the message to Washington that rural health will not be left behind.
Attending the conference February 26-28, on behalf of the state were
Dennis Berens,
David Palm,
Roxanna Jokela,
Joleen Henke,
Keith Mueller,
Tom Rauner,
Becky Tines,
Julie Smith, and
John Roberts
Areas specifically addressed with congressional leaders and staff included:
• Protect funding for the rural safety net programs and grants
• Reject cuts to Medicare and Medicaid that fail to protect rural providers, and push for extension of rural provisions from MMA
• Ensure Rural Representation on the Medicare Payment Advisory Committee
Group Presents Health Care Reform Ideas To Senator Hagel
A 15-member panel that spent most of the past year looking for ways to improve this country's health-care system delivered its recommendations to U.S. Sen. Chuck Hagel last month.
The commission recommends mandating basic health insurance for all Americans and creating a new federal agency to develop and oversee that basic health plan. A combination of private premiums and public dollars -- including a national tax on alcohol and tobacco consumption -- would be needed to pay for the reforms, the report said. Hagel said he will use the group's recommendations to help him craft bills he wants to introduce.
The panel made eight specific recommendations:
Mandate a basic health care plan for all Americans that emphasizes patient-centered care focused on prevention, health promotion, and coordinated care across the life-span. Often called a "medical home," this model integrates all aspects of the care continuum and focuses on care coordination and active disease management.
Address the problem of attracting, developing, educating, and retaining health care providers by designing a funding mechanism to support workforce development and by creating innovative incentives to attract practitioners to high-need areas.
Focus on quality and safety as key components in American health care. Ensure that all participants are accountable for using evidence-based guidelines and are rewarded for positive outcomes. Create a secure, universal, individual standardized electronic medical record to facilitate this transformation.
Emphasize the vital role of public health in improving health, life expectancy, and quality of life. Expand public health infrastructure and services.
Decrease the practice of defensive medicine by establishing mandatory dispute resolution procedures that address malpractice claims under the basic health care package.
Give all Americans free choice in the purchase of insurance plans, and give consumers clear information in billing and coding for health services.
To finance the new system, establish a public-private partnership that includes employers, employees, and government support. The new system will be funded by eliminating inefficiencies and duplication in American health care today; a redesigned Medicare FICA tax; state contributions that are now directed toward the Medicaid program; continued federal funds presently committed to Medicare, Medicaid, and other national health plans; and a national tax on alcohol and tobacco consumption.
To carry out these recommendations, the Hagel Commission proposes creating an independent Health Care Transformation Commission patterned after the Federal Reserve Board, as outlined in this report. This body also will make binding resolutions, carry out ongoing modifications and updates, and evaluate changes to national health care policies. The President and the Senate will make bipartisan appointments, and commissioners will serve staggered terms.
For a copy of the full report, Click Here
Value Exchanges -- Value-Driven Health Care Initiative
HHS Secretary Mike Leavitt unveiled a plan for chartering local collaborative organizations that are working to improve quality and value in health care by assessing the performance of local health care providers and reporting these findings publicly. The plan would bring the local collaboratives into a nation-wide system, and the collaboratives would use nationally-recognized standards to measure and improve quality of care in their local areas.
Under the plan, HHS would select qualified regional collaboratives to be chartered as Value Exchanges. In such collaboratives, local area physicians, nurses, hospitals and other health care providers are working collaboratively with health plans, employers, unions and other health care purchasers to achieve reliable public reporting on quality and cost of care. As HHS-chartered Value Exchanges, they would continue to focus on quality improvement and would provide public reports on the performance of providers in their area.
The plan for Value Exchanges is part of the Value-Driven Health Care Initiative, a public-private effort launched by Secretary Leavitt last year to improve quality and lower costs in health care delivery. The first element of this Initiative, which is still on-going, aims at national coordination by calling on all health care stakeholders to commit to public reporting on quality and costs, including recognition of consensus standards of care. The initiative also supports interoperable health information technology and incentives for value purchasing in health care.
The Value Exchanges would be independent, non-profit organizations. In recent years, a number of collaboratives of this kind have been created independently in communities throughout the country.
The system would include two types of collaboratives:
Community Leaders -- Less-developed collaboratives, especially those aiming at growth in stakeholder participation and quality measurement capacity. Value Exchanges -- Collaboratives that best meet criteria and are selected by HHS to be chartered and carry out quality improvement and public reporting. Advanced collaboratives that meet additional criteria may qualify to pool their data with Medicare data for broadest-based measurement of provider performance and quality outcomes.
Existing local and regional collaboratives that have developed independently in recent years would be expected to form the initial core of Value Exchanges receiving HHS charters. In addition, six existing collaboratives were selected last year to pioneer the process of pooling local and Medicare data, under Medicare's “Better Quality Information to Improve Care for Medicare Beneficiaries” program. The six pilots will continue to function as special Medicare demonstrations.
The new system would be administered by HHS' Agency for Healthcare Research and Quality (AHRQ). AHRQ Director Carolyn M. Clancy, M.D., said providers would lead in the development of standards.
For more information, click here
New Web Site A Gateway to Rural Health Research
The University of North Dakota Center for Rural Health launched its new Rural Health Research Gateway Web site at the National Rural Health Association’s Rural Health Policy Institute (Feb. 26) in Washington, D.C.
The Web site, funded by the U.S. Department of Health and Human Services, features rural health research conducted by the federal Office of Rural Health Policy (ORHP)’s Rural Health Research Centers on topics such as access to care, health care quality management and improvement, Medicare and Medicaid, health information technology, health workforce, patient safety, and public and mental health.
At the Web site users can:
Search for summaries of research projects, both underway and completed.
Find fact sheets, policy briefs, and other publications resulting from the work of the research centers.
Access information about the eight ORHP-funded Rural Health Research Centers, including contacts and areas of expertise.
“Rural health care can face significant challenges and it is hard to find solutions when you are operating in a data-free zone,” said Mary Wakefield, director of the Center for Rural Health. “The Rural Health Research Gateway will help to move information more rapidly so it can be used to address those challenges.”
“As an organization that represents diverse interests across the U.S., this is a highly valuable, and frankly essential resource,” said Alan Morgan, CEO of the National Rural Health Association. “This site will help new rural health research findings get to the field as quickly as possible, which can be a challenge.”
The Rural Health Research Gateway is a project of the University of North Dakota Center for Rural Health, in conjunction with the RUPRI Health Panel and the University of Southern Maine.
To go to the web site, click here
Bush Administration Proposes $1.6 Billion in Loans for Critical Access Hospitals
On Wednesday, January 31, the Bush Administration released details of their rural development proposal for the reauthorization of the Farm Bill. While NeRHA staff is still reviewing the proposal, the Administration's recommendations include an investment of $85 million to support $1.6 billion in guaranteed loans and $5 million for grants. The purpose of this proposal according to the recommendation would be, "Complete the reconstruction and rehabilitation of all 1,283 certified rural Critical Access Hospitals."
A copy of the summary recommendations can be found by clicking here
USDA Publishes 2006 Rural America at a Glance
The USDA has published the 2006 Rural America at a Glance report, drawing upon the work of ERS researchers.
The report presents statistics on rural America, including the areas of employment, healthcare, technology and transportation. The most recent data are provided, ranging from 2003 to 2006.
The report may be viewed and
