Update from the CEO: Unprecedented Future in Healthcare

The rain here in Colorado over the past several days has surpassed our annual totals and our thoughts are with those individuals and communities that are experiencing the destructive aspects of this weather.

2013 is passing quickly and fall is nearly upon us and the implementation of the Affordable Care Act (ACA) is just around the corner.  As we venture into this new territory we are filled with a sense of uncertainty as well as the complexity of the ACA.   Recently, the Office of the Inspector General (OIG) released recommendations to reduce Medicare reimbursements that would jeopardize two thirds of the nation’s critical access hospitals.  The Colorado marketplace, Connect for Health Colorado, will open October 1st and will bring private health insurance into a public market.  Healthcare providers have increasing pressures to improve population health resulting in reduced hospital readmissions through the CMS Readmission Program.  Further, the ACA calls for improved mechanisms for the recruitment and retention of the healthcare workforce.  And the triple aim is the foundation of all these efforts – to improve quality and outcomes, while reducing costs.

As your Colorado State Office of Rural Health (SORH), it is our responsibility to provide the education, linkages, tools, and energy necessary for our members during this time of profound healthcare evolution.  In 1991, the SORH was developed as a Federal-State program.  Today, Colorado is still unique in that we are one of three states that operate their SORH as an independent 501(c)(3).  Our organizational structure allows us to broaden our response to current healthcare trends through vital technical assistance programs.

In August, Colorado’s U.S. senators and representatives were home in their districts while Congress was in recess.  Recess provided an opportunity for CRHC to connect with the federal electeds, as well as members of their staff.  CRHC engaged members of Congress regarding a recent report from the Office of the Inspector General.  If the recommendations in the report were adopted, the necessary provider status and related funding would disappear from 35 percent of Colorado’s Critical Access Hospitals (CAHs).  In addition, CRHC partnered with ClinicNET to celebrate the fourth annual Safety Net Clinic Week.  Elected officials at all levels of government participated throughout the week by touring Rural Health Clinics or community safety net clinics in their district.  Also, two CRHC board members were among a small group of stakeholders who met with Senator Bennet regarding the SGR (Sustainable Growth Rate).  The Senator was collecting feedback as members are in support of a full repeal and replacement of the SGR this fall.

To read more about the OIG report, Safety Net Clinic Week activities, the SGR conversation, or to find out how you can participate in the conversation, read the full article here

CRHC is taking a holistic approach to working on readmissions and the triple aim.  In 2010, CRHC started a program called iCARE (Improving Communications and Readmissions) as an opportunity to engage crucial access hospitals in a statewide improvement project aligning with national trends and funding priorities.  This program is funded through the Health Resources and Services Administration (HRSA) FLEX dollars.  In 2012, we expanded the program to include provider based rural health clinics and 2013 we are partnering with local public health departments and patient navigators/care coordinators.    As the hub of healthcare in their rural communities, critical access hospitals and rural health clinics are well-positioned to be leaders and have a significant impact on the communities they serve.

The initiative focuses on three primary goals:
(1)   improve communication in transitions of care,

(2)   maintain low readmission rates, and

(3)   improve clinical processes contributing to readmissions, particularly for heart failure, pneumonia and diabetic patients

Read more about the program here.

Achieving the triple aim is certainly a huge undertaking and one that has a great deal of moving parts.  While some of our rural health clinics are poised to actively engage in our iCARE program others are working towards the triple aim through our Healthy Clinic Assessment work, which involves making improvements in basic business operations.

In addition to the activities listed above our rural hospitals and clinics have been actively engaged in implementation of Stage 1 Meaningful Use, which is certainly another step towards quality improvement, care coordination and connection among patients and providers.

As you know, rural providers are among the most difficult to recruit and retain to healthcare positions.  CRHC is the only Colorado organization with a department solely devoted to addressing this problem through direct recruitment.  Studies show that one rural physician annually generates approximately $1.5 million in community revenue, nearly $1 million in payroll, and 23 additional jobs.  In August, Colorado Provider Recruitment (CPR), the CRHC recruitment department, placed three providers to rural communities.  Read more about these placements here.

We exist because of the healthcare professionals dedicated to serving our rural communities.  Because of the incredible efforts of our members, we strive to be the voice of Colorado rural health.  Our programs are quantitatively validated by a high level of participation.  In fact, out of the 109 healthcare provider and facility members, 80 percent are actively engaged in our services.  Mia Hamm, the famous American soccer player, said “I am a member of a team, and I rely on the team, I defer to it and sacrifice for it, because the team, not the individual, is the ultimate champion.”  Together, we are the champions for rural health in Colorado. 

We end this year by planning for an unprecedented future in healthcare.  We hope our current members will continue to support one another and take advantage of our invaluable services.  We also hope future members will join our network to further strengthen our united voice.  You can find out how to get more involved here.
Much is happening in healthcare. Check out my monthly CEO update for the latest in rural healthcare.


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