NRHA today - 8/17/2017
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ral childbirth a harrowing crisis for many rural mothers

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NRHA Today
Membership Blog Events Subscribe 8/17/2017
NRHA Today
In this issue:
WSJ: A harrowing account of rural America’s childbirth crisis
NRHA CEO speaks up for rural hospitals in need of health reform
Can ERs improve rural primary care, population health?
Webinar today: Overcoming rural opioid abuse treatment barriers
NRHA’s Alan Morgan on 'ground zero' of rural health challenges
Two weeks to save up to $200 on NRHA's clinic, CAH events
NRHA pressures CMS to ease rural readmission penalties
Telehealth would shorten health care supply chains
One week to present with NRHA in New Orleans
Leveraging public-private funds to improve health
NRHA board members on rural health community, quality
COPD National Action Plan impacts rural patients
Rural Health Fellows program a springboard for leadership
How one rural health system tackles the opioid epidemic
Achieving telehealth’s promise for rural health
NRHA partner on chronic care management
August is Immunization Awareness Month
Comments requested on reducing Medicaid DSH allotments
 
 
WSJ: A harrowing account of rural America’s childbirth crisis
For some women, the time and distance from hospitals with the resources and specialists to handle an obstetric emergency can be fatal. Many rural hospitals have eliminated labor and delivery services, creating maternity deserts where women must travel, sometimes hours, for prenatal care and to give birth. The rate at which women died of pregnancy-related complications was 64 percent higher in rural areas than in large U.S. cities in 2015. That is a switch from 2000, when the rate in the cities was higher, according to Centers for Disease Control and Prevention data analyzed by the Wall Street Journal. Discover community-oriented solutions to current crises at NRHA’s Critical Access Hospital ConferenceSept. 27-29 in Kansas City, Mo.
 
NRHA CEO speaks up for rural hospitals in need of health reform
Even with ACA repeal seemingly out of the equation, rural hospitals still worry about their future in an increasingly difficult industry. “The underlying problem is still there. It's just the fix they were working on didn't address the underlying problem and made things worse," says NRHA CEO Alan Morgan. "Hopefully the debate has shifted off of cutting Medicaid to ‘how do we make the system better.’" Hospitals with greater shares of Medicaid and Medicare patients have to find ways to make up the difference. "Somehow, some way, those resources need to be found to support those needs," says NRHA member Jason Justus, CFO of Pomerene Hospital. With your help, NRHA’s Save Rural Hospitals Act will create a unique payment designation to offer a path forward for struggling rural hospitals.
 
Can ERs improve rural primary care, population health?
Rural hospitals often have a higher proportion of emergency department patients who are uninsured or can't pay their insurance deductibles, which results in higher rates of uncompensated care for such facilities. But a proposal published this week in the Annals of Emergency Medicine suggests that embracing innovative models may hold the key for improving both the delivery of care and health outcomes for rural communities through use of the emergency department. NRHA’s Rural Health Clinicand Critical Access Hospital Conferences will highlight more payment and care delivery reform trends Sept. 26-29 in Kansas City, Mo.
 
Webinar today: Overcoming rural opioid abuse treatment barriers
A study in Annals of Family Medicine found that about 60 percent of rural counties in the United States, where much of the epidemic is located, don't have a single physician who has a DEA waiver to prescribe buprenorphine. Making matters worse, study co-author Holly Andrilla, an NRHA member, says "more than half of physicians with the initial (DEA) waiver are not actually treating patients." HRSA’s Bureau of Primary Health Care will host a webinar at 1 p.m. CDT today to address these specific challenges. You’ll discover proven opioid abuse prevention strategies at NRHA’s Critical Access Hospital Conference Sept. 27-29 in Kansas City, Mo. NRHA recently released a policy paper outlining strategies for rural communities in an opioid epidemic crisis.
 
NRHA’s Alan Morgan on 'ground zero' of rural health challenges
Rural health care advocates say Alabama is ground zero nationally. The state has the highest infant mortality rate in the U.S. and leads the nation for diabetes. “Hypertension, obesity, diabetes … unfortunately, almost all the health disparity metrics … Alabama, unfortunately leads the country, or is in the top five when you look at states across that,” says NRHA CEO Alan Morgan, who spoke at the annual meeting of the Alabama Rural Health Association, an NRHA member. Despite all this, rural hospitals in the state receive among the lowest reimbursements nationally from Medicare. J. Paul Jones Hospital in Camden, Ala., is set to become the sixth rural hospital in the state to close since 2010. You can help the estimated 80 percent of rural hospitals operating in the red by supporting NRHA’s Save Rural Hospitals Act today.
 
Two weeks to save up to $200 on NRHA's clinic, CAH events
With the small-town charm of its neighborhoods, NRHA’s hometown of Kansas City is the perfect place to rediscover the roots of rural health care by joining colleagues and experts at NRHA’s Rural Health Clinic and Critical Access Hospital Conferences Sept. 26-29. Now in their 10th year in the city of fountains, BBQ and jazz, these groundbreaking events are a KC tradition that attracts a growing number of rural health clinic and CAH pros from across the country to meet in the Midwest. Register today to save up to $200 by attending both conferences.
 
NRHA pressures CMS to ease rural readmission penalties
CMS recently estimated the 21st Century Cures Act would do little to help providers who feel they are unfairly penalized because they see a disproportionate number of low-income and sick patients. NRHA is pushing CMS to work harder to avoid penalizing hospitals with high-risk populations. The group's members believe their patients are more likely to struggle given few provider options, little or no public transportation and the long distances many must travel. NRHA’s Diane Calmus says CMS is not taking into account "the true socio-demographic risk adjustment that is needed in the readmissions penalty policy." NRHA’s Critical Access Hospital Conference will focus on reducing ED visits and readmissions in rural hospitals Sept. 27-29 in Kansas City.
 
Telehealth would shorten health care supply chains
Advancing telehealth technology, and the growing ability of payers and patients to utilize it, is transforming nearly every corner of health care through disintermediation. The market viability of telemedicine platforms is solidified by first designing them to directly serve the needs of rural hospitals and patients, eliminating middlemen, then evolving to serve the needs of ever larger, more sophisticated hospitals. Insurers are finally beginning to reimburse telehealth providers for an array of specialty services in short supply in rural areas, including behavioral health, impacting the growing physician shortage. NRHA’s Critical Access Hospital Conference will focus on the next steps in telehealth integration Sept. 27-29 in Kansas City, Mo.
 

Upcoming events 

Rural Health Clinic Conference

Sept. 26-27

Kansas City, Mo.

Critical Access Hospital Conference

Sept. 27-29

Kansas City, Mo.

Rural Health Policy Institute

Feb. 6-8

Washington D.C.

Annual Rural Health Conference

May 8-11

New Orleans, La.

Rural Hospital Innovation Summit

May 8-11

New Orleans, La.

Health Equity Conference

May 8

New Orleans, La.

Rural Medical Education Conference

May 8

New Orleans, La.

NRHA opportunity spotlight
One week to present with NRHA in New Orleans
NRHA’s Annual Rural Health Conference and Rural Hospital Innovation Summit are the nation’s premier events celebrating rural health. Each year, more than 200 rural health pros present 48 concurrent educational sessions, 20 research papers and up to 100 research and educational posters.

NRHA is soliciting session proposals for the 2018 events to be held May 8-11 in New Orleans, La. This is an opportunity to share effective models, policies, research and information and provide your colleagues with insights and best practices addressing many of the access, quality and geographic issues confronted by rural communities.

Any person with an interest in rural health care or rural health research is invited to submit session proposals or original research for presentation during the 2018 conferences through Aug. 24.
 
Leveraging public-private funds to improve health
new video from the Rural Health Information Hub features two grantees who received funding from both the Federal Office of Rural Health Policy and private philanthropic donors to use the care coordination model – that is, sharing information and resources across different health care settings – in rural communities. The grant program is a product of the Rural Health Philanthropy Partnership, which brings federal programs together with private foundations to address health care needs in rural areas. Leveraging public-private funds to improve health was discussed during a presentation at NRHA’s Annual Rural Health Conference in 2012, prompting NRHA member Kim Tieman to create a unique grant.
 
NRHA board members on rural health community, quality
NRHA member Tim Size, NRHA president in 1997 and member of the association’s Government Affairs Committee, recently spoke to Rural Health Leadership Radio: “Rural health is as important to the economy, and the development of the local community, as any other major economic sector,” Size reminds us. Colorado Rural Health Center CEO Michelle Mills, NRHA’s Rural Health Clinic Constituency Group chair, stressed the necessity of a healthy rural health foundation for “quality improvement and population health” in her recent interview. Deepen your focus on quality and value in small facilities at NRHA’s Rural Health Clinic Conference Sept. 26-27 in Kansas City, Mo.
 
COPD National Action Plan impacts rural patients
COPD Foundation president Grace Anne Dorney Koppel, who delivered the keynote address at NRHA’s 40th Annual Rural Health Conference in May, is quick to point out the need to reduce COPD in rural communities. “Over the past 15 years, there is this growing divide between rural and metropolitan America, especially for the five leading rural causes of excess deaths,” Koppel says. NRHA member Alana Knudson, co-director of the NORC Walsh Center for Rural Health Analysis, points out that that the rural smoking connection with COPD can’t be ignored. In May, the National Heart, Lung, and Blood Institute, in official partnership with the CDC, released the COPD National Action Plan.
 
Rural Health Fellows program a springboard for leadership
NRHA is now accepting applications for its year-long Rural Health Fellows programthat develops leaders who can articulate a clear and compelling vision for rural America. The program aims to educate and inspire a networked community of rural health leaders who will step forward to serve key positions in the association, affiliated rural health advocacy groups and local and state legislative bodies. Each year, NRHA selects up to 15 highly motivated individuals who have proven their dedication to improving the health of rural Americans through their educational or professional experience. Please share this opportunity, as the deadline is Aug. 31.
 
How one rural health system tackles the opioid epidemic
In 2014, opioid addiction was already overwhelming CHI St. Gabriel’s Health in Little Falls, Minn. The No. 1 reason patients visited the rural hospital's emergency department was to obtain narcotics for chronic pain. A grant enabled CHI St. Gabriel’s to launch Morrison County Community-Based Care Coordination. The program’s three-part care team was designed to serve patient needs beyond the boundaries of the traditional care delivery model. You’ll discover more proven opioid abuse prevention strategies from rural health and hospital pros at NRHA’s Critical Access Hospital Conference Sept. 27-29 in Kansas City.
 
Achieving telehealth’s promise for rural health
Since its introduction into the medical field, obstacles have slowed the process of utilizing telehealth as a common, viable medical practice. Many challenges still stand in the way of its full potential. To learn what it will take to fully integrate it into rural health care practices, Rural Health Information Hub asked five leaders in the field, including NRHA member Marcia M. Ward, PhD, Director of the Rural Telehealth Research Center. Discover the next steps in telehealth integration from rural health and hospital pros at NRHA’s Critical Access Hospital Conference Sept. 27-29 in Kansas City.
 
NRHA partner on chronic care management
NRHA partner Trubridge Healthcare will host a webinar at 2 p.m. CDT Aug. 22 on chronic care management. Chronic care management has benefits for both providers and their patients. Twenty minutes of non-face-to-face contact can be invaluable to the health of your patients. Learn how Cumberland County Hospital was able to navigate the strict guidelines and expectations set by CMS to develop a chronic care management program that is seamless and sustainable.
 
August is Immunization Awareness Month
Flu season will be here soon. Adult vaccination rates are low. The CDC encourages health centers to prepare their organization’s flu shot campaign now to advise patients to receive all recommended vaccinationsCDC Standards for Adult Immunization Practice can provide a helpful framework to ensure full immunization for adults. Most adults are familiar with annual influenza immunization, which may create a convenient opportunity to assess their vaccination status in general. Public and private insurance plans usually cover common vaccinations that adults need without requiring a co-payment.
 
Comments requested on reducing Medicaid DSH allotments
Federal allotments to states for the Medicaid Disproportionate Share Hospital (DSH) program are required to be reduced beginning in October 2017. In this rule, CMS proposes a methodology for calculating state-specific reductions in Medicaid DSH allotments, estimated to range from 2 percent to 31 percent from current levels. While CMS is not able to estimate the impacts of these reductions on DSH providers, input from rural Medicaid DSH providers and state Offices of Rural Health will help CMS determine potential effects of the proposed methodology on rural areas. Comments should be submitted by Aug. 28.
 
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