8 Benefits Achieved by Providing Mental Health Care in Rural Communities

April 28, 2023

8 Benefits Achieved by Providing Mental Health Care in Rural Communities

People are suffering and the need to offer mental health care in every medical setting is needed. Humanity is impacted by an increase in suicide rates, substance abuse, acts of violence & depression, and rural communities are especially affected.

Small communities band together after tragedy, but problems in delivering a desperately needed service remain. Some organizations have come together and banded forces to develop creative ways about how mental health care can be better delivered in rural communities.

1. It’s the right thing to do (spiritual benefits)

  • Benefits achieved by providing this care nourishes the souls of people delivering the care and makes communities stronger by offering them. Supporting a community’s mental health is not a hard sell.

2. The opportunity to provide care to people who have gotten no care previously in incredibly rewarding

  • Supporting people with mental health issues, suicidal tendencies, substance abuse and addiction, to name a few, may seem challenging. But once you have started helping people get better, you realize the changes are transformational.

3. Invest in your future

  • Providing a service like this separates you apart from the rest, and the cost is usually low compared to for example, the purchase of an MRI machine. The trust that is built from helping someone through a mental health crisis is totally priceless.

4. Instant reputation and good standing in your community

  • Clinics that serve mental health are an instant magnet for your community partners, like schools, churches and other places of worship, shelters, and local governments. Once you can show as a proof of concept that your program works, you will forever be a trusted resource in your community.

5. Benefits to your clinic or hospital

  • Did you know that it may cost over one million dollars in lost revenue, to replace a good primary care provider working full time in your clinic? Provider burnout, or care-giver fatigue, is the number one reason why providers who wish to continue working leave a job. Primary care providers are uniquely under siege for handling every medical and emotional problem of their patients in rural communities. Why not give them a hand and support them from provider fatigue and burn-out and allow them to be continue being long-term leaders in your community. By offering psychiatric care, you are protecting your most important asset, which is your people. Rural communities have potential for programs that allow for cost benefit reimbursements and other financing sources. For example, both for-profit and non-profit organizations are eligible for unique grants specific for rural areas. Rural Health Clinics (RHCs) are uniquely positioned to provide excellent mental health care. Also, mental health care integrated in primary care, is the direction where the standard of care is heading.

6. A stronger, happier and more dependable workforce

  • Employees who know their employer is passionate about providing mental health care, are happier and more fulfilled. You gain instant respect. This separates you from the rest, instantly, as being the premier place to work in your community.

7. Why not have a partner share in the legal responsibility, accountability and liability, instead of shouldering it all on your own

  • As it stands right now, most mental health is already being delivered in primary care clinics. Most estimates are that 70- 80% of all mental health care is delivered in a primary care clinic. Unfortunately, these clinics are not getting the credit they deserve, nor are they making the most on the opportunities. Also, they are inherently liable for all the mental health care they are delivering. It would make sense for all the reasons here alone, to share in these legal liabilities and partner with mental health providers willing to share the accountability/liability and opportunity.

8. Refer back to #1

  • Rural Communities are special. They are inherently American and full of rich history. Keeping our small towns full of spirit and good mental health is of benefit to everyone, and we are grateful to your commitment to your patients, and your communities. Providing mental health care in your community not only makes sense, from a human level and spiritual level, it is the right thing to do, and you will achieve rewards that are priceless by offering this service.

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Annual Wellness Visits and Advance Care Planning for Rural Health Clinics

April 28, 2023

Annual Wellness Visits and Advance Care Planning for Rural Health Clinics

A study published by Preventive medicine found that patients significantly reduced their total healthcare costs when they completed an Annual Wellness Visit (AWV). “Practices adopting AWVs have noted increased revenue, more stable patient populations, and stronger provider-patient relationships,” according to the study’s authors, Arpit Misra and Jennifer Lloyd.

Advance Care Planning (ACP) can help physicians and care teams adhere to a patients’ wishes in the event this person cannot speak for themselves.

Combining the delivery of annual wellness assessments with advance care planning can inherently create value for your patients. Both services are entirely covered for Medicare beneficiaries and support comprehensive care coordination. For clinics and providers, value can be found in meeting performance metrics and capturing additional reimbursement.

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Convenience vs Compliance: How Much is it Costing You?

April 28, 2023

Convenience vs Compliance: How Much is it Costing You?

Federal law requires that rural health clinics (RHCs) are HIPPA compliant. An RHC could face stiff fines and penalties if they are not compliant or if there is a breach. In today’s age of electronics, many RHCs are already using the various EHR/EMR programs that are available to them.

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Introduction to RHCs Free to NARHC Members

April 28, 2023

Introduction to RHCs Free to NARHC Members

The National Association for Rural Health Clinics is offering an online course consisting of 4 short modules that cover all of the basics of what it means to be a Rural Health Clinic. The modules cover the basics of what it means to be a Rural Health Clinic and explores how RHCs differ from other types of clinician offices. This is a self-paced course consisting of approximately 1 hour of video content

Cost: Free for NARHC members; Non-Member $50

Educational Learning Format: On-Line. It is recommended that Chrome is used as the browser for all NARHC courses.

Length: Approximately 60 minutes

Content: Those going through this orientation tool will learn about the history of the RHC program and how the National Association of Rural Health Clinics came to be. In addition, they will be educated with a high-level overview of managing an RHC vs a Non-RHC, RHC basics, best practices for RHC managers and understanding the value of being a Rural Health Clinic.

Pre-requisites: None

Who should take this course? New employees and individuals that are new to rural health clinics.

Register Now

Public Health Emergency Ends May 11th – Implications for Rural Health Clinics

April 28, 2023

Public Health Emergency Ends May 11th – Implications for Rural Health Clinics

The COVID-19 Public Health Emergency (PHE) initially declared on January 27, 2020, will conclude on May 11, 2023. Please note: this is a separate emergency declaration from the COVID-19 National Emergency declared by the President that can be ended via a joint resolution from Congress. For a full explanation of these provisions please review the recent NARHC webinar.

RHC Specific Waivers

The conclusion of the PHE will end the below waivers:

Certain Staffing Requirements. 42 CFR 491.8(a)(6)

  • During the PHE, CMS waived the requirement that a NP, PA, or CNM be available to furnish patient care services at least 50% of the time the RHC is operating.

Temporary Expansion Locations. 42 CFR §491.5(a)(3)(iii)

  • During the PHE, CMS waived the requirement that RHCs be separately considered for Medicare survey and certification if services were expanded into more than one permanent location, including areas that would not typically meet RHC location requirements. Upon termination of the PHE, these expanded locations will be subject to location requirements and separate survey and certification.

Bed Count for Provider-Based RHCs

  • During the PHE, CMS permitted provider-based RHCs subject to their clinic-specific, grandfathered upper payment limit to increase their hospital bed count to 50+ without losing their grandfathered status. At the conclusion of the PHE, grandfathered RHCs must lower their bed count or lose their grandfathered payment status.

Nursing Home Visits

  • During the PHE, CMS removed the requirement that RHCs in an area without a current home health area shortage needed a written request and justification in order to provide home nursing services.

Virtual Communication Services

  • During the PHE, CMS allowed for online digital evaluation and management services (99421, 99422, and 99423) to be reimbursed under G0071. After the PHE, G0071 should only be used for G2012 and G2010. This was one of the first telecommunications flexibilities granted to RHCs during COVID, but the passing of the CARES Act allowed many more services to be done via telehealth during the PHE and beyond.

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RHC COVID-19 Program Reminders and Updates

April 28, 2023

RHC COVID-19 Program Reminders and Updates

The Rural Health Clinic (RHC) COVID-19 Testing & Mitigation (RHCCTM) program final reporting requirements are open for RHCs or their parent TIN organizations to complete on RHCcovidreporting.com. As a reminder, this program allocated $100,000 per eligible RHC in 2021 for COVID-19 testing-related and mitigation-related expenses and could be spent between January 1, 2021 and December 31, 2022.

The RHCCTM program closeout reporting requires RHCs to attest whether they fully spent, partially spent, or did not spend the funding. It is a simple one question attestation that does not require any submission of cost documentation.

Click Here for More Information

Use Your Voice – Advocate on Behalf of RHC Burden Reduction Act

April 28, 2023

Use Your Voice – Advocate on Behalf of RHC Burden Reduction Act

The National Association of Rural Health Clinics (NARHC) is requesting your help in generating support for the Rural Health Clinic Burden Reduction Act (S.198). This important piece of legislation modernizes 5 pieces of the RHC statute written in 1977 to better reflect the changing world of health care delivery.

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CMS Releases Intermediate Policy on Rural Health Clinic (RHC) Rurality Determinations

April 28, 2023

CMS Releases Intermediate Policy on Rural Health Clinic (RHC) Rurality Determinations

In late March, the Centers for Medicare & Medicaid Services (CMS) released the interim process that will be used in determining Rural Health Clinics (RHCs) rural location determination following the Census Bureau’s definition changes.

The interim process is as follows:

  • RHC applicants or relocating RHCs will meet the rural location requirement if the physical address is “non-urbanized” or in an “urban cluster” per 2010 Census Bureau Data, OR if the physical address is not an urban area per the 2020 Census Bureau Data
  • Both 2010 and 2020 Census Bureau Data can be found here

For questions, please contract Nathan Baugh, NARHC Executive Director at Nathan.Baugh@narhc.org or Sarah Hohman, NARHC Director of Government Affairs at Sarah.Hohman@narch.org 

Click Here for Full Details

Webinar – Rural Emergency Hospital Conversion and Technical Assistance Educational Webinar

April 17, 2023

Webinar – Rural Emergency Hospital Conversion and Technical Assistance Educational Webinar

Medicare designated the Rural Emergency Hospitals (REH) as a new provider type through the Consolidated Appropriations Act of 2021 to address concerns that some rural hospitals would not be able to sustain operations and are at risk of closure. Under the new REH designation, which became effective January 1, 2023, CAHs and certain rural hospitals can convert to a REH, allowing continued access to certain health services in the communities they serve.

On May 1, 2023, 11:00 a.m. – noon ET, the Rural Health Redesign Center (RHRC) and Mathematica, will host a 60-minute webinar to provide an overview of the REH program. During the webinar, participants will learn about the REH provider type, conversion and participation requirements, and no-cost technical assistance available through the Rural Emergency Hospital Technical Assistance Center (REH-TAC) for hospitals considering a conversion. If you have questions about this event, please email ctalkington@mathematica-mpr.com.

Register Here

MBQIP Data Reporting Reminders – April 2023

April 13, 2023

MBQIP Data Reporting Reminders – April 2023

Important Notice

Dates for measure submission and manual/CART versions are based on currently available information and may be subject to change.

April 30, 2023

Emergency Department Transfer Communication (EDTC)

  • Patients seen Q1 2023 (January, February, March)

May 1, 2023

CMS Population and Sampling (optional)*

  • Patients seen Q4 2022 (October, November, December)
  • Inpatient** and outpatient
  • Entered via the Hospital Quality Reporting (HQR) HARP account

May 1, 2023

CMS Outpatient Measures:

  • Patients seen Q4 2022 (October, November, December)
  • CMS Hospital Outpatient Reporting Specifications Manual version 15.0b 
  • Submitted to HQR via CART or by vendor
  • CART version – 1.21.0

May 15, 2023

Healthcare Personnel Influenza Vaccination – HCP/IMM-3

  • For data October 1, 2022 – March 31, 2023
  • Submitted through the National Healthcare Safety Network (NHSN)

May 15, 2023

CMS Outpatient Web-based Measure:

  • Measure OP-22: Patient Left Without Being Seen – full calendar year 2022
  • CMS Hospital Outpatient Reporting Specifications Manual version 15.0b
  • Entered via HQR HARP account

May 15, 2023

CMS Inpatient Measures**:

  • Patients seen Q4 2022 (October, November, December)
  • CMS Hospital Inpatient Reporting Specifications Manual version  5.12
  • Submitted to HQR via CART or by vendor
  • CART version –  4.30.0

*Population and sampling refers to the recording of the number of cases the hospital is submitting to Hospital Quality Reporting thru a HARP account.

** Currently there are no inpatient core MBQIP measures required.

For questions:  Stroudwater Associates, Carla Wilber, cwilber@stroudwater.com