Tom Morris Associate Administrator Department of Health and Human Services

1. National Rural Health Issues10th Annual Mid-South CAH ConferenceAugust 24th, 2012Memphis, TN Tom Morris Associate Administrator Department of Health and Human Services Health Resources and Services Administration Office of Rural Health Policy

2. Department of Health & Human Services (HHS) Key Activities • 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 HHS Headquarters

3. Health Resources & Services Administration (HRSA) Key Programs Supporting Rural Communities • 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 http://datawarehouse.hrsa.gov/FactSheetNav.aspx

4. http://www.whitehouse.gov/administration/eop/rural-council

5. 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 Executive Order Establishing the Council

6. USDA Contacts

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

8. 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.”

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

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

12. 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 http://www.hrsa.gov/ruralhealth/about/hospitalstate/delta/index.html

13. Improving Rural Health Care Initiative Building a Rural Community Health Evidence Base http://www.raconline.org/collaborate/pr_chwtoolkit.php

14. Improving Rural Health Care Initiative Technical Assistance: Sustainability • Economic Multiplier Calculator for Community-Based Programs • Available on the Rural Assistance Center Website • (http://www.raconline.org/econtool/) • Sustainability Primer (http://www.raconline.org/pdf/sustain_primer508.pdf)

15. Improving Rural Health Care Initiative Upcoming Funding Opportunities

16. Improving Rural Health Care Initiative Overview: Building a Rural Hospital Evidence Base Focus Programs • 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

17. Hospital State Division (HSD) Medicare Beneficiary Quality Improvement Project (MBQIP) • Pilot Project under Quality Improvement • Common Metrics • Measuring Outcomes and Demonstrating Improvements • Sharing Best Practices http://www.hrsa.gov/ruralhealth/about/video/index.html

18. 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 • http://www.hrsa.gov/ruralhealth/pdf/ruralhealthfundingguidance.pdf

19. Improving Rural Health Care Initiative Workforce: Rural Training Tracks • 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 • www.raconline.org/rtt_new

20. 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 http://www.hrsa.gov/ruralhealth/aout/telehealth/telehealth.html

22. 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: http://www.iom.edu/Home/Activities/HealthServices/Telehealth/2012-AUG-08/webcast.aspx http://www.iom.edu/Activities/HealthServices/Telehealth/2012-AUG-08.aspx

23. Leveraging Our Policy and Research Activities Policy • 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

24. Leveraging Our Policy and Research Activities Research • 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 http://www.hrsa.gov/advisorycommittees/rural/publications/index.html

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

26. Office of Rural Health Policy (ORHP) Activities National Advisory Committee on Rural Health & Human Services • Advises the Secretary of HHS on Rural Issues • Eight Affordable Care Act Policy Briefs Available Online http://www.hrsa.gov/advisorycommittees/rural/publications/index.html

27. The Goal … Helping CAHs Make the Transition Providing Grants, Data and Technical Assistance to CAHs

28. Resources Key Partners & Resources • American Hospital Association • Policy Analysis

29. 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

30. Contact Information Tom Morris Associate Administrator Rural Health Policy Health Resources & Services Administration U.S. Department of Health & Human Services tmorris@hrsa.gov http://www.hrsa.gov 301-443-4269