National Rural Health Issues 10 th Annual Mid-South CAH Conference August 24 th, 2012 Memphis, TN Tom Morris Associate Administrator Department of Health and Human Services Health Resources and Services Administration Office of Rural Health Policy

Department of Health & Human Services (HHS) HHS Headquarters Implementation of the Affordable Care Act Setting the Stage for Expanded Coverage Focusing on Improving Quality Expanding the Primary Care Workforce Completion of the Medicare Payment Updates for 2013 Inpatient Outpatient SNF and Home Health Physician Fee Schedule Key Activities

Health Resources & Services Administration (HRSA) Maternal & Child Health Programs Ryan White HIV Aids Programs Health Professions Training Community Health Centers National Health Service Corps Resources HRSA In Your State Shortage Designation Finder Key Programs Supporting Rural Communities

Executive Order Establishing the Council Expansion of National Health Service Corps to Critical Access Hospitals Expanding Access to HIT Capital through an HHS-USDA Partnership National Call Regional Workshops Expanding Training of Health Information Technology Workers The White House Rural Council Key Health Activities

USDA Contacts AR Lawrence McCullough, State Director 700 West Capital Avenue, room 3416 Little Rock, AR (501) TN Bob Mack Goode, State Director 3322 West End Avenue, Suite 300 Nashville, TN (615) LA Clarence Hawkins, State Director 3727 Government St Alexandria, LA (318) MS Trina George, State Director Federal Building, Suite 831 Jackson, MS (601)

Responding to the Drought Crisis Rural Access to Capital Meeting The White House Rural Council Current Activities and Next Steps Follow up from Rural Health Stakeholder Meeting Identifying New Policy Proposals

Office of Rural Health Policy (ORHP) 2012 Budget Improving Rural Health Initiative “Within the total amount requested for Rural Health Activities, the Budget includes $79 million to continue the President’s initiative to improve rural health. The goal of this initiative is to improve the access to and quality of health care in rural areas.”

Current Environment Facing Rural Health Opportunities Expanded Coverage Partnership for Patients Innovation Center HIT Challenges Industry Consolidation Uncertainty Transition from Volume to Value Meeting Meaningful Use Opportunities and Challenges

What’s ORHP’s Role? How best to help rural communities through a transitioning health care environment? Community-Based Pilot Programs Policy and Research Hospital-State Programs Telehealth Programs and Resources

The Mid-South: A Key Focus Area Building a Rural Community Health Evidence Base Delta States Initiatives Delta States Networking Grants Delta Rural Hospital Performance Improvement Project

Improving Rural Health Care Initiative Building a Rural Community Health Evidence Base Community Health Workers Toolkit Obesity Toolkit (in Final Review)

Improving Rural Health Care Initiative Technical Assistance: Sustainability Economic Multiplier Calculator for Community-Based Programs Available on the Rural Assistance Center Website ( Sustainability Primer (

Improving Rural Health Care Initiative Upcoming Funding Opportunities FY 2013: Network Planning Guidance available: Now Application deadline: October 15 th, 2012 # of New Awards: Funding: up to $85K /yr (1yr) Start Date: 04/2013 Contact: Eileen Holloran, FY 2013: Small Health Care Provider Quality Improvement Program Guidance Available: Winter 2012 Application deadline: early Spring 2013 # of New Awards: Funding: up to $100K/yr (3 years) Start Date: 09/2013 Contact: Ann Ferrero, FY 2013: Delta States Rural Development Network Program Guidance Available: early Winter 2012 Application deadline: late Winter 2012 # of new awards: TBD Funding up to: TBD Start date: 8/2012 Contact: Valerie Darden,

Improving Rural Health Care Initiative Overview: Building a Rural Hospital Evidence Base Measuring Outcomes Sharing Best Practices Providing Resources Aligning Programs to the Health Care Environment Grants Small Hospital Improvement Program (SHIP) State Offices of Rural Health (SORH) Medicare Rural Hospital Flexibility Program (FLEX) Initiatives Flex Medicare Beneficiary Quality Improvement Project (MBQIP) Technical Assistance Focus Programs

Hospital State Division (HSD) Pilot Project under Quality Improvement Common Metrics Measuring Outcomes and Demonstrating Improvements Sharing Best Practices Medicare Beneficiary Quality Improvement Project (MBQIP)

Improving Rural Health Care Initiative Workforce: Linking Rural Health Care Providers to the Federal Workforce Programs HRSA Programs National Health Service Corps Nursing Loan Repayment Primary Care Training Nursing Education Key Challenge: Linking Providers & Educational Institutions

Improving Rural Health Care Initiative Technical Assistance Grant with the National Rural Health Association Sustaining & Expanding the “1+2” Family Medicine Residences Helping Communities Start New RTTs Increasing Resident Interest in RTTs Workforce: Rural Training Tracks

Improving Rural Health Care Initiative Telehealth Programs: Offering a Continuum of Program Resources Telehealth Network Grant Including Tele-Home Care Telehealth Resource Centers Free Technical Assistance Nationally Telehealth Technology Assessment Center Guidance in Matching Technology to Need and Resources Licensure and Portability Program Information and Collaboration on Cross- State Telehealth Practice

Improving Rural Health Care Initiative Partnering with the Institute of Medicine Planning Meeting August 8-9 Focus on the Role of Telehealth in an Evolving Health Care Environment Report Due in Fall Key Issues Evidence Base Reimbursement Privacy and Standards Infrastructure Watch the archived webcast at: alth/2012-AUG-08/webcast.aspx

Leveraging Our Policy and Research Activities Analyzing the Regulations Collaboration with CMS Central Office Point of Contact Regional Office Rural Coordinators Collaboration with the Office of the National Coordinator for HIT HHS Rural HIT Task Force Rural Hospital Issues Group Rural Primary Care Providers Issues Group Policy

Leveraging Our Policy and Research Activities Research Center Findings Rural Research Gateway New Rural Health Systems Analysis and Technical Assistance Center Flex Monitoring Team Reports Annual Compendiums of Financial and Quality Data for All CAHs Research

Leveraging Our Policy and Research Activities Frontier Extended Stay Clinic Frontier Community Health Integration Project Working with CMS Center for Innovation Leveraging Demonstrations

Office of Rural Health Policy (ORHP) Activities Advises the Secretary of HHS on Rural Issues Eight Affordable Care Act Policy Briefs Available Online National Advisory Committee on Rural Health & Human Services

The Goal … Helping CAHs Make the Transition Providing Grants, Data and Technical Assistance to CAHs Grants Flex SHIP Outreach Network Network Development Quality Improvement Telehealth Network Technical Assistance TASC Flex Monitoring Team RHSATA Rural Assistance Center Telehealth Resource Centers Telehealth Licensure and Technology Assessment National Center for Rural Health Works Rural Health Clinic TA Policy Regulation Review White House Rural Council National Advisory Committee on Rural Health and Human Services Collaboration with NRHA, AHA and NOSORH

Resources Key Partners & Resources National Rural Health Association Annual Policy Brainstorming Sessions State Rural Health Association Support Rural Medical Educators Partner in Rural Hospital Issues Group American Hospital Association Policy Analysis

SORHs Making a Difference Promotion of the first Rural Health Day: November 17, 2011! This Year: November 15, 2012 Collaboration with USDA for Rural HIT Investment Promotion of Partnership for Patients Enhanced Performance Measurement

Contact Information Tom Morris Associate Administrator Rural Health Policy Health Resources & Services Administration U.S. Department of Health & Human Services