Federal Office of Rural Health Policy Announcement

August 1, 2019

What’s New

New Rural Quality Grants Awarded. The Federal Office of Rural Health Policy (FORHP) is pleased to announce over $6.3M has been awarded to 32 rural community healthcare organizations for the new competitive funding cycle of the Small Health Care Provider Quality Improvement (Rural Quality) Program. The Rural Quality Program is a three-year grant program designed to provide support to rural primary care providers for the implementation of activities that address improvements to the quality and delivery of rural health care services in the primary care setting using evidence-based models. Quality improvement activities that address the integration of behavioral health into the primary care setting, value-based care, and patient centered medical homes are also encouraged by the program. Additional program objectives include: improved health outcomes for patients; enhanced chronic disease management; and better engagement with patients and their caregivers.

Improving the Health of Rural Communities Through Collaboration – Thursday, August 15 at 1:00 pm ET. This webinar introduces a new resource, A Guide for Rural Healthcare Collaboration and Coordination. Hear how rural hospitals, community health centers, local public health departments and other rural stakeholders work together to assess and address their rural communities’ health needs. Two innovative rural health organizations will be highlighted that have developed strategies to meet population health goals, address social determinants of health, and improve health outcomes. Solutions to support rural health organizations’ financial viability and lessons learned will also be shared. The guide was created by the Federal Office of Rural Health Policy and the Health Centers program at the Health Resources and Services Administration.

Funding Opportunities

Pew/RWJF Community Opioid Response and Evaluation (CORE) Project – August 30. The Pew Charitable Trusts and the Robert Wood Johnson Foundation (RWJF) will provide grants and technical assistance to support community-research collaboratives that evaluate programs that address opioid use disorder (OUD). The objective of the CORE Project is to identify a diverse array of community-level programs, understand their impact, and create an evidence base for other communities. Preference will be given to tax-exempt 501(c)3 public and nonprofit entities for six awards of up to $500,000 each. Each selected community-research collaborative must include both a lead organization and a local evaluation partner. To apply, register with Pew Charitable Trusts to receive an email invitation with a link to their online grant system. Submit a letter of interest by August 30, 2019. Selected applicants will be invited to submit a full proposal.

HRSA Rural Health Network Development Planning Program – November 29. The Health Resources and Services Administration (HRSA) expects to invest approximately $2 million for this program that helps rural communities develop integrated health care networks, specifically those who do not have a formal history of collaboration. Up to 20 awards will be made to public or nonprofit private rural entities that represent a network and/or consortium of three or more participants. The goals of the program are to expand access to quality care in underserved areas by creating efficiencies and coordination of care across multiple providers to strengthen the rural health care system. The program is competitive every year and assists rural health care networks increase the use of health information technology, transition from volume-based to value-based care, and explore alternative health care delivery models.

Rural Health Research & Policy Centers

Rural, Minority Social Determinants of Health. The Rural & Minority Health Research Center (RMHRC) is one of ten HRSA/FORHP-supported centers for research and policy analysis. In this series of policy briefs, the RMHRC provides data on social determinants of health (SDOH) for four minority groups living in rural areas: African American, Hispanic, American Indian/Alaska Native, and Asian and Pacific Islander. For each of these groups, researchers used several national data resources such as the U.S. Census to determine rates for educational attainment, poverty status, disability, veteran status, nativity, access to computers and broadband, and access to health care.

Policy Updates

Visit the FORHP Policy page to see all recent updates and send questions to ruralpolicy@hrsa.gov.

Comments Requested: Proposed VA Center for Innovation for Care and Payment – August 28. The Department of Veterans Affairs (VA) seeks comments on their plans to implement a Center for Innovation for Care and Payment as authorized under the VA MISSION Act of 2018. Modeled after the CMS Innovation Center, the VA Center would develop pilot programs to test innovative payment and service delivery models with the goals of reducing expenditures, preserving or enhancing the quality of care furnished by the VA, and improving access, quality, timeliness, and patient satisfaction of care and services. As veterans face a variety of challenges to getting care, this rule seeks public input on how to define the terms ‘access’, ‘patient satisfaction’, and ‘quality’ in order to ensure the greatest benefit to veterans affected by the Center’s pilot programs. About 2.9 million veterans live in rural areas and rely on the VA for health care.

Comments Requested: Proposed Updates to Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment System – September 27. On July 29, the Centers for Medicare & Medicaid Services (CMS) released proposed changes to the outpatient prospective payment system and the ambulatory payment system for the 2020 calendar year. The proposals on price transparency are highlighted with CMS proposing that all hospitals, including rural PPS hospitals and critical access hospitals (CAHs) make pricing information publicly available. Proposals also include reducing payment differences between certain sites of services, using the inpatient wage index values to address wage index disparities, and changing the generally applicable minimum required level of supervision from direct supervision to general supervision for hospital outpatient therapeutic services furnished by all hospitals and CAHs.

Comments Requested: Medicare Physician Fee Schedule Proposed Policy, Payment, and Quality Provisions for CY 2020 – September 27. On July 29, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2020. Proposals that may be of interest to rural stakeholders include adding telehealth codes for bundled episodes of care in the treatment of opioid use disorders (OUDs); modifying the regulation on physician supervision of physician assistants (PAs) to give PAs greater flexibility; updating payment and/or codes for certain care management services; and implementing a new Medicare Part B benefit for OUD treatment services, including medication-assisted treatment (MAT), furnished by opioid treatment programs (OTPs).

Comments Requested: ESRD and DMEPOS CY 2020 Proposed Rule – September 27. On July 29, the Centers for Medicare & Medicaid Services (CMS) proposed updates to payment policies and rates under the End Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services and changes to the ESRD Quality Incentive Program (QIP) for CY 2020. The proposed CY 2020 ESRD PPS base rate is $240.27, reflecting a market basket and wage index adjustment. CMS projects that rural ESRD facilities will experience a 1.8 percent increase in their CY 2020 estimated payments compared to CY 2019. In addition, CMS proposes a methodology for pricing new Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items and services.

Learning Events and Technical Assistance

Primary Care First Payment Model Office Hours – Tuesday, August 6 at 12:00 pm ET. The CMS Innovation Center is hosting this hour-long webinar to answer payment questions on the new model options entitled Primary Care First, which will test whether advanced primary care can reduce total cost of care for Medicare. One option under this model will focus on advanced primary care practices who are ready to assume financial risk in exchange for reduced administrative burdens and performance-based payments. A second option encourages advanced primary care practices to take responsibility for high need, seriously ill beneficiaries who currently lack a primary care practitioner and/or effective care coordination. This model will be offered in 26 regions, including several states with large rural populations (e.g., Montana, Maine, and Tennessee).

HRSA Virtual Job Fair – Wednesday, August 7 at 7:00 pm ET. The Health Resources and Services Administration (HRSA) will hold a three-hour virtual job fair to connect job-seeking primary care trainees and practicing clinicians with employment opportunities at participating health care facilities.

AgriSafe: Focus on Rural Mental Health – Monday, August 12 at 1:00 pm ET. The AgriSafe Network hosts this hour-long webinar for rural health care providers and safety professionals prepare for and respond to mental health challenges experienced by farmers and their families.

Supporting Emergency Departments in Addressing Pediatric Mental Health – Thursday, August 15 at 3:00 pm ET. The Health Resources and Services Administration (HRSA) has a new resource, the Critical Crossroads Toolkit, for hospitals with strategies and best practices for addressing pediatric mental health within the emergency department (ED). This resource is targeted to all hospitals, but rural hospitals have been specifically included as a key audience for this resource from its inception, and the guide includes examples from a few rural hospitals across the country on what they’ve put in to place within their EDs. This 30-minute webcast will provide background and overview of the new resource, which is a collaborative effort between HRSA’s Maternal and Child Health Bureau and the Federal Office of Rural Health Policy.

CMS National Training Program Workshops – Through September 12. The Centers for Medicare & Medicaid Services (CMS) will hold five workshops around the country, each lasting 2-3 days, to increase knowledge about updates to the Medicare program. Attendees of the workshops will learn about new changes and innovations for this program that provides significant support for rural health care delivery, including information on opioids and other current topics. Click for more information on the agendas in each of the five cities – Philadelphia, San Francisco, Chicago, Arlington, and Providence.

Save the Date: 3RNet 2019 Annual Conference – September 24-26 in Wichita, KS. The National Rural Recruitment and Retention Network (3RNet) is a nonprofit organization that matches health care professionals to employers in rural and underserved areas. Attendees of this annual two-day conference will network with other 3RNet members, learn strategies for rural recruitment and retention, and gain insight from experienced leaders in health professions staffing. Last year, 3RNet made more than 2,500 clinician placements in rural, frontier, and underserved urban communities.