Rural health care facilities face unique challenges in the fight against COVID-19. Developed by the Rural Surge Readiness Team, COVID-19 Healthcare Resilience Working Group, the Rural Health Surge Readiness web portal provides essential resources, tools, and trainings for rural health care systems preparing for and responding to a COVID-19 surge. The material is appropriate for executives, managers, and providers at a wide range of health care settings, and it covers topics including behavioral health, operations, and telehealth.
August 4, 2020
WASHINGTON D.C. ~ President Trump signed an Executive Order late on Monday aimed at improving rural health and telehealth access. At his news conference afterwards, President Trump specifically notated the number of “rural health clinics” that received funds as a result of the CARES Act. I was pleased to see the President explicitly recognize rural health clinics in his comments and firmly believe that this recognition is, in part, due to NARHC efforts to elevate the profile of the rural health clinic program.
After the announcement, Deputy Secretary of Health and Human Services Eric Hargan hosted representatives from the National Rural Health Association, National Association of Community Health Centers, and myself, for a brief discussion of the Administration’s goals and plans. On this call, the Deputy Secretary indicated that the Administration would be unveiling more detailed plans in the weeks to come on these topics. It was made clear that while the Executive Order directs the various agencies submit plans within 30 days, the Administration has already been working for months on these policies.
The Executive Order has four main policy sections:
Sec. 2 – Launching an Innovative Payment Model to Enable Rural Healthcare Transformation
The Administration plans to release a new rural payment model in the next few weeks. Details are largely forthcoming, but Secretary Hargan did confirm that the model would not be only for hospitals.
Sec. 3 – Investments in Physical and Communications Infrastructure
This effort is designed to improve broadband in rural areas. It is unclear to me if this plan would be separate from the Federal Communications Commission’s (FCC) Rural Health Care Program or an expansion of the FCC program.
Sec. 4 – Improving the Health of Rural Americans
A Rural Health Action Plan will be unveiled in the coming weeks but should represent a renewed effort to eliminate regulatory burdens and improve health outcomes in rural areas.
Sec. 5 – Expanding Flexibilities Beyond the Public Health Emergency
The Administration is preparing several regulatory actions that will make aspects of the telehealth Medicare benefit (that were temporarily expanded for the public health emergency) permanent. I expect that these policies will be proposed in the annual physician fee schedule rule which should be released very soon.
You can read the full Executive Order here: https://www.whitehouse.gov/presidential-actions/executive-order-improving-rural-health-telehealth-access/
Director of Government Affairs
National Association of Rural Health Clinics
Date: August 5, 2020
Time: 7:00 PM CT
Join us on Wednesday, August 5, from 7 p.m. to 8:15 p.m. (CDT) for a can’t-miss webinar showcasing HPI’s Wave 10 data that thousands of dentists have contributed to in order to help us understand how COVID-19 is impacting dental practices. New this week, we’ll be presenting this webinar directly to a dentist audience, including a presentation and panel discussion among ADA leaders, and you’re welcome to join.
During the webinar, we’ll discuss how consumers feel about returning to the dentist, including who is ready to visit, who isn’t, and who they trust, based on data collected by Engagious, a renowned consumer research firm the ADA has partnered with.
Key ADA leaders will also discuss the ADA’s role in supporting dentists and safeguarding the safety of the public during the pandemic.
The webinar will feature an introduction from ADA President Dr. Chad Gehani and will be moderated by ADA Executive Director Dr. Kathy O’Loughlin.
Presenters and Panelists: Marko Vujicic, Chief Economist & VP | ADA’s Health Policy Institute
- Jon Last, President | SLRG & Partner in ‘Back-to-Normal Barometer’
- Michael Graham, Senior Vice President | ADA’s Government and Public Affairs
- Dr. Kirk Norbo, Chair | ADA’s COVID-19 Recovery Task Force
- Dr. Nipa Thakkar, Owner | Nipa Thakkar DMD, LLC Dental Office
This will be an information-packed webinar, so we encourage you to submit your questions in advance on the registration form.
Can’t make it? You can still register and we’ll send you a link to the recording a few days after the webinar.
July 30, 2020
On July 30, CMS and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to counsel patients, at the time of Coronavirus Disease 2019 (COVID-19) testing, about the importance of self-isolation after they are tested and prior to the onset of symptoms.
The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and asymptomatic individuals emphasizing the importance of education on self-isolation as the spread of the virus can be reduced significantly by having patients isolated earlier, while waiting for test results or symptom onset. The CDC models show that when individuals who are tested for the virus are separated from others and placed in quarantine, there can be up to an 86 percent reduction in the transmission of the virus compared to a 40 percent decrease in viral transmission if the person isolates after symptoms arise.
Provider counseling to patients, at the time of their COVID-19 testing, will include the discussion of immediate need for isolation, even before results are available, the importance to inform their immediate household that they too should be tested for COVID-19, and the review of signs and symptoms and services available to them to aid in isolating at home. In addition, they will be counseled that if they test positive, to wear a mask at all times, and they will be contacted by public health authorities and asked to provide information for contact tracing and to tell their immediate household and recent contacts in case it is appropriate for these individuals to be tested for the virus and to self-isolate as well.
CMS will use existing evaluation and management payment codes to reimburse providers who are eligible to bill CMS for counseling services no matter where a test is administered, including doctor’s offices, urgent care clinics, hospitals, and community drive-thru or pharmacy testing sites.
For More Information:
- Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) MLN Matters Special Edition Article SE20011
- Counseling Check List, including resource links
July 30, 2020
Click to view Update.
Description: This session is designed to provide rural hospital and clinic leaders with information needed to retain COVID funding and prepare for a single audit. BKD will recommend best practices for procedures, documentation and example methodologies for tracking various funding sources, revenues and expenses related to COVID.
BKD Speaker(s): Travis Skinner, Ally Jackson, and Ryan O’Grady
Description: Staying up-to-date on funding opportunities and associated guidance has been a challenge for all hospital leaders. BKD’s subject matter experts will share the most current information on funding sources and explore the potential downstream impact on the hospital’s the cost report.
BKD Speaker(s): Derek Pierce, Krystal Creach, Julia Mast, and Steve Parde
When: Friday, July 31, 2020 at 11:00 AM CST
Description: Hospitals and clinics are eager to resume operations and reach pre-COVID volumes as quickly as possible. However, with threat of a possible COVID resurgence, labor disruptions and community uncertainty, the rebound is slower than expected.
BKD Speaker(s):Kevin Rash and Jaimie Pham
When: Friday, August 7, 2020 at 11:00 AM CST
Description: BKD will review the revenue cycle strategies rural hospital leaders should be aware of as they determine how to prioritize and address any backlog in revenue cycle. This session will provide leaders example of how to prioritize A/R, opportunities for uninsured COVID reimbursement programs and discuss how to manage remote staff productivity.
BKD Speaker(s): Deb Kozlowski and Brenda Christman
Part V: Physicians: Strategic Planning
When: Friday, August 14, 2020 at 11:00 AM CST
Description: Proper alignment with employed and affiliated physicians continues to present challenges, especially to rural providers. With growing practice subsidies and recruitment and retention difficulties, hospital leaders must engage at a deeper level with the medical staff to achieve sustainable arrangements.
BKD Speaker(s): Randy Biernat and Mark Blessing
- Health Center Program COVID-19 Survey Update
Beginning with this Friday’s survey, you will now receive an email confirming that you’ve successfully submitted the survey. This change is in response to your feedback that a confirmation would be helpful. In order to do this, we require the submitter to include their email address. (Primary Care Associations will see this change next week.)
- Deadline Extended: Provider Relief Fund
Eligible Medicaid, CHIP, and dental providers who had not yet received a payment from the $50 billion General Distribution have the opportunity to apply for COVID-related relief by Monday, August 3.
- Considerations for Health Center Scope of Project and the COVID-19 Public Health Emergency
We’ve consolidated existing information about scope of project as it relates to the COVID-19 public health emergency onto a single webpage. It does not include any new guidance. Instead, it provides a single place for resources about scope of project and COVID-19.
- Frequently Asked Questions
We recently updated our COVID-19 FAQ webpage, adding: Who can health centers contact if they are unable to obtain COVID-19 testing supplies or equipment? We also continually update our page for coronavirus-related funding FAQs. Our COVID-19 Information for Health Centers and Partners webpage now includes links to Provider Relief Fund FAQs/resources.
- Visit our Technical Assistance Calendar for upcoming sessions related to COVID-19 and other important topics.
If you have questions about the Health Center Program and COVID-19, please contact Health Center Program Support online. Select “Coronavirus Inquiries (COVID-19)” as the issue type—the third option on the “Health Center or EHBs Question” screen.
You can also call Health Center Program Support at 877-464-4772, option 2, 7:00 a.m. to 8:00 p.m. ET, Monday-Friday (except federal holidays).
July 30, 2020
Click to view NHRAtoday Newsletter.
July 30, 2020
National Advisory Group on Rural Health Meets Virtually Today. The public is invited to join the National Advisory Committee on Rural Health and Human Services online from noon until 5:00 pm ET July 30, 2020. The committee of more than 20 rural health experts from across the country convenes twice each year to examine rural health issues and make recommendations to the U.S. Department of Health & Human Services. Past meetings have covered topics such as Adverse Childhood Experiences, the impact of suicide, and challenges to maternal and obstetric care.
HHS Coronavirus Data Hub. Last week, the U.S. Department of Health & Human Services (HHS) launched a website with data on the COVID-19 response at federal, state, and local levels. The hub includes estimated and reported hospital capacity by state, with numbers updated daily.
Federal Office of Rural Health Policy FAQs for COVID-19. A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders, updated regularly.
COVID-19 FAQs and Funding for HRSA Programs. Find all funding and frequently asked questions for programs administered by the Health Resources and Services Administration (HRSA).
CDC COVID-19 Updates. The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, including a section specific to rural health care providers, patients, and community-based organizations. New this week: COVID-19 Toolkit for Tribal Communities. And, in its latest Morbidity and Mortality Weekly Report, the CDC estimates that more rural counties have a higher prevalence of five underlying medical conditions – chronic obstructive pulmonary disease, cardiovascular disease, diabetes, chronic kidney disease, and obesity – associated with increased risk of severe COVID-19-associated illness.
GHPC’s Collection of Rural Health Strategies for COVID-19. With support from the Federal Office of Rural Health Policy (FORHP), the Georgia Health Policy Center (GHPC) provides reports, guidance, and innovative strategies gleaned from their technical assistance and peer learning sessions with FORHP grantees.
Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties. The RUPRI Center for Rural Health Policy Analysis provides up-to-date data and maps on rural and urban confirmed cases throughout the United States. An animated map shows the progression of cases beginning January 21.
Rural Response to Coronavirus Disease 2019. The Rural Health Information Hub posted a guide to help you learn about activities underway to address COVID-19. New this week: Rural Healthcare Surge Readiness a tool developed by the COVID-19 Healthcare Resilience Working Group that helps rural healthcare facilities prepare for and respond to a COVID-19 surge. The tool provides the most up-to-date resources for rural healthcare systems preparing for and responding to a COVID-19 surge in a range of healthcare settings (EMS, inpatient and hospital care, ambulatory care, and long-term care) and covers a range of topics including behavioral health, healthcare operations to telehealth, and more.
July 28, 2020
The updated data confirm that the COVID-19 public health emergency is disproportionately affecting vulnerable populations, particularly racial and ethnic minorities. This is due, in part, to the higher rates of chronic health conditions in these populations and issues related to the social determinants of health.
In response to the first Medicare data snapshot and related call to action from CMS Administrator Seema Verma on June 22, the CMS Office of Minority Health hosted three listening sessions with stakeholders who serve and represent racial and ethnic minority Medicare beneficiaries. These sessions provided helpful insight into ways in which CMS can address social risks and other barriers to health care that will help in our efforts to reduce health disparities.
The updated data on COVID-19 cases and hospitalizations of Medicare beneficiaries covers the period from January 1 to June 20, 2020. It is based on Medicare claims and encounter data CMS received by July 17, 2020.
Other key data points:
- Black beneficiaries continue to be hospitalized at higher rates than other racial and ethnic groups, with 670 hospitalizations per 100,000 beneficiaries.
- Beneficiaries eligible for both Medicare and Medicaid – who often suffer from multiple chronic conditions and have low incomes – were hospitalized at a rate more than 4.5 times higher than beneficiaries with Medicare only (719 versus 153 per 100,000).
- Beneficiaries with end-stage renal disease (ESRD) continue to be hospitalized at higher rates than other segments of the Medicare population, with 1,911 hospitalizations per 100,000 beneficiaries, compared with 241 per 100,000 for aged and 226 per 100,000 for disabled.
- CMS paid $2.8 billion in Medicare fee-for-service claims for COVID-related hospitalizations, or an average of $25,255 per beneficiary.
For more information on the Medicare COVID-19 data, visit: https://www.cms.gov/research-statistics-data-systems/preliminary-medicare-covid-19-data-snapshot
For an FAQ on this data release, visit: https://www.cms.gov/files/document/medicare-covid-19-data-snapshot-faqs.pdf