Author: Horizon Professional Services

The next cohort for the Delta Region Community Health Systems Development (DRCHSD) Program is forming now. They are accepting applications from interested facilities now to begin programming in Winter 2023.

To learn more about the program and application process, you are invited to attend an informational webinars for hospitals and FQHCs on Tuesday, June 6^th from 11am-12pm CST and for RHCs and small clinics on Thursday, June 29^th from 11am-12pm CST.

The DRCHSD program is a collaboration between FORHP, DRA and the National Rural Health Resource Center and has served 54 health care organizations and communities since 2017. The program is open to Critical Access Hospitals, small rural hospitals, Rural Health Clinics, and other rural health care organizations and offers nearly $250,000 per year in technical assistance around quality improvement, financial and operational improvement, telehealth, community care coordination, workforce/leadership development, emergency medical services, and population health. In addition to TA, the program also provides financial support to facilities for the development and implementation of telehealth services, which includes funding for equipment, hardware, software, and training. 

Eligible counties in the State of Mississippi are included below.

DRA designated counties in Mississippi:

Adams	Issaquena	Sharkey
Amite	Jasper	Simpson
Attala	Jefferson	Smith
Benton	Jefferson Davis	Sunflower
Bolivar	Lafayette	Tallahatchie
Carroll	Lawrence	Tate
Claiborne	Leflore	Tippah
Coahoma	Lincoln	Tunica
Copiah	Madison	Union
Covington	Marion	Walthall
DeSoto	Marshall	Warren
Franklin	Montgomery	Washington
Grenada	Panola	Wilkinson
Hinds	Pike	Yalobusha
Holmes	Quitman	Yazoo
Humphreys	Rankin

The Federal Communications Commission has recently released a proposed rule and a final rule and order concerning an interim and a proposed rural rate setting methodology for the Rural Health Care (RHC) Program. The final rule and order consists of various interim decisions made that concern how to determine rural rates, capitation on satellite services, and the invoicing process between the RHC’s Telecom and Healthcare Connect Fund Programs.

The current rate methods are as follows until a new method can be determined:

• Method 1: The average of rates that the carrier charges for non-health care commercial

customers for the same or similar service in the rural area where the health care provider is located;

• Method 2: If there are no other commercial providers in the rural area, the average of tariffed and other publicly available rates charged by other service providers for the same or similar services provided over the same distance in the rural health care provider’s area;
• Method 3: If there are no such rates or the carrier reasonably determines that those rates would be unfair, a cost-based rate that is approved by FCC for interstate services.

FCC is proposing alternative sequential methods for determining rural rates:

• Method A: The median of publicly available rates charged by other service providers for the same or similar services over the same distance in the rural area where the health care provider is located.
• Method B: If there are no publicly available rates that would be used under Method A, the rural rate is the median of the rates that the carrier actually charges to non-health care provider commercial customers for the same or similar services provided in the rural area where the health care provider is located.
• Cost-based rates: If the rural rate cannot be determined from Methods A or B, FCC proposes that service providers use a cost-based method with certain evidentiary requirements.
• Capping the rural rate at the monthly rate in the contract or other agreement between the service provider and health care provider.
• Requiring service providers with multiyear or evergreen contracts to justify rural rates only in the first year of the contract.

The notice of proposed rulemaking can be found on this website and final rules can be found on this website.

This proposed rule is open for comments until April 24th, 2023 on this website.

The guidelines below have just been released by the Mississippi State Department of Health regarding the process of investigating and seeking approval for conversion to a Rural Emergency Hospital model.

Process:

1. Notification:  Notify the MSDH Office of Licensure of the intent to convert to a REH on facility letterhead.   
   • Please send notice of intent to:  HFLC-NLTC@msdh.ms.gov
     
2. Required Documents (The following documents must  be included with CMS Federal Enrollment application [CMS PECOS] and State Licensure application):
   • EXHIBIT Model Attestation 
   • EXHIBIT Model REH Action Plan
   • Copy of executed Transfer Agreement(s) with Level I and/or Level II Trauma Center as required by 42 CFR § 485.538 Condition of Participation: Agreements (See QSO-23-07-REH for full details).

2. Federal Application:  Prior to completing the licensure application, facilities should complete the CMS enrollment process to convert to a REH.  See the following enclosures for enrollment steps:
   • QSO-23-07-REH final.pdf
   • REH Medicare Provider Instructions
   • MLN2259384 CMS Rural Emergency Hospital Enrollment
   • Complete CMS Enrollment through the CMS PECOS Website at: https://pecos.cms.hhs.gov.  See REH Enrollment Instructions PECOS or 855A (attached).

4. REH Initial Survey:  Eligible facilities that are existing CAHs and hospitals converting to an REH may attest to meeting the REH CoPs and will not require an automatic on-site initial survey as eligible facilities are expected to be in full compliance with the existing CAH and hospital requirements (as applicable) at the time of the request for conversion (See QSO-23-07-REH for full details).
   
5. License Application:   After CMS has approved the conversion to a REH and the facility has received their new CMS REH provider number with effective date, click the following link to complete the MSDH Rural Emergency Hospital License application:   https://app.smartsheet.com/b/form/e688589dd5304695a4c78efaebfcd38e
   
6. Fees:  There are no licensure fees to convert to a REH.
   
7. License Effective Date:  Upon approval of the licensure application, the MSDH License Administrator will issue a REH License backdated to the effective CMS REH Certification date.
   
8. Certificate of Need (CON):  CON approval is NOT required to convert to a REH, however, after receiving CMS Certification as an REH, your facility must contact the MSDH Office of Health Policy and Planning (CON) at (601) 576-7874 to request placing inpatient beds in abeyance (do not include acute beds allocated for a SNF Unit). 
   
9. SNF Unit – Facilities considering adding SNF services in a Distinct Part Unit: 
   • Contact the CON office for a Determination 
   • Complete the CMS enrollment process – Contact the MSDH Long Term Care Division for additional information at 601-364-1110.

9. License Renewal:  REH License year is January 1 – December 31.  
   • Renewal notices are sent in October. 
   • Annual renewal fee of $661.25.  

Contact the MSDH License Administrator at (601) 364-2722 with any questions.

The Mississippi Rural Health Association is pleased to announce the results of its recent board election. The association enjoyed a very competitive election of highly qualified and experienced candidates for the board. The top two candidates to receive votes were Toby Butler and Shana Lane.

Toby Butler is the Managing Partner of the Trilogy Healthcare Solutions LLC, a Partner in Trilogy Revenue Cycle Solutions LLC, and a Partner in Trilogy Care Connect LLC.  Toby is a proven healthcare executive with over 25 years of healthcare financial and operational leadership experience in the publicly traded, for profit environment, as well as the community based not for profit environment.  He has a passion for rural communities and has dedicated his career to helping rural hospitals and health systems identify and execute strategies to ensure the provision of quality, sustainable healthcare for the communities they serve.  Toby and his team at Trilogy are specifically dedicated to helping rural communities and their hospitals and health systems navigate the many changes and challenges facing rural hospitals and health systems.

Shana Lane, RN, CPHQ has been employed at Simpson General Hospital for 29 years. She is the Director of Quality, Infection Control, and Risk Management at the facility.  Shana currently serves on the HPIC Claims and Risk Management Committee, as well as the Compass Rural Health Advisory Panel. In addition, Shana has been elected to her third term on the Board of Alderman for the Town of New Hebron and has been appointed to the 2022-2023 MS Municipal League Health Committee.

Butler and Lane will fill the roles vacated by Michael Nester of H.C. Watkins Hospital, and Paula Turner of North Mississippi Medical Center. Both Nester and Turner completed their maximum terms on the board. Butler and Lane will join the remaining eleven directors on the board to begin the term in January, 2023.

For more information on the Board of Directors of the association, visit us at http://www.msrha.org.

TrueCare has awarded a notice of intent from the Mississippi Division of Medicaid to administer the statewide Mississippi Coordinated Access Network (MississippiCan) and the Mississippi Children’s Health Insurance Program (CHIP) with a proposed go live date of 07-01-2023. Please see the announcement from the state of MS Update on Mississippi Coordinated Care Procurement – Mississippi Division of Medicaid (ms.gov). 

Attached is the contract, roster template, HIE form and W9 that we would need to have reviewed, signed and filled out in their entirety. If you have any questions as you go through the process, please feel free to outreach to Dana Drew at Dana.Drew@caresource.com or her direct phone number is 717-701-6607. If faxing is a better option for you, please utilize 937-396-3825 for faxing.

Provider Agreement Signature Page

New Provider Contract

Roster Template

W-9

The Mississippi Rural Health Association recognized significant individuals and hospitals for dedication to excellence during the Mississippi Rural Health Annual Conference held on November 17-18, 2022 in Jackson, MS. Held during Mississippi / National Rural Health Day, these awards are presented to symbolize and recognize the superior work performed by providers, administrators and facilities that makeup Mississippi rural health care system.

Awardees are as follows:

State Legislator of the Year: Sen. Ben Suber
Senator Suber, among many bills, sponsored the Rural Emergency Hospital bill that will allow hospitals to convert to a new model that emphases emergency care in rural communities.

National Legislator of the Year: US Senator Cindy Hyde-Smith
Senator Hyde-Smith has once again received this award from the association due to her continued support of national legislation supporting rural health practice, including hospital funding, telehealth, reducing administrative burden, and more.

Mary Ann Sones Distinguished Leadership Award: Paula Turner, MRHF
The Association’s top leadership award was presented to Paula Turner of North Mississippi Health Systems. Paula is a past president of the association and has been an active member for more than a decade. She has led substantial membership growth in the association and has been active in legislative support and advice to the association.

One Rural Award: Michael Nester
The One Rural Award is presented to Michael Nester, administrator of H.C. Watkins Hospital in Quitman, for his consistent work with the association as treasurer of the organization as well as having been very active in legislative advocacy, often traveling with the Association and MHA to Washington D.C. for legislative visits.

Hospital Quality Awards
Each year, the Chartis Group recognizes the top quartile of hospitals in the nation based on quality outcomes from CMS data. The following hospitals were recognized and awarded by the Association for this exceptional quality:

Baptist Memorial Hospital – Booneville
Baptist Memorial Hospital – Calhoun
Baptist Memorial Hospital – Leake
North Mississippi Medical Center – Eupora
North Mississippi Medical Center – Iuka
Baptist Memorial Hospital – Attala
Scott Regional Hospital
Neshoba County General Hospital
North Mississippi Medical Center – Pontotoc
HC Watkins Memorial Hospital
Laird Hospital
North Mississippi Medical Center – West Point

All award recipients received a recognition piece for their accomplishment. For questions or more information, please contact Ryan Kelly at 601-898-3001 or ryan.kelly@mississippirural.org.

Rural hospitals are an integral part of our nation’s healthcare infrastructure providing critical services – from primary to long-term care – for nearly 57 million Americans. Recent years have presented countless challenges for rural hospitals. Factors such as rising cost of care, increased competition, lower reimbursement rates, unbalanced payer populations, reduced patient volume, uncompensated care, increasing labor costs and increased regulation have constricted operating margins for rural hospitals.

These challenges require hospitals to focus on efficiency to survive. While most savings initiatives focus on revenue cycle and care partnerships, our experience working with hospitals has uncovered innovative approaches to reducing the administrative load of Health Information Management (HIM) departments.

Click here to view five ideas rural hospitals should consider to reduce their Information Management expense.

By: Andrea Casiano, Beverly Banez, Sunitha Dharman, & Trentan Pecorelli

University of St. Augustine for Health Sciences

Instructor: Dr. Ellen Jones

Although medical robots made their first appearance about 34 years ago to obtain a biopsy specimen, recent years of research using artificial intelligence and computer technology have led to diversified strategic uses of these robots in healthcare (Gyles, 2019). Today, medical robots are being deployed in surgical suites to assist with surgery, facilitate hospital logistical movements, and improve patient and provider experience. The CoVID experience has increased the burden to rural emergency departments, need for immediate triage, provide mental health services, and minimize the risk of contagion transmission in congested areas.  

Robotic telemedicine allows remote patient monitoring, improves access to care without exposure to contagions, and is smart enough to learn and be taught how to take vitals, deliver samples to the lab, and many other tasks (Zubrog, 2020). It can be leveraged to offload various exams and tasks, leading to more efficient and timely care.

Specialists are especially stretched in rural areas.  Presently, 39.5% of radiology consults, 27.8% of mental health consults, and 24.1% of cardiology consults take place via telehealth or telemedicine platforms.

Costs for robotic equipment include $50,000 for startup costs and $6,000 of maintenance costs.  This will result in an estimated reduction of operational costs of approximately $1,508 per patient served annually (Gkegkes et al., 2017; Jang, 2020).  

Medicaid has implemented the Quality Incentive Payment Program, whereby hospitals are compensated for improving quality benchmarks by reducing readmissions and improving population health, which can be achieved with the assistance of robotic telemedicine.The North American medical robot market is expected to see significant growth between 2022 and 2029, estimated to reach $5.67 billion (Data Bridge Market Research, 2022).

As part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Congress  approved 200 million dollars in funding for telehealth programs (Federal Communications Commission, 2021). The Connected Care Pilot Program, a $100 million dollar project, is another federal initiative that provides up to 85% funding for pilot programs to cover network and broadband connectivity costs intended to improve connected care services to patients requiring care (Federal Communications Commission, 2021).

The COVID-19 pandemic has changed healthcare utilization, and we must analyze and explore all available resources to implement robotic telemedicine to support current healthcare and improve future care and outreach.

References

Association of American Medical Colleges. (2021, June 11). AAMC Report Reinforces Mounting Physician Shortage. AAMC. Retrieved March 01, 2022, from https://www.aamc.org/news-insights/press-releases/aamc-report-reinforces-mounting-physician-shortage.

Centers for Disease Control. (n.d.). Health equity guiding principles for inclusive

communication. https://www.cdc.gov/healthcommunication/Health_Equity.html

Centers for Medicare and Medicaid Services. (2022). Historical. CMS. Retrieved March 2, 2022, from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical

Data Bridge Market Research. (2022). North America medical robots market report – Industry trends and forecast to 2029. https://www.databridgemarketresearch.com/reports/north-america-medical-robots-market

Data USA. (2019). Greenwood, MS. Data USA. Retrieved February 18, 2022, from https://datausa.io/profile/geo/greenwood-ms/#about 

Federal Communications Commission. (2021). Connected care pilot program. https://www.fcc.gov/wireline-competition/telecommunications-access-policy-division/connected-care-pilot-program

Federal Communications Commission. (2021). COVID-19 Telehealth program (Invoices & reimbursements). https://www.fcc.gov/covid-19-telehealth-program-invoices-reimbursements

Gyles C. (2019). Robots in medicine. The Canadian veterinary journal = La revue veterinaire canadienne, 60(8), 819–820. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625162/

Healthcare Financial Management Association. (2021). Revenue cycle innovation: How automation can mitigate the financial impact of COVID-19. https://www.hfma.org/topics/hfm/2021/november/revenue-cycle-innovation-how-automation-can-mitigate-the-financial-impact-of-covid-19.html

IFR. (2021). The role of robots in healthcare. IFR International Federation of Robotics. https://ifr.org/post/the-role-of-robots-in-healthcare-part2

Mississippi Division of Medicaid. (2021). Comprehensive quality strategy. https://medicaid.ms.gov/wp-content/uploads/2021/09/MS-DOM-                                                   Comprehensive-Quality-Strategy-2021.pdf   

Rice, J. C. (2015). Healthcare information technology: A correlational study of governance maturity and patient costs. ResearchGate, 1–108. https://doi.org/10.13140 

Robnezieks, A. (2019, January 11). Which medical specialties use telemedicine the most? Retrieved March 6, 2022, from https://www.ama-assn.org/practice-management/digital/which-medical-specialties-use-telemedicine-most

SHRM. (2022). What is the difference between mission, vision, and values statements? SHRM. Retrieved February 17, 2022, from https://www.shrm.org/resourcesandtools/tools-and-samples/hr-qa/pages/isthereadifferencebetweenacompany%E2%80%99smission,visionandvaluestatements.aspx?_ga=2.1809329.1275640098.1627228177-151836398.1626106211

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal Of Medical Internet Research, 22(10), e17298. https://doi.org/10.2196/17298

Walston, S.L. (2018). Strategic healthcare management: Planning and execution, second edition (2nd Edition). Health Administration Press. https://bookshelf.vitalsource.com/books/9781567939606