Rural Health Network Development Program Funding Opportunity Released By: U.S. Department of Health and Human Services Health Resources and Services Administration Federal Office of Rural Health Policy Community Based Division October 6, 2016

Overview Rural Health Network Development (RHND) Funding Opportunity Overview Rural Health Network Development Program Technical Requirements HRSA Clinical and Population Health Measures Interventions That Strengthen the Rural Health Care System as a Whole - Intervention/Program Discussion Next Steps in Grant Application Development

Rural Health Network Development (RHND) Funding Opportunity Overview

RHND Funding Opportunity Overview Funding opportunity number: HRSA-17-018 Application due date: November 28, 2016 Target submission date: November 21, 2016 Response limited to 80 pages, including 15 attachments Estimated total program funding: $9,000,000 (per year) Expected number of awards: 30 Term: 3 years Approximately $9,000,000 is expected to be available annually to fund 30 recipients. Applicants may apply for a ceiling amount of up to $300,000 per year. Project period: May 1, 2017, through April 30, 2020

RHND Funding Opportunity Overview The purpose of the Rural Health Network Development Program is to support mature, integrated rural health care networks that have combined the functions of the entities participating in the network to address the health care needs of the targeted rural community. Awardees will combine the functions of the entities participating in the network to address the following statutory charges: Achieve efficiencies Expand access, coordinate, and improve the quality of essential health care services Strengthen the rural health care system as a whole. The RHND Program encourages innovative solutions to local health care needs identified by local communities and supports rural communities in preparing for changes within the health care environment.

Rural Health Network Development Program Technical Requirements

RHND Program Technical Requirements Applicants to the Rural Health Network Development Program will be required to select at least one activity from a prescribed topic from one statutory charge outlined by the authorizing legislation. Statutory Charge 1: Achieve efficiencies Statutory Charge 2: Expand access to, coordinate and improve the quality of essential health care services Statutory Charge 3: Strengthen the rural health care system as a whole

RHND Program Technical Requirements Statutory Charge 1: Achieve efficiencies Topic: Integrated health networks will focus on integrating health care services and/or health care delivery of services to achieve efficiencies and improve rural health care services. Networks will focus on integrating their individual systems of care to achieve the following: Goals 1. Implement a financial strategy that will reduce costs, 2. Improve quality and delivery of health care services, and 3. Improve medical oversight.

RHND Program Technical Requirements Statutory Charge 1: Achieve efficiencies (concluded) Activities 1. Integrating behavioral health in primary care settings 2. Integrating primary care in behavioral health care settings 3. Integrating oral health in primary care settings 4. Integrating primary care in oral health settings 5. Integrating emergency medical services (EMS) in hospital settings

RHND Program Technical Requirements Statutory Charge 2: Expand access to, coordinate and improve the quality of essential health care services Topic: Integrated health networks will collaborate to expand access to and improve the quality of essential health care services by focusing on projects and/or network activities directly related to the evolving health care environment. The new health care environment has a large emphasis on improving and transforming the quality of hospital care by realigning hospital financial incentives. Networks can achieve efficiencies and increase economic and provider financial viability through projects that focus on payment and care reform. Networks are also integral to providing effective coordination of services and expanded access to care through a range of care coordination activities, Health IT use (which meets meaningful use standards) and telehealth implementation.

RHND Program Technical Requirements Statutory Charge 2: Expand access to, coordinate and improve the quality of essential health care services (continued) Activities 1. Improving performance on quality measures for clinicians such as through the Physician Quality Reporting System or the Medicare Quality Payment Program, as well as for hospitals, skilled nursing facilities, home health agencies, and/or ambulatory surgical facilities 2. Improving the quality and safety of health care by improving care transitions from the hospital to other settings and reducing hospital readmissions 3. Improving coordination of services 4. Implementing innovative solutions to alleviate the loss of local services and enhance access to care for communities that may have or are at risk of losing their local hospital

RHND Program Technical Requirements Statutory Charge 2: Expand access to, coordinate and improve the quality of essential health care services (continued) Activities (continued) 5. Implementing telehealth services that may include: remote monitoring, interactive telehealth services, store and forward telehealth, imaging services, specialist and primary care consultation 6. Implementing Health IT and Meaningful Use (MU) activities that may include: E-prescribing and incorporating lab results into a Health Information Exchange (HIE), electronic transmission of patient care summaries, patient access to self-management tools, and patient centered HIE 7. Facilitating enrollment in the health insurance marketplace, Medicaid, Children’s Health Insurance Program (CHIP), Medicare Advantage and other forms of health insurance coverage through the use of Consumer Assistance Programs/Patient Navigation

RHND Program Technical Requirements Statutory Charge 2: Expand access to, coordinate and improve the quality of essential health care services (concluded) Activities (concluded) 8. Leveraging competitive negotiations and contracts with Qualified Health Plans (QHPs) through Essential Community Provider (ECP) collaboration 9. Implementing innovative alternative payment and delivery models 10. Implementing programs to increase primary care workforce in rural areas 11. Expanding access to outpatient cardiology and/or pulmonary rehabilitation, speech therapy, child psychology or other critical shortages.

RHND Program Technical Requirements Statutory Charge 3: Strengthen the rural health care system as a whole Topic: Networks will improve population health by implementing promising practice, evidence-informed and/or evidence-based approaches to address health disparities and enhance population health in their communities. Population health can be defined as an approach that focuses on interrelated conditions and factors that influence the health of populations over the course of their lives. The health outcomes and distribution of health outcomes in a population are studied and appropriate policies and interventions are created to address the health concern of that population. Programs implementing a promising practice, evidence-informed and/or evidence-based approaches to address population health may choose the intervention the best meets the needs of their community.

RHND Program Technical Requirements Statutory Charge 3: Strengthen the rural health care system as a whole (continued) Many rural communities have specific health outcomes particular to their community alone. Therefore, networks may serve as an appropriate organization to address population health needs and social determinants of health due to network attributes of integration, collaboration and community focus. Applicants are required to include abstracts for project model(s)! The solicitation references projects from which the model is to be selected Evidence-Based Interventions (7) - The highest level of evidence included. A review study of the approach has been published. Effective Interventions (24) - The second highest level of evidence. The approach has been reported in a peer-reviewed publication. Promising Interventions (39) - A program evaluation of this approach showed positive results.

RHND Program Technical Requirements Statutory Charge 3: Strengthen the rural health care system as a whole (concluded) Intervention Examples Cited in the Solicitation 1. Medicare Diabetes Prevention Program 2. Rural Training Track Technical Assistance Program 3. Midcoast Maine Prescription Opioid Reduction Program – Effective Intervention 4. Project ECHO® – Extension for Community Healthcare Outcomes - Evidence-Based Interventions 5. SAMA HealthCare Services, a Patient-Centered Medical Home

HRSA Clinical and Population Health Measures

HRSA Clinical and Population Health Measures Categories 1. Obesity 2. Diabetes (DM) 3. Cardiovascular Disease (CVD) 4. Chronic Heart Failure (CHF) 5. Chronic Obstructive Pulmonary Disease (COPD) 6. Tobacco Use 7. Behavioral Health/Substance Abuse 8. Immunizations 9. Oral Health 10. Care Coordination 11. EHR/HIT and Care Coordination 12. Additional Measures

Interventions That Strengthen the Rural Health Care System as a Whole - Intervention/Program Discussion

Interventions That Strengthen the Rural Health Care System as a Whole - Intervention/Program Discussion Intervention Examples Cited in the Solicitation 1. Medicare Diabetes Prevention Program 2. Rural Training Track Technical Assistance Program 3. Midcoast Maine Prescription Opioid Reduction Program – Effective Intervention 4. Project ECHO® – Extension for Community Healthcare Outcomes - Evidence-Based Interventions 5. SAMA HealthCare Services, a Patient-Centered Medical Home Interventions Referenced in the Solicitation Evidence-Based Interventions (7) Effective Interventions (24) Promising Interventions (39)

Next Steps in Grant Application Development

Next Steps in Grant Application Development Develop grant application guidelines Finalize technical approach Gather information and produce a winning grant application that will result in improved health outcomes in our community!