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Paul Moore, DPhSenior Health Policy Advisor

Federal Office of Rural Health Policy Health Resources and Services Administration

Federal Office of Rural Health PolicyJune 9, 2016

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Improve Access to

Quality Health Care and Services

Strengthen the Health

Workforce

Build Healthy Communities

Improve Health Equity

Strengthen HRSA Program

Management & Operations

HRSA Strategic Goals

Build Healthy Rural

Communities

Policy & Research

Community Based Programs

TelehealthPrograms

State & Hospital

Programs ValuesAccountable Knowledgeable Collaborative RespectfulInnovative Responsive

MissionFORHP collaborates with rural communities and partners to support programs and shape policy that will improve health in rural America.

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State Offices of Rural

Health Grants

Rural Health Care Delta Program

Radiation Exposure

Screening and Education

Program (RESEP)

Flex Funding

SHIP Grants

MBQIP Rural Health Information Technology

Network Development

GrantsRHC Specific

Quality Measure Set

Network Planning Grants

Network Development

Grants

TCPI

MIPS

DSRAPMs

Small Provider Quality

Improvement Program

Rural Health

Workforce Development Grants

Black

Lung/Coal Miner Clinics

Program

Rural Health Care Services Outreach Grant

OATEvidence-based Tele-emergency grant program

Telehealth Network

Grant Program

ImprovedPopulation

Health

FORHP Programs and Grants

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Key Considerations for Rural Health

Legislation moving toward value has

emphasized standard payment

The Rural Safety Net

CAH Cost-Based Reimbursement

Rural Health Clinic and FQHC

Payment

Swing Bed Payment

Method II Billing

Traditional Medicare

DRGs

Physician Fee Schedule

Medicare DSH

Medicare GME

Unique rural payment

methodologies not often included

in quality reporting

requirements

Are the rural payment protections a dividing line?

A Transitioning Landscape Toward Value

• Potential Alignment with Rural Health• Transforming Clinical

Practice Initiative

• Health Learning Action Network

• ACO Investment Model (AIM)

• Global Budgeting RFI• MACRA TA• Chronic Disease Campaign

Delivery System Reform Support Declining Rural Life Expectancy

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Source: Singh GK, Siahpush M. American Journal of Preventive Medicine. 2014;46(2):e19-e29 (updated data)

65

70

75

80

85

1969-1971 1975-1977 1981-1983 1987-1989 1993-1995 1999-2001 2005-2009

Metro, Both Sexes Non-Metro, Both Sexes

Metro Males Non-Metro, Males

Metro, Females Non-Metro, Females

Findings from the 2016 RWJ County Health Rankings

Drug-related deaths 45% higher in rural

Rural communities have a history of substance abuse

• Rural has greater prevalence of risk factors and fewer options for treatment.

Rural residents are most likely to be prescribed opioid painkillers

Though opioid abuse and opioid-related death has been on the rise nationally, rural communities are disproportionately affected.

Opioid Use Disorder

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January 2005 to February 2016, 110 rural hospitals have closed

2005 – 2016 Was the Western Region the front edge?

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Articles

• Improving Quality

• Improving Finances

• Strengthening Health

Systems

FORHP Assisting Hospitals

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Assisting Critical Access Hospitals - Data

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FORHP ProgramsBlack Lung Clinics Program’s (BL) Miners Colfax Medical Center (MCMC) serves coal miners across the state of New Mexico

Radiation Exposure Screening & Education Program’s (RESEP) University of New Mexico (UNM) Health Sciences Center serves New Mexico’s former Uranium Miner populations

InnovationCreation of a “one stop shop” for miners for 20 sites across New Mexico through a collaborative approach using telemedicine, MCM’s mobile unit and UNM’s specialty provider

Outcomes• Videoconferencing technology enables miners to interact directly

with pulmonologist, which increases access to specialty care• 6,685 eligible miners screened using this method from 1989-2014• 100% patients rated their services as good or very good (2015-

2016)• 45% of patients at last four clinics were returning patients (11/2015-

3/2016)• Addresses transportation barriers and service delivery challenges

Grants in Motion….ting to

• Community Health

• Supporting Rural Hospitals

• Leveraging Telehealth

Investing in Rural Communities

• Increasing Interest and Attention

• Integrating the Technology into the Broader Value Discussion

• Informing the Policy Discussion

Telehealth

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http://www.telehealthresourcecenter.org22

• Serving as a Voice …

• Technical Assistance

• Focus on Partnerships• NOSORH

• State Offices of Rural Health

• National and State Associations

Policy & Research

http://www.ruralhealthresearch.org/

Policy & Research

• ORHP funded through the National

Association of Rural Health Clinics

• Listserv

o Exchange info, ask questions

o Sign up at http://03672e4.netsolhost.com/?page_id=712

• Conference Calls

o 6 per year on range of topics

o Sign up and review previous calls at http://www.hrsa.gov/ruralhealth/policy/confcall/index.html

Rural Health ClinicTechnical Assistance Series

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https://nosorh.org/nosorh-members/nosorh-members-browse-by-statee/

• Source for information on rural health issues and resources from state and federal level

• Provide technical assistance to rural communities.

• Encourage recruitment and retention of health professionals in rural areas.

• Coordinate activities within the state to avoid duplication of effort and activities.

State Offices of Rural Health

http://www.hrsa.gov/advisorycommittees/rural/publications/index.html

Health Challenges Moving Beyond the Clinical

To sign up: Email Michelle Daniels at:mdaniels@hrsa.gov

Sign up for our Weekly Announcements …

• Rural-focused Funding opportunities

• Rural Research findings

• Policy updates from a Rural Perspective

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Paul Moore, DPh

Senior Health Policy Advisor

Federal Office of Rural Health Policy (FORHP)Health Resources and Services Administration (HRSA)

Email: Paul.Moore@hrsa.hhs.gov

Phone: (301) 443-1271

Web: hrsa.gov/ruralhealth/

Twitter: twitter.com/HRSAgov

Facebook: facebook.com/HHS.HRSA

Contact Information