HRSA Strategic Goals Federal Office of Policy June 9, 2016 Improve Access to Quality Health Care and Services Strengthen the Health Workforce Build Healthy Communities Improve Health Equity Strengthen HRSA Management & Operations Paul Moore, DPh Senior Health Policy Advisor Federal Office of Policy Health Resources and Services Administration FORHP s and Grants Mission FORHP collaborates with rural communities and partners to support programs and shape policy that will improve health in rural America. Values Accountable Collaborative Innovative Knowledgeable Respectful Responsive State & Hospital s Policy & Research Build Healthy Rural Communities Telehealth s Community Based s Radiation Exposure Screening and Education (RESEP) Care Delta Rural Health Workforce Developm ent Grants Black Lung/Coal Miner Clinics Flex Funding SHIP Grants MBQIP State Offices of Rural Health Grants Planning Grants Development Grants Information Technology Development Grants Care Services Outreach Grant Small Provider Quality Improvement RHC Specific Quality Measure Set OAT Evidence-based Tele-emergency grant program TCPI MIPS DSR APMs Telehealth Grant Improved Population Health 1
Key Considerations for A Transitioning Landscape Toward Value Are the rural payment protections a dividing line? The Rural Safety Net Traditional Medicare Unique rural payment methodologies not often included in quality reporting requirements CAH Cost-Based Reimbursement Clinic and FQHC Payment DRGs Physician Fee Schedule Legislation moving toward value has emphasized standard payment Swing Bed Payment Medicare DSH Method II Billing Medicare GME Delivery System Reform Support Declining Rural Life Expectancy Potential Alignment with Transforming Clinical Practice Initiative Health Learning Action ACO Investment Model (AIM) Global Budgeting RFI MACRA TA Chronic Disease Campaign 2
85 Metro, Both Sexes Non-Metro, Both Sexes Findings from the 2016 RWJ County Health Rankings Metro Males Non-Metro, Males 80 Metro, Females Non-Metro, Females 75 70 65 1969-1971 1975-1977 1981-1983 1987-1989 1993-1995 1999-2001 2005-2009 Source: Singh GK, Siahpush M. American Journal of Preventive Medicine. 2014;46(2):e19-e29 (updated data) Opioid Use Disorder Though opioid abuse and opioid-related death has been on the rise nationally, rural communities are disproportionately affected. Drug-related deaths 45% higher in rural Rural communities have a history of substance abuse Rural residents are most likely to be prescribed opioid painkillers Rural has greater prevalence of risk factors and fewer options for treatment. 3
Articles 6/17/2016 2005 2016 Was the Western Region the front edge? January 2005 to February 2016, 110 rural hospitals have closed 14 13 FORHP Assisting Hospitals Improving Quality Improving Finances Strengthening Health Systems 4
Assisting Critical Access Hospitals - Data Grants in Motion. ting to FORHP s Black Lung Clinics s (BL) Miners Colfax Medical Center (MCMC) serves coal miners across the state of New Mexico Radiation Exposure Screening & Education s (RESEP) University of New Mexico (UNM) Health Sciences Center serves New Mexico s former Uranium Miner populations Innovation Creation 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 18 Investing in Rural Communities Telehealth Community Health Supporting Rural Hospitals Leveraging Telehealth Increasing Interest and Attention Integrating the Technology into the Broader Value Discussion Informing the Policy Discussion 5
Policy & Research Serving as a Voice Technical Assistance Focus on Partnerships NOSORH State Offices of National and State Associations http://www.telehealthresourcecenter.org 22 Policy & Research http://www.ruralhealthresearch.org/ Clinic Technical Assistance Series ORHP funded through the National Association of Clinics Listserv o Exchange info, ask questions o Sign up at http://03672e4.netsolhost.com/?page_i d=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 6
State Offices of Health Challenges Moving Beyond the Clinical https://nosorh.org/nosorh-members/nosorh-membersbrowse-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. http://www.hrsa.gov/advisorycommittees/rural/publications/index.html Sign up for our Weekly Announcements Rural-focused Funding opportunities Rural Research findings Policy updates from a Rural Perspective To sign up: Email Michelle Daniels at: mdaniels@hrsa.gov Contact Information Paul Moore, DPh Senior Health Policy Advisor Federal Office of 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 7