Hospital State Division

Kristi MartinsenHospital State Division Director

HSD OverviewSeptember 2014

Department of Health and Human ServicesHealth Resources and Services Administration

Office of Rural Health Policy

Hospital State Division - Regional Liaisons

Hospital State Division

ORHP Project Officers

TA Partners (NOSORH, TASC, FMT)

Grantees

Collaborative Partnership

Office of Rural Health Policy (ORHP) ActivitiesImproving 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.”

Office of Rural Health Policy (ORHP) ActivitiesImproving Rural Health Initiative: Key Elements

• Building a Programmatic “Evidence Base”

• Health Workforce Recruitment & Retention

• Telehealth/ HIT Coordination

• Cross Governmental Collaboration

Hospital State Division (HSD)Overview

• Improving Outcomes• Using and Sharing the Program Data• Collaborating and Sharing Best

Practices• Aligning Programs to the Health Care

Environment• Program Integrity

• Grants• State Offices of Rural Health

(SORH)• Medicare Rural Hospital

Flexibility Program (FLEX)• Small Hospital Improvement

Program (SHIP)• Initiatives

• Flex Medicare Beneficiary Quality Improvement Project (MBQIP)

• Small Rural Hospital Transitions Project

Focus Programs

Hospital State Division (HSD)Grants: State Offices of Rural Health (SORH)

• State / Federal partnership assist States in strengthening rural health care delivery systems

• Establish & maintain clearinghouse• Coordinate activities within state to

avoid duplication of effort & activities. • Provide technical assistance• Encourage recruitment & retention of

health professionals

• FY 15 continuation awards• Focus on key SORH activities for all 50

states

Purpose Awards

Hospital State Division (HSD)SORH Grant TA Partners

• National Organization of State Offices of Rural Health

• Provide education, resources and TA to State SORH Programs

• http://www.nosorh.org

Need Assessment Activities Measures Outcomes

Grantee (State) Process

Program (National) Context

Hospital State Division (HSD)Grants: Outcomes Focus – Quality and Performance Improvement

Hospital Level

State Program

Level

National Program

Level

Determine Effective

Interventions

Refine Flex Program Activities

Hospital State Division (HSD)Grants: Small Rural Hospital Improvement Program (SHIP)

• Encouraging Networking• Strategically Using Grant Dollars• Updated SHIP Categories Aligned to

Affordable Care Act• ICD 10 Updates:

http://www.cms.gov/ICD10/

• Anticipated amount of award: ~ $9,300 per hospital

• FY14 SHIP Focus:• MBQIP Activities• ICD-10

• Limiting SHIP allowable expenses to 4-5 options

Purpose Awards

Hospital State Division (HSD)SHIP Grant TA Partners

• Technical Assistance and Services Center• Provide education, resources and TA to State SHIP

Programs

• http://www.ruralcenter.org/tasc

Hospital State Division (HSD)

• Four Core Focus Areas:

Grants: Medicare Rural Hospital Flexibility Program (FLEX)

• Support for Quality Improvement in CAHs

• Support for Operational & Financial Improvement in CAHs

• Support for Health System Development and Community Engagement• Including integrating EMS in regional and local systems of care

• Designation of CAHs in the State

Flex In Motion

Need

Assessment

ActivitiesMeasures

Outcomes

Hospital State Division (HSD)Flex Grant TA Partners

• Technical Assistance and Services Center• Provide education, resources and TA to State Flex

Programs and CAHs

• http://www.ruralcenter.org/tasc• Flex Monitoring Team

• CAH Financial Indicator Reports• State Hospital Compare & Quality Measure Reports• Other briefs & reports yearly on quality, finance, and

community engagement

• www.flexmonitoring.org

• Pilot project focusing upon quality improvement and data reporting

• Common clinical and process metrics (i.e., syncing with NQF and Hospital Compare)

• Measuring outcomes and demonstrating improvements via evidence-based practices

• Sharing evidence-based practices

http://www.hrsa.gov/ruralhealth/about/video/index.html

Medicare Beneficiary Quality Improvement Project (MBQIP)

Hospital State Division (HSD)Medicare Beneficiary Quality Improvement Project (MBQIP)

Total CAHsCAHs

participating% participation

1331 94%Goal: 100%

• Reporting on Rural-Relevant and Common National Measures

• Measuring Outcomes and Demonstrating Improvements

• Sharing Best Practices

Hospital State Division (HSD)

http://www.hrsa.gov/ruralhealth/about/video/index.html

Medicare Beneficiary Quality Improvement Project (MBQIP)

• Pneumonia: Hospital Compare CMS Core Measure (participate in all sub-measures); AND

• Congestive Heart Failure: Hospital Compare CMS Core Measure (participate in all sub-measures)

Phase 1 Measures (Begin September 2011)

• Outpatient 1-7: Hospital Compare CMS Measure (all sub-measures that apply); AND

• Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)

Phase 2 Measures (Begin September 2012)

• Pharmacist CPOE/Verification of Medication Orders Within 24 Hours; AND

• Outpatient Emergency Department Transfer Communication• *Reporting tool for Phase 3 Measures is yet to be determined

Phase 3 Measures* (Begin September 2013)

Health Reform Initiatives

• Reduce harm caused to patients in hospitals.

We will accelerate the reduction of preventable harms to inpatients starting now, so that by the end of 2013 we will observe a 40% reduction in preventable harm compared to 2010. Based on our calculations, this would mean almost two million fewer injuries to patients and more than 60,000 lives saved.

• Reduce preventable hospital readmissions.

We will advance efforts to decrease preventable hospital readmissions within 30 days of discharge, so that by 2013 all readmissions would be reduced by 20% compared to 2010. This would mean prevention of more than 1,600,000 hospital readmissions.

Achieving these two goals will not only save lives and greatly reduce injuries to millions of

Americans, it will also result in savings of billions of dollars that help put the nation on

the path to having a more sustainable health care system.

Partnership for Patients

Office of Rural Health Policy (ORHP) ActivitiesWhite House Rural Council

• National Health Service Corps• Expansion to Critical Access Hospitals

• Access to Capital Workgroup • Federal partners and rural stakeholders

discuss challenges and opportunities

Federal Capital Programs

Quick Reference Guide on Capital Programs and Eligibilityhttp://www.raconline.org/pdf/financing-capital-investments-resource-overview.pdf

Contact Information

Kristi Martinsen

Hospital State Division Director

301-594-4438

kmartinsen@hrsa.gov

www.hrsa.gov/ruralhealth